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AAAC22 21/5/05 10:47 AM Page 52
22 Surface anatomy of the abdomen

Vertical line Epigastrium Hypochondrium

Costal margin
Umbilical Lumbar

Transpyloric plane L1
Subcostal plane L2 Suprapubic Iliac fossa
Level of umbilicus L3
Transtubercular plane L4

Fig.22.1
The nine regions
of the abdomen Liver, lower edge
(sometimes)
Linea alba
Gall bladder
(when distended) Spleen, anterior notched
Lower pole of right margin (when grossly enlarged)
kidney (sometimes)
Linea semilunaris
McBurney's point
(lateral border of rectus)
Fig.22.2 Inguinal ligament
McBurney's point and some Deep inguinal ring Sigmoid colon
of the structures that may be and inferior (sometimes)
palpated in the abdomen epigastric artery

Deep Superficial Spermatic cord
ring ring
External spermatic fascia
External oblique
aponeurosis Internal spermatic fascia
Internal oblique Cremasteric fascia and muscle
Transversus Lower end of rectus abdominus
Transversalis fascia
(a)
Peritoneum Pubic tubercle
(b)
Inferior Conjoint
epigastric tendon
artery
Fig.22.3
A horizontal section through the inguinal canal. Diagrammatic.
(a) and (b) show the sites of indirect and direct herniae respectively

52 Abdomen and pelvis