Atlas of Human Anatomy by Netter

FACTS & HINTS

High-Yield Facts

Clinical Points

McBurney's Point and Appendicitis

McBurney's point: A surface landmark that roughly indicates the location of the appendix, located approximately one third of the way along a

line from the anterior superior iliac spine to the umbilicus.

Appendicitis: inflammation of the appendix. Pain first presents in the epigastric region, moves to the umbilical region and then localizes in

the right lower quadrant. Rupture of the appendix leads to peritonitis (inflammation of the peritoneum). This presents with severe pain, fever,

and abdominal rigidity.

Muscle-splitting incision (of McBurney): used to access the appendix. Each muscle layer is split in the direction of the fiber orientation. The

incision must not go too far laterally or the ascending branch of the deep circumflex iliac artery may be severed.

Clinical Points

Grey-Turner's sign

Local right flank redness or bruising (ecchymosis)

Indicates a retroperitoneal hemorrhage

Usually takes 24 to 48 hours to appear

Can be predictive of severe hemorrhagic pancreatitis, abdominal injury, or metastatic cancer

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Clinical Points

Cullen's sign

Discoloration (ecchymosis) around the umbilicus

A result of peritoneal hemorrhage

Mnemonics

Memory Aids

Causes for abdominal expansion (protuberance):

Remember the five Fs: Fat

Feces

Fetus

Flatus

Fluid.