Fun Fact: Posterior Median Furrow

Anatomy Def: Midline vertical depression in the surface of the back (red arrows).

Outlander Def:  Deep, lovely groove of Jamie’s back!  

Get in the groove and Learn about Jamie’s back furrow by reading Anatomy Lesson #10, Jamie’s Back!

The posterior median furrow (PMF) literally means “back middle groove.” This vertical depression is most visible in thoracic and lumbar regions of the back. It tends to be shallow in the cervical region, diminishes over the sacrum and is continuous with the gluteal cleft (Aye, the sweet cheeks! <G>).

PMF is most visible in those with robust para-spinal (erector spinae) muscles. These muscles flank the vertebral column; the more developed the muscles, the deeper the PMF.

PMF is useful during physical exam because the vertebral spines can be palpated and counted in the groove. Specific vertebral spines mark levels for anesthesia delivery, location of abdominal organs, and vascular anatomy. For example, C3 marks the level of the hyoid bone (wink, wink to book readers).

More Fun Facts: English is replete with idioms about the back. These are  a few of the many:

  • Back away
  • Back me up
  • Back and forth
  • Back to square one
  • Back in the day
  • Back to the drawing board
  • Back down from
  • Back the wrong horse
  • Back to back
  • Back in circulation

Read about Jamie’s posterior median furrow in Outlander book. Yes, Herself describes it! 👏🏻👏🏻👏🏻

Compassionate Claire notes the groove as she describes Jamie’s badly damaged back: 

He sat patiently, not moving as I circled behind him and inspected his back…I was appalled…The scars covered his entire back from shoulders to waist. While many had faded to little more than thin white lines, the worst formed thick silver wedges, cutting across the smooth muscles. I thought with some regret that it must have been quite a beautiful back at one time. His skin was fair and fresh, and the lines of bone and muscle were still solid and graceful, the shoulders flat and square-set and the backbone a smooth, straight groove cut deep between the rounded columns of muscle that rose on either side of it…I tried not to imagine the muscular arms raised…ropes cutting into wrists, the coppery head pressed hard against the post in agony…Involuntarily, I reached out, as though I might heal him with a touch and erase the marks with my fingers. He sighed deeply, but didn’t move as I traced the deep scars, one by one, as though to show him the extent of the damage he couldn’t see.

Och! See Jamie’s PMF in Outlander, episode 105, Rent, after Uncle Dougal rends Jamie’s sark to expose BJR’s handiwork! 😱 Back off, Dougal!

The deeply grateful,

Outlander Anatomist

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Photo Credit: Sony/Starz

Fun Fact: Tendinous Intersection

Anatomy Def: Tendinous intersections are fibrous bands crossing the rectus abdominis muscles and marked by overlying skin grooves (curved red arrow).

Outlander Def: Belly grooves defining Jamie’s six-pack. Woot!

Learn about tendinous intersections (TAs) in Anatomy Lesson #16, Jamie’s Belly or Scottish Six-Pack.

Skin grooves overlying TAs are typically visible only in the lean and fit. Most humans have three pair:

    • Pair near tip of breastbone (xiphoid process),
    • Pair at navel
    • Pair midway between xiphoid and navel

Anatomical Variations:

  • TAs may be  horizontal, zigzag, arched or oblique
  • TA may be offset relative to its partner
  • Partial TAs are common (see Jamies top L groove)
  • 4th (& 5th) TA pairs may occur but usually incomplete
  • Extra TA pairs produce  an eight-pack

Question: Why do we have TAs? Are they for beauty or are they useful? Turns out, they are extremely useful.

As rectus abdominis muscles contract, the torso draws nearer the lower body. This is forward flexion. TAs allow rectus abdominis muscles to contract in segments permitting greater control over the degree of forward flexion.

Without TAs, there would be one long rectus abdominis on each side. Reduced strength can be predicted along with reduced control over the degree of forward flexion.

Does this ever happen? There is one report in the literature of a man who died at 64. Subsequent dissection revealed he had no TAs in either rectus abdominis muscle, so clearly, one can survive without these interesting structures.

Fun Fact:  are studied because the rectus abdominis muscle is used in reconstructive surgeries, especially those involving the breast.

Read about Jamie’s belly in Outlander book. Here’s Claire’s “frank” (Isn’t he 200 years away?) appraisal of Jamie on their wedding night:

“Take off your shirt,” I said, sitting up and pulling at the hem of the garment.

“Why?” he asked, but sat up and obliged. I knelt in front of him, admiring his naked body.

” ‘Because I want to look at you,’ I said.

He was beautifully made, with long graceful bones and flat muscles that flowed smoothly from the curves of chest and shoulder to the slight concavities of belly and thigh.”

See Jamie’s beautiful belly with its tendinous intersections in the above  publicity photo.

‘Nuff said!

The deeply grateful,

Outlander Anatomist

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Photo Credit: Sony, Entertainment Weekly

Fun Fact: Incisura

Anatomy Def: Notch between tragus and antitragus of the auricle. To understand the meaning of these words, read on!

Outlander Def: The ear cleft (red arrow) patiently awaiting Claire’s attention!

Learn about incisura in Anatomy Lesson #24  Hear, Here – The Ear! 

The auricle, part of the outer ear, is the visible, bendable flap situated on either side of the head. Like fingerprints or venous patterns on the back of hands, each auricle is unique to its owner.  The auricle has a cartilage core enveloped by thin skin. Auricular (adj.) anatomy is complex; it’s hollows, ridges, and whorls act to modify sounds waves of particular frequencies.

Near the base of the auricle and just above the ear lobe are two wee bumps: tragus is nearest the face; anti-tragus is nearest the outer rim. These bumps are separated by a notch, the incisura. Yay!

Incisura is also known as the intertragic notch.  An apropos name for that tragic moment when young Ian, Jamie’s beloved nephew, chooses to exchange himself for Roger Mac. Ian proves himself “a man of worth!”

Fun Fact: This is one good reason to know about the incisura. The incisura/intertagic notch is the point specified  in the U.S. Army’s regulation governing the length of sideburns in male soldiers. In other words, sideburns cannot be longer than the incisura. Who knew? Male soldiers, I presume! <G>

Try This: Find the notch near the base of your auricle. Insert finger. This is the incisura (intertragic notch), flanked on either side by the cartilaginous bumps, tragus and anti-tragus. Specific function of incisura is not known but likely aids in sound wave modification.

Otalgia: Some people experience incisural pain, generally known as otalgia, meaning “ear pain.” The most common causes of incisural pain are:

    • otitis externa or inflammation of outer ear (auricle/ear canal)
    • otitis media or inflammation of middle ear (between ear drum and inner ear)

Read about the auricle in Diana’s splendid big book, The fiery Cross. Many ear quotes to choose from, but in this one, Jamie’s wandering thumb comes verra close to Claire’s incisura! (cough, cough)

His fingers went under the mass of hair, and I felt his hand cup the base of my skull, holding my head like a chalice. 

“I saw my mother in her coffin,” he said at last. His thumb touched my ear, drew down the curve of helix and lobule, and I shivered at his touch. 

“The women had plaited her hair, to be seemly, but my father wouldna have it. I heard him. He didna shout, though, he was verra quiet… He undid her plaits and he spread out her hair in his two hands across the pillow…”

Sob!

See Jamie’s left incisura as he sadly ponders Ian’s decision to remain with the Mohawk in Starz Outlander episode 413, A Man of Worth! 

The deeply grateful,

Outlander Anatomist

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Photo Credit:   Starz ep 413, A Man of Worth