Abdomen

Quadrants
Right Upper
Quadrant
(RUQ)

Description

Doctors often assess this portion to localize pain and

tenderness.
Organs found in this quadrant include the liver, the gall
bladder, duodenum the upper portion of the pancreas
and the hepatic flexure of the colon.
The RUQ is commonly tender in cases of hepatitis,
cholecystitis and with the formation of a peptic ulcer.
Right Lower
The right lower quadrant extends from the median plane
Quadrant
to the right side of the body and then from the umbilical
(RLQ)
plane to the right inguinal ligament.
Important organs found in the right lower quadrant
include the appendix, the upper portion of the colon, the
right ovary and Fallopian tube in women and the right
ureterpenus.
The right lower quadrant may be assessed when
diagnosing appendicitis in which case this quadrant
would be tender and painful.
Left Upper
The left upper quadrant rests alongside the RUQ. The
Quadrant
left upper quadrant is formed by the median plane
(LUQ)
extending to the left of the patient and with the
umbilical plane to the left rib cage.
Organs found in the left upper quadrant are the
stomach, the spleen, the left portion of the liver, and the
main body of the pancreas. The left portion of the kidney
and the adrenal gland are also found in this quadrant.
The splenic flexure of the colon and the bottom portion
of the colon also sit in the left upper quadrant.
The LUQ will be tender and a point of interest in cases of
appendicitis and abnormalities of the intestines such as
malrotation.
Left Lower
The left lower quadrant is located below the umbilicus
Quadrant (LLQ) plane. Essential organs found in this region include the
bottom portion of the colon, the sigmoid colon, the left
ovary, Fallopian tube and the left uterine tube.
The doctors will assess this area if there is abdominal
pain in this region. Abdominal pain in the LLQ may be a
symptom of colitis, diverticulitis, or ureteral colic. Pain in
this region may also be caused by ovarian cysts or a
pelvic inflammation. Tumors found in this region can be
serious determinants of colon or ovarian cancer.

Abdomen
Regions

Organs

Right
Hypochondrium

Liver, Gallbladder, Right Kidney, Small Intestine

Left
Hypochondrium

Spleen, Colon, Left Kidney, Pancreas

Epigastrium

Stomach, Liver, Pancreas, Duodenum, Spleen, Adrenal

Glands

Right Lumber
Region

Gallbladder, Liver, Right Colon

Left Lumber
Region

Descending Colon, Left Kidney

Umbilical
Region

Umbilicus, Jejunum, Ileum, Duodenum

Right Iliac Fossa Appendix, Cecum

Left Iliac Fossa
Hypogastrium

Descending Colon, Sigmoid Colon

Urinary Bladder, Sigmoid Colon, Female Reproductive
Organs

The primary survey is a quick maneuver that attempts to identify life-threatening

problems, as follows:

To assess the airway, ask the patient's name. If the answer is articulated clearly,
the airway is patent.
The oral pharynx is inspected for blood or foreign materials.
The neck is inspected for hematomas or tracheal deviation.
The lungs are auscultated and percussed for signs of pneumothorax or
hemothorax.
The radial and femoral pulses are palpated for strength and rate.
A quick inspection is made to rule out any external sources of bleeding.
A gross neurological examination is performed by asking the patient to squeeze
each hand and dorsiflex both feet against pressure. Advanced trauma life support
(ATLS) suggests that a "miniature" neurologic examination categorizes the
patient's level of consciousness by whether the patient is alert, responds to voice,
responds to pain, or is unresponsive (ie, AVPU).

The patient then is exposed completely, taking care to maintain thermoregulation

with blankets and external warming devices.
The secondary examination is a head-to-toe, careful examination that attempts to
identify all injuries, as follows:

The scalp is inspected for bleeding. Any active bleeding from the scalp should be
controlled before proceeding with the examination.
The mouth and pharynx are examined for blood.
The abdomen is inspected and palpated. Distention, pain on palpation, and
external ecchymosis are indications of intra-abdominal bleeding.
The pelvis is palpated for stability. Crepitus or instability may be an indication of a
pelvis fracture, which can cause life-threatening hemorrhage into the
retroperitoneum.
Long bone fractures are noted by localized pain to palpation and boney crepitus
at the site of fracture. All long bone fractures should be straightened and splinted
to prevent ongoing bleeding at the sites. Femur fractures are especially prone to
large blood losses and should be immobilized immediately in a traction splint.
Further diagnostic tests are warranted to diagnose intrathoracic, intra-abdominal,
or retroperitoneal bleeding.