Anatomy Trains

One final picture – a teaser for those who share my hunger for ‘just the facts, ma’am’, a relief for those of you who have found these last few posts a trial of too much meaty reality.  Conceived by Todd Garcia, realized by David Lesondak, with some of yours truly in there for the actual arrangement.  There’ll be a video tour of this available later this year with any luck:

But this week, thanks to Todd, David, Eric, and all the other students who supported our work with theirs.

This continues as the most successful dissection in which I have been fortunate to participate in terms of the learning obtained.

• Fabulous group of students who are doing great work (special mention here to Daphne Mosko, who unraveled the foot for all to see).

• Luck with the condition of the cadavers (although Todd may have something to do with this, even though he says he can’t control what they send him).

• Todd’s focus and consummate skill at the table, not to mention his willingness to set aside the conventions of dissection to patiently entertain my ignorant fumblings for a new order.

• David Lesondak’s skill with the cameras, allowing us to retain the memory for ourselves and share it with others

• Eric Root’s microscopic explorations of the interaction between fibers, glue, capillaries, lymph vessels at various levels of stretch and at various levels in the body, giving us a whole new dimension between gooey and Guimberteau.

• And I am not forgetting Penelope’s informed guidance of the students, Michelle’s slaving over a hot sink to wash away the blood, poop, and fat from the towels, J.C’s willingness to lean over a stinky mass of guts to reveal the mesenteric tree, and everyone else’s cooperating to stop what they are doing to let me video the results of all our work.  Thanks to everyone!

Yesterday the traditional calvarium cuts were made to reveal brains and dura; today will be largely show-and-tell as we bring things to a close, so here are a few of the pictures from the last couple of days:

Fascia, fascia everywhere, nor any drop to drink…

The lower half of the Superficial Front Line (SFL) – this guy had some quads on him!  Very hard to retain the fascia going over the tibia on this specimen – it was there and came up fine and clear, but as soon as you bring it away from the underlying bone, in seconds it curls up and dyes like a hairdresser.  Even the interosseous membrane between the tibia and fibula – surely a strong, bilaminar, tough-stuff structure – almost disappears into gossamer as soon as it is removed.  Long live biotrensegrity! (This is a convincing correlate of the tensegrity concept – funnily, it gives me new appreciation for the role and shape of bone in stretching the tensegrity into shape – Grandma’s orthogonal rack, I believe Ron McComb callled it, referring to Ida Rolf.)

The upper Superficial Front Line from the pubic symphysis (left) up through the rectus (and yes, he had a diastasis – spreading of the linea alba – like a pregnant woman, but this fellow was ‘pregnant’ with overeating) to the SCM on the right.  The kicker for me came in the middle, which we preserved on his right side only.  Some of my readers will know I have puzzled over the connection between the rectus and the SCM in the SFL, searching through sternalis (which despite the great example in the pervious post is often too flimsy to serve) and the sternal fascia (which works, but is too narrow to convey the full mechanical force.

So this time we left the proximal portion of the pectoralis major in place.  This created a great connection, but would break the Anatomy Trains ‘rules’ since the muscle fibers of the pectoralis run counter to the direction of the line (expressed by the rectus and SCM).  So imagine out surprise when we turned the specimen over and found plenty of vertical fascial fibers embedded into the posterior side of the pectoralis.  Anatomy Trains rules may be made to be broken, but this was victory enough for me: Anatomy Trains rules! (maniacal laughter echoes down the corridor…)

The Superficial Back Line from a fresh-tissue cadaver.  This specimen, relaxed, measured 81 inches; the cadaver, relaxed, stood at about 5′ 7″ or so.  Fromt left: Epicranial fascia from eyebrow to nuchal line, erector spinae (and some transversospinalis) to sacral fascia, the isthmus of the sacrotuberous ligament leading to the hamstrings intertwined with the gastrocs and around the calcaneus to the plantar aponeurosis.

And finally, a first: The Deep Front (core) line from a fresh tissue cadaver.  Deep toe flexors at the bottom, joined across the back of the knee to the adductors across the groin with the psoas complex (from here on up we have both sides) to the diaphragm and mediastinum, and finally up to the bat ears of the temporalis muscle joined to the jaw.  The mandible and hyoid are the only bones in this specimen, and there are no breaks from the inner ankle to the underside of the skull. This ancient creature lives inside us, one and all.

Thanks again to one and all.  This was such a team effort.

We have now finished four days of the dissection project, and I am very pleased with what we have got.  The students have been great, Todd has been a steady worker, following my crazy ideas and making them real, and David Lesondak has been literally on top of things (often atop a swaying stepladder) to document both process and product in video and in photos.

It is very interesting how some things are possible in one cadaver, and impossible in another.   Bodies are so variable.

Here’s an example of the upper posterior Spiral Line we were able to dissect out of George (we name the cadavers, not their real names – it’s amazing what affection you have for them as you learn about their lives through the ‘track’ they have left – their physical form.  Millie is heartbreaking with her painted nails but no uterus; drooping transverse colon and a wicked-looking plate in her head that resulted from a brain surgery we haven’t been able to expose the cause of yet.  Richard has bad dental work and a twisted spine and a collapsed chest, but strong legs.  George has no teeth at all, but this seems not to have dimmed his appetite; we had to flense the fat off from him, and his guts were very full.  He is without a gall bladder, an operation which left many adhesions in his belly.):

On the left is the splenius capitis and cervicis, the gap in the middle shows where we were able to dissect a connection between the splenius capitis and the rhomboid minor, but were unable to get a clean fabric connection between the cervicis and the rhomboid major – a connection we were able to get easily (well, not easily but cleanly) on our previous encounter with a fresh-tissue cadaver.

On the right is the many fingered serratus anterior.  Please note the strong connection between the rhomboids and the serratus – here is a clear picture of the rhomboserratus muscle.  Here’s the kicker: the scapula has been removed from this specimen, and it does nothing to separate the rhomboids from the serratus.  Note please that I am not saying that the rhomboids or serratus don’t connect to the scapula; it’s just that they also have a strong (strong! literally) fascial connection behind the scapula that is seldom if ever listed in the books.  The scapula could easily be moved 1.5 inches either way on the rhomboserratus without the profoudn side of this connection being moved.

Here is a brilliant (I can say so, Todd did it) dissection of the Superficial Back Line from toes to nose up the back of the body – planter fascia to the left, epicranial fascia to the right.  This specimen measured 81 inches (206 cm) when laid out relaxed.  George measures about 5’7″ (67 inches, 170 cm).  This increase of nearly 20% is partially due to the addition of the plantar fascia to and epicranial fascia to the length, partially due to the straightening of the primary and secondary curves this line traverses.

Finally, the Superficial Back Arm Line.  In this case we included the trapezius on both sides (easily dissected together, though you can see the holes in the very thin aponeurosis  between the middle trapezii), with the rest of the line running down the right side only: deltoid, lateral intermuscular septum, and his strong extensors (maybe he rode a Harley?) leading to the backs of his fingers.

Everyone is punch drunk on this fourth day – the initial enthusiasm worn down by the smell of formaldehyde, the vague aroma (and accoutrements) of a butcher shop, the bending over the table, the exacting and slowly progressing work.

Meanwhile, in the background, we are working toward my goal for this workshop: the Deep front Line from ankle to jaw in a fresh tissue extraction.  Stay tuned.

Twenty of us have gathered at Todd Garcia’s Laboratory for Anatomical Enlightenment in Denver – mostly KMI practitioners, but with a good smatteirng of movement teachers as well.  Todd has brought in a retired podiatrist, Penelope, who is helping us all with dissection, especially with the feet.

I cannot give you any photos or video rushes (we’re heading for a ‘new and improved’ dissection DVD by the end of the year, though).  This encounter with a gift of our form from the dead is always deep – my own death and that of those I love always comes up – but I am leaving those issues for later or another spot.

For those interested, here are a couple of highlights from our first couple of days:

1) We’ve been having trouble getting the upper Superficial Front Line to go from the pubis to the mastoid process without significant ‘holes’ (places where the fascia is so stuck down to the underlying bone – in the SFL case the sternum and the sternochondral joints with the ribs).  Jeff Mahadeen, Gerald Brasile, and Jackie Wayda, however, found a specimen where the sternalis was so hefty that he was able to dissect out an SFL intact with no holes, just like the first edition says it is.  This is funny to me, because we had been so unsuccessful with this to date – the sternalis is often absent or too fascially flimsy for the job – that I left it out of the second edition.  Now, suddenly, thanks to Jeff and this donor, I have an excellent example of what I originally proposed, but abandoned when the ugly facts did not fit my beautiful theory.

Here’s a beautiful picture to fit my now ugly ducking theory – thanks to Jeff, Jackie, and Gerald!

2) Todd, working with speedy patience as always, took out the first example of the Back Functional Line from the fresh-tissue cadaver.  From the latissimus across the throacolumbar fascia to the gluteus on the other side.  I have not gone for this line before because it seemed so ‘obvious’, and Vleeming had already detected a line of tension in the fascia from latissimus to contralateral gluteus.  But it was interesting nevertheless how difficult it was to get the connection across the midline where all the fascia was tacked down to the buried lumbar spinous processes.  The resulting specimen was good, but more flimsy than the connection from the splenius to the contralateral rhomboids farther up the spine.

On the right you see the latissimus dorsi, connecting to the right humerus.  In the middle is the superficial lamina of the thoracolumbar and sacral fascia.  The hole is where is was tightly tied to the PSIS (where your dimple is above your bum).  On the left is the gluteus maximus, with the connection into the iliotibial tract (top left) and the lateral intermuscular septum between the vastus lateralis and the biceps femoris (lower left).  Can’t see the difference?  That’s because they are part and parcel of the same fascia.