Adult skeleton of the abdominal region – from the front
1 Xiphoid process
2 Sixth (VI) rib
3 Seventh (VII) rib
4 Eighth (VIII) rib
5 Ninth (IX) rib
6 Tenth (X) rib
7 Eleventh (XI) rib
8 Twelfth (XII) rib
9 Sixth costal cartilage
10 Seventh costal cartilage
11 Tenth (TX) thoracic vertebra
12 Eleventh (TXI) thoracic vertebra
13 Twelfth (TXII) thoracic vertebra
14 First (LI) lumbar vertebra
15 Second (LII) lumbar vertebra
16 Third (LIII) lumbar vertebra
17 Fourth (LIV) lumbar vertebra
18 Fifth (LV) lumbar vertebra
19 Sacrum (sacral vertebrae I–V)
20 Coccyx (coccygeal vertebrae I–IV)
21 Hip bone
22 Anterior superior iliac spine
23 Anterior inferior iliac spine
24 Obturator foramen
25 Pubic symphysis
26 Iliac crest
27 Sacro-iliac joint
28 Pubic tubercle
29 Head of femur
30 Neck of femur
31 Shaft of femur
Abdomen, muscles of the anterior wall – from the front
The nine regions of the abdomen:
A Upper central – epigastric region
B Central – umbilical region
C Lower central – pubic region
D Right – hypochondrium – left
E Right – lateral (flank) region – left
F Right – inguinal (groin) region – left
1 Xiphoid process of sternum
2 Sternocostal part of pectoralis major
3 Serratus anterior
4 External oblique
5 External oblique aponeurosis
6 Rectus abdominis
7 Tendinous intersection of rectus abdominis
8 Linea alba
9 Rectus sheath
10 Umbilicus
11 Anterior cutaneous nerve (eighth intercostal)
12 Anterior cutaneous nerve (tenth intercostal)
13 McBurney’s point (circled)
14 Posterior layer of oblique aponeurosis
15 Linea semilunaris
16 Anterior layer of oblique aponeurosis
17 Superficial inguinal lymph nodes
18 Pubic tubercle
19 Pyramidalis
20 Pubic symphysis
21 Mons pubis
22 Inguinal ring (position of)
23 Ilioinguinal nerve
24 Anterior superior iliac spine
25 Inguinal ligament
26 Tensor fascia latae
27 Transpyloric plane
28 Intertubercular plane
McBurney’s point:
➤ Is an important site locatable on the surface of the anterior abdominal wall.
➤ It identifies the usual internal location of the base of the appendix.
➤ The point lies one-third of the way along a direct line from the right anterior superior iliac spine of the hip bone to the umbilicus.
Abdominal viscera I – from the front Structures of the internal abdominal wall – from below
The nine regions of the abdomen:
A Upper central – epigastric region
B Central – umbilical region
C Lower central – pubic region
D Right – hypochondrium – left
E Right – lateral (flank) region – left
F Right – inguinal (groin) region – left
1 Right lobe of liver
2 Gall bladder
3 Falciform ligament
4 Left lobe of liver
5 Duodenum, superior (1st part)
6 Body of stomach
7 Greater omentum
8 Terminal part of ileum
9 Caecum
10 Small intestine (coils of jejunum and ileum)
11 Transpyloric plane
12 Intertubercular plane plane
13 Inferior epigastric artery and vein
14 Rectus abdominis
15 Arcuate line (free edge of posterior rectus sheath)
16 Umbilicus
17 Rectus sheath
18 Transversus abdominis
19 Internal oblique
Abdominal viscera II, with greater omentum reflected superiorly – from the front
1 Left lobe of liver
2 Body of stomach
3 Greater omentum
4 Transverse colon
5 Mesentary
6 Jejunum
7 Ileum
8 Caecum
The passage of food via the digestive alimentary tract
From the:
➤ Mouth – to the
➤ Pharynx – approximately 12–14 cm in length, extending from the base of the skull to the sixth (CVI) cervical vertebra; then into the
➤ Oesophagus – approximately 25 cm in length, extending from the sixth (CVI) cervical vertebra, passing through the diaphragm at the level of the tenth (TX) thoracic vertebra; to the
➤ Stomach – at the level of the ninth (TIX) thoracic vertebra (gastro-oesophageal junction); then through the stomachs fundus, body and pylorus; to the
➤ Small intestine – which is approximately 6–7 metres in total length from the pylorus of the stomach to the ileocaecal junction;
• duodenum – approximately 20–25 cm in total length; through the superior (1st part) 5 cm, descending (2nd part) 8–10 cm, inferior (3rd part) 10 cm, and ascending (4th part) 2.5 cm; to the
• jejunum – approximately 2.5 metres in length; and
• ileum – approximately 3.5 metres in length; to the
➤ Large intestine – which is approximately 1.5 metres in total length from the caecum to the anus;
• caecum – then from the ilocaecal junction, location of the appendix, to the
• colon – through its ascending, transverse, descending and sigmoid parts; to the
• rectum – and into
• anal canal – as food waste (faeces); finally exiting the
• anus – after travelling an overall distance from mouth to anus of approximately 9 metres.
1 Linea alba
2 Rectus abdominis
3 External oblique
4 Internal oblique
5 Transversus abdominis
6 Latissimus dorsi
7 Quadratus lumborum
8 Erector spinae
9 Psoas major
10 Cauda equina within vertebral canal
11 Intervertebral disc between the second (LII) and third (LIII) lumbar vertebra
12 Root of second lumbar nerve
13 Left ureter
14 Inferior mesenteric vein
15 Left testicular artery and vein
16 Para-aortic lymph nodes
17 Aorta
18 Inferior vena cava
19 Right sympathetic chain
20 Right ureter
21 Right testicular artery and vein
22 Lower pole of right kidney
23 Renal fascia
24 Ascending colon and right colic (hepatic) flexure
25 Right lobe of liver
26 Greater omentum
27 Transeverse colon
28 Jejunum
29 Mesentary with mesenteric vessels
30 Superior mesenteric artery and vein
31 Duodenum, inferior (3rd part)
32 Descending colon
Caecum, terminal ileum (the iliocaecal junction) and vermiform appendix – from the front
1 Caecum
2 Anterior taenia coli (taenia libra)
3 Ascending colon
4 Ileocaecal junction
5 Terminal ileum
6 Base of vermiform appendix
7 Mesentery of vermiform appendix
8 Tip of vermiform appendix
9 Ileocaecal artery and vein
The vermiform appendix:
➤ Usually has an internal diameter of 0.5 cm.
➤ Length varies between 2 and 20 cm, with an average of 8 cm.
➤ Position is variable but consensus of research data gives:
• Retrocolic and retrocaecal 70%.
• Subcaecal and pelvic 20%.
• Retro-ileal and pre-ileal 5%.
Transverse section through the abdomen at the level of the first (LI) lumbar vertebra – from below
1 Latissimus dorsi
2 Serratus posterior inferior
3 Erector spinae
4 Quadratus lumborum
5 Left kidney
6 Left ureter
7 Cauda equina within vertebral canal
8 Body of first (LI) lumbar vertebra
9 Right crus of diaphragm
10 Right sympathetic chain
11 Inferior vena cava
12 Cisterna chyli
13 Aorta
14 Common bile duct
15 Duodenum
16 Gall bladder
17 Commencement of right ureter
18 Right kidney
19 Twelfth (XII) rib
20 Renal fascia
21 Eleventh (XI) rib
22 Tenth (X) rib
23 Right lobe of liver
24 Ninth costal cartilage
25 Left lobe of liver (medial segment)
26 Linea alba
27 Falciform ligament
28 Antrum of stomach
29 Transverse colon
30 Jejunum
31 Head of pancreas
32 Superior mesenteric vein
33 Superior mesenteric artery
34 Greater omentum
35 Para-aortic lymph node
36 Inferior mesenteric vein
37 Descending colon
38 Internal oblique
39 External oblique
40 Rectus abdominis
41 Transverse abdominis
42 Left lobe of liver (lateral segment)
43 Portion of disc between first (LI) and second (LII) lumbar vertebra
A Right subphrenic space
B Right subhepatic space
C Left subphrenic space
D Left subhepatic space
1 Right inferior surface of the dome of diaphragm
2 Left inferior surface of the dome of diaphragm
3 Right lobe of liver
4 Quadrate lobe of liver
5 Falciform ligament
6 Left lobe of liver
7 Fundus of gall bladder
8 Body of gall bladder
9 Neck of gall bladder
10 Cystic duct
11 Common hepatic duct
12 Portal vein
13 Common hepatic trunk
14 Left gastric artery
15 Anterior vagal trunk
16 Oesophagus
17 Gastro-oesophageal junction
18 Fundus of stomach
19 Splenic artery
20 Spleen
21 Body of stomach
22 Lesser curvature of stomach
23 Greater curvature of stomach
24 Pyloric antrum
25 Pylorus of stomach
26 Duodenum, superior (1st part)
27 Head of pancreas
28 Uncinate process of pancreas
29 Body of pancreas
30 Tail of pancreas
31 Lower pole of left kidney
32 Greater omentum
33 Right gastro-epiploic artery
34 Aorta
35 Inferior vena cava
36 Lower pole of right kidney
37 Duodenum, descending (2nd part)
38 Major duodenal papilla with the common opening for the bile and main pancreatic duct (ampulla of Vater)
39 Minor duodenal papilla with the opening of the accessory pancreatic duct
A Right subphrenic space
B Right subhepatic space
C Left subphrenic space
D Left subhepatic space
1 Right inferior surface of the dome of diaphragm
2 Left inferior surface of the dome of diaphragm
3 Right lobe of liver
4 Quadrate lobe of liver
5 Falciform ligament
6 Left lobe of liver
7 Fundus of gall bladder
8 Body of gall bladder
9 Neck of gall bladder
10 Cystic duct
11 Common hepatic duct
12 Splenic artery
13 Left gastric artery
14 Oesophagus
15 Gastro-oesophageal junction
16 Fundus of stomach
17 Body of stomach
18 Lesser curvature of stomach
19 Greater curvature of stomach
20 Pyloric antrum
21 Pylorus of stomach
22 Superior (1st part) of duodenum
23 Descending (2nd part) of duodenum
24 Inferior (3rd part) of duodenum
25 Ascending (4th part) of duodenum
26 Head of pancreas
27 Body of pancreas
28 Tail of pancreas
29 Spleen
30 Lower pole of right kidney
31 Gastro-epiploic vessels within greater omentum
32 Aorta
33 Inferior vena cava
34 Lower pole of left kidney
A Anterior portion reflected superiorly, from behind
B Posterior portion, from the front
1 Greature curvature of stomach
2 Folds of mucous membrane (gastric rugae)
3 Body of stomach
4 Oesophagus at the gastro-oesophageal junction
5 Cardiac part of stomach
6 Gastric canal
7 Pyloric antrum
8 Pyloric canal
9 Pylorus (gastroduodenal junction)
10 Fundus of stomach
11 Muscular coat of stomach
The stomach:
➤ Is shaped like the letter J.
➤ The gastro-oesophageal junction (upper opening into the stomach), lies to the left of the midline at the level of the ninth (TIX) thoracic vertebra.
➤ The gastroduodenal junction at the pylorus (lower opening out of the stomach), lies to the right of the midline at the level of the first (LI) lumbar vertebra.
➤ Upper border has the lesser curvature.
➤ Lower border has the greater curvature.
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