And so day three of dissection has come to an end! It becomes more and more fascinating for every day. For every hour, really. I can't really say it enough - I'm so grateful for this opportunity, and I believe everybody who has anything to do with the human body as their profession should do something like this. It really puts things into perspective! And Dr Todd Garcia is all that a student could wish for in a teacher.
Today started off just like yesterday - taking up the cadavers from the freezer and putting them into the right position on the table. We started off with them on their backs today, to continue work on the arms and legs (separating muscles from each other).
Before doing any work at all, we did a "tour" of the cadavers to see what everybody was working on at their respective tables. That was really interesting!
There's one cadaver who only has four toes on each foot. It is apparently the first time anyone in the group, or Todd himself, has ever come across this phenomena! Today was interesting as the dissection has come to a deeper level, and we would likely be able to tell if she was born like that and if there were any signs of a fifth toe anywhere in there. What the group had discovered at this point was that the tendon that goes down the foot to the little toe was extraordinarily thick, and they suspected that it could be that what would have been the tendon to the little toe (or the one next to it - we don't know which one is missing), had merged with the neighboring tendon as the bone to which that was attached to is really the only thing it could have inserted to (what a confusing paragraph!). All very fascinating!
The next cadaver had a very thick compartment fascia in the calf, looking like an extension of the IT band (which is the tight fascia and going from the hip to the knee). When asked about it, Todd said that there's textbook fascia, and then there's what we see on the table. And in this case the IT band and (relatively thick) fascia of the calf was pretty much the same thing. It's all connected!
We also learned that in "med speak" (=language of doctors!) the leg is actually the part from the knee down, and the thigh is simply the thigh. If we are talking about the whole structure it is referred to as "lower extremity". So now you know that too :)
Going on to the third cadaver we got to look at movement testing in the lower extremities (see what I did there?!), and it was SO cool to see the movement right around the hips, and the ankle during movement. Again, it is great that we get to work with fresh tissue so we can actually MOVE them! The body is a wonder. The group had also found plaque in some of the arteries on the thigh, and getting to feel that was actually quite creepy. Plaque in blood vessels can be caused by high blood pressure, which create small "cracks" in the vessels. Small junk (=like fat, cholesterol and calcium) get stuck in the cracks and builds up over time, increasing the risk of heart attacks, stroke and other unpleasantries. This is not med speak btw. Anyway, the other cadavers had some buildup too, but not quite as much. It felt as it there were small plastic bits in the blood vessel, so no wonder blood vessels with buildup can't function properly!
While moving the legs we got on to another interesting point regarding knee pain. With the muscles now separated we looked at how dysfunction of the calf and foot can inhibit good knee function. Which would make them hurt! Also having tight adductors (=inside of thigh) has a huge effect on how the knee can function properly. It was so cool to see this with no skin, because it became clear that the knee is SO dependent on its neighbors to be able to have a good "working environment"! And just think about how much knee pain we could get rid of, if we only make sure that the tissue above and under the knee actually works! We actually have muscle that connects to the meniscus too, and what do you think would happen if that muscle didn't do its job well?
Next was my groups cadaver, where we got to show some cool upper body movement! I got to show some movement in the hand and forearm, and we also managed to see (thanks to Todd's great eye) the omohyoid inferior in action. To see it we tipped the head back a little to create neck extension + a slight lateral flex (head going to the left), and manually put the arm on the right side in a reach position (so we got tension in the omohyoids, head and arm away from each other). When in the reach position, when I moved the mandible, there was some very nice movement in the muscle. But think of that - your chin is pretty well connected to the shoulder. So what happens if tissue on the front of your neck doesn't work? Wouldn't that likely affect shoulder function? (Yes)
In the last one we also got to see some good neck action. The group had dissected and separated the front very well, so when grabbing the larynx and moving it side to side, there was loads of movement! We also got to learn about how much tension in the muscles around the larynx can affect our voice. Like when we're nervous about something! Another thing I wasn't aware of at all, is that there's actually a connection from the front of the neck to the heart (I forgot the name dammit!), so you can actually stimulate the heart by using the muscles in your neck.. I don't quite understand this let yet, so I'll ask some questions tomorrow!
After the general presentation of the stages of work, we got to go back to actually dissecting. I went even deeper into the forearm and hand, and managed to get it quite "clean" during the day, thanks to a lot of help from Niklas Andersson. I am totally fascinated with this pet of the body! It's insanely complex, beautiful and simply outstanding. Hello fine motor skills!
The carpal tunnel is about as big as my thumb (it fit perfectly in there, once the tendons were removed), and there are plenty of tendons and nerves that needs to have space enough in there to be able to slide through the way they're supposed to. So when finding yourself with symptoms of carpal tunnel syndrome, it's quite possible that you can do something about it by treating the forearm and hand, to try to "make space" in there. Movement makes movement :)
During the last part of the day I continued to do a bit of work on the face and scalp just to clean up from yesterday.
Another GREAT part of today was when we looked more at movement in the shoulder. We first located the musculocutaneous nerve right under the bicep, and then traced it back up to the shoulder. At the shoulder, the pectoralis is coming in over the bicep (biceps being under the pec). With really tight pecs, tension in the bicep is forced (so there will be tension in the biceps even when relaxed, which would cause someone to stand around with slightly flexed arms all the time). Which also means that the risk for a nerve impingement would be pretty likely! We see plenty of people with shoulder and arm issues that train a lot of chest - so this could be part of the explanation of why it occurs so often in that population. So keep your chest balanced - not too tight!
Todd showed us his dissecting skills today when he separated the external abdominal oblique, internal abdominal oblique and the transversus abdominis. I couldn't believe my eyes when I saw the thin layers of muscle - I had expected something thick and probably stiffer. But it does make sense that the abdominal are thinner and goes in different directions. It's where our upper and lower body connects, and it needs to be able to move. It needs to be able to be strong and fast and elastic. One thing that is simply impossible though, is the idea that you'd be able to use one of these muscles by itself (how many people haven't heard they need to strengthen transversus?), since they can only be separated by scalpel and a skilled hand... Its neighbor will move, and then the movement or force will "spread" over muscles, because logically, that means least resistance for the body. If one of these muscles took all the force of movement, people would be broken, like really broken. Anyways. Before we knew it we had reached the peritoneum (=the "sack" which hold the internal organs). I am not looking forward to the smell tomorrow 😳
Last for tonight was a discussion regarding stiff hamstrings (so common). The feel femoral artery has some perforating arteries that goes through the adductor magnus. It is really important that the blood can pass through these arteries in order for the hamstrings to get their blood supply and function! So keeping things moving and elastic in this region is essential.