1 hypochrondriac (r,l) 2 lumbar  (flank-r, l)) 3 paraumbilical  4 Iliac (iliac fossa, r, l)) 5 suprapubic (hypogastric) 6 epigastric 7 left lateral line 8 transpyloric plane (L1) 9 subcostal plane 10 transtubercular plane (L5)


 
Appendix

 

 
Clinical examination of appendix

Compare the pictures on the video on the left  with those of the digital locator to locate the appendix from the skin on the right

  DIGITAL LOCATOR OF APPENDIX: Layer 1 Skin of abdomen (anterior abdominal wall). Layer 2- Layer of Camper's fascia. Layer 3 - layer of Scarpa's fascia. Layer  4 - layer of external oblique muscle/aponeurosisLayer 5- layer of rectus sheath. Layer 6- layer of internal oblique. Layer 7 - layer of transversus abdominis. Layer 8- layer of transversus abdominis/parietal peritoneum. Layer 9- layer of greater sac of peritoneum. Layer 10- layer of small intestine. Layer 11- layer of transverse colon. Layer 12- layer of posterior abdominal wall. Layer 13 - layer of deep posterior abdominal wall. Layer 14 - layer of bones of abdominal region..

 

This region contains cecum, appendix, ascending colon

Pain/tenderness can be caused by appendicitis primarily and then volvulus, colonic cancer, pelvic abscess, abnormality of the right hip, urinary tract infection, right testicular cancer in cryptorchidism. In the female it includes torsion of ovarian cyst, salpingitis and ectopic pregnancy. It also includes Crohn's ileitis but EXCLUDES diverticulitis.

Mass in the right iliac fossa may be caused by appendix mass  or abscess, kidney mass, pelvic mass, Crohn's mass, tuberculous mass, intussusception and amebic mass

Roll over mouse


      

Palpate the right iliac fossa with the mouse to demonstrate appendix and cecum  Deep palpation may cause rebound tenderness due to localized peritonitis

 

 

 

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