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Abdominal quadrants and the organs in each
Two lines crossing at the belly button divide the abdomen into four quadrants: right upper (liver, gallbladder), left upper (stomach, spleen), right lower (appendix, cecum) and left lower (sigmoid colon). For an abdominal assessment, inspect, then auscultate, then percuss, then palpate.
Organs by quadrant
| Quadrant | Main organs | Pain may suggest |
|---|---|---|
| Right upper (RUQ) | Liver, gallbladder, part of the duodenum, head of the pancreas, right kidney | Gallbladder disease (cholecystitis), liver problems |
| Left upper (LUQ) | Stomach, spleen, body and tail of the pancreas, left kidney | Spleen injury, stomach problems |
| Right lower (RLQ) | Cecum, appendix, right ovary and fallopian tube, right ureter | Appendicitis (McBurney point), ovarian problems |
| Left lower (LLQ) | Sigmoid colon, descending colon, left ovary and fallopian tube, left ureter | Diverticulitis |
The nine regions
- Top row: right hypochondriac, epigastric, left hypochondriac.
- Middle row: right lumbar, umbilical, left lumbar.
- Bottom row: right iliac (inguinal), hypogastric (suprapubic), left iliac (inguinal).
- Epigastric pain can come from the stomach or pancreas, and sometimes from the heart.
How to assess the abdomen, in order
- Inspect: shape, scars, distention, visible movement.
- Auscultate: listen in all four quadrants before touching, because pressing can change bowel sounds.
- Percuss: tympany over gas, dullness over organs or fluid.
- Palpate: light, then deep, and save any painful area for last.
NCLEX tip: The abdomen is the one exam where you auscultate before you palpate. On the NCLEX, the correct order is inspect, auscultate, percuss, palpate.
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Frequently asked questions
What organs are in the right upper quadrant?
Mainly the liver and gallbladder, plus part of the duodenum, the head of the pancreas and the right kidney.
Which quadrant is the appendix in?
The right lower quadrant. Pain at McBurney point, about one third of the way from the right hip bone to the belly button, is a classic sign of appendicitis.
Why listen to the abdomen before palpating?
Pressing on the abdomen can change bowel sounds, so you auscultate first to hear them as they are.
Keep studying
Sources
- Anatomy and Physiology 2e, 1.6 Anatomical Terminology, OpenStax
- Clinical Nursing Skills, 27.2 Physical Assessment, OpenStax
- Abdominal Examination, StatPearls, NCBI Bookshelf
For study only, not medical advice. Ranges and protocols vary by facility; follow your program, your facility's policies and the provider's orders.