SURFACE MARKINGS 215 



seldom be felt through the abdominal wall. The right kidney as 

 a rule lies a little lower than the lef t, and a little further from 

 the mid-line. For practical purposes the hilum of the kidney 

 may be regarded as opposite a point J inch internal to the 

 tip of the ninth costal cartilage ; and a line joining the two hili 

 is in the transpyloric plane. 



The Abdominal Aorta. The abdominal aorta commences 

 about 1 inch above the transpyloric plane, and bifurcates a 

 little to the left of the mid-line on a level with the highest part 

 of the iliac crest, generally about f inch below the umbilicus, 

 opposite the fourth lumbar vertebra. 



The Back. 



In the middle line of the back is the spinal furrow, along 

 which the spines of the vertebrae can be easily palpated, 

 becoming more distinct when the spine is flexed. 



The spine of the first dorsal vertebra is more prominent than 

 that of the vertebra prominens (seventh cervical), the third dorsal 

 is on a level with the root of the spine of the scapula, the 

 seventh dorsal with its inferior angle, the fourth lumbar with 

 the highest part of the iliac crest, and the second sacral with 

 the posterior superior iliac spine. 



Over the upper sacral region is a flattened triangular area, the 

 angles of which correspond with the posterior superior iliac 

 spines and the third sacral vertebra. 



Above the spine of the scapula is the suprascapular region ; 

 the levator anguli scapulae and trapezius muscles can easily be 

 seen by shrugging the shoulders. The lower border of the 

 trapezius is indicated by a line from the twelfth dorsal spine to 

 the root of the spine of the scapula. 



The upper border of the latissimus dorsi is indicated by a line 

 extending outwards from the sixth dorsal spine across the angle 

 of the scapula. 



The outer border of the erector spinse is indicated by drawing 

 a line from a point on the iliac crest 3 J inches from the mid-line 

 upwards and outwards to the angles of the ribs. The outer 

 border of quadratus lumborum lies external to that of the erector 

 spinas at the iliac crest and internal to it at the twelfth rib. 



