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If you manage this site and have a question about why the site is not available, please contact us directly. The umbilicus is at the level of the fibrocartilage between the third and fourth lumbar vertebræ. The junction between the body of the sternum and the xiphoid process is on the level of the tenth thoracic vertebra. Each of these is further subdivided into three regions by the two sagittal planes, which are indicated on the surface by a right and a left lateral line drawn vertically through points halfway between the anterior superior iliac spines and the middle line.
1223– Front of abdomen, showing surface markings for liver, stomach, and great intestine.
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. The right colic flexure is situated in the upper and right angle of intersection of the subcostal and right lateral lines. The descending colon courses down through the left lumbar region, lateral to the left lateral line, as far as the iliac crest (see footnote p. 1226– Back of lumbar region, showing surface markings for kidneys, ureters, and spleen. The termination of the seventh nerve is at the level of the xiphoid process, the tenth reaches the vicinity of the umbilicus, the twelfth ends about midway between the umbilicus and the upper border of the symphysis pubis. Below, the main landmarks are the symphysis pubis and the pubic crest and tubercle, the anterior superior iliac spine, and the iliac crest.

The middle region of the upper zone is called the epigastric, and the two lateral regions the right and left hypochondriac. 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 upper limit of the left lobe can be defined by continuing this line downward and to the left to the sixth costal cartilage, 5 cm. Its head occupies the curve of the duodenum and is therefore indicated by the same lines as that viscus; its neck corresponds to the pylorus. The lower pole is situated midway between the transpyloric and intertubercular planes, 7 cm.
The line indicating the junction of the muscular fibers of Obliquus externus with its aponeurosis extends from the tip of the ninth costal cartilage to a point just medial to the anterior superior iliac spine.
The central region of the middle zone is the umbilical, and the two lateral regions the right and left lumbar.
1221, 1222), so that it is impossible to indicate it on the surface with any degree of accuracy. Its body extends along the transpyloric line, the bulk of it lying above this line to the tail which is in the left hypochondriac region slightly to the left of the lateral line and above the transpyloric. The middle region of the lower zone is the hypogastric or pubic, and the lateral are the right and left iliac or inguinal.
The measurements given refer to a moderately filled stomach with the body in the supine position.

The middle regions, viz., epigastric, umbilical, and pubic, can each be divided into right and left portions by the middle line. A curved line, convex downward and to the left, joining these points indicates the lesser curvature. In the following description of the viscera the regions marked out by Addison’s lines are those referred to. In the left lateral line the fundus of the stomach reaches as high as the fifth interspace or the sixth costal cartilage, a little below the apex of the heart. To indicate the greater curvature a curved line is drawn from the cardiac orifice to the summit of the fundus, thence downward and to the left, finally turning medialward to the pyloric orifice, but passing, on its way, through the intersection of the left lateral with the transpyloric line. The portion of the stomach which is in contact with the abdominal wall can be represented roughly by a triangular area the base of which is formed by a line drawn from the tip of the tenth left costal cartilage to the tip of the ninth 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.
The point of termination of the abdominal aorta corresponds to the level of the fourth lumbar vertebra; a line drawn from it to a point midway between the anterior superior iliac spine and the symphysis pubis indicates the common and external iliac arteries. The common iliac is represented by the upper third of this line, the external iliac by the remaining two-thirds.

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