Surface anatomy Flashcards
Identify anatomical landmarks for adjacent internal organs
Which vertebral level is the suprasternal notch?
T2
What is the anterior anatomical landmark for T2?
Suprasternal nothc
Which vertebral level is the angle of louis?
T5
What is the anterior anatomical landmark for T5?
Angle of Louis
What is the vertebral level for the xiphoid process?
T9
What is the anterior anatomical landmark for T9?
The xiphoid process
What is the vertebral level for the Transpyloric plane of Addison?
L1
What is the anterior anatomical landmark for L1?
The transpyloric plane of Addison
What is the Transpyloric plane of Addision?
An imaginary line that runs along the anterior surface of the abdomen at the level of L1 posteriorly and 9th cartilage anteriorly. It is mid distance between the xiphoid process and the umbilicus (about a hands breadth below the xiphoid process)
Name the significant structures related to the landmark called the “Transpyloric plane of Addison” (intra-abdominal organs, blood vessels, bones, spinal cord)
Duodenal- jejunal flexure Neck of pancreas Hilar of both kidneys Fundus of the gallbladder Superior mesenteric artery from aorta 9th cartilage of ribs L1 vertebra Where the spinal cord terminates
What is the anterior abdominal landmark for the kidneys?
Transpyloric plane of Addison bisects the hilar of both kidneys
What is the vertebral level for the subcostal plane?
L3
What is the anterior abdominal wall landmark for L3?
The subcostal plane - just below 10th rib
Where does the iliac crest plane run?
An imaginary line on the anterior abdomen which runs between the two iliac tubercules and therefore is sometimes referred to as the transtubercular plane (5cm superior to ASIS)
Which vertebral level is at the iliac crest or transtubercular plane?
L4
Which anatomical landmark demarcates the bifurcation of the aorta?
The transtubercular plane (L4)
Which vertebral level is the umbilicus?
Variable but typically L3-5
Where does the linea semilunaris run?
Anterior abdominal wall, on the lateral borders of the rectus abdominus muscle from the 9th rib to the pubic tubercle
Where do spigelian hernias occur?
At the linea semilunaris
Where is McBurney’s point?
Draw a line from ASIS to the umbilicus and it is 2/3 away from the umbilicus or 1/3 close the ASIS (whichever way you look at it)
What is the clinical significance of McBurney’s point?
It is the point at which the appendix typically attaches to the umbilicus
Where is Palmer’s point?
Left upper quadrant, Mid clavicular line, 3cm below the costal margin
What is the clinical significance of Palmer’s point?
Laparoscopic port entry point on the superior lateral aspect of anterior abdominal wall for better views on a patient with suspected or known dense adhesions, or large fibroids/large pelvic mass
Where does the arcuate line of Douglas run?
Anterior abdominal wall, half way between the umbilicus and the pubic symphsis
What is the clinical significance of the arcuate line of Douglas?
It is where the inferior epigastric artery enters the rectus sheath
It is where the posterior rectus sheath terminates
Where is the linea alba?
Aponeurosis between the anterior abdominal wall musces - it runs in the midline from xiphoid process to pubic symphysis
Where is it safe to perform paracentesis?>
Midline at linea alba or 3cm lateral to McBurney’s point to avoid the inferior epigastric artery
What is the difference in terms of position between the Arcuate line of Douglas and the Trans-tubercular plane?
Arcuate line of douglas (midway between pubic crest and umbilicus)
Transtubercle plane is between the iliac tubercles which lie 5cm superior to ASIS
What is the difference in terms of clinical significance between the Arcuate line of Douglas and the Trans-tubercular plane?
Arcuate line of douglas - area where the posterior rectus sheath ends and the inferior epigastric artery enters the rectus sheath
Transtubercle plan is at the level of L$ and is the site of the bifurcation of the aorta
Which vertebral level does the spinal cord end at?
L1
At which point does the epigastric artery enter the rectus sheath?
At the arcuate line of douglas
How do you avoid the inferior epigastric arteries during paracentesis?
By entering at either linea alba (midline) or lateral to McBurney’s point
