McBurney's point
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2008-06-21T04:25:36Z
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{{Infobox Anatomy |
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Image = McBurney's point.jpg|
Caption = Location of McBurney's point (1), located two thirds the distance from the [[umbilicus]] (2) to the [[anterior superior iliac spine]] (3). |
Image2 = Stomach_colon_rectum_diagram.svg |
Caption2 = Normal location of the appendix relative to other organs of the digestive system (anterior view). Cecum and appendix are visible at bottom left. |
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DorlandsPre = p_26 |
DorlandsSuf = 12653438 |
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'''McBurney's point''' is the name given to the point over the right side of the human [[abdomen]] that is one-third of the distance from the ASIS ([[anterior superior iliac spine]]) to the [[umbilicus]]. This point roughly corresponds to the most common location of the base of the [[Vermiform appendix|appendix]] where it is attached to the [[cecum]].
The [[anterior cutaneous branch of iliohypogastric nerve]] is found near McBurney's point.<ref name="isbn0-7817-5309-0">{{cite book |author=Kyung Won, PhD. Chung |title=Gross Anatomy (Board Review) |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2005 |pages=255 |isbn=0-7817-5309-0 |oclc= |doi=}}</ref>
==Clinical relevance==
Deep tenderness at McBurney's point, known as '''McBurney's sign''', is a sign of [[acute appendicitis]].<ref name="titleDefinition: McBurney's sign from Online Medical Dictionary">{{cite web |url=http://cancerweb.ncl.ac.uk/cgi-bin/omd?McBurney's+sign |title=Definition: McBurney's sign from Online Medical Dictionary |accessdate=2007-12-06 |format= |work=}}</ref>
The clinical sign of rebound pain when pressure is applied is also known as [[Aaron's sign]]. However almost every surgeon and doctor misquote 'McBurney's point as shown incorrectly in the diagram. Charles McBurney described a point in his original article about this subject in the Annals of Surgery. He described his point as being ''One inch from the anterior superior iliac spine (ASIS)on a line drawn from the ASIS to the umbilicus. The incision is four inches long one third above the line and two thirds below the line''. This is so often misquoted that there are no surgical text books with the correct description in them (Even Bailey and Love). Now that the Annals of Surgery are available on-line with a search facility all surgeons in training must look at his original article as it quotes the gridiron approach.
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. Because the location of the appendix is often different in different people, and can migrate within the abdomen, many cases of appendicitis do not cause point tenderness at McBurney's point. Other abdominal processes can also sometimes cause tenderness at McBurney's point. Thus, this sign is highly useful but neither necessary nor sufficient to make a diagnosis of acute appendicitis. Also, 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.
==Eponym==
The sign is named for [[Charles McBurney (surgeon)]], U.S. surgeon, 1845–1913. <ref>[http://www.whonamedit.com/doctor.cfm/572.html Charles McBurney (www.whonamedit.com)<!-- Bot generated title -->]</ref>
== See also ==
* [[Human superficial anatomy]]
* [[Rovsing's sign]]
==References==
{{reflist}}
==External links==
* {{cite journal |author=Naraynsingh V, Ramdass MJ, Singh J, Singh-Rampaul R, Maharaj D |title=McBurney's point: are we missing it? |journal=Surgical and radiologic anatomy : SRA |volume=24 |issue=6 |pages=363–5 |year=2003 |pmid=12652363 |doi=10.1007/s00276-002-0069-7}}
{{Torso general}}
[[Category:Medical signs]]
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