This presentation will give detail knowledge about surface anatomy of Abdomen and Pelvis.will helpful for students and surgeons.

1. SURFACE
AND
RADIOLOGIC
AL
ANATOMY
OF
TH
E ABDOMEN
AND
PE
LVIS
Dr. Komal Parmar

2. ABDOMINA
L PLANES
AND
REGIONS
Vertical planes-
🢝Midline- Xiphisternum to
Pubic Symphysis
Paramedian Planes-
🢝 Midclavicular line (also
sometimes called the lateral or
the mammary line).- the
midpoint of the clavicle
🢝 crosses the costal margin just
lateral to the tip of the ninth
costal cartilage, and passes
through a point mid way
between the anterior superior
iliac spine and the
symphysis pubis.
🢝 It approximates to, but does
not exactly correspond to, the
lateral border of rectus
abdominis.

3. HORIZONTALPLANES

4. XIPHISTERNALPLANE
Runs horizontally
through the xiphoid
processes at the level
of the ninth thoracic
vertebra
Demarcates the
level of the cardiac
plateau on the
central part of the
upper border of the
liver.

6. TRANSPYLORICPLANE
The linea semilunaris crosses the costal
margin on the transpyloric plane.
Structures-
The hilum of both kidneys
the origin of the superior
mesenteric artery
the termination of the spinal
cord
the neck, adjacent body and
head of the pancreas
the confluence of the superior
mesenteric and splenic veins as
they form the hepatic portal vein
may all lie in this plane.
The pylorus may be found in the
transpyloric plane, but is not a
constant feature.

7. The transtubercular
plane joins the
tubercles of the iliac
crests
and usually lies at
the level of the
body of the fifth
lumbar vertebra
near its upper
border.
It indicates, or is
just above, the
confluence of the
common iliac veins
and marks the
origin of the inferior
vena cava.

12. The interspinous
plane joins the
centres of the anterior
superior spines of the
iliac crests. It passes
through either the
lumbosacral disc, or the
sacral promontory, or
just below them,
depending on the
degree of lumbar
lordosis, sacral
inclination and
curvature.
The plane of the
pubic crest lies at
the level of the inferior
end of the sacrum or
part of the coccyx,
depending on the
degree of lumbar
lordosis, sacral
inclination and

13. ABDOMINAL REGIONS

16. SOFT
TISSUE
LANDMARK
S

17. UMBILICUS
L3/L4 Disc
The
bifurcation of
the
abdominal
aorta then
lies about 2
cm caudal to
the
umbilicus.

18. LAPAROSC
OPI C
SURGERY
PORTALS
primary access to the peritoneal
cavity during laparoscopic surgery.
Site of thinnest abdominal wall with
no significant blood vessels resulting
into easy and safe access.
Trans umbilical access to peritoneal
cavity is also cosmetically and
ergonomically better.

20. RECTUSABDOMINIS
Rectus Abdominis
Linea Alba
Linea Semilunaris
Median vs
Paramedian
Incisions-
Incidence of early
complications was
more in paramedian
incision but midline
incision is associated
with more chances of
development of
incisional hernia.

22. KOCHERINCISION
gain access for the gall bladder
the biliary tree.
run parallel to the costal margin,
starting below the xiphoid
and extending laterally.
The incision will then pass through
the all the rectus sheath and rectus
muscle, internal oblique and
transversus abdominus, before
passing through the transversalis
fascia and then peritoneum to enter
the abdominal cavity.

23. CHEVRON
AND
MERCEDEZ
BENZ

25. MC BURNEY’S= GRIDION
INCISION
LANZ
The position of the
incision is based
upon the location of
the McBurney
point, which is a
point one third of the
distance from the
anterior superior iliac
spine (ASIS) to the
umbilicus.
Place the incision
(1.5-5.0 cm in length,
depending on the
patient's age)
between the first
third and the second
third of the distance
from the ASIS to the
umbilicus,

26. PFANNELSTEIL
INCISION
A Pfannenstiel
incision or pubic
incision is a type
of abdominal
surgical incision
that allows access
to the abdomen.
It is used for
gynecologic and
orthopedics
surgeries, and it is
the most common
method for
performing
Caesarian sections

27. INGUINALPOINTS

28. INTR
A-
ABDOMIN
AL
VISCERA

30. LIVER
Upper margin: level with
xiphisternal joint, 5th intercostal
space 7-8cm from midline; on L,
5th rib on R.
R border: ribs 7-11 in mid-axillary
line.
Lower border partly lies along
right costal margin, crosses in
upper abdominal wall, hands
breadth below xiphisternum

33. PANCREAS
The surface projection of
the head of the pancreas
lies within the duodenal
curve.
The neck lies in the
transpyloric plane, behind
the pylorus in the midline.
The body passes obliquely
up and to the left for
approximately 10 cm, its
left part lying a little above
the transpyloric plane.
The tail lies a little above
and to the left of the
intersection of the
transpyloric and left lateral
planes.

34. KIDNEY
Anterior: The right kidney lies 1.25 cm lower than
the left.
On the anterior surface, the centre of the hilum lies in
the transpyloric plane 5 cm from the midline and
slightly medial to the tip of the ninth costal cartilage.
From the hilum, the outline of the anterior surface can
be drawn 11 cm long and 4.5 cm broad, the upper pole
being 2.5 cm, and the lower 7.5 cm, from the midline
Posterior- the posterior surface, the centre of the
hilum lies opposite the lower border of the spinous
process of the first lumbar vertebra and 5 cm from the
midline.
The outline of the posterior surface can be traced
similarly to the anterior surface.
The lower pole is 2.5 cm above the summit of the iliac
crest.
The kidneys are 2.5 cm lower in the standing than in
the supine

38. ABDOMINALAORTA
Supracristal Plane
Interspinous plane