McBurney's point | |
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Identifiers | |
FMA | 11362 |
Anatomical terminology |
McBurney's point is the point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus (navel). This is near the most common location of the appendix.
McBurney's point is located one third of the distance from the right anterior superior iliac spine to the umbilicus (navel). [1] [2] This point roughly corresponds to the most common location of the base of the appendix, where it is attached to the cecum. [3]
Deep tenderness at McBurney's point, known as McBurney's sign, is a sign of acute appendicitis. [1] [2] [4] The clinical sign of referred pain in the epigastrium when pressure is applied is also known as Aaron's sign. Specific localization of tenderness to McBurney's point indicates that inflammation is no longer limited to the lumen of the bowel (which localizes pain poorly), and is irritating the lining of the peritoneum at the place where the peritoneum comes into contact with the appendix.
Tenderness at McBurney's point suggests the evolution of acute appendicitis to a later stage, and thus, the increased likelihood of rupture. Other abdominal processes can also sometimes cause tenderness at McBurney's point. [5] Thus, this sign is highly useful but neither necessary nor sufficient to make a diagnosis of acute appendicitis. [5] The anatomical position of the appendix is highly variable (for example in retrocaecal appendix, an appendix behind the caecum), which also limits the use of this sign, as many cases of appendicitis do not cause point tenderness at McBurney's point. For most open appendectomies (as opposed to laparoscopic appendectomies), the incision is made at McBurney's point. [6]
A pseudoaneurysm in the aorta may be treated surgically, with an incision made between McBurney's point and the lower intercostal spaces. [7]
McBurney's point may be a useful site for insertion of a peritoneal dialysis catheter. [8]
McBurney's point is named after American surgeon Charles McBurney (1845–1913). [1] [6] McBurney himself did not locate his point in a precise way in his original article.
The seat of greatest pain, determined by the pressure of one finger, has been very exactly between an inch and a half and two inches from the anterior spinous process of the ilium on a straight line drawn from that process to the umbilicus
— Charles McBurney, "Experience with Early Operative Interference in Cases of Disease of the Vermiform Appendix"; New York Medical Journal , 1889, 50: 676–684 [pg 678].
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis.
The appendix is a finger-like, blind-ended tube connected to the cecum, from which it develops in the embryo.
An appendectomy or appendicectomy is a surgical operation in which the vermiform appendix is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acute appendicitis.
The umbilical artery is a paired artery that is found in the abdominal and pelvic regions. In the fetus, it extends into the umbilical cord.
Rovsing's sign, named after the Danish surgeon Niels Thorkild Rovsing (1862–1927), is a sign of appendicitis. If palpation of the left lower quadrant of a person's abdomen increases the pain felt in the right lower quadrant, the patient is said to have a positive Rovsing's sign and may have appendicitis. The phenomenon was first described by Swedish surgeon Emil Samuel Perman (1856–1945) writing in the journal Hygiea in 1904.
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen. Auscultation (listening) of the abdomen with a stethoscope. Palpation of the patient's abdomen. Finally, percussion (tapping) of the patient's abdomen and abdominal organs. Depending on the need to test for specific diseases such as ascites, special tests may be performed as a part of the physical examination. An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity (including the liver, spleen, large or small intestines), or simply as a part of a complete physical examination for other conditions. In a complete physical examination, the abdominal exam classically follows the respiratory examination and cardiovascular examination.
The psoas sign, also known as Cope's sign or Obraztsova's sign, is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation.
The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation.
The anterior superior iliac spine (ASIS) is a bony projection of the iliac bone, and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis. It provides attachment for the inguinal ligament, and the sartorius muscle. The tensor fasciae latae muscle attaches to the lateral aspect of the superior anterior iliac spine, and also about 5 cm away at the iliac tubercle.
The abdomen is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. The area occupied by the abdomen is called the abdominal cavity. In arthropods, it is the posterior tagma of the body; it follows the thorax or cephalothorax.
The internal iliac artery is the main artery of the pelvis.
In human anatomy, the inferior epigastric artery is an artery that arises from the external iliac artery. It is accompanied by the inferior epigastric vein; inferiorly, these two inferior epigastric vessels together travel within the lateral umbilical fold The inferior epigastric artery then traverses the arcuate line of rectus sheath to enter the rectus sheath, then anastomoses with the superior epigastric artery within the rectus sheath.
Postural drainage (PD) is the drainage of lung secretions using gravity. It is used to treat a variety of conditions that cause the build-up of secretions in the lungs.
Valentino's syndrome is pain presenting in the right lower quadrant of the abdomen caused by a duodenal ulcer with perforation through the retroperitoneum.
The retromandibular vein is a major vein of the face. It is formed within the parotid gland by the confluence of the maxillary vein, and superficial temporal vein. It descends in the gland and splits into two branches upon emerging from the gland. Its anterior branch then joins the (anterior) facial vein forming the common facial vein, while its posterior branch joins the posterior auricular vein forming the external jugular vein.
The obturator sign, also called Cope's obturator test, is an indicator of irritation to the obturator internus muscle.
The glenoid labrum is a fibrocartilaginous structure attached around the rim of the glenoid cavity on the shoulder blade. The shoulder joint is considered a ball-and-socket joint. However, in bony terms the 'socket' is quite shallow and small, covering at most only a third of the 'ball'. The socket is deepened by the glenoid labrum, stabilizing the shoulder joint.
The testicular vein, the male gonadal vein, carries deoxygenated blood from its corresponding testis to the inferior vena cava or one of its tributaries. It is the male equivalent of the ovarian vein, and is the venous counterpart of the testicular artery.
The rectovesical pouch is the pocket that lies between the rectum and the bladder in males in humans and other mammals. It is lined by peritoneum.
In surgery, a surgical incision is a cut made through the skin and soft tissue to facilitate an operation or procedure. Often, multiple incisions are possible for an operation. In general, a surgical incision is made as small and unobtrusive as possible to facilitate safe and timely operating conditions.