Understanding Abdominal Anatomy: A Simple Guide

Question
Dr. Borucki,

I am just a little confused by anatomy. I know the stomach is really in the upper abdomen, not lower like most people think. And I think the liver, spleen, gallbladder, kidneys, etc are all in the upper abdomen as well. I am just trying to figure out which one is where. Well, specifically, which *one* is *there*. :D

I'm going to ask first in lay terms, as I am unsure of my medical terminolgy. I'm trying to figure out what is directly below the apex of the rib cage, between the lower ribs, and closest to the skin.

I have looked over my Gray's Anatomy and many websites, but I'm still unclear. It looks like the liver is there. But it also looks like the liver is set-back some (as in, not close to the skin). And the many references I see say the liver is pretty much covered by ribs. But it looks like the stomach is down a little lower, so I am thinking it isn't that either.

If I have my medical terms correct (which I'm not sure of) then this is what I would be asking: What organ (or tissues, etc) lie directly inferior to the sternum (or xiphoid process), between the costal margins, and in the most anterior position?

I appreciate the help!

Katy

Answer
The anatomy obviously is very complicated.... if you were able to remove the skin, then remove the muscle wall, you would see the stomach right there in the center below the ribs.  On the right side, you would see the liver, with the gall bladder embedded underneath and up in the lower part.  Then, the small intestines come off the stomach, and loop back and forth, then change to the large intestines in the right lower abdomen where the appendix is, then they loop up to the liver, across, right under the stomach, then down from the left upper abd to the left lower area, then loop around in the pelvis and out thru the butt.

Now, the pancreas and kidneys are "retroperitoneal organs" which means that if you emptied all the above stuff out, then you would have an empty cavity and would have to dig deeper, through the back wall of the abd cavity and thru some muscle to get to those organs.  They are not in the general abd cavity.  Not sure all that helps, because hollow organ pain is referred pain, which means when an organ is inflamed or diseased... the pain is expressed in a general area, for example, heart pain during a heart attack is chest, jaw, left arm; appendix pain is around the belly button, even tho it is in the right lower area.

Hope this answers your questions...