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Abdomen surface marking and radiology
This document provides an overview of the surface and radiological anatomy of the abdomen and pelvis. It describes the abdominal planes and regions, including vertical, horizontal, and soft tissue landmarks. It also outlines various abdominal incisions and portals used in laparoscopic surgery. Finally, it reviews the radiological anatomy of intra-abdominal organs and various imaging modalities used to visualize the abdomen such as x-rays, CT, MRI, ultrasound, and endoscopy.
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Abdomen surface marking and radiology
- 1. SURFACE AND RADIOLOGICAL ANATOMY OF THE ABDOMENAND PELVIS Dr. Komal Parmar
- 2. ABDOMINAL 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.
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- 4. XIPHISTERNAL PLANE Runs horizontally throughthe 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. TRANSPYLORIC PLANE The lineasemilunaris 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 joinsthe 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 joinsthe 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
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- 17. UMBILICUS L3/L4 Disc The bifurcation of the abdominal aortathen lies about 2 cm caudal to the umbilicus.
- 18. LAPAROSCOPI C SURGERY PORTALS primary accessto 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. RECTUS ABDOMINIS Rectus Abdominis LineaAlba 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. KOCHER INCISION gain accessfor 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.
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- 25. MC BURNEY’S= GRIDION INCISION LANZ Theposition 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 orpubic 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
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- 30. LIVER Upper margin: levelwith 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 projectionof 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 rightkidney 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
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- 44. SIALOGRA PHY injection of asmall amount of contrast medium into the salivary duct of a single gland, followed by routine X- ray projections
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- 116. MODALITY OF CHOICE CaraianiC, Yi D, Petresc B, Dietrich C. Indications for abdominal imaging: When and what to choose?. J Ultrason. 2020;20(80):e43- e54. doi:10.15557/JoU.2020.0008