SURFACE MARKINGS OF THE ABDOMEN 



1319 



right cartilage, and the sides by two lines drawn from the end of the eighth left 

 costal cartilage to the ends of the base line. 



A space of some clinical importance the space of Traube overlies the stomach 

 and may be thus indicated.. It is semilunar in outline and lies within the following 

 boundaries: the lower edge of the left lung, the anterior border of the spleen, the 

 left costal margin and the inferior margin of the left lobe of the liver. 



Duodenum (Fig. 1225). The superior part is horizontal and extends from the 

 pylorus to the right lateral line; the descending part is situated medial to the 

 right lateral line, from the transpyloric line to a point midway between the trans- 

 pyloric and transtubercular lines. The horizontal part runs with a slight upward 

 slope from the end of the descending part to the left of the middle line ; the ascending 

 part is vertical, and reaches the transpyloric line, where it ends in the duodeno- 

 jejunal flexure, about 2.5 cm. to the left of the middle line. 



Transpyloric 

 plane 



plane 



\Transtubercular 

 plane. 



FIG. 1225. Front of abdomen, showing surface markings for duodenum, pancreas, and kidneys. A A'. Plane 

 through joint between body and xiphoid process of sternum. B B'. Plane midway between A A' and transpyloric 

 plane. C C'. Plane midway between transpyloric and transtubercular planes. 



Small Intestine. The coils of small intestine occupy the front of the abdomen. 

 For the most part the coils of the jejunum are situated on the left side, i. e., in the 

 left lumbar and iliac regions, and in the left half of the umbilical region. The coils 

 of the ileum lie toward the right in the right lumbar and iliac regions, in the right 

 half of the umbilical region, and in the hypogastric region; a portion of the ileum 

 is within the pelvis. The end of the ileum, i. e., the ileocolic junction, is slightly 

 below and medial to the intersection of the right lateral and transtubercular lines. 



Cecum and Vermiform Process. The cecum is in the right iliac and hypo- 

 gastric regions; its position varies with its degree of distension, but the midpoint 

 of a line drawn from the right anterior superior iliac spine to the upper margin of 

 the symphysis pubis will mark approximately the middle of its lower border. 



The position of the base of the vermiform process is indicated by a point on the 

 lateral line on a level with the anterior superior iliac spine. 



Ascending Colon. The ascending colon passes upward through the right 

 lumbar region, lateral to the right lateral line. The right colic flexure is situated in 

 the upper and right angle of intersection of the subcostal and right lateral lines. 



Transverse Colon. The transverse colon crosses the abdomen on the confines 

 of the umbilical and epigastric regions, its lower border being on a level slightly 



