Clinicians use theoretical abdominal divisions to localize, identify, and diagnose symptoms. One method categorizes into four quadrants of abdomen, while the other divides it into nine segments. Internationally recognized abdominal ideas can be used daily in clinical practice.
Abdomen
The abdomen contains all body structures between the thorax (chest) and the pelvis, separated by the diaphragm. The abdominal cavity is enclosed by the abdominal muscles in front and sides and part of the vertebral column in back. Each abdominal anatomical area has its own contents and borders. The abdominal cavity, Calot’s triangle, peritoneum, inguinal canal, and Hesselbach’s triangle. The abdomen comprises the lumbar spine and the third segment of the vertebral column located in the lower back, situated between the thoracic and sacral segments.
The anterolateral and posterior abdominal wall muscles cover the viscera to protect them. The abdomen houses the esophagus, stomach, small intestine, cecum, appendix, colon, rectum, and anal canal. Food is digested, absorbed, and expelled as feces by the gastrointestinal tract. The liver, gallbladder, pancreas, spleen, adrenal glands, kidneys, and mesentery are in the abdomen. These organs aid systemic organ function. The abdominal vasculature includes arterial branches from the aorta and two venous structures that drain deoxygenated blood and waste.
What are Abdominal Quadrants?
The abdomen is partitioned into four quadrants to facilitate clinical examination and communication. Based on pain and symptoms, dividing the abdomen into quadrants helps pain management in Dallas identify affected organs. Four abdominal quadrants are divided along the median and transverse planes by a vertical and horizontal line that perpendicularly intersects at the navel.
Abdominal Quadrants Divisions
Anatomically, the abdomen has four quadrants. They are separated by theoretical abdominal anatomical lines traceable using landmarks. The median plane follows the linea alba from the xiphoid process to the pubic symphysis and divides the abdomen vertically. The umbilicus-level transumbilical plane is horizontal. Crossing at the umbilicus, these two planes divide the abdomen into four quarters.
Upper Right Quadrant
In craniocaudal order, the right upper quadrant of abdomen(RUQ) includes the liver lobe, gallbladder, stomach pylorus, first 3 duodenum parts, pancreas head, kidney, and suprarenal gland. Right half of the transverse colon distal ascending colon hepatic flexure
Lower Right Quadrant
In the right lower quadrant (RLQ), the ileum, cecum, vermiform appendix, ascending colon, and right ureter are predominant.
Upper Left Quadrant
In order, the left upper quadrant (LUQ) includes the liver lobe, spleen, stomach, jejunum, proximal ileum, pancreas body and tail, left kidney, left suprarenal gland, left half of the transverse colon, splenic flexure, and superior part of the descending colon.
Lower Left Quadrant
Left lower quadrant (LLQ): distal descending colon, sigmoid colon, left ureter . Both the left and right lower quadrants house the urinary bladder, uterus, and ovary/uterine tube, depending on gender.
Abdominal Regions Divisions
The nine-region abdomen scheme may seem more complicated than the four-region scheme. However, it can help localize clinical symptoms and speed up diagnosis. Two vertical and two horizontal planes divide the nine segments. Left and right midclavicular lines are vertical planes. They run caudally from the clavicle midpoint to the inguinal ligament midpoint.
Subcostal and transtubercular planes are horizontal. The subcostal plane runs horizontally through both sides of the tenth costal cartilage’s lower border. Last, the transtubercular plane passes through the iliac crest tubercles and fifth lumbar vertebra body. The epigastric region is central and superior to the right and left hypochondriac regions on either side of the abdomen. Right and left lumbar regions surround the central umbilical region, which has the umbilicus at its center. Lastly, the right and left inguinal areas are below the hypogastric area, which is the lowest part of the central line.
According to pain physicians in Dallas, each of the nine regions will be listed chronologically from left to right:
- Left Hypochondrium: The left hypochondriac region includes the stomach, liver lobe top, kidney, spleen, pancreas tail, small intestine, transverse colon, and descending colon.
- Right Hypochondrium: The right hypochondriac region includes the liver, gallbladder, small intestine, and ascending colon.
- Epigastric Area: The epigastric region comprises the esophagus, stomach, liver, spleen, pancreas, kidney, ureters, and adrenal glands.
- Left Lateral/Lumbar: The left lateral region includes the small intestine, descending colon, and left kidney.
- Right Lateral/Lumbar: The right lateral region includes the inferior liver lobe, gallbladder, small intestine, ascending colon, and right kidney.
- Umbilical Region: The umbilical region encompasses the stomach, pancreas, small intestine, and transverse colon. Medial extremities of the right and left kidneys’ inferior poles and ureters.
- Left Inguinal Region: This area comprises the descending colon, sigmoid colon, small intestine, left ovary, and left uterine tube (in females).
- Right Inguinal: In females, the right inguinal region includes the small intestine, vermiform appendix, cecum, ascending colon, right ovary, and right uterine tube.
- Hypogastric Area: The hypogastric region comprises the small intestine, sigmoid colon, rectum, urinary bladder, ureters, uterus, ovaries, ductus deferens, seminal vesicles, and prostate gland.
Clinical Significance
Quadrants of abdomen and regions help locate pain and determine treatment. The LUQ may hurt from kidney stones, inflammatory bowel disease, or ovarian cysts. RLQ pain indicates Crohn’s, endometriosis, and inguinal hernia, while LLQ pain indicates pelvic inflammatory diseases. RUQ pain is common in gastric reflux or pancreatitis, while right iliac pain is usually appendicitis.