More Adventures in Anatomy by Lauri Nemetz

Notes from the American Association of Anatomists Regional Meeting

by guest blogger, Lauri Nemetz

In the latest in my own anatomy adventures, I was at the regional NYC meeting of the American Association of Anatomists on November 5th, taking in a day of learning and also presenting my poster on “Space for Well-being: Understanding How Humans Shape Architecture and Why Where We Live Shapes Us Anatomically” (mine is poster #10- read all the abstracts here.)

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Appropriately this was held at the brand new Vagelos Education Center for Medical and Graduate Education, part of Columbia Medical Center in NYC, which is striking in its bold design by Diller Scofidio + Renfro, the same design team responsible for the High Line renovation project in NYC.
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My own look at spatial use in architecture related to anatomy is currently focused on how cultural and personal preferences impact spatial use and vice versa, but also the need for our bodies to be challenged in architectural design given our use of computers, smart phones, etc. Additionally, given the Mayo Clinic’s estimates that we are spending an average of 90% our time indoors, we have a great need for healthy movement and to recognize we are rarely getting time to move effectively for our bodies. I imagine the numbers for many of actually might higher, and natural spaces are increasingly impacted. I would love to see design incorporate more challenging floor surfaces, or spaces that would allow us to take brachiation breaks instead of coffee breaks, or bring us to outdoor spaces more easily to allow us to walk in normal gait needed in efficient bipedalism. The importance of one legged balance, used when we walk or run, is less challenged in our day-to-day life. Traditional folk dances, such as the balance-challenging step folk dances of Macedonia, were part of the human experience in practicing balance needed for the environment around us. Sitting in office chairs, and slow walking on even surfaces leaves us less practiced in efficient bipedal movement.
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The American Association of Anatomists, founded in 1888, for the “advancement of anatomical science” (AAA website) focused this particular meeting on “Locomotion from an Anatomical, Orthopedic & Physical Therapy Perspective”. The day mixed a blend of history, running and gait lectures, hands-on labs in movement and ultrasound testing, as well as a cadaver lab focusing on surgical approaches to the hip and arthroscopic knee exams. Assisting our AT dissection labs has allowed me to see many surgeries, and types of hip, knee and other replacements.

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I appreciated having surgeons actually demonstrating the approaches of anterior vs. posterior hip surgeries, which I see the results of in my clients and of course, in dissection lab. In the posterior approach, the surgeon demoed techniques, but pointed out the importance of how to find the deep lateral rotators of the hip, and separate out the space by the piriformis and gently allow the sciatic nerve to rest carefully to the side during surgery. Anterior approaches are becoming more common, but require a different level of finesse. However, the weakening by surgery in the front of the hip is usually less significant, given the fewer cuts through muscle and fascia, and the ability to return to gait, often almost a week earlier than the posterior approach.

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Other talks and break sessions focused on gait analysis as a predictor for cognition abilities in aging, bringing in early studies that loss of speed and coordination in gait may be an indicator for diseases like Alzheimer’s. Examples were shown of walking patterns while speaking every other letter of the alphabet to challenge coordination. Studies such as O’Keefe’s on spatial navigation (“place cells”) peaked my interest. Perhaps we can do more to prevent these losses through coordinated movement. Additionally, there was a lecture on exoskeletal-assisted walking devices for those with spinal cord injury; fascinating since I’ve worked with a lot of young adults with spinal cord injury. In these cases, the loss of bone mass is extreme- higher than the loss an astronaut faces post-flight. Early advances are still primitive but offer some ability to walk, although the devices are controlled through upper body movement, leading to different challenges in coordination.

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The overwhelming majorities of attendees were anatomists in medical teaching positions, as well as a high proportion of current medical and PT students and other related faculty. Several people throughout the day approached my poster discussion time with curiosity in the Anatomy Trains® myofascial concepts as well as the idea of biotensegrity. Interestingly, in the traditional anatomy world, I was still explaining the concept of Anatomy Trains®, which is less known, but amongst the PT students, many of them had heard of Tom Myers and the work of AT, but were just beginning to hear of the connections into the world of movement applications. Focusing on gait particularly at this conference, I referred many to my friend and AT colleague James Earls’ book, “Born to Walk.”


I am happy to say this community of anatomists are quite interested life-long learners and happy to share and exchange ideas. Far from stagnant, the world of anatomy is ever changing, just as we are in our dance with the world.