A reappraisal of adult thoracic and abdominal surface anatomy in Iranians in vivo using computed tomography

Abstract

Surface anatomy is a core component of human anatomy in clinical practice. It allows clinicians to assess patients accurately and quickly; however, recent studies have revealed variability among individuals and ethnicities. The aim of this study is to investigate possible variations in adult thoracic and abdominal surface anatomy landmarks in an Iranian population. This study used 100 thoracoabdominal CT scans (mean age: 47 ± 17 years, age range: 20-77 years, 47% females), noted the most common locations of clinically relevant surface markings, and analyzed correlations between these variables and age or gender. While many common surface markings in Iranians were consistent with the evidence-based literature, there were some differences. In relation to the corresponding segments of the vertebral column, the superior vena cava formation and the lower border of the pleura adjacent to the vertebral column and right kidney tended to be at higher levels in adult Iranians than a Caucasian population. There were also discrepancies between the Iranian population and commonly-referenced medical textbooks and recent evidence-based literature concerning the vertebral levels of the diaphragmatic openings of the esophagus, aorta, and inferior vena cava. This study emphasizes the need to consider evidence-based reappraisals of surface anatomy to guide clinical practice. Much of our current knowledge of surface anatomy is based on older studies of cadavers rather than living people, and does not take ethnic and individual variations into consideration.

Apprasial of the surface anatomy of the Thorax in an adolescent population

“…In children younger than 7 years old, it is reported that the cardiac apex lies in relation to the fourth ICS, and at the 5, sixth ICS in older children (Tasker et al ; Park ). This is similar to what was reported in the current study and in recent adult population studies (Mirjalili et al ; Pak et al ; Shen et al ; Keough et al ), as well as in children younger than 4 years old (Fischer et al ) where the cardiac apex was reported at the fifth ICS on the left. Fischer et al () had found that the cardiac apex children older than 4 years old were in relation to the fourth ICS and fifth rib.…”

“…The previously mentioned studies looking at pediatric surface anatomy focused mainly on ages 0–12, whereas adult population studies focused only on individuals over 18 years of age (Chukwuemeka et al ; Mirjalili et al , , ; Pak et al ; Shen et al ; Uzun et al ; Keough et al ). Based on the groups (pediatric and adult), the age range between 12 and 18 years (the adolescent age group) has not been evaluated or compared previously.…”

The thoracic surface anatomy of adult black South Africans: A reappraisal from CT scans

“…We focused on CT scans of adult black South Africans for comparative purposes. We compare our results to the in vivo surface anatomical landmarks of adults of Chinese (Shen et al, ), European (Mirjalili et al, ), Iranian (Pak et al, ), and Turkish (Uzun et al, ) ancestry.…”

A reappraisal of pediatric thoracic surface anatomy

“…The accuracy of surface anatomy was therefore called into question by Hale and his colleagues (2010) and it was recognized that an evidence‐basis for surface anatomy was required (Mirjalili and Stringer, ). An evidence‐basis for surface anatomy in adults and pediatrics has subsequently been developed (Mirjalili et al ; Uzun et al ; Koch et al ; Pak et al ; Shen et al ) using in‐vivo Computed Tomography (CT) scans.…”