Surface
Landmarks of the Abdominal Viscera
Gallbladder
The gallbladder is a pear-shaped sac,The fundus of the
gallbladder lies opposite the tip of the right ninth costal cartilage—that is,
where the lateral edge of the right rectus abdominis muscle crosses the costal margin
Spleen
It lies in the left upper quadrant and lies under cover of
the 9th, 10th, and 11th ribs. Its long axis corresponds to that of the 10th
rib, and in the adult it does not normally project forward in front of the midaxillary
line. In infants, the lower pole of the spleen may just be felt
Liver
The liver is a large organ that occupies the upper part of
the abdominal cavity is covered under
the lower ribs, and most of its bulk lies on the right side.
In infants, until about the end of the third year, the lower margin of the liver extends one or two fingerbreadths below the costal margin. In the adult who is obese or has a welldeveloped right rectus abdominis muscle, the liver is not palpable. In a thin adult, the lower edge of the liver may be felt a fingerbreadth below the costal margin. It is most easily felt when the patient inspires deeply and the diaphragm contracts and pushes down the liver.
In infants, until about the end of the third year, the lower margin of the liver extends one or two fingerbreadths below the costal margin. In the adult who is obese or has a welldeveloped right rectus abdominis muscle, the liver is not palpable. In a thin adult, the lower edge of the liver may be felt a fingerbreadth below the costal margin. It is most easily felt when the patient inspires deeply and the diaphragm contracts and pushes down the liver.
Pancreas
The pancreas lies across the transpyloric plane. The head lies
below and to the right, the neck lies on the plane, and the body and tail lie
above and to the left.
Kidneys
the left kidney lies at a slightly higher level than The right kidney (because of
the bulk of the right lobe of the liver), and the lower pole can be palpated in
the right lumbar region at the end of deep inspiration in a person with poorly
developed abdominal muscles. Each kidney moves about 1 in. (2.5 cm) in a
vertical direction during full respiratory movement of the diaphragm. The
normal left kidney, which is higher than the right kidney, is not palpable. On
the anterior abdominal wall, the hilum of each kidney lies on the transpyloric
plane, about three fingerbreadths from the midline. On the back, the kidneys
extend from the 12th thoracic spine to the 3rd lumbar spine, and the hili are
opposite the 1st lumbar vertebra
Stomach
The stomach is a dilated part of the alimentary canal
between the esophagus and the small intestine ,The cardioesophageal junction
lies about three fingerbreadths below and to the left of the xiphisternal
junction (the esophagus pierces the diaphragm at the level of the10th thoracic
vertebra).
The pylorus lies on the transpyloric plane just to the right
of the midline. The lesser curvature lies on a curved line joining the
cardioesophageal junction and the pylorus. The greater curvature has an
extremely variable position in the umbilical region or below.
Aorta
The aorta lies in the midline of the abdomen and bifurcates below
into the right and left common iliac arteries opposite the 4th lumbar
vertebra—that is, on the intercristal plane. The pulsations of the aorta can be
easily palpated through the upper part of the anterior abdominal wall just to
the left of the midline.
