Anatomy Lesson 9: “The Gathering” or “Gore by a Boar”

Anatomy Lesson #9: Tibialis Anterior, Femoral Artery and Intestines.

Holiday greetings fledging anatomists! Hope ye have been good since my last post. This lesson follows Starz episode 4, The Gathering. It also contains lots o’ anatomy so let’s begin!

Warning: if ye havna seen episode #4 or are a wee bit squeamish, this post contains a graphic photo of Geordie’s innards; ye’ll get a second warning just before it comes inta view.

Starting off, I nearly choked on me ale when naughty Angus, that shagger of wee beasties, offers Claire a look-see under his kilt! Claire’s no likely to forget that sight! Speaking of kilts, at the end o’ this lesson I’m gonna show ye what is under a Scotsman’s kilt. But, dinna be scrolling to the end just yet! Ye will want ta read through yer anatomy lesson first…

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Claire is headed out on the hunt thinking boars are just wee, hairy piggies. Our stylish lassie is outfitted in the latest over-the-shoulder, wicker medical basket wit’ a fine leather strap.

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But, her first physicking is fer a young man gored by a boar. Near the knee, a horrific meaty-looking wound gapes the length o’ his right leg (see Anatomy Lesson #7). The gash is huge and Claire applies a nice field dressing while givin’ him holy hell fer messin’ wit’ the pigs. She tells him he will walk with a limp!

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Now, let’s puzzle out the anatomy of this wound. Ye may ken from Anatomy Lesson #7 that anatomists divide the lower limb into thigh, leg and foot. Ye also ken that the leg contains two bones (Photo A): the larger, medial tibia and the smaller, lateral fibula. The tibia, or shin bone, has a sharp anterior border and a broad medial surface ye can easily palpate (feel) through yer own skin. Try it. These tibial surfaces are so superficial that they are easily barked on projections such as stair risers.

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Photo A

The gash (indicated by the red dashed line in Photo B) runs the length of tibialis anterior (Photo B, black arrow) a fleshy leg muscle just lateral to the anterior tibial border. Test yer own tibialis anterior muscles this way: wit’ the legs side-by-side, stand on yer heels. Ye’ll see fleshy bumps to the side of each tibia – the tibialis anterior muscles. If yers aren’t verra fleshy, read on ta find out how to strengthen them!

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Photo B

Tibialis anterior arises (takes origin) from the tibia, turns into tendon, angles across the ankle joint and ends (inserts) on foot bones near the instep (Photo C). It has two major functions: it inverts the ankle (the sole faces the midline) and it lifts the foot at the ankle (dorsiflexion) allowing the toes to be pulled up and held in a locked position. This muscle is critical for walking, running, kicking a ball, or any activity that requires moving the leg or keeping the leg vertical. Now ye ken why Claire warns the young man that he will walk wit’ a limp.

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Photo C

Ye can strengthen yer own tibialis anterior using a verra simple exercise (Photo D). Tie an exercise band around an upright, place the loop over the foot (not just the toes) and dorsiflex the foot against tension. Repeat on the other side gradually increasing the number of repetitions over time. Ye can also find tibialis anterior strengthening exercises on YouTube.

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Photo D

TAKE NOTE! Flawed running technique, poor athletic shoes, overuse, etc., can cause tibialis anterior muscles to become seriously inflamed (redness, swelling, pain, heat, and loss of function). In Photo E the inflammation is so extensive ye can see the entire course o’ the muscle and its tendon just under the skin!

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Photo E

Movin’ on: Claire’s next challenge is puir Geordie whose gory thigh bears multiple lacerations from a boar’s tusk! Claire correctly concludes that the gouges missed his femoral artery because there is no spurt ta the blood flow.

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Where is Geordie’s femoral artery? Weel, the (common) femoral artery starts at the inguinal ligament accompanied by a vein and nerve of the same name (Photo F). It bears another name before passing behind the inguinal ligament but it doesn’t concern us just now. Soon, (2-3 inches) it passes behind the sartorius and vastus medialis muscles (see Anatomy lesson #7) too deep fer a boar tusk ta reach.

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Photo F

Ready fer a wee bit o’ self-examination? Or, ye can play doctor with a friend!…Snort! Lie on your back and put yer fingers in the groin near the middle of the thigh. Move them up and down. Do ye feel a thick band? This is the inguinal ligament (Photo I – black arrow). Next, place yer middle and ring fingers just below the inguinal ligament and press deep. Ye should feel a strong, even pulse; this is the femoral artery! It lies deep just below the middle o’ the inguinal ligament (Photo G – green arrow). It is often as big as yer thumb because it supplies blood to the entire lower limb (almost).

Hint: ne’er take a pulse with yer thumb or index finger as these vessels have their own pulses that may interfere wit’ yer assessment. The femoral artery is catheterized for diagnostic purposes and medical intervention.

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Photo G

Weel, if Geordie’s femoral artery wasna gored, where did all that dark blood come from (ye ken that arterial blood is bright red and venous blood is deep red). It came from tributaries of the great saphenous vein (GSV), the longest vein in the body (Photo H)! Saphenous is from the Greek meaning “to manifest” because often it can be seen through the skin. The GSV begins in the foot and courses up the inside of the leg and thigh ending in the femoral vein. It receives numerous tributaries (dashed oval in Photo H) along its path and these are the sources of Geordie’s blood. Claire stems the bleeding with a tourniquet knowing that she can stitch the lacerations and save his leg.

WARNING: The next image shows Geordie’s gut wound.  Scroll past if ye dinna wish to see it!

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Photo H

But, sadly, Claire kens puir Geordie’s other wound: a hugh gash through the belly wall exposing globs of yellow fat (green arrows) and loops o’ intestine! This wound will be fatal in the 18th century and can be today because it exposes a normally sterile space to the outside world wit’ its teeming hordes of bacteria! She canna do anything fer him except take him ta a peaceful place! Kind Claire!

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As anatomists, we should learn from Geordie’s wound. The loops shown are o’ small intestine; how do we ken that? Easy! Inspect the loop surfaces and see that they are smooth so this is small intestine; if the loops have pouches (haustra) then it is large intestine (see Photo I – black arrows). The small intestine is divided into duodenum, jejunum and ileum but we see only jejunum and ileum as the duodenum lies too deep.

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Photo I

BTW, again verra good special effects because globs of yellow fat show just under Geordie’s belly skin. Anatomists call this layer the superficial fascia of the anterior abdominal wall. But, a shorter name is Camper’s fascia (Photo J). The depth of the fatty layer depends on us. The more belly fat, the thicker Camper’s fascia; the leaner we are, the thinner Camper’s fascia! Clearly, Geordie is a slim-Jim.

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Photo J

After Claire telegraphs puir Geordie’s fate, Dougal cradles him gently in his arms (finally a kind deed!) – we hear them reliving fun times together…stealing kine, terrorizing the neighborhood, swiving Geordie’s bonny sister Doreen. What’s a guid friend fer, aye?

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Next, Dougal arrives at the shinty field leading a horse carrying puir Geordie wrapped in a plaid death shroud (the great kilt scores again!). A rough but good-spirited game is in progress. Is it Geordie’s death or seein’ his damn nephew playin’? Either way, a black-clad Dougal roars onto the field like an 18th century Darth Vader (and boy! Isn’t he in braw, shinty-fighting form!)! He is filled wit’ rage and looking fer victims!

OK, time fer an anatomy review pop quiz!  So, please git out paper and pencil and keep score…

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First, Dougal clips an unwitting player from behind! Dirty pool! (Hey, who’s that running ahead o’ Unca D. and victim #1)? Clipping in the US version of football has been banned for almost 100 years (one type is still permitted in the NFL and CFL). Why is clipping so dangerous? Can ye puzzle it out?

Anatomy quiz question #1: Clipping puts what knee structures at risk?

 

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If ye answered the medial or collateral ligaments and/or the medial or lateral meniscus (see Anatomy Lesson #7) then give yerself 15 points!

A wee aside: why doesn’t Dougal ever wear a kilt? He’s always dressed in breeches. I’d love ta know what the dickens that is all about! Mayhap he gits saddle sore or is jealous of Jamie’s knees? He seems jealous of everythin’ else about the lad!

Next, Dougal shoulders a friend or foe into the fire pit!

Anatomy quiz question #2: What body part(s) does Dougal use to shove the man into a fiery pit?

 

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If ye answered acromion, point of shoulder and/or arm (see Anatomy Lesson #2 and Anatomy Lesson #3) then give yerself another 15 points!

Then, Dougal goes after Jamie big time. Whoa! Watch out Big Red! Yer ever lovin’ uncle is after ye!

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Then, Angus (he looks so funny in his poufy kilt) joins the fray ta help Dougal beat up on Jamie. Murtagh, Jamie’s ever watchful god-father, stops Angus in his tracks wit’ a shinty stick to the nether regions! Sorry Angus, but ye shouldna ha’ been so cheeky strutting yer stuff to Mistress Beauchamp!

Anatomy quiz question #3: What body part(s) did Murtagh hurt?

 

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Weel, ye dinna need an anatomy lesson ta’ figure this one out!  If ye answered testicles, baws or any of at least 100 other names, then gie yerself 50 points! Yep. Ye ken these parts are super important and worth a whole lot more points! Ouch! Nothin’ does it like a good whack ta the stones – and I don’t even ha’ any! I havena taught an Anatomy Lesson yet on these goodly body parts but I likely will.

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Then Dougal and Jamie go at it over the shinty ball followed by a mess o’ blows ta Jamie who remains the high born Scottish gentleman that he is! Finally, Jamie has enough and wit’ a great heave, hoists Dougal o’er his right shoulder!

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Anatomy quiz question #4: What body part might Jamie hae damaged wit’ this mightly effort (Dougal is a big man, aye)?

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If ye said shoulder joint re-dislocation (see Anatomy Lesson #2) then gie yerself another 20 points!

When I saw Jamie standin’ there nodding to Claire (he always knows right where she is) with his right shoulder droopin’ and his palm turned  backwards me thinks, CRAP, he’s done it again!

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What do I mean? Weel, once a shoulder has been dislocated, it’s much easier another time. Also, the position of Jamie’s drooping right upper limb is consistent wit’ an anterior dislocation which looks like this (Photo K – ken the black arrow on the acromion?):

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Now adding up the points, what was yer final score? Kudos if it was 100%!

Now, I’m done wit’ this anatomy lesson, but I have more ta say about “The Gathering”. I just canna help meself!

I thought Claire is the only time traveler at Castle Leoch, but no, there are two others! First, there’s the lovely Fiona and Mrs. Fitz is sharpenin’ claws on her!

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Then, there’s the elegant, hand wavin’, finger pointin’ Moore! He looks mighty dapper!

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Next, I love where Murtagh explains the oath takin’ ta Claire. I swear she is the only woman he ever speaks to. Mayhap ‘tis because her smile is as sweet as Jamie’s mother? And, that gown! OMG! Terry and her team work their magic again!

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Then, the hilarious scene between Claire and Angus over the “Spanish” sedative. Ha! She even spits her mouthful of port on the floor. Oh yeah, Claire! That is more like it – she an irreverent leddy wit’ a wicked sense of humor! If she and Angus weren’t at such odds, they’d probably be besties!

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Next, I must riff on Claire’s cynical horse dung love potion for an unsuspecting Jamie. Handing it to that nasty lassie LogHair, Claire instructs her to scatter it on his threshold, click her heels together three times and recite “There’s no place like love,” “There’s no place like love.” I dinna ken if ye recognize it but this line is straight out of the Wizard of Oz where the Good Witch of the North tells Dorothy to click her heels together three times and repeat “There’s no place like home,”  “There’s no place like home!” Since the W of O was released in 1939 Claire could have seen it at a cinema. If ye believe in time travel, then it’s possible!

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Finally, I love the intimate scene where Claire stumbles over Jamie in the stables. Fichu and ribbons not-wit’-standing, she left a trail of bread crumbs to mark her escape route? Ha! People, this is verra funny! I live in a forest and bread crumbs willna last more than a few minutes wit’ all the furry, wee beasties around. Would it be different in 18th Century Scotland?

After some difference of opinion, Claire reveals she walloped Dougal over the head with a chair. Jamie rubs the back o’ his heid sayin’ he hopes she left a good mark so Dougal will remember his error in judgment. Mayhap his rubbin’ is in sympathy fer puir Dougal? More likely, he’s feelin’ a 6” scar on the back o’ his own heid left by a wicked Lochaber ax (from the Outlander book) – likely wielded by his connivin’ uncle Dougal!

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Here’s what one o’ those wicked 18th century things looks like:

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OK, I’m leavin’ ye wit’ the photo I promised at the start o’ this lesson: what does a Scotsman wears under his kilt? I added the star, ye ken? Back in 2004 when this photo was taken, Queen Elizabeth did indeed visit the 1st Battalion of Argyll and Sutherland Highlanders. If ye wish ta see the full monty (I’m bettin’ ye do) then search online fer “Scotsman seated next to the Queen” and up, er, pops the whole kilt and kaboodle! Ha! This photo is a bit o’ an urban legend and Snopes rates it as un-determined authenticity. But, the Colonel (Snopes identifies him) sports such a cheeky grin that I canna help thinkin’ the photo is likely real – but, this man is no saying one way or the other!

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I do hope ye enjoyed this post. Please tune in 14 days from now for Anatomy Lesson #10, Jamie’s back! Until then, I wish ye the happiest of holiday seasons. Be safe! Take good care of yer amazing bodies!

Be sure to follow me on Facebook and Twitter!

The deeply grateful,

Outlander Anatomist

All photos are credited to Starz,Netter’s Atlas of Human Anatomy 4th ed., Hollingshead’s Textbook of Anatomy, 5th ed., www.wikihow.com, www.wikipedia.org, Bodyspace.bodybuilding.com, www.sportsmed.or.nz, www.Radiopaedia.or, www.Wikipedia.org, www.home.southernct.edu, www.williammitchellsstudio.com, www.bodyspace.bodybuilder, www.thesportsphysio.wordpress.com, www.pinterest.com

Anatomy Lesson 7: “Jamie’s Thighs – Ode to Joy!”

Anatomy Lesson #7, Jamie’s Thighs, is a true ode to joy! I hope Ludwig won’t be offended by my reference to his 9th, but the title perfectly suits this lesson! Perfect timing with the upcoming US Thanksgiving Holiday.  I’m down on my knees giving thanks because Jamie’s knees also appear in this lesson! 🙏🏻

Are you ready? Let’s go!

Just to prove my goodwill, take a gander at Jamie’s knees in the image below. May this tide you over as our lesson proceeds!

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Definitions: Let’s begin with a few basic tidbits, otherwise much of this lesson might remain obscure!

  • Joint – Site where bones meet and move relative to each other
  • Muscle – Muscles attach to bones (some exceptions); these are voluntary meaning we can contract them at will – a.k.a. skeletal muscle
  • Contraction – As muscles contract, a joint moves in various ways (Image A)
  • Origin – Attachment site of muscle to bone – site moves little or not at all during contraction
  • Insertion – Attachment site of muscle to bone – site moves during contraction
  • Flexion – Muscle contraction closes (approximates) bones of a joint
  • Extension – Muscle contraction opens (straightens) bones of a joint

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Image A

Lower limb: Our lower limbs are the body parts from hip joints to toes. Anatomists don’t use the terms upper and lower leg. Rather, the lower limb is divided into (Image B):

  • Thigh – segment between hip and knee joints
  • Leg – segment between knee and ankle joint
  • Foot – segment beyond ankle joint

BTW, the dashed blue line in Image B represents a vertical midline through the body. A medial structure lies closer to this midline – lateral structure lies further from this midline. That’s the gist of it!

Try this: Locate your thigh, leg, foot and midline.

Test Q: Are your tiny toes medial or lateral to your middle toes?

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Image B

Test A: They are lateral. Great job!

Outlander Time! The first time we rencounter Jamie’s thighs is in Outlander book where Claire straddles-his-saddle on the way to Castle Leoch. Herself writes:

My companion seemed to be having little trouble, in spite of being unable to use his right hand. I could feel his thighs behind mine, shifting and pressing occasionally to guide the horse. I clutched the edge of the short saddle in order to stay seated; I had been on horses before, but was by no means the horseman this Jamie was.

And yet another quote from Outlander book – this one from randy-dandy, Jamie:

But then that ride through the dark together….with that lovely broad arse wedged between my thighs…

Well! Starz Claire doesn’t sport a broad arse, but it surely is curvaceous and pert and we all ken where it was wedged during this ride!  Mmphm!

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Back to anatomy and more about bones!

Femur: The thigh contains one bone, the femur. I love superlatives, so here’s the first one for this lesson: the femur is the longest bone of the human body (Image C – front of right femur). The top of each femur ends in an angled neck and head that fits securely into the acetabulum, a deep socket of the hip bone Together, they form the acetabulo-femoral (hip) joint, a ball and socket joint.

Fun Facts: You may recall from Anatomy Lesson #2, When Claire Meets Jamie or How to Fall in Love While Reducing a Dislocated Shoulder Joint!:  although the glenohumeral (shoulder) joint is very moveable it is also less stable due to a shallow ball and socket joint! Conversely, each hip joint is very stable but less moveable due to a deep ball and socket joint. The hip joint needs to be stable to support our weight against gravity. Very interesting!

At the knee, the femur ends in two sturdy knobs, medial and lateral condyles (Greek for knuckle); both knobs help form the knee joint (Image C).

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Image C

Tibia and Fibula: The leg contains two bones, tibia and fibula (Image D – front of right leg bones). The larger tibia is medial to the smaller, more lateral, fibula. The top of tibia ends in two flat surfaces, the medial and lateral condyles; lower down, it bears a midline knob, the tibial tuberosity. Only tibia helps form the knee joint; fibula plays no role.

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Image D

Patella: The small patella or knee cap is critical to knee anatomy. Patella is the largest sesamoid bone of the body (there are others) meaning it is enveloped in tendon. Its deep surface slides in a groove between medial and lateral femoral condyles as the knee joint extends and flexes (Image E – front of right knee joint).

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Image E

Thigh Muscles: Yes! Thigh muscles are massive because they support much of our weight and help maintain our bipedal stance against gravity.

There are 13 thigh muscles divided into three compartments. To keep this lesson shorter than a bloody master’s thesis, we will cover only quadraceps femoris (Latin meaning four-headed muscle of the femur) with a wee bit about iliopsoas muscle.

Quadraceps: The quads (as trainers call them) are four muscles at the front of each thigh:

    • rectus femoris
    • vastus lateralis
    • vastus intermedius
    • vastus medialis

Image F (front of right thigh) shows the three of the quad muscles. A fourth, vastus intermedius, is visible only after removal of rectus femoris  (Image G).

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Image F

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Image G

Origins: Each quad muscle has a different origin (Image H –  red marks). Rectus femoris originates from hip bone and crosses both hip and knee joints . The three vasti (pl.) muscles take origin from different sites on the femur and cross only the knee joint.

Insertion:  All four muscles  fuse into a common quadraceps tendon that engulfs the patella and then continues as the patellar ligament to insert (Image H – blue mark) on the tibial tuberosity.

Actions: Acting together, all four heads of each quad extend the knee joint but only rectus femoris also flexes the hip joint.

Because quads are the only muscles that extend the knee joints, they are crucial for walking, running, jumping and squatting. Quads are also called anti-gravity muscles because they contract as we rise from a seated position or lower our bodies in reverse, holding our weight against gravity (think of thighs during snow skiing or Jamie lowering Claire onto the marriage bed. Yum!).

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Image H

Iliopsoas: One last muscle… Although recti femoris (pl.) are decent hip flexors, iliopsoas muscles are the strongest. Like the quads, iliopsoas is a compound muscle formed by fusion of iliacus and psoas (pronounced soas) muscles.

Iliacus arises from the hip bone and psoas arises from the lumbar vertebrae (Image I – right front). They fuse into a single tendon that inserts into the femur. These muscles draw the femur closer to the torso, assisted by rectus femoris and a few other minor hip flexors. Or, with thighs held stationary, they draw torso closer to thighs (think sit-ups).

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Try this: To test your quads, place back against a wall.  Drop the tush while walking your legs away from the wall until you assume a squat position (Image J). Thighs and legs should be at 90° to each other (don’t drop lower – this is bad for knee joints!). Now hold your torso in place for 30 seconds and then gradually straighten (extend) the knee joints. If you feel wobbly, then you may need quad work as these muscles quickly lose mass and strength due to inactivity, sedentary jobs or aging. Quads can be strengthened by wall squats or by any exercise that adds resistence while extending the knee joint!

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Image J

Knee Joint: Now on to the knee jointlargest joint of the human body (Image K – right side and front)! Here medial and lateral femoral condyles (knuckles) ride atop a flat plateau formed by the medial and lateral tibial condyles – no stable joint here!

All bony surfaces of knee joint are covered with articular cartilage, a bloodless, firm connective tissue that allows for smooth movement. This odd joint also has medial and a lateral meniscus (different type of cartilage) that create two shallow sockets atop the tibial plateau – one for each femoral condyle; these also act as shock absorbers.

As mentioned above, the patella glides between the femoral condyles during flexion and extension.

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Image K

Knee Ligaments: The knee is stabilized by very strong ligaments designed to secure the tibia and femur (Image L – right knee in full flexion – patella absent):

  • medial (tibial) collateral ligament
  • lateral (fibular) collateral ligament
  • anterior cruciate ligament
  • posterior cruciate ligament (and, there are others!)

Overall, the knee joint is at risk due to our sports-crazy cultures and because supporting the body weight while in motion is a challenge for these relatively flat surfaces. Hence, the über-strong ligaments.

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Image L

Now, for the fun stuff!  I promised in Anatomy Lesson #3 that I would be returning to the scene where Jamie dismounts to grab Claire (Starz episode 101, Sassenach).  Yep, that’s the one!  Let’s relive that scene wherein we first spy Jamie’s thigh – aye, readers, there’s a first time for everything.  Hah!

Wait fer it…………….”Lost yer way?”

Wait fer it……….. Jamie’s shifts his weight. Um…..he looks a wee bit fashed!

Wait fer it.…. With a high kick Jamie’s right thigh clears the steed’s neck. Yay, iliopsoas!

Wait is over! Jamie’s drops.  Gad, this lad has loooooong legs!!!!  Thank gawd that kilt didna do its job here! (That impressive thigh muscle is vastus lateralis!)

A firm landing and further evidence of those thighs and knees!

This just keeps getting better and better! Geez, Jamie is a perfect anatomical model!

Three of four quad heads are visible as he strides towards Claire. The red arrow points to the head of rectus femoris! (Claire! why aren’t ye laid out in a swoon?)

OK, Claire, now you are in fer it! Ye’re gonna get what ye deserve!  Oops, sorry, wrong  Starz episode.  (Thinking 109, The Reckoning). Snort!

Okey dokey then, are you ready for a pop quiz? Let’s go for it!

Can you identify one of Jamie’s quads in the next image (Starz episode 7, The Wedding)?

Q: Name the major bulge (no, not that one! <G>) on the inside of his thigh (red arrow).

A: Right vastus medialis muscle. Good job!

Q: The light is dim, but name the quad at the red arrow.

A: Left vastus lateralis muscl– just peeking out from under his wedding sark. He is sooo modest!

Back to anatomy!

Knees: Now for those gorgeous knees!  I know gazillions of you have been awaiting another glimpse of Jamie’s knees!  Sorry to mess them up with a quiver of arrows, but just so you ken:

  • Blue arrow marks his lateral femoral condyle
  • Red arrow is his medial femoral condyle
  • Green arrow marks his patella
  • Orange arrow is his tibial tuberosity.

So now you can name all the knuckles and knobs o’ Jamie’s knees!

Claire, lift your eyes lass! He squatted down to show off his gorgeous gams! He kens he is one damn fine-looking Scot – grubby sark or no!image

Almost done, so hang with me!

IT Band: Lastly, thigh muscles are wrapped in a strong sleeve of connective tissue, the fascia lata (Image M – right lower limb). Fascia lata thickens at the side to form the iliotibial (IT) tract or IT band (Anatomy Lesson #1, Jamie’s Tush).

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Image M

Now, for more applied anatomy! The red arrow marks a thick ridge of tissue at the back of Jamie’s thigh (Starz episode 101, Sassenach). Yep, that’s his right IT band! You can see it plain as Rupert swigging that raw whisky!

Fascia lata Function: You all should understand the importance of the fascia lata and IT band. The heart faces a long haul to pump venous blood against gravity from the foot back to the chest. Thigh muscle contractions help milk venous blood back toward the heart. Fascia lata aids this process by compressing contracting muscles against the deep thigh veins.

Danger!  If thigh muscles get seriously injured, they swell and the inelastic fascia lata does not stretch to accommodate the swelling. When this happens, it is a medical emergency because swollen muscles restrict the return of venous blood to the heart and diminish the flow of oxygen-rich arterial blood to the lower limb – and, as you ken, tissue dies if deprived of oxygen!

This condition is known as compartment syndrome and the next photo (Image N) shows the result of medical intervention. This is the right thigh of a former students (he gave permission to post). After injuring his thigh muscles, the swelling threaten necrosis (death) of his thigh muscles so surgeons slit his fascia lata (near the IT band) to relieve pressure and re-establish blood flow. Now, when he contracts his right quads, they bulge through the slit in the fascia lata! An excellent visual of how the fascia lata compresses the thigh muscles!

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Image N

Okey dokey, with this example, we come to the end of our thigh and knee lesson! But, I’ll not leave you bereft. Here is one last image designed to increase your admiration and respect for Jamie’s anti-gravity quads and iliopsoas muscles!

In this, ahem, modest scene from Starz episode 7, The Wedding, Jamie bears Claire’s entire weight (9 stone or 126 lb – Herself records in Outlander). Then, he slowly lowers their combined weight (about 23 stone/322 lb?) to the bed afore he flips her over! That takes a whole lot of quad strength!  Are you impressed?  <G>

Ok, mukkers, that’s it for now. Please stay tuned for our next lesson.  Still gobs of anatomy to cover as we work our way through the first eight episodes of Outlander!

The lessons are deliberately slow-paced to keep us occupied until Starz episode 109 makes its way into our hearts and minds!

Oh, almost forgot. You can now follow me on Facebook, Tumblr, IG and Twitter.

The deeply grateful,

Outlander Anatomist

Image credits: Starz, Grant’s Atlas of Anatomy, 10th ed., Netter’s Atlas of Human Anatomy, 4th ed., Clinically Oriented Anatomy, 5th ed, www.AuthenticFX.com, www.gouletballet.com, Wikipedia, OA archival photos, AAOC Website, Tumblr.com

Anatomy Lesson #6: “Claire’s Hair – Jamie’s Mane” or “Jesus H. Roosevelt Christ!”

Hallo again, friends of Outlander Anatomy! Today’s Anatomy Lesson #6:  The Skin – Part 2, Hair, will continue with skin but, today, will focus on hair, hair follicles, arrector pili muscles and sebaceous glands, all of which you learned from Skin Part 1 are made by skin and are therefore appendages of this organ.

Now, before we get on with today’s lesson, I must confess that I did a quiet switcheroo on you in the last anatomy lesson. My first four lessons were confined to that part of human anatomy known as gross anatomy, the field revealed by human dissection.

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Nay…not that kind of gross, Rupert!  It is termed “gross” not because it is yucky, but because it deals with structures visible to the naked eye. In Anatomy Lesson #5, I switched (without telling) to another field of human anatomy, that of microscopic anatomy.

Microscopes are used to magnify structures too wee for us to see with eyes unaided by magnifying lenses. Many of today’s images are drawings made from images observed with a compound microscope such as this one (photo A):

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photo A

Once again there are 3-D images taken with powerful SEM/scanning electron microscope (Photo B). I have used both types of microscopes many times in teaching and various research projects!

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photo B

Now, getting in the mood for today’s Anatomy Lesson: Skin 2 – the Hair! As with skin, Herself often writes about hair in the Outlander books, offering her audience a more intimate glimpse into characters and situations through vivid use of this physical trait. So, once again, I begin our lesson with images from the Starz Outlander series and with words from the Outlander books.

Let’s begin with our heroine. Early in Starz episode 1, Sassenach, Claire emerges from the roadster standing in the picturesque village of Inverness.  We can clearly appreciate her dark brown hair – very full and very curly.

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Later, during a lighting storm, Herself writes

The wind was rising and the very air of the bedroom was prickly with electricity. I drew the brush through my hair, making the curls snap with static and spring into knots and furious tangles!

The humid air makes Claire’s hair wildly curly and disobedient (Starz, episode 101, Sassenach) to which she exclaims: Jesus H. Roosevelt Christ!!!

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All the while, someone is awatching her futile struggles through the window of her room.

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Nay, it isn’t a peeping tom, it is a keeking Jamie! Ha!

This next image of Claire always makes me laugh! In Starz episode 102, Castle Leoch, Mrs. Fitz unceremoniously rouses Claire from her sleep, seats her in a chair and hands her a cup ‘o brakfast fer her empty belly. Mrs. Fitz then whisks it away afore Claire even finishes! Look at Claire’s hair! It is absolutely fabulous! She certainly looks like the “wee milkweed” Jamie affectionately calls her later in the Outlander book.

“Fretful porpentine, was it?” he asked. He tilted his head, examining me inquisitively. “Mmm,” he said, running a hand over his head to smooth down his own hair. “Fretful, at least. You’re a fuzzy wee thing when ye wake, to be sure.” He rolled over toward me, reaching out a hand. “Come here, my wee milkweed.

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With these great images to set the mood, it is time for our anatomy lesson on hair and with it a lot of  juicy tidbits to share!

First, the length of body hair varies a lot – from less than 1 mm (.04 in) on the forehead to well over 1 m (3.3 ft) with long scalp hair (Photo C)! But, the wee hairs of the eyelids (not the eyelashes) are so short they barely reach the skin surface! And, you should know that most hair grows very rapidly, about 0.3 mm/day or 1 cm/per month.

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photo C

You should also know that hair does not grow straight out of the skin; it emerges at a slant (Photo D).

Try this: Check the angle of growth of your own hair: place your forearm on a flat surface with the palm down. Examine your forearm hairs and see that they are angled toward the little finger side of the forearm. That’s the slant I’m a talking about.

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photo D

Hair is also denser in some skin areas than in others: the face has about 600 hairs/cm2 (.16 in2) compared to about 60 hairs/cm2 on the rest of the body. 

Hair diameter also varies greatly but even the coarsest hair is only about .5 mm (.02 in) in diameter (Photo E). Even so, a scalp hair is strong enough to support the weight of 100 gm (3.5 oz)!

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photo E

Another interesting tidbit: Human hair grows autonomously; each hair cycles at its own pace through periods of growth and periods of quiescence. If all our hair were on the same cycle, we would molt!

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And sometimes our hair does unspeakable things and we just have to pull it outta the way like Angus here who does prefer a wee bit o’ purple ribbon fer his scalp hairs!

Now back to microscopic anatomy! Using the same image from Skin – Part 1, I’ll be reminding ye that skin is divided into a thin outer epidermis that overlies a thicker dermis. And, although not part of skin the hypodermis lies deeper still. The dermis and hypodermis also anchor structures that we’ll cover in this anatomy lesson: hair, hair follicles, arrector pili muscles, and sebaceous glands (Photo F).

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photo F

Hairs emerge from hair follicles which are down growths of the epidermis (Photo G). The internal anatomy of each follicle is verra complex so I’m simplifying it: the hair and its follicle are divided into a hair root and a hair shaft. At the root is a bulb where cells divide and push older cells toward the surface to form the hair shaft!

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photo G

Along the way, hair cells harden and get plastered together so by the time the hair clears the skin surface, the cells are dead, flat and stiff with their free edges pointing toward the hair tip. They also overlap each other like shingles on a roof (Photo H). This is a SEM image of a single hair!

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Photo H

Ye should also ken that hair follicles are verra sensitive to the influence of hormones! These chemicals produce secondary sex characteristics such as hair distribution. In fact, the distribution of hair between the two sexes play an important role in socio-sexual communications!

In women, estrogens (oestrogens) cause most body hair to develop as short, thin vellus hairs that are anchored in the dermis. Both genders exhibit the coarse terminal hairs of scalp, eyelashes, eyebrows, axilla and pubis that are embedded deep in the hypodermis.

In men, androgens (testosterone being the most important) also convert facial and chest hairs into terminal hairs. Now then, isna this the right place to offer praises to Dougal MacKenzie who won Saturday’s Starz contest with his comely beard? Congrats! It looks mighty fine on ye, man! Tulach Ard!

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And, no anatomy lecture is ever complete without at least one image of a half-dressed Jamie! So here is his chest hair just in case ye be forgettin’!  No verra damn likely! Gawd!

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Something else: When viewed by SEM, straight hair has a round shaft as seen in this photo of scalp hair (Photo I –computer generated color); the surrounding dead skin cells look like scatter leaves on a forest floor.

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Photo I

Murtagh’s scalp offers a perfect example of straight hair – here he is explaining to Claire why Jamie is nowhere to be seen (Starz episode 5, Rent)! Plus, he has mighty fine eyes and braw eyebrows just in case ye been so focused on Jamie that ye havena been noticing!

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Scalp hair that is curly like Claire’s…

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…has a shaft that is flattened in cross-section as shown in this SEM image (Photo J). The flatter the shaft, the curlier the hair!

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Photo J

Now, onto a couple of other structures associated with the hair follicle. First, stretched between the follicle and the dermis is a thin band of tissue, the arrector pili muscle. Second, between the hair follicle and the arrector pili muscle lays one or more sebaceous glands with ducts opening into the hair follicle (Photo K). Sebaceous glands produce sebum, a complex mixture of fats, waxes and other materials.

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photo K

The arrector pili muscles are made of smooth muscle cells that are not under conscious control. They contract in response to cold or the fright, flight, fight reflex! Contractions of this muscle elevate the hair, forming goose bumps or goose flesh and help squeeze sebum from the sebaceous glands into the hair follicle and onto the hair shaft (Photo L).

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Photo L

Contraction of the arrector pili muscles in animals traps air between the erect hairs to retain body heat or to help the creature appear more fierce (Photo M)! This adaptation isn’t of much use to us short haired humans but the release of sebum does help lubricate and protect the hair itself.

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Photo M

Finally, on to hair color! Like the epidermis, hair color requires the presence of melanin; melanocytes in the hair bulb synthesize melanin and package it into granules that move up the hair shaft as it forms. Now, it turns out that there are a couple of different types of melanin!

Like Claire, most hair color is due to the presence of varying amounts of brown or black eumelanin. But, now, ye are in fer a BIG surprise! I bet ye dinna ken this! Flaming red hair in one such as our Great Scott, Jamie, contains a chemically different type of melanin known as pheomelanin and this molecule is red (or red-brown)! Thus, Jamie’s gorgeous mane of red hair is due to the presence of pheomelanin as seen from the back in this image (Starz episode 7, The Wedding)!

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And just so ye won’t ferget it, here is Jamie’s hair from the front! We can literally see the words Herself wrote in Outlander about his hair:

…a mass of auburn, copper, cinnamon and gold all gleaming together in the morning sun…

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And one last point fer yer eddycation: Check out both upper corners of Jamie’s forehead. See how the hair line is squared off? This is known as the temporal notch; it is a secondary sexual characteristic in men brought about by the influence of testosterone. Women typically have an oval hairline in the corresponding areas of the forehead!

And now, folks, our journey through the skin and its appendages has come to an end! I do hope you have enjoyed learning about the skin ye are in and that of the Outlander cast while we are at it! At some point in the future, I will post Skin 3 – The Breast.

In the meantime, I’ll be leaving ye with these lovely words from Herself in the Outlander book and an image from Starz episode 7 (The Wedding):

You’ve the loveliest hair,” said Jamie, watching me.  ….”But it’s so .…curly,” I said, blushing a little….“Aye, of course.” ….He sat up and tugged gently on one curl, stretching it down so that, uncurled, it reached nearly to my breast…

And:

 “Mo duinne?”…“It means ’my brown one.’ ”He raised a lock of hair to his lips and smiled, with a look in his eyes that started all the drops of my own blood chasing each other through my veins. Rather a dull color, brown, I’ve always thought,”….”No, I’d not say that, Sassenach. Not dull at all.”  He lifted the mass of my hair with both hands and fanned it out. “It’s like the water in a bern, where it ruffles over the stones. Dark in the wavy spots, with bits of silver (auburn on Starz) on the surface where the sun catches it.”

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Gah, this man has a way with words! Does he ever say anything wrong?  Just look at the look on Claire’s face! She’s both enchanting and enchanted!

Psst…next time, I will be writing about someone’s thighs and knees (guess whose?)! Stay tuned!

The deeply grateful,

Outlander Anatomist

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Photo credit: Starz, Cat photo from goosecam Edmonton Journal, Goosebumps from genius.com, Basic Histology by Junqueira and Carneiro, 11th ed., University of Leeds, Rochester education Foundation, Wikipedia, WebMD, Loyola University Dermatology website, Histology Guide, University of Leeds, Wikimedia.org. CSIR – Council for Scientific and Industrial Research, South Africa. OA archival photos, Aersol Research – Washington University St. Louis