232k views
1 vote
A 22-year-old man comes to the clinic for an examination after falling off his motorcycle and landing on his left side on the handlebars. The nurse suspects that he may have injured his spleen. Which of the following is true regarding assessment of the spleen in this situation?

1.
The spleen can be enlarged as a result of trauma.
2.
The spleen is normally felt upon routine palpation.
3.
If an enlarged spleen is noted, palpate thoroughly to determine size.
4.
An enlarged spleen should not be palpated because it can rupture easily.

1 Answer

1 vote

Final answer:

The spleen can be enlarged due to trauma, but it is not normally palpable in healthy individuals. An enlarged spleen should not be palpated vigorously because of the risk of rupture, and medical imaging should be used to assess size and extent of injury.

Step-by-step explanation:

The assessment of the spleen in a trauma situation involves careful consideration of its vulnerability to injury. It is true that the spleen can be enlarged as a result of trauma, which makes it a concern when a patient reports a mechanism of injury that could affect it, such as a motorcycle accident. Although the spleen is indeed located in the upper-left quadrant of the abdominopelvic cavity just inferior to the diaphragm and has critical functions within the immune system and in filtering blood, it is not normally felt upon routine palpation in healthy adults because it is well protected by the rib cage. If an enlarged spleen is suspected, it is important to proceed with caution. Palpation should be gentle and minimal; it is recommended that a health professional should not palpate an enlarged spleen vigorously as it can rupture easily. Rupture can lead to internal bleeding and cause symptoms such as Kehr's sign, which is referred pain in the shoulder area due to diaphragmatic irritation. Thus, if splenomegaly is noted, further medical imaging rather than thorough palpation is usually indicated in order to determine the size and extent of any injury.

User Plmk
by
7.7k points