Regions of the abdomen
The regions of the abdomen are theoretical divisions used by clinicians to help localize, identify and diagnose a patients symptoms. There are two main forms of categorization, the first which is simpler and is mapped out by dividing the abdomen into four quadrants, while the second method divides it into nine segments.
Either of these two ideas about the abdominal regions are internationally recognized and can be used on a daily basis during clinical practice. It is simply up to the physician on how they wish to present their findings.
This article will discuss both schemes and include a list of the internal organs and other important anatomical structures that can be found within each region.
Four region scheme |
Principle: vertical line through linea alba (median plane) crosses horizontal line through the umbilicus (transumbilical plane) -> four quadrants: right upper quadrant (RUQ), right lower quadrant (RLQ), left upper quadrant (LUQ), left lower quadrant (LLQ) Quadrants: RUQ - LUQ | | RLQ - LLQ |
Nine region scheme |
Principle: two vertical midclavicular lines (left and right) cross two horizontal: subcostal (through lower edge of 10th costal cartilage) and transtubercular (through tubercles of iliac crests) -> nine segments: right and left hypochondrium, epigastrium, right and left lumbar regions, umbilical region, right and left inguinal regions, hypogastrium Segments: right hipochondrium - epigastrium - left hipochondrium right lumbar - umbilical - left lumbar right inguinal - hypogastrium - left inguinal |
Clinical relations | Grey-Turner's sign, Cullen's sign |
The four region scheme
Divisions and landmarks
The four anatomical regions of the abdomen are known as quadrants. They are separated by theoretical anatomical lines that can be traced on the abdomen using certain anatomical landmarks. The median plane is that which follows the linea alba and extends from the xiphoid process to the pubic symphysis and splits the abdomen vertically in half. The transumbilical plane is a horizontal line that runs at the level of the umbilicus. These two planes transect at the umbilicus in a cross-like form and divide the abdomen into four quarters.
Before learning everything about the regions of the abdomen, test your knowledge with our quiz:
Right upper quadrant
The right upper quadrant (RUQ), in a craniocaudal order, contains:
- The right lobe of the liver
- The gallbladder
- The pylorus of the stomach
- The 3 first parts of duodenum
- The head of the pancreas
- The right kidney and the right suprarenal gland
- The distal ascending colon
- The hepatic flexure of the colon
- The right half of the transverse colon
Right lower quadrant
The right lower quadrant (RLQ) contains:
- The majority of the ileum
- The cecum and vermiform appendix
- The proximal ascending colon
- The proximal right ureter
Left upper quadrant
The left upper quadrant (LUQ), in a craniocaudal order, contains:
Left lower quadrant
The left lower quadrant (LLQ) contains:
- the distal descending colon
- the sigmoid colon
- the left ureter
Depending on the sex of the individual, both the left and right lower quadrants contain either:
- A ovary
- An uterine tube
- A ductus deferens
- The uterus
- The urinary bladder
Has this article on the regions of the abdomen made you realise that you need to review your knowledge of medical terminology? Check out our guide to basic medical terminology 101.
The nine region scheme
Divisions and landmarks
Compared to the four region scheme, the nine region scheme of the abdomen may seem more complicated. However, it can help to further localize clinical symptoms and arrive at an accurate diagnosis more quickly. There are two vertical planes and two horizontal planes that are used to separate the nine segments. The vertical planes are known as the left and right midclavicular lines. They run from the midpoint in the clavicle caudally towards the midpoint of the inguinal ligament.
The horizontal planes include the subcostal plane and the transtubercular plane. The subcostal plane runs horizontally through the lower border of the tenth costal cartilage on either side. Finally, the transtubercular plane passes through the tubercles of the iliac crest and the body of the fifth lumbar vertebra.
The right and left hypochondriac regions are found superiorly on either side of the abdomen, while the epigastric region sits between them in a central, superior position. The right and left lumbar regions surround the umbilical region, which is central and has the umbilicus as its centre point. Lastly, the right and left inguinal regions are found inferiorly on either side of the hypogastric region, which is the most inferior of the central line of segments.
Each of the nine regions shall now be listed individually, running craniocaudally from left to right:
Left hypochondriac region
The left hypochondriac region contains the:
- The stomach
- The top of the left lobe of the liver
- The left kidney
- The spleen
- The tail of the pancreas
- Parts of the small intestine
- The transverse colon
- The descending colon
Learn everything about the abdominal regions with our videos, quizzes, labeled diagrams, and articles:
Right hypochondriac region
The right hypochondriac region contains the:
- The liver
- The gallbladder
- The small intestine
- The ascending colon
- The transverse colon
- The right kidney
Epigastric region
The epigastric region contains the:
- The esophagus
- The stomach
- The liver
- The spleen
- The pancreas
- The right and left kidneys
- The right and left ureters
- The right and left suprarenal glands
- The small intestine
- The transverse colon
The position of the transverse colon can differ slightly from person to person due its mobile suspension within the transverse mesocolon. It is, however, usually located between the epigastric and umbilical regions of the abdomen.
Left lumbar region
The left lumbar region contains:
- A portion of the small intestine
- A part of the descending colon
- The tip of the left kidney
Right lumbar region
The right lumbar region contains the:
- The tip of the liver
- The gallbladder
- The small intestine
- The ascending colon
- The right kidney
Umbilical region
The umbilical region contains the:
- The stomach
- The pancreas
- The small intestine
- The transverse colon
- The medial extremities of right and left kidneys
- The right and left ureters
- The cisterna chyli
Left inguinal region
The left inguinal region contains:
- Part of the small intestine
- The descending colon
- The sigmoid colon
- The left ovary and the left fallopian tube in females.
Right inguinal region
The right inguinal region contains the:
- The small intestine
- The appendix
- The cecum
- The ascending colon
- The right ovary and right fallopian tube in females.
Hypogastric region
The hypogastric region contains:
- The small intestine
- The sigmoid colon
- The rectum
- The urinary bladder
- The right and left ureters
- The uterus, the right and left ovaries and the fallopian tubes can be found in females
- The ductus deferens, seminal vesicles and prostate in males
Clinical aspects
Grey-Turner’s sign is a redness or bruising that can be seen on the right lumbar region after a period of 24 to 48 hours, indicating a retroperitoneal hemorrhage. Its presence is significant because it can be predictive of severe hemorrhagic pancreatitis, abdominal injury or even metastatic cancer. Cullen’s sign is a discoloration of the skin around the umbilicus and points to a peritoneal hemorrhage.
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