Traube's space

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Traube's space
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Surface lines of the front of the thorax and abdomen. (Traube's space not labeled, but is in hypochondriac region.)
Illu spleen.jpg
Spleen
Dorlands/Elsevier s_16/12745893

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Traube's (semilunar) 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.

Percussion for splenomegaly

The normal human spleen measures about 125 millimeters in length, and splenomegaly is an important clinical sign. There are 2 possibilities to evaluate splenomegaly in the clinical examination: percussion and palpation.[1] Percussion can be done in this space.

Underneath Traube's space lies the stomach, which produces a tympanic sound on percussion (medicine). If percussion over Traube's space produces a dull tone, this indicates splenomegaly. Assessing this may be more difficult in obese patients.

In 1993, a systematic review by the Rational Clinical Examination found that percussion over Traube's space yields[2]:

Specificity may be higher if the patient has not eaten in the last two hours.[2]

Eponym

It is named for Ludwig Traube, although it was first described by his pupil in 1868.[3] Another method was described by Donald O. Castell in 1967 (Castell's sign).

References

  1. ↑ Dubey S, Swaroop A, Jain R, Verma K, Garg P, Agarwal S (2000). "Percussion of Traube's space--a useful index of splenic enlargement". The Journal of the Association of Physicians of India 48 (3): 326-8. PMID 11229121.
  2. ↑ 2.0 2.1 Grover SA, Barkun AN, Sackett DL (1993). "The rational clinical examination. Does this patient have splenomegaly?". JAMA 270 (18): 2218-21. PMID 8411607. Ovid full text
  3. ↑ synd/3182 at Who Named It

See also

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v • d • e
General anatomy of torso
Thorax/
Thoracic cavity		Mediastinum (Superior, Anterior, Middle, Posterior) • Superior thoracic aperture • Inferior thoracic aperture • Triangle of auscultation • Intercostal space • Thoracic plane • Thoracic wall/Thoracic cage - fascia (Pectoral fascia, Clavipectoral fascia, Thoracolumbar fascia) • Chest • Midsternal line
Thoracic diaphragmopenings (Caval opening, Esophageal hiatus, Aortic hiatus, Foramina of Morgagni) • Central tendon • Crus of diaphragm • arcuate ligaments (Lateral, Medial, Median)
Abdomen/
Abdominal cavity		Retroperitoneum • Paracolic gutters • Hepatobiliary triangle

anterior abdominal wall (Arcuate line, Linea alba, Tendinous intersection, Linea semilunaris, McBurney's point, Traube's space, Inguinal triangle) • Inguinal canal (Deep inguinal ring, Superficial inguinal ring, Intercrural fibers, Crura of superficial inguinal ring) • Lumbar triangle • regions (Epigastrium, Hypochondrium, Umbilical region, Latus, Hypogastrium, Inguinal region) • planes (Transpyloric plane, Intertubercular plane, Midclavicular line)

fascia (Fascia of Camper, Fascia of Scarpa, Transversalis fascia, Renal fascia, Rectus sheath)
Pelvis/
Pelvic cavity		Pelvic floor • Retropubic space
fascia (Pelvic fascia, Superior fascia of diaphragm of pelvis, Inferior fascia of diaphragm of pelvis, Fascia of the Obturator internus, Tendinous arch, Iliac fascia, Iliopectineal fascia)
PerineumAnal triangle (Ischioanal fossa, Pudendal canal, Anococcygeal raphe)

Urogenital triangle (Superficial perineal pouch, Deep perineal pouch)

Perineal body

fascia (Dartos/fascia of perineum/superficial perineal fascia/Fascia of Colles, Perineal membrane/"Inferior fascia of UGD", "Superior fascia of UGD")
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Symptoms and signs: circulatory (R00–R03, 785)
Cardiovascular
Heart disease * Tachycardia/Bradycardia
Vascular disease * Bruit
Myeloid/blood
Shock * Cardiogenic
Hyperaemia * Functional
Anemia * Pagophagia
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Symptoms and signs: respiratory system (R04–R07, 786)
Hemorrhage* Epistaxis
Abnormalities
of breathing		; Respiratory sounds:
Stridor
Wheeze
Crackles
Rhonchi
Hamman's sign
Apnea
Dyspnea
Hyperventilation/Hypoventilation
Hyperpnea/Tachypnea/Hypopnea/Bradypnea
Orthopnea/Platypnea
Trepopnea
Biot's respiration
Cheyne-Stokes respiration
Kussmaul breathing
Hiccup
Mouth breathing/Snoring
Breath-holding
Other* Asphyxia
Chest, general* Chest pain
v • d • e
Symptoms and signs: digestive system and abdomen (R10–R19, 787,789)
GI tract
Upper GI tract Nausea/Vomiting · Heartburn · Dysphagia (Oropharyngeal, Esophageal)
Halitosis
Lower GI tract Psoas sign · Obturator sign · Rovsing's sign
AccessoryHepatosplenomegaly/Hepatomegaly
Jaundice
AbdominopelvicAscites
Abdominal – general
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Symptoms and signs: skin and subcutaneous tissue (R20-R23, 782)
Disturbances of skin sensationHypoesthesia - Paresthesia - Hyperesthesia
OtherRash - Cyanosis - Pallor - Flushing - Petechia - Desquamation - Induration - Diaphoresis
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Symptoms and signs: nervous and musculoskeletal systems (R25-R29, 781)
Abnormal involuntary movements
(see also movement disorders)		Tremor - Spasm - Fasciculation - Athetosis
Gait abnormalityScissor gait - Antalgic gait - Cerebellar ataxia - Festinating gait - Pigeon gait - Propulsive gait - Steppage gait - Stomping gait - Spastic gait - Myopathic gait - Magnetic gait - Trendelenburg gait
Lack of coordinationAtaxia (Cerebellar ataxia, Sensory ataxia) - Dysmetria - Dysdiadochokinesia - Hypotonia
OtherTetany - Meningism - Hyperreflexia - Opisthotonus - Abnormal posturing - Hemispatial neglect
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Symptoms and signs: urinary system (R30-R39, 788)
GeneralRenal colic - Dysuria - Vesical tenesmus - Urinary incontinence - Urinary retention - Oliguria - Polyuria - Nocturia - Extravasation of urine - Extrarenal uremia
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Symptoms and signs: cognition, perception, emotional state and behaviour (R40-R46, 780-781)
GeneralAnxiety - Somnolence - Coma - Amnesia (Anterograde amnesia, Retrograde amnesia) - Dizziness/Vertigo
OlfactionAnosmia - Parosmia
TasteAgeusia - Parageusia
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Other speech disturbancesDysarthria - Schizophasia
Symbolic dysfunctionsDyslexia - Alexia - Agnosia (Prosopagnosia) - Apraxia - Acalculia - Agraphia
Voice disturbancesDysphonia - Aphonia
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Symptoms and signs: general (R50-R69, 780-789)
GeneralFever (Hyperpyrexia) - Headache - Chronic pain - Malaise/Fatigue (Asthenia, Debility) - Fainting (Vasovagal syncope) - Febrile seizure - Shock (Cardiogenic shock) - Lymphadenopathy - Edema (Peripheral edema, Anasarca) - Hyperhidrosis (Sleep hyperhidrosis) - Delayed milestone - Failure to thrive - Short stature (Idiopathic) - food and fluid intake (Anorexia, Polydipsia, Polyphagia) - Cachexia - Xerostomia - Clubbing - Tenderness
v • d • e
Symptoms and signs: Symptoms concerning nutrition, metabolism and development (R62–R64, 783)
Ingestion/Weight
GrowthDelayed milestone • Failure to thrive • Short stature (e.g., Idiopathic)
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