AN55.1-2 | Surface marking — Glossary

Surface projection of the appendix base at the junction of the lateral one-third and medial two-thirds of the line from right ASIS to umbilicus

Intersection of the right midclavicular line and right costal margin; surface projection of the gallbladder fundus

Patient catches breath and experiences pain during deep palpation at Murphy's point during inspiration; positive in acute cholecystitis

Costovertebral angle between the 12th rib and lateral border of erector spinae; tender in pyelonephritis

Opening in the transversalis fascia 1.5 cm above the midpoint of the inguinal ligament; entry point for indirect inguinal hernias

Triangular gap in the external oblique aponeurosis 1 cm above and lateral to the pubic tubercle; exit point of the inguinal canal

Addison's plane at L1, halfway between jugular notch and pubic symphysis; passes through the pylorus, kidney hila, SMA origin, and 9th costal cartilage tips

Horizontal plane at L3 through the lowest point of the costal margin (10th costal cartilage); separates epigastrium from umbilical region

Horizontal plane at L5 through the iliac tubercles; separates umbilical from hypogastric region

Vertical line through the midpoint of the clavicle; passes medial to the nipple and the ASIS

Division of the abdomen into nine regions by two horizontal planes (subcostal, transtubercular) and two vertical midclavicular lines

Central upper abdominal region between the two hypochondria; contains the stomach, pancreas, and duodenum

Lower right abdominal region containing the caecum, appendix, and terminal ileum; site of appendicitis tenderness

Upper lateral abdominal region below the costal margin; right contains the liver, left contains the spleen

Line of attachment of the mesentery to the posterior abdominal wall from the DJ flexure (L2, left) to the right sacroiliac joint; about 15 cm long

DJ flexure — junction of the duodenum and jejunum at L2 left of midline; supported by the ligament of Treitz; landmark for upper vs lower GI bleeding

Rebound tenderness at McBurney's point — pain on sudden release of pressure; indicates peritoneal irritation in acute appendicitis

Bony prominence at the medial end of the pubic crest; landmark for the inguinal canal and hernia examination

The curved lower border of the thoracic cage formed by the cartilages of ribs 7-10; landmark for liver and spleen palpation

ASIS — bony prominence at the anterior end of the iliac crest; landmark for inguinal ligament, McBurney's point, and abdominal regions

Poupart's ligament — thickened lower border of the external oblique aponeurosis from ASIS to pubic tubercle; floor of the inguinal canal