Anatomy
Abdomen
Posteriorly the spleen lies in the region of which of the following:
Answer:
The spleen projects onto the left side and back in the area of ribs 9 - 11. The spleen follows the contour of rib 10 and extends from the superior pole of the left kidney to just posterior to the midaxillary line.Spleen
Anatomy / Abdomen / Pancreas and Spleen
Last Updated: 4th October 2020
The intraperitoneal spleen is situated principally in the left hypochondriac region; it lies between the fundus of the stomach and the diaphragm. The spleen cannot normally be palpated on clinical examination.
Functional Overview
The spleen is an organ of the reticuloendothelial system and acts:
- to filter blood to remove old and defective blood cells
- as a blood reservoir
- to produce white blood cells
- to produce an immune response
Relations
The spleen lies posterior to the stomach, superior to the left colic flexure and lateral to the left kidney and tail of the pancreas.
Relations of the Spleen. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
Surface Markings
The spleen projects onto the left side and back in the area of ribs 9 - 11. The spleen follows the contour of rib 10 and extends from the superior pole of the left kidney to just posterior to the midaxillary line.
![By Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://primary-cdn.frcemsuccess.com/wp-content/uploads/2017/02/Spleen.gif)
Surface Markings of Spleen (Posterior View). (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
![By Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://primary-cdn.frcemsuccess.com/wp-content/uploads/2017/02/Spleen2.gif)
Surface Markings of Spleen (Lateral View). (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
Splenic Rupture
This most commonly occurs due to localised trauma to the left upper quadrant. It may be associated with left lower rib fractures. Because the spleen has an extremely thin capsule it is susceptible to injury even when there is no damage to surrounding structures and because the spleen is highly vascular, when ruptured, it bleeds profusely into the peritoneal cavity.
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
