McBurney's point
Location of McBurney's point (1), located two thirds the distance from the umbilicus (2) to the anterior superior iliac spine (3).
Normal location of the appendix relative to other organs of the digestive system (anterior view). Cecum and appendix are visible at bottom left.
Dorlands/Elsevier	p_26/12653438

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 appendix where it is attached to the cecum.

The anterior cutaneous branch of iliohypogastric nerve is found near McBurney's point.^[1]

Clinical relevance

Deep tenderness at McBurney's point, known as McBurney's sign, is a sign of acute appendicitis.^[2] 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. ^[3]

See also

• Human superficial anatomy
• Rovsing's sign

References

External links

• Naraynsingh V, Ramdass MJ, Singh J, Singh-Rampaul R, Maharaj D (2003). "McBurney's point: are we missing it?". Surgical and radiologic anatomy : SRA 24 (6): 363-5. doi:10.1007/s00276-002-0069-7. PMID 12652363. 

General anatomy of torso
Thorax/ Thoracic cavity	Mediastinum (Superior, Anterior, Middle, Posterior) • Superior thoracic aperture • Inferior thoracic aperture • Triangle of auscultation • Intercostal space • Thoracic plane • Thoracic wall/Thoracic cage - fascia (Pectoral fascia, Clavipectoral fascia, Thoracolumbar fascia) • Chest • Midsternal line
Thoracic diaphragm	openings (Caval opening, Esophageal hiatus, Aortic hiatus, Foramina of Morgagni) • Central tendon • Crus of diaphragm • arcuate ligaments (Lateral, Medial, Median)
Abdomen/ Abdominal cavity	Retroperitoneum • Paracolic gutters • Hepatobiliary triangle anterior abdominal wall (Arcuate line, Linea alba, Tendinous intersection, Linea semilunaris, McBurney's point, Traube's space, Inguinal triangle) • Inguinal canal (Deep inguinal ring, Superficial inguinal ring, Intercrural fibers, Crura of superficial inguinal ring) • Lumbar triangle • regions (Epigastrium, Hypochondrium, Umbilical region, Latus, Hypogastrium, Inguinal region) • planes (Transpyloric plane, Intertubercular plane, Midclavicular line) fascia (Fascia of Camper, Fascia of Scarpa, Transversalis fascia, Renal fascia, Rectus sheath)
Pelvis/ Pelvic cavity	Pelvic floor • Retropubic space fascia (Pelvic fascia, Superior fascia of diaphragm of pelvis, Inferior fascia of diaphragm of pelvis, Fascia of the Obturator internus, Tendinous arch, Iliac fascia, Iliopectineal fascia)
Perineum	Anal triangle (Ischioanal fossa, Pudendal canal, Anococcygeal raphe) Urogenital triangle (Superficial perineal pouch, Deep perineal pouch) Perineal body fascia (Dartos/fascia of perineum/superficial perineal fascia/Fascia of Colles, Perineal membrane/"Inferior fascia of UGD", "Superior fascia of UGD")

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Source: adapted by the editor from Wikipedia, the free encyclopedia under a copyleft GNU Free Documentation License (GFDL) from the article "McBurney's point"