Surface Anatomy of

GIT
Abdominal planes
 Abdominal Planes
• 9 regions are delineated by four planes
• Two sagittal (vertical) planes
• From midclavicular planes (midpoint of the
clavicles approximately 9 cm from the
midline) to the midinguinal point, (midpoints
of the lines joining ASIS and the pubic
tubercles on each side.)
• Two transverse (horizontal) planes.
• Transpyloric plane,
• extrapolated midway between the superior
borders of the manubrium of the sternum
and the pubic symphysis (typically the L1
vertebral level)
• Or
• Tip of 9th costal cartilage at the level of L1
vertebrae
• Transtubercular plane
• passing through the iliac tubercles
(approximately 5 cm posterior to the ASIS on
each side) and the body of the L5 vertebra
 Abdominal Quadrants
• 4 quadrants of the abdominal
cavity (right and left upper and
lower quadrants) are defined
• (1) the transverse transumbilical
plane, passing through the
umbilicus (and the
intervertebral [IV] disc between
the L3 and L4 vertebrae),
dividing it into upper and lower
halves
• (2) the vertical median plane,
passing longitudinally through
the body, dividing it into right
and left halves
 Spleen
• Along long axis of 10th rib
• Upper border
– Upper border of 9th rib
• Lower border
– Lower border of 11th rib
• Medial end
– 2-4 cm from posterior
midline
• Lateral end
– Midaxillary line
 Stomach
• Cardiac orifice
– 2 parallel lines
– Downward and to the left
– Left 7th costal cartilage
– 2.5 cm from midline
• Pyloric orifice
– 2 parallel lines
– Upward and to the left
– Transpyloric plane
– 1.2cm from midline
 stomach
• Lesser curvature
– J-shaped line
– From right margin of
cardiac orifice to the
upper margin of pyloric
orifice
– Lowest point of the line
reaches transpyloric
plane
 Stomach
• Fundus
– Line convex upward
– Left margin of cardiac
orifice
– Highest point in left 5th
intercostal plane
• Greater curvature
– From fundus to lower
margin of pyloric orifice
– Cuts the left costal margin
between tips of 9th and 10th
costal cartilages
 Appendix
• Ileocecal orifice
– Junction of right lateral &
transtubercular planes
• Appendicular orifice
– 2cm below ileocecal
orifice
• Appendix
– 2 parallel lines 1cm apart
– 7-10 cm long
– Extending up from
ileocecal orifice
 Liver
• Upper border
– 1st point
• Below and inferior to left
nipple
– 2nd point
• Xiphisternal joint
– 3rd point
• Upper margin of right 5th
costal cartilage
• Midclavicular line
 Liver
• Lower border
– 1st point
• Left 5th intercostal space
below and medial to left
nipple
– 2nd point
• Tip of 8th costal cartilage on
left costal margin
– 3rd point
• Midline at the level of
transpyloric plane
– 4th point
• Tip of 9th costal cartilage on
right costal margin
 Liver
• Right border
– 1st point
• Below the right nipple
– 2nd point
• Tip of 10th costal cartilage
1cm below the costal
margin
 Gall bladder
• Gallbladder has 3 parts
• Fundus,body,neck

• Fundus is marked by
small convex area at tip
of the right 9th costal
cartilage
 Duodenum
• 1st part
two parallel lines 2.5 cm apart extending from the pyloric orifice
upwards and to the right for 2.5 cm
• 2nd part
• two parallel lines on the right lateral vertical plane extending
from the end of the first part downwards for 7.5 cm.
• 3rd part
• two transverse parallel lines 2.5 cm apart on the subcostal
plane, extending towards the left for 10 cm.
• 4th part
• two lines from the left end of the third part to the
duodenojejunal flexure 1 cm below the transpyloric plane,
 Pancreas
• The head is marked within the
concavity of the duodenum
• The neck passes upwards and
to the left behind the pylorus
in the transpyloric plane.
• The body is marked by two
parallel lines 3 cm apart,
drawn upwards and to the left
for 10 cm from the neck,
occupying the upper two-
thirds of the space between
the transpyloric and subcostal
planes.