Links to other anatomy blogs added...

(... located at bottom left of this page.)

Mnemonic for the Lumbar plexus.

System for studying anatomy.

Due to a number of requests for some advice on studying techniques, I have prepared the following…

Anatomy is one of those subjects where you do, in fact, usually get out of the course what you put into it. Fortunately, this means that most students are quite capable of earning a high grade. Unfortunately, this means that what you have to put in is time – especially for a dissection course. If you dedicate yourself to doing well in the course, the time will be well spent.

Below is a study system that I (and many of my subsequent students) have successfully used for learning anatomy. It may give you some ideas on how you might study for this course:

First, read the lecture notes before the lecture.

I recommend that you prepare (read ahead) at least a couple lectures, because there will be lectures that will pertain directly to the dissections. For example, one week there may be a lecture on the muscles of the back and shoulder, which you could already be dissecting the week prior…

Additionally, each lecture will likely contain material that is conceptual in nature, and not simply identification. If you have not prepared in advance, this material may not be easy to grasp during lecture. As cliche as it is, "there is no substitute for good planning."

If the notes are in outline form, use them as such: understand the Objectives, and then look at how the notes are organized (read the Roman numerals, then capital letters). Only after you have done this, go back and read the “meat” of the notes. This will help you to understand the organization and pattern of the regional anatomy.

Secondly, do the supplemental reading (anatomy textbooks, atlases, etc.) for the lecture before the lecture (I recommend doing this immediately after reviewing the lecture notes).

Thirdly, read the lab notes, Grant’s Dissector and Moore & Dalley’s before the applicable lab day. If you don’t know what you are supposed to do each day (and have some idea how to do it), your dissections will go very slowly. If they are too slow, you will take more than your share of the allotted time, and hold up the other groups at your table. Your tablemates will not appreciate this, and it will be your fault.

Next, prepare “cheat sheets” for the labs, for every dissection (even the ones that you do not do). This should be done before the applicable dissection is started (if you are performing it; by the presentation otherwise). Or… if you feel that it’s too much work, arrange for the groups at your table to make up the sheets for their dissections, and have them bring hardcopies for everyone at your table no later that the lab before the applicable presentation. I highly recommend typed sheets for legibility (esp. if others do them for you).

The structures to be listed on the lab “cheat” sheets can be culled from a variety of sources, such as:

Lab notes

Lecture notes (see above)

Grant’s Dissector (every structure in boldface or italics)

Moore & Dalley’s

Netter’s flash cards

The muscle charts (origin/insertion/action/innervations/blood supply) are a useful study tool, since we are

responsible for that material. The info to complete them can be found in the sources above (esp. the last three

and online (see links at left).

Okay… the sample (below) is of my lab “cheat” sheets that I made for one of the Gross anatomy courses that I have taken. What I did was make up these… guides… that I used during my dissections (a list of what to find and make sure not to blow) and presentations (everything to point out). I create them in Excel (easier column creation and text justification), but use whatever you are comfortable with. I highly recommend that you organize your cheat sheets by dissection regions. Additionally, the muscle charts included on most cheat sheets include all muscles that are viewable in this region, not just those that are assigned to the specific dissection; review and global understanding is an important part of learning anatomy…

Next, learn the organizational patterns of anatomy within the regions. For example:

The common origins of muscle groups

Why structures are named as they are

How origins and insertions affect actions

Innervations of muscle groups

Muscular “compartments” (# of muscles included, common actions and/or innervations, etc.)

Mnemonics

Dermatomes and cutaneous nerve distributions

etc.

Second-to-last, fill in the specifics by memorization:

muscle charts

arterial/nervous system diagrams

lab “cheat” sheet structures contained within specific regions

"triangles,” "spaces," etc. (contents and borders)

Finally, review everything, OFTEN!!!!!!!!!!

Review lecture notes within one day of initially reading them, and again the day after that. Research shows that retention decreases dramatically after 24 hours from initial introduction, so reviewing two days in a row should really help you learn the material!

Use the Netter’s flash cards to test yourself during any available free time (e.g. in the 10 minutes before a class starts, during a meal break, etc.)

Review the material from the lab “cheat” sheets during open lab time, on as many cadavers as possible! As you cover each structure, mentally review everything that you have learned about it.

Attend as much “Open Lab” time as possible! The more time you spend reviewing anatomy, the more the material will stick. I also highly recommend that you spend open lab time reviewing cadavers other than your own! You have all your normal lab time to learn your cadaver’s anatomy, but you need to understand anatomical variation and how the same structures can appear different from one specimen to another. Remember, you will not be tested on just your cadaver, but all of them…

Find or form a study group. Testing (quizzing) each other is a great way to learn.

I’m sure that you noted that the key to studying anatomy is to prepare ahead of time. Unlike most undergrad work, you will have to teach yourself most of the material, so be prepared to invest the time and effort necessary to learn the material. When taking Gross anatomy courses, I have spent 2-4 hours studying during the weekdays and an entire day on the weekend (8 hours or so). Obviously, this system takes a lot of time, so you may well want to figure out what works for you…

Good luck!

Mnemonic for retroperitoneal organs.

Kids-------Kidneys
Under-----Ureter
Swings----Suprarenal Gland
Are--------Aorta
In----------Inferior Vena Cava
Severe----Sympathetic trunk
Pain-------Pancreas (except tail)
And-------Ascending Colon
Deep------Descending Colon
Danger----Duodenum (segments 2 & 3)

Which long bone ossifies first?

The clavicle is the first (long) bone to ossify in the body, starting at about the fifth or sixth week of fetal life. It is followed shortly by the femur, which first exhibits ossification at around the seventh prenatal week. The clavicle is also one of the last to finish growing (generally during the 25^th year)!

Flexor digitorum superficialis and profundus mm.

The tendons of the Flexor digitorum superficialis (FDS) m. insert onto the intermediate phalanges of digits II-V, while the Flexor digitorum profundus (FDP) m. inserts onto the distal phalanges of those digits. This breaks the ‘rule’ in which more ‘superficial’ muscles insert farther distally along a limb than muscles originating from deeper levels. How is this possible?

It is possible because the FDS tendons split (see pics, below), allowing the tendons of FDP to come up from underneath and between the FDS tendon(s). Due to this, the FDS tendons can insert onto the intermediate phalanges, while the FDP tendons to insert onto the distal phalanges.

A good way to demonstrate this when presenting a hand dissection is to insert a probe under the FDP tendon after it comes up through the split FDS tendon, then pull up (anteriorly) to exacerbate the situation:

Pictures from http://www.turntillburn.ch/ttbs/en/med/ringband.htm.

These muscles have analogs in the feet: the Flexor digitorum brevis (FDB) m. works as the FDS does (although it is an intrinsic muscle of the foot), while the Flexor digitorum longus (FDL) m. (extrinsic to the foot) fulfills the same function as the FDP. The tendons are oriented as they are in the digits of the hand, with the tendons of the FDB splitting to allow the FDL tendons to pass through and insert onto the distal phalanges of digits II-V.

The Carpal Tunnel

The ‘carpal tunnel’ consists of ten structures (9 tendons for three muscles, and the median nerve) that pass over the carpal bones and under the flexor retinaculum. The relationship of the ten structures to each other is important for identification as well as the understanding of Carpal Tunnel Syndrome.

Picture from: http://www.aidmycts.com/_img/carpal-tendon.jpg.

The four tendons of the Flexor digitorum superficialis m. are located anterior to (on top of) the four tendons of Flexor digitorum profundus m., and are ‘stacked’ with the tendons to digits III and IV over lying the tendons to digits II and V (see below, click pic to enlarge).

Picture from: 2006 Elsevier Inc. Atlas of Human Anatomy 4^th Edition, Frank H. Netter MD, NetterAnatomy.com

As you can see from the pictures, the Median n. is located anteriorly within the carpal tunnel. When this nerve is compressed due to various issues (swelling of surrounding tissues, mechanical impingement, etc.), often resulting from repetitive motion, the result may be Carpal Tunnel Syndrome. A common treatment for this condition is the surgical release of the transverse carpal ligament (flexor retinaculum).