Atlas of Human Anatomy in Cross Section: Appendix: Topography of the Thorax and Abdomen
Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul
C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed
Highest Point
The highest point of the spleen, based on the findings of Eycleshymer and Schoemaker, varies from a level between the seventh thoracic disk and the upper third of the eighth thoracic vertebra to the lower third of the eleventh thoracic vertebra. The average position is at the level of the lower third of the tenth thoracic vertebra. Piersol places the highest point of the spleen at the level of the ninth thoracic vertebra, whereas Joessel places it at the level of the tenth thoracic vertebra. Quain, Treves, Morris, and Cunningham place the highest point at the level of the ninth thoracic spine.
Lowest Point
Eycleshymer and Schoemaker reported the lowest point of the spleen to vary between the eleventh thoracic disk and the second lumbar disk. The average position is at the level of the middle third of the first lumbar vertebra. Quain and Treves place the lowest point at the level of the first lumbar spine; Piersol, at the first or second lumbar vertebra; Cunningham, at the level of the twelfth thoracic spine or first lumbar spine; and Morris, at the level of the twelfth thoracic spine or the level of the eleventh thoracic vertebra.
In relation to the thoracic wall, in the scapular line, its upper margin lies at the level of the upper margin of the ninth rib. Its long axis coincides with the ninth rib. Its maximal medial extension is within about 4 cm of the medial plane. It lies nearly opposite the ninth, tenth, and eleventh ribs. A line drawn from the top of the sternum to the tip of the eleventh rib should lie anterior to the spleen. According to Picou (cited but not referenced in Eycleshymer and Schoemaker), the internal extremity of the spleen (upper end) is about 4.5 cm to the left of the Midline in the upper portion of the tenth intercostal space. The anterior angle, on the average, corresponds to the inferior border of the ninth rib. The posterior basal angle (posterior angle) corresponds to the eleventh rib in the posterior axillary line. The anterior border is opposite the tenth rib about 6 cm from the Midline; it is opposite the ninth rib in the scapular line and opposite the lower border of the eighth rib in the axillary line.
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