Traube's space
Encyclopedia
Traube's space is an anatomic region of some clinical importance. It's a crescent-shaped space, encompassed by the lower edge of the left lung
, the anterior border of the spleen
, the left costal margin and the inferior margin of the left lobe of the liver
. Thus, its surface markings are respectively the left sixth rib
, the left anterior axillary line, and the left costal margin.
is an important clinical sign. There are 2 possibilities to evaluate splenomegaly in the clinical examination: percussion and palpation. Percussion can be done in this space.
Beneath Traube's space lies the stomach
, which produces a tympanic sound on percussion
. Dullness to percussion over Traube's space may indicate splenomegaly, although this can also be a normal finding after a meal. Assessing dullness to percussion may be more difficult in obese patients.
A 1993 systematic review
by The Rational Clinical Examination found that, as a test for splenomegaly, percussion over Traube's space yields a sensitivity and specificity of 62% and 72%, respectively. Specificity may be higher if the patient has not eaten in the last two hours.
, although it was first described by his pupil in 1868. Another method was described by Donald O. Castell in 1967 (Castell's sign
).
Left lung
The human left lung is divided into two lobes, an upper and a lower, by the oblique fissure, which extends from the costal to the mediastinal surface of the lung both above and below the hilum....
, the anterior border of the spleen
Spleen
The spleen is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells and the immune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock...
, the left costal margin and the inferior margin of the left lobe of the liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
. Thus, its surface markings are respectively the left sixth rib
Rib
In vertebrate anatomy, ribs are the long curved bones which form the rib cage. In most vertebrates, ribs surround the chest, enabling the lungs to expand and thus facilitate breathing by expanding the chest cavity. They serve to protect the lungs, heart, and other internal organs of the thorax...
, the left anterior axillary line, and the left costal margin.
Percussion for splenomegaly
The normal human spleen measures about 125 millimeters in length, and splenomegalySplenomegaly
Splenomegaly is an enlargement of the spleen. The spleen usually lies in the left upper quadrant of the human abdomen. It is one of the four cardinal signs of hypersplenism, some reduction in the number of circulating blood cells affecting granulocytes, erythrocytes or platelets in any...
is an important clinical sign. There are 2 possibilities to evaluate splenomegaly in the clinical examination: percussion and palpation. Percussion can be done in this space.
Beneath Traube's space lies the stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
, which produces a tympanic sound on percussion
Percussion (medicine)
Percussion is a method of tapping on a surface to determine the underlying structure, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the four methods of clinical examination, together with inspection, palpation and auscultation...
. Dullness to percussion over Traube's space may indicate splenomegaly, although this can also be a normal finding after a meal. Assessing dullness to percussion may be more difficult in obese patients.
A 1993 systematic review
Systematic review
A systematic review is a literature review focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Systematic reviews of high-quality randomized controlled trials are crucial to evidence-based medicine...
by The Rational Clinical Examination found that, as a test for splenomegaly, percussion over Traube's space yields a sensitivity and specificity of 62% and 72%, respectively. Specificity may be higher if the patient has not eaten in the last two hours.
Eponym
It is named for Ludwig TraubeLudwig Traube (physician)
Ludwig Traube was a German physician and co-founder of the experimental pathology in Germany.-Biography:...
, although it was first described by his pupil in 1868. Another method was described by Donald O. Castell in 1967 (Castell's sign
Castell's sign
Castell's sign is a medical sign assessed to evaluate splenomegaly and typically part of an abdominal examination. It is an alternative physical examination maneuver to percussion over Traube's space....
).
External links
- Image at luc.edu