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this is a cartoon which are probably
really familiar with as you've gone
through your education and just the idea
of where the organs are within the
abdominal cavity so here we can see
we've got the sternum here now we can
see the Zippy sternum this inferior
limit of the sternum which demarcates
the superior aspect of the abdomen and
then we can see it radiating down in
this direction with those costal
cartilages we can see really clearly now
tucked up on this right hand side
protected by the ribs we've got the
liver this large organ the larger gland
in the human body and in the midline we
can see just about we've got the stomach
here which is then continuous with
what's called the duodenum and that's
the first part of the small intestine
but previously I mentioned the appendix
down in this lower was right inguinal
region and here we can see in the lower
right inguinal region we can actually
find the appendix so these are really
important landmarks which we can
identify in the abdominal cavity this is
an anterior view over here we've got a
posterior view and we can see where the
kidneys are located either side of the
vertebral column we can also see tucked
up over here we have the spleen which
you can just about make out on this left
hand side
so we'll look at the various positions
of these organs as we go through the
course but this provides a good general
overview so now we can relate the
surface landmarks that we spoke about
previously so a couple of these organs
like the liver and the appendix here we
can start off with the appendix this
blind pouch that's located at the
beginning of the large intestine by the
cecum and this is really important
because as I mentioned before we may
have radiating pain coming from this
region so a useful technique for
locating this pain is to use what's
known as McBurney's point and this is a
surface landmark for the appendix so
again we can remind ourselves of where
the umbilicus is we can see it here we
can remind ourselves aware the anterior
superior iliac spine is and as we can
see in the diagram we can draw a line
between these two regions a third of the
way from the anterior superior iliac
spine towards the umbilicus so about a
third of the way across we can locate
our appendix and that's known as
McBurney's point palpation in this
region can lead to quite severe acute
pain and this could indicate that the
patient maybe has appendicitis so that's
where the surface landmarks are really
important in being able to identify
which organs lie deep to the skin we can
also see over on this side again
mentioned it in the previous slide the
position of the liver and here we can
see that actually the liver is hard to
palpate because most of the liver is
actually covered by these ribs and here
this diagram may not be a hundred
percent correct in that it's quite
unusual for the liver to actually be so
clearly observed three of the ribs is
usually only in patients that have an
enlarged liver that it can actually
radiate below the ribs and to palpate
the liver you can feel this costal
margin and asking the patient to breathe
in and out moves the liver and you can
actually pressing on the skin deep to
these ribs can feel this edge of the
liver pressing against your fingers
so it's really important that we
mentioned the surface landmarks as you
can use them to try and feel and locate
organs deep to the skin you just
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