Cody is a teenager with a history of leukemia and an enlarged spleen. today he presents with fairly significant left upper quadrant (luq) pain. on examination of this area, a rough grating noise is heard. what is this sound?

The pain in the upper left quadrant match's with the location of the spleen.

The noise heard is called a splenic rub and can be accompanied with splenic infarction (occlusion of the artery that supplies the spleen). This sound is scratchy, rough and possible to hear when Cody breathes. If he holds his breath, the rub stops.