Almost All Dissection Manual Min Suk Chung, Beom Sun Chung



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Almost All Dissection Manual
c:\users\정범선\desktop\해부길잡이 영작\이가은쌤이 고친 그림\00-00.bmp
Min Suk Chung, Beom Sun Chung
Department of Anatomy,

Ajou University School of Medicine, Korea

Orientation
Anatomy is a very important subject in the field of medicine as it is the foundation of all the other studies. You will be able to ascertain almost everything in the lab from the textbook. You need a lab manual in order to quickly perform dissection and learn as much as you can from the anatomy lab. However, I think this simplified lab manual is more helpful to students than other published lab manuals.

This manual contains very simple diagrams to help you perform dissections, and you do not necessarily need to follow the instruction word by word. For example, it is suggested that you approach the specimen from various angles and dissect in many different ways when working on arms and legs which have bilateral symmetry. The goal of anatomy labs is to repeatedly see and understand the structures of the human body.

Under each picture, there is a list of structures that should be found during dissection. At the end of each chapter, you will find a list of structures that are to be studied. I hope you will be able to compare every structure from this manual to the actual specimen. Please bring this manual and a notebook to the lab. In case you cannot find a structure that you are supposed to, you should determine why. It is advised to memorize this manual before coming to the lab because it allows you more time to work on the body. If you are too cautious, you will not have enough time. Be moderately bold, but with a little bit of prudence.

I recommend students to dissect and feel the human body as much as possible. For example, it can be boring to separate skin from fascia sometimes; however you will become more familiar with the human body. Also, it is important to have relevant discussions with colleagues and professors beforehand and afterwards. These are keys to good grades and to becoming a great physician.

When performing dissections, always be courteous and thankful to the family of the deceased and those who donated their cadavers.
October 2, 2014
Min Suk Chung (Professor, PhD, MD) / dissect@ajou.ac.kr
Beom Sun Chung (Teaching Assistant, MD) / bschung@ajou.ac.kr
anatomy.co.kr
Department of Anatomy, Ajou University School of Medicine, 164 Worldcup-ro, Suwon, Republic of Korea / 443-380

1. Anatomy terms in this manual follow the TerminologiaAnatomica (Thieme, 1998).


2. The names of the cranial nerves are written in following abbreviations.
I = Olfactory nerve

II = Optic nerve

III = Oculomotor nerve

IV = Trochlear nerve

V = Trigeminal nerve

V1 = Ophthalmic nerve

V2 = Maxillary nerve

V3 = Mandibular nerve

VI = Abducens nerve

VII = Facial nerve

VIII = Vestibulocochlear nerve

IX = Glossopharyngeal nerve

X = Vagus nerve

XI = Accessory nerve

XII = Hypoglossal nerve

3. Orientations of the head and methods of dissection are represented like below.







- Anterior view

- Posterior view

- Superior view

- Inferior view

- Right side view

- Oblique view

- Cut

- Reflect



- Remove
Contents
Chapter I. Dry bone 1

Chapter II. General principles of dissection 7

Chapter III. Back 10

Chapter IV. Upper limb 16

Chapter V. Neck 23

Chapter VI. Head 27

Chapter VII. Thorax 37

Chapter VIII. Abdomen 45

Chapter IX. Pelvis & perineum 53

Chapter X. Lower limb 57



Chapter I. Dry bone
1. Do not leave the lab with the dry bone. Do not write on the bone. Be careful not to break the bone.
2. Leave the lab after reorganizing bones like below.
Calvaria

Cranial base

Mandible
Vertebral column Clavicle Pelvic girdle or Hip bone

1st rib Scapula Femur

Rib Humerus Patella

Sternum Radius Tibia

Ulna Fibula

Bones of hand Bones of foot





Touch and memorize the following bone structures from the dry bone. If the structure is marked with (surface), try to palpate them on your own body.





* Skull

Calvaria


Cranial base

Cranial cavity

Outer table

Diploe


Inner table

Groove for superior sagittal sinus

Anterior cranial fossa

Middle cranial fossa

Posteriorcranial fossa

Clivus


Groove for inferior petrosal sinus

Anterior fontanelle

Orbit

Supraorbital margin



Infraorbital margin

Superior orbital fissure

Inferior orbital fissure

Optic canal

Choana

Nasolacrimal canal



Pterion

Temporal fossa

Zygomatic arch (surface)

Infratemporal fossa

Pterygopalatine fossa

Pterygomaxillary fissure

Jugular foramen

Foramen lacerum

Greater palatine foramen

Incisive foramen

Parietal bone

Groove for sigmoid sinus

Groove for middle meningeal artery

Superior temporal line

Inferior temporal line

Parietal foramen

Sagittal suture

Frontal bone

Supraorbital notch (surface)

Supraorbital foramen

Frontal sinus

Coronal suture

Occipital bone

Foramen magnum

Occipital condyle

Condylar canal

Hypoglossal canal

External occipital protuberance (surface)

Highest nuchal line

Superior nuchal line

Inferior nuchal line

Internal occipital protuberance

Lambdoid suture

Sphenoid bone

Sellaturcica

Hypophysial fossa

Posteriorclinoid process

Sphenoid sinus

Lesser wing

Anterior clinoid process

Greater wing

Foramen rotundum

Foramen ovale

Foramen spinosum

Lateral pterygoid plate

Medial pterygoid plate

Temporal bone

Styloid process

Mastoid process (surface)

Carotid canal

Internal acoustic meatus

Stylomastoid foramen

External acoustic meatus

Zygomatic process

Mandibular fossa

Articular tubercle

Auditory ossicle

Malleus


Incus

Stapes


Ethmoid bone

Cribriform plate

Crista galli

Perpendicular plate

Ethmoidal cell

Superior nasal concha

Middle nasal concha

Inferior nasal concha

Lacrimal bone

Nasal bone

Vomer

Maxilla


Infraorbital foramen

Maxillary sinus

Frontal process

Zygomatic process

Palatine process

Alveolar process

Dental alveolus

Palatine bone

Perpendicular plate

Horizontal plate

Lesser palatine foramen

Zygomatic bone

Temporal process

Frontal process

Mandible

Body of mandible

Mental spine

Mylohyoid line

Ramus of mandible

Mandibular foramen

Lingula (surface) (need to put hand inside the oral cavity)

Mandibular canal

Mental foramen

Mylohyoid groove

Coronoid process

Condylar process

Head of mandible (surface)

Neck of mandible

Hyoid bone (surface)

Body of hyoid bone

Greater horn

Lesser horn

* Vertebra

Vertebral column

Cervical curvature

Thoracic curvature

Lumbar curvature

Sacral curvature

Vertebral canal

Vertebral body

Vertebral arch

Pedicle


Lamina

Vertebral foramen

Superior vertebral notch

Inferior vertebral notch

Intervertebral foramen

Spinous process

Transverse process

Superior articular process

Inferior articular process

Cervical vertebra

Transverse foramen

Atlas


Lateral mass

Anterior arch

Posteriorarch

Groove for vertebral artery

Axis

Dens


Vertebraprominens (surface)

Thoracic vertebra

Superior costal facet

Inferior costal facet

Transverse costal facet

Lumbar vertebra

Sacrum

Promontory



Ala of sacrum

Auricular surface

Anterior sacral foramen

Posteriorsacral foramen

Median sacral crest (surface)

Intermediate sacral crest

Lateral sacral crest

Sacral horn

Sacral hiatus (surface)

Sacral canal

Coccyx
* Rib

True rib


False rib

Floating rib

Head of rib

Neck of rib

Body of rib

Tubercle of rib

Costal angle

Costal groove

Scalene tubercle

Groove for subclavian artery

Groove for subclavian vein

Costal cartilage

* Sternum

Manubrium of sternum

Jugular notch (surface)

Clavicular notch

Sternal angle (surface)

Body of sternum

Xiphoid process

Costal notch


* Shoulder girdle

Clavicle


Sternal end (surface)

Acromial end (surface)

Conoid tubercle

Scapula


Subscapular fossa

Spine of scapula (surface)

Supraspinous fossa

Infraspinous fossa

Acromion (surface)

Suprascapular notch

Glenoid cavity

Coracoid process (surface)


* Humerus

Head of humerus (surface)

Anatomical neck

Surgical neck

Greater tubercle

Lesser tubercle

Intertubercular groove

Body of humerus

Radial groove

Medial supracondylar ridge

Lateral supracondylar ridge

Deltoid tuberosity

Capitulum of humerus

Trochlea of humerus

Olecranon fossa

Coronoid fossa

Medial epicondyle (surface)

Lateral epicondyle (surface)


* Radius

Head of radius (surface)

Neck of radius

Body of radius

Radial tuberosity

Interosseous border

Styloid process (surface)

Dorsal tubercle (surface)


* Ulna

Olecranon (surface)

Coronoid process

Trochlear notch

Radial notch

Interosseous border

Head of ulna (surface)

Styloid process (surface)


* Carpal bone

Scaphoid


Tubercle of scaphoid (surface)

Lunate


Triquetrum

Pisiform (surface)

Trapezium

Tubercle of trapezium (surface)

Trapezoid

Capitate


Hamate

Hook of hamate (surface)


*Metacarpal bone

Base of metacarpal bone

Body of metacarpal bone

Head of metacarpal bone (surface)


* Phalanx

Proximal phalanx

Middle phalanx

Distal phalanx

Base of phalanx

Body of phalanx

Head of phalanx
* Pelvic girdle = Hip bone

Acetabulum

Acetabular notch

Acetabular fossa

Lunate surface

Obturator foramen

Ilium

Arcuate line



Iliac crest (surface)

Iliac tubercle (surface)

Anterior superior iliac spine (surface)

Anterior inferior iliac spine

Posteriorsuperior iliac spine (surface)

Posterior inferior iliac spine

Greater sciatic notch

Posterior gluteal line

Anterior gluteal line

Inferior gluteal line

Iliac fossa

Auricular surface

Ischium

Body of ischium



Ramus of ischium

Ischial tuberosity (surface)

Ischial spine

Lesser sciatic notch

Pubis

Body of pubis



Pubic crest

Pubic tubercle (surface)

Superior ramus of pubis

Pectineal line

Inferior ramus of pubis

Pelvic inlet

Linea terminalis

Anatomical conjugate

Pelvic outlet

Greater pelvis

Lesser pelvis
* Femur

Head of femur

Fovea for ligament of head

Neck of femur

Greater trochanter (surface)

Lesser trochanter

Intertrochanteric line

Intertrochanteric crest

Body of femur

Linea aspera

Lateral lip

Medial lip

Gluteal tuberosity

Medial supracondylar line

Lateral supracondylar line

Medial epicondyle

Medial condyle (surface)

Adductor tubercle

Lateral epicondyle

Lateral condyle (surface)

Intercondylar fossa

Patellar surface


* Patella (surface)
* Tibia

Medial condyle (surface)

Lateral condyle (surface)

Intercondylar eminence

Body of tibia

Tibial tuberosity (surface)

Soleal line

Interosseous border

Medial malleolus (surface)
* Fibula

Head of fibula (surface)

Neck of fibula

Body of fibula

Interosseous border

Lateral malleolus (surface)

Malleolar fossa
* Tarsal bone

Talus


Head of talus

Neck of talus

Body of talus

Calcaneus

Talar shelf (surface)

Calcaneal tuberosity (surface)

Navicular

Medial cuneiform

Intermediate cuneiform

Lateral cuneiform

Cuboid
* Metatarsal bone

Base of metatarsal bone

Body of metatarsal bone

Head of metatarsal bone

Tuberosity of 5th metatarsal bone (surface)
* Phalanx

Proximal phalanx

Middle phalanx

Distal phalanx

Base of phalanx

Body of phalanx

Head of phalanx


Chapter II. General principles of dissection



1.Teacher prepares forceps, a handle of scalpel, a blade, a hook, scissors, a chisel, a hammer, a saw, nippers, a 1 mm thick soft wire, a pin, a disposable razor, a wooden prop, a scoop to poor preservative, a bucket to put under the table, a container to put a part of the cadaver, strings (red, blue, yellow, green), cloth, vinyl, a soap powder, a disinfectant, and disposable band-aids.
2. Students prepare rubber gloves, a mask, a towel, a soap, a chalk, and a water soluble pen.
3.In order to identify the number of the body, tie all the tags attatched to both arms and legs to the desk’s legs. Identify the age and the reason of death.
4. If the smell of cadaver fixative is too strong, spray water on the body. The cadaver fixative contains following chemicals:

Formalin 3 L

Ethanol (95%) 10 L

Phenol 1 kg

Water 22 L

5.Sufficiently cover the non-dissecting parts to prevent drying. (For example, when dissecting the back and the upper limbs, cover the head, neck, pelvis, perineum, torse and lower limbs with cloth.) Clean after each dissection lab. Spray enough cadaver conservative to keep the cadaver moist, and cover with vinyl. Cadaver conservative contains followings:

Formalin 1 L

Water 100 L


6.Put removed parts of a cadaver during dissection (removed skin for example) into a container. Do not mix with other garbages or parts from a different cadaver. This will be cremated with the cadaver in a coffin.
7.Feel free to see and refer to useful materials such as a dry bone, a plastic model, and anatomical specimans. Put it back when you are done using it.
8.Do not leave the lab with a model or a specimen.
9.On each dissection stage, encircled “d” stands for dissection method.

10.Skin: during skinning process, snip a shallow cut. Do not cut the muscle. Refer to the subcutaneous papilla while skinning. Keep the skin thin. Make holes on skin and pull to ease the skinning process.


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When each lab is done, re-cover the skin to prevent drying or collect the removed skin in a container.
11. Subcutaneous tissue: after skinning, scratch the subcutaneous tissue with a hook and find cutaneous nerve and cutaneous vein

12. Muscle: remove the fascia that covers the muscle, tendon, and aponeurosis with a knife. It is better to remove the fascia in the muscle bundle direction. Also remove the intermuscular septum. The purpose of removing a fascia is to identify the border, origin and insertion of the muscle. After identifying the muscle, cut and fold the necessary muscle to see other structures inside (e.g. other muscle). Give a clean horizontal cut to a muscle belly near the origin and fold towards the insertion. The tendon should not be cut since it is hard to match and identify later. When cutting and folding the muscle, be cautious not to damage other muscle, nerve and artery. After folding the muscle, detach the fascia covering inside the muscle and identify the nerve and a located in the muscle Remove the vein located in the muscle


13. Blood vessel: because artery has a thicker wall and a smaller lumen compare to vein, there is almost no blood clot in a lumen which makes it appear white. Although artery appears white like nerve, unlike vein, artery has smooth muscle and elastic fiber on the wall. This allows artery to have a circular cross section.
14. Lymph node: check which region it belongs and then remove. Lymphatic vessel that connects lymph node can be hardly seen.

15. Bone: use both chisel and hammer or saw or pincer to cut. Electric saws, electric drills, or osteotomes.


16. Variation does not have a trouble in functioning. Congenital malformation has problem in functioning. Congenital malformation can be used for case report. When you find one, reporight to teacher. Remove vein that accompany artery. When detaching vein, make sure a blood cloth inside does not contaminate the surrounding area. Do not detach a vein that does not accompany a, cutaneous vein, superior vena cava, pulmonary vein, azygos vein, and portal vein.


Chapter III. Back
1.Skin of the back

2.Trapezius & latissimus dorsi

3.Rhomboid muscles

4.Serratus posterior & erector spinae

5.Splenius & transversospinalis

6.Suboccipital triangle

7.Deltoid muscle

8.Muscles of scapula

9.Laminectomy

10.Spinal cord





1.Skin of the back

ⓓ Skin the back. Do not make a deep cut. Keep skin thin during the process. The figure below is just an example. You don’t need to exactly follow it. Skinning process becomes easier if you poke a hole in the removed skin, insert your finger in the hole, and pull the skin. If you support the chest area with a wooden prop instead of the head, the head tilts due to gravity. Hence the skinning of the neck area becomes easier.



c:\users\정범선\desktop\해부길잡이 영작\이가은쌤이 고친 그림\03-01.bmp
o Locate the medial branch and the lateral branch of posteriorramus and posteriorbranch of lateral cutaneous branch from the centre of the body respectively.

2. Trapezius & latissimus dorsi

ⓓ Cut and fold the trapezius and latissimus dorsi muscle When you fold the latissimus dorsi, cut the origin of the muscle between 10th - 12th ribs and inferior angle of scapula. Be careful not to damage the serratus anterior when folding the latissimus dorsi.
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o Notice that the nuchal ligament continues from under the 7th cervical vertebra to the supraspinous ligament.
o Notice that the thoracolumbar fascia is an aponeurosis of the latissimus dorsi and a fascia of the deep back muscle.

3. Rhomboid muscles

ⓓ Cut and reflect the rhomboid minor muscle and the rhomboid major muscle Be careful not to damage the dorsal scapular nerve inside.
c:\users\정범선\desktop\해부길잡이 영작\이가은쌤이 고친 그림\03-03.bmp
4. Serratus posterior& erector spinae

ⓓ Cut and fold the serratus posteriorsuperior and the serratus posteriorinferior.


c:\users\정범선\desktop\해부길잡이 영작\이가은쌤이 고친 그림\03-04.bmp
o Remove the posteriorlayer of the thoracolumbar fascia. Then divide the iliocostalis into the cervicis, thoracis, and lumborum. Divide the longissimus into the capitis, cervicis and thoracis. Insertion is the guideline of division.

5. Splenius & transversospinalis

ⓓ Cut and fold the splenius capitis and the splenius cervicis.
c:\users\정범선\desktop\해부길잡이 영작\이가은쌤이 고친 그림\03-05.bmp
o On one side, organize the iliocostalis, longissimus, and spinalis. On the other side, remove these muscles and organize the semispinalis, multifidus, rotatores.
o Remove a part of the external intercostal muscle and internal intercostal muscle Then locate the intercostal vein, artery, and nerve.

6. Suboccipital triangle

ⓓ Cut and fold the semispinalis capitis. Be careful not to damage the suboccipital triangle inside.
c:\users\정범선\desktop\해부길잡이 영작\이가은쌤이 고친 그림\03-06.bmp
o From the suboccipital triangle, examine that suboccipital nerve which is a branch of 1st cervial nerve and that the vertebral artery is above 1st cervical vertebra.
7. Deltoid muscle

ⓓ Cut and fold the deltoid muscle Be careful not to damage the axillary nerve.


c:\users\정범선\desktop\해부길잡이 영작\이가은쌤이 고친 그림\03-07.bmp
o Fold the deltoid muscle Locate the subacromial bursa below the deltoid muscle and the acromion. The subacromial bursa is similar to a synovial membrane of a synovial joint.

8. Muscles of scapula

ⓓ Cut and fold the supraspinatus and the infraspinatus. Be careful not to damage the suprascapular nerve inside.
c:\users\정범선\desktop\14. 06. 해부길잡이 논문\diagram\(03-08) muscles of scapula.bmp
o Locate the omohyoid muscle which is located at the upper corner of the scapula and its insertion is the hyoid bone.
o Remove the fascia of the serratus ant. located inside the scapula. Tear the serratus ant. with fingers and touch the subscapularis.

9. Laminectomy

ⓓ In order to perform laminectomy of a vertebral column, completely remove the deep back muscle, supraspinous ligament, and interspinous ligament Remove the spinous process and lamina, then transverse process and articular process. Completely expose the spinal ganglion in the intervertebral foramen. Be careful not to cut spinal nerve For some groups, do not cut and leave the suboccipital triangle. Remove the backside of the sacrum and locate all of the spinal nerve Cut the origin of the gluteus maximus from the sacrum. Vertically cut the back of the dura mater, spread it to both sides and pin it.

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