NBME 22 Splenic flexure (NBME Answers)

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Retired NBME 22 Answers

nbme22/Block 4/Question#30 (reveal difficulty score)
A 27-year-old man who is a construction ...
Splenic flexure 🔍 / 📺 / 🌳 / 📖
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+7 upvote downvote
submitted by ∗humble_station(85)

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The question here stated that the patient was stabbed beneath the 12th rib grazing the inferior pole of the left kidney.

From this you have to know the anatomical associations with the left kidney. The left kidney is in contact with the spleen, stomach & splenic flexure.

Out of these 3 options you have the stomach and Splenic flexure anterior to the kidney but what makes the splenic flexure the best answer is the description of where the he was stabbed. Stomach will be higher up than the splenic flexure.

Apply the same concept to the left kidney!

Hope this helps

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madamestep Lol my dumbass thought splenic flexure meant the inner curvature of the spleen. Even though I am well aware of what the actual splenic flexure is... +1

abhishek021196 https://s3.us-west-2.amazonaws.com/secure.notion-static.com/4529deb9-c776-4a7d-a60f-9ddb0272c383/Untitled.png?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAT73L2G45O3KS52Y5%2F20210211%2Fus-west-2%2Fs3%2Faws4_request&X-Amz-Date=20210211T091552Z&X-Amz-Expires=86400&X-Amz-Signature=13d45b2cfdaa26155ce9c6ef8d68a00c13f6a67bbd11e63da34dcfe65d1a418e&X-Amz-SignedHeaders=host&response-content-disposition=filename%20%3D%22Untitled.png%22 +

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+4 upvote downvote
submitted by ∗meningitis(643)

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I thought: lower pole then cant be suprarenal nor stomach which are higher""

Duodenum and Body of pancreas (except tail) are retroperitoneal and midline

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makinallkindzofgainz I ruled out duodenum because it's towards the right side, and I ruled out body of pancreas because that's basically midline. We are talking about the left lower kidney, which is by the spleen and splenic flexure. Idk if this logic checks out, but I got it right +

chaosawaits The only part that frustrated me about this picture is that the stomach is incredibly variable in its final resting place within the population and, as the picture provided on this page shows, the splenic flexure is a bit lateral to the kidneys. So I overthought it and chose not-so-wisely +

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+2 upvote downvote
submitted by ∗johnthurtjr(168)

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I think this is as good an explanation as I can find

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niboonsh this is also a good picture https://4.bp.blogspot.com/-QK6piHLZjR8/Vt6Zb2cYuKI/AAAAAAAAEK4/4UIE6lWvI-E/s1600/p0529flexures.jpg +4

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+2 upvote downvote
submitted by ∗sweetmed(157)

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https://www.google.com/search?q=anterior+relations+of+kidney&tbm=isch#imgrc=fRhVDG8eBSFDKM:

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+1 upvote downvote
submitted by ∗adong(144)

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hit the kidney so retroperitoneal. leaves only the duodenum and splenic flexure. kidneys are more lateral structures so splenic flexure (at turn of descending colon)

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jackie_chan Basically how I reasoned too; left kidney is close to tail, not body, of pancreas so that was out, duodenum is right side, stomach is not retroperitoneal, supraadrenal gland is superior to kidney, not immediately anterior; thus leaves splenic flexure (and its also left side) +1

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-8 upvote downvote
submitted by ∗praderwilli(87)

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I crossed out all of the other ones and all of the sudden that was all that was left 🤘

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https://www.google.com/search?q=splenic+flexure+kidney&sxsrf=ALeKk01v2A0tn0TxySIthA3WWhsmnQxINw:1584309226815&source=lnms&tbm=isch&sa=X&ved=2ahUKEwjz1Lblu53oAhWdmHIEHUSDCkIQ_AUoAXoECA4QAw#imgrc=Iuk-ecePDo7UkM

https://www.google.com/search?q=left+kidney+spleen+posterior+view&tbm=isch&ved=2ahUKEwi1o6XQu53oAhXQAd8KHcLKDF0Q2-cCegQIABAA&oq=left+kidney+spleen+posterior+view&gs_l=img.3...14500.15337..15630...0.0..0.117.618.5j2......0....1..gws-wiz-img._CKCanvlhEA&ei=vqNuXrXMHdCD_AbClbPoBQ#imgrc=vTOx8ekR7NUIBM

+2/- alexv0815(10)

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