HB II Seminar

1. Surface Anatomy of the abdominal
viscera and abdominal regions.

2. OBJECTIVES
1. Abdomen surface anatomy.
2. Defining the surface projection of the abdomen.
3. How to find the Superficial inguinal ring.
4. How to determine lumbar vertebral levels.
5. Visualizing structures at the L1 vertebral level.
6. Visualizing the position of major blood vessels.
7. Using abdominal quadrants to locate major viscera.
8. Where to find the kidneys & spleen.
9. Defining surface regions to which pain from gut is referred.

3. Landmarks
Imaginary planes and lines
Regions and areas
Kidneys & Spleen

4.  Lumbar vertebral levels
 Superficial inguinal ring
 Quadrants
 Major blood vessels

5. 1. Abdomen Surface Anatomy.
Sulaiman Abuhaimad

6. Abdominal Boundaries
 Superior Boundary
 Posterior Boundary
 Anterolateral Borders
 Inferior Borders

7. 1.Xiphoid.
2.Costal margin.
3.9th costal cartilage
4.Tendinous intersections.
5.Umbilicus.
6.Iliac Crest.
7.Anterior superior iliac spine.
8.Linea semilunaris.
9.Linea Alba.
10.Inguinal ligament.
11.Pubic tubercle.
12.Pubic crest.
13.Pubic symphysis.

8. 2. Defining the surface projection of
the abdomen.
Moath Alkeaid

9. Palpable landmarks can
determine the extant of
the abdomen on the
surface of the body
These landmarks
are:
The costal margin
The pubic tubercle
Anterior superior
iliac spine
Iliac crest

11. 3. How to find the Superficial
inguinal ring.
Naif Alrajhi

12. Inguinal Canal
It begins at the deep inguinal ring and ending at the superficial inguinal ring

13. Deep Inguinal Ring
The deep (internal) inguinal ring is the beginning
of the inguinal canal

14. Superficial Inguinal Ring
The superficial (external) inguinal ring is the end of the inguinal canal

17. 4. How to determine lumbar
vertebral levels.
Abdulmalik Alawam

18. Lumbar Vertebrae
• 5 vertebrae between the rib
cage and the pelvis
• Largest segments of the
vertebral column
• Support the weight of the body
and permit movement

19. Position
First lumbar:
• Horizontally level with the
transpyloric plane, on level
with the 9th costal cartilage
Third lumbar:
• Horizontally level with the
subcostal plane, on level with
the 10th costal cartilage
• The umbilicus is found
between the L2 and L3
vertebra

20. Position
Fourth lumbar:
• Horizontally level with the
supracristal plane on level
with the Iliac crest
Fifth lumbar:
• Horizontally level with the
intertubercular plane on
level with the tubercle of
the crest of ilium

21. 5. Visualizing structures at the L1
vertebral level.
Fawaz Al Afandi

22. Determining the L1 vertebral level.
• Medial end of the 9th CC & body of L1 /
transpyloric plane.
• Midway between suprasternal –jugular- notch
& pubic symphysis.

24. Structures at the L1 level
• Beginning & upper limit of the
Duodenum.
• Hill of the Kidneys.
• Neck of Pancreas.
• Origin of Sup. Mesentric artery.
• Right & left colic flexures also are close
to this level.

26. Major blood vessels relation.
• Celiac trunk at the upper border.
• Sup. Mesenteric artery at the lower border.

27. 6. Visualizing the position of
major blood vessels.
Saleh Alorainy

28. Each of the vertebral
levels in the abdomen
is related to the origin
of major blood vessels

29. LI Vertebra
• The celiac trunk originates
from the aorta at the
upper border of the LI
vertebra.
• The superior mesenteric
artery originates at the lower
border of the LI vertebra.

30. LII Vertebra
• The renal arteries
originate at approximately
the LII vertebra.

31. LIII Vertebra
• The inferior mesenteric
artery originates at the LIII
vertebra.

32. LIV Vertebra
• The aorta bifurcates into
the right and left common
iliac arteries at the level of
the LIV vertebra.

33. LV Vertebra
• The left and right common
iliac veins join to form the
inferior vena cava at the
LV vertebral level.

34. What is the purpose ?
Vascular surgery

35. 7. Using abdominal quadrants to
locate major viscera.
Tariq Dabil

36. Importance :
Used to help :
Anatomists, Doctors, Medical students

37. Location Of Major Viscera by using
Quadrants of the Abdomen:
RUQ:
• Liver
• Gallbladder
LUQ:
• Spleen
• Stomach
RLQ:
• The Cecum
• Appendix
LLQ:
• The Descending Colon
• Sigmoid Colon

38. Using Abdominal Quadrants To
Locate Major Viscera:

39. 8. Where to find the kidneys & spleen.
Abdullah Alrudayni

40. Kidneys

41. Where to find kidneys
• The kidneys project onto the back on either side
of the midline and are related to the lower ribs

42. Where to find kidneys
• The left kidney is a little higher than the right and
reaches as high as rib XI
• The superior pole of the right kidney reaches only
as high as rib XII

43. Where to find kidneys
• The lower poles of the kidneys occur around the
level of the disc between the LIII and LIV
vertebrae

45. Spleen

46. Where to find spleen
• The spleen projects onto the left side and back in
the area of ribs IX to XI

47. Where to find spleen
• The spleen follows the contour of rib X and
extends from the superior pole of the left kidney to
just posterior to the mid axillary line

49. 9. Defining surface regions to which
pain from gut is referred.
Fahad Alhussainan

50. THE ABDOMINAL REGION
The Regions are formed by:
 Two Horizontal Planes
• Midclavicular Planes
 Two Vertical Planes
• Subcostal
• Intertubercular
Central regions
• Epigastric, Umbilical,
Hypogastric/Pubic
Regions on each side
• Hypochondrium, Lumbar/Flank,
Iliac/Groin

51. Defining surface regions to
which pain from the gut is
referred

52. Referred Pain?
Three distinct forms of pain exist:
• Somatic
• Visceral
• Referred pain

53. Referred Pain

54. Referred Pain

55. References
• Gray’s Anatomy for students 3rd edition
• NETTER , MD ATLAS OF HUMAN
ANATOMY 6TH EDITION

56. QUESTIONS ?

57. This Seminar was done by:
1. Sulaiman Abuhaimad
2. Moath Alkeaid
3. Naif Alrajhi
4. Abdulmalik Alawam
5. Fawaz Al Afandi
6. Saleh Alorainy
7. Tariq Dabil
8. Abdullah Alrudayni
9. Fahad Alhussainan

58. Thank you!