Posts

Neuro

Last weekend saw the first National Undergraduate Neuroanatomy Competition that took place on line.

The NUNC team were absolutely on fire and produced a fantastic competition with a professionally delivered MCQ and spotter.

At the closing remarks I spotted this little felt on their desk.

It is a cross section of a spinal cord showing the ascending and descending paths along with the nerve rootlets leaving the spine and the spinal canal in the centre. I produced it a few months before the competition and had sent it down to Dr Scott Border because he is a neuro guy (and my house is getting a bit full of felts).

There is such a thing as neurophobia; the fear of learning neuroanatomy because it is so complicated. Each of the coloured sections above carries neurons either towards the brain – green, the sensory pathways, or away from the brain – red, the motor pathways. When an injury occurs to the spine someone who understands this can work out where the damage is based on the symptoms that are displayed. It’s mind blowing.

When I learnt my neuroanatomy I studied these cross sections for ages. The information went in well enough to pass the exams.

Having spent a few hours felting the various tracts, their positions and relations to each other, it is now firmly cemented in there.

The act of doing enhances the retention of the information. Maybe learning can be combined with a craft project that helps us destress. Maybe there is more of a role for art in learning. Could be an interesting little research project.

Standing on your own two feet

Art meets Anatomy

I have been experimenting with various felting techniques building towards a bigger project. Last month it was smaller faces and so I made a model of a small girl. Usually when making felt models a wire armature is used. This gives a frame to build around and enables the structure to stand easily when finished.

The other option is to make it anatomically correct.

When humans became bipedal it had an effect on the spine, causing it to become a series of gentle curves. If you image an foetus curled into a ball then all of the spine curves towards the back – this is the shape of the primary curves, described as kyphotic. The curves that can be seen at the back and the neck, where the curve is towards the front of the body are described as secondary curves or lordotic. Between them they document your development.

As a foetus you have just the one kyphotic curve. Once born you spend most of your time lying on your back. Around 3 months you develop the ability to lift your head. The head is a large weight balanced on top of a narrow support structure called the neck. To be able to balance it the neck arches forward so that the mass of the head can be centred over the support. This gives you the first secondary curve at the neck. Imagine how big your neck muscles would have to be if you didn’t have this curve and you relied on the muscles to hold your head up!

At this point you have a child who can sit up with a beautiful straight back. Despite what you might have heard in exercise classes that this is the posture you should be aiming for – it is unobtainable as a bipedal human.

The next stage of development requires you to balance the weight of your body over two small feet. This is not possible unless your body arches forward to recentralise the centre of mass of the torso. This gives you the secondary curve in your lower back. Only with these curves in place can a human body be easily balanced over two feet. Apes lack these curves and so they can only walk a short distance on two feet and it looks ungainly. Despite what people say about the drawings of Di Vinci showing a J shaped spine – they don’t – he drew bipedal people – they would have had the same curves as you and I.

To get a felt model to balance these same curves had to be in place. It’s only when you are trying to shape a small body that you appreciate how pronounced these curves can be. The bottom has to stick out quite a way and you need to make sure the shoulders are pulled back. Placing one foot in front of the other made it easier to ensure the balance was obtained.

The feet and ankle joint also had to be correct. When you look at the ankle from behind it is trapezoid shaped and behind the lower leg. This structure needs to be the same to offer a counter to the balance of the body; an ankle that sits behind the leg and a forefoot that spreads out.

Once you have all these in place, it will stand.

What has this taught me?

To balance not only do I need the curves in my back, I also need my head to be on top of my neck and my shoulders back. No more head forward posture or slouching shoulders because these are postures that are causing muscles all over my body to work more.

I balance best when my feet are flat and my forefoot spread – remember that when you are wearing shoes that alter the shape of your foot.

Only when all of those things are in alignment will I be able to balance without extra muscular effort.

It amazing what you can learn from felt.

p.s. – I managed the small face

Neuroscience?

When did neuroscience get so trendy?

I have been attending a leadership course recently that claims it looks at the neuroscience of leadership. I think they mean psychology, but it seems neuroscience is the new buzz word.

I lost a section of the presentation this week when comments they made sent me off at a tangent.

We were presented with an MRI of a brain.

A section of the image was alight. This, we were told is the area of the brain which lights up if you are physically hurt. It is apparently the same area that lights up if you feel excluded. Therefore (and this is where is started to fall apart) if you exclude someone, the brain sees it the same as physical pain.

Pain and the brain is fascinating and I would encourage anyone interested in this to look at the work of Lorimer Moseley. His TED talk about the snake bite makes you rethink pain)

It was indisputable. Science said so.

My mind went to how on earth they had done that experiment. Had they put someone into an MRI and then physically hurt them to see what happened? How did that pass ethical approval? Even more intriguing, had they put someone into an MRI and then told them they were excluded from something. How did they know that what had caused the physical pain wasn’t a by product of some exclusion.

Even more challenging, in another seminar I was told that it was scientifically proven that if you placed your hand over your heart and told yourself you were loved, it caused your vagus nerve to fire. Does it not work if I put my hand over my elbow? I hope it’s not location dependant because the presenter was American and had their hand way too far to the left to be over their heart. Maybe it calms you down which may affect your nervous system but surely you can’t say its scientifically proven to cause nerves to fire.

Of course, what is and isn’t science is a massively grey area.

Doing a PhD between a medical school and humanities has unveiled a whole new aspect of this debate. The seminal work by Gieryn demonstrates that the boundaries between science and non science are mobile and people redefine them to suit their purposes.

The leadership company wants to present its theories as being valid. They are correct because their theories are backed up with science and this in some way is better than someone who has experience.

A year spent in the quagmire of disputed science has caused me to be a bit less trusting of what is being held up as scientifically proven and on the look out for when science is used to bolster up claims that may be a little dubious.

Mind – does it matter?

Any study that involves Humans has trouble accounting for the mystery that is the human mind. That is why clinical trials are so in favour of the double blind trial; neither the test subject or the person applying the test know whether the person is getting the treatment being tested or the placebo. It should eliminate the role played by the human mind. It is that powerful and yet we often dismiss it with – it’s all in your head.

There is the famous scene at the end of the Harry Potter books where Harry asks if something is real or whether it is all in his head and Dumbledore answers with some snapping rhetoric that the two are not mutually exclusive – just because it’s in your head doesn’t mean it’s not real.

Scientists don’t like the dubious nature of the mind. This drug works so well because it does A, B and C, not because you believe it is going to work. The craze of drinking a tablespoon of cider vinegar doesn’t re acidify your body’s systems because we have a whole physiology that works to stabilise your internal environment. So why do people feel better if they do it? Because they believe it is making an effect. Does it matter that their belief is based on something that some people, think is wrong? That’s the situation with a lot of things in the world and so long as nobody is exploiting their beliefs does it really matter?

Why this reflection this week?

I am studying fascia in the human body as part of my PhD studies. There are a number of different beliefs about what this structure does, connected to established science by varying degrees.

I had a friend who recently broke her wrist and although she has been going through physio she had reached 50 degrees of movement and hadn’t seen any improvement for a few weeks.

Do you want to try something? The science behind it is a little … It certainly won’t do any harm. That was the conversation over a zoom meeting. One week later and she visits the physio again. She is now at 70 degrees of movement. Did the fascial treatment do that? Was it her belief that it was going to make a difference that actually made the difference? It’s not a controlled study. You can’t do double blind trials on treatments where both the person applying it and the person it is applied to will know what has been done. Does it matter?

It’s a challenge to doing the PhD I wasn’t really expecting

Production of a Netter Felt

I recently constructed a felt inspired by a Netter illustration for a friend. The construction was posted on social media with the final piece receiving quite a few comments and likes.

I thought I would break down the process so that you could see how it was done.

Needle felting is an ancient craft that matts together wool fibres by repeatedly stabbing them with a very sharp barbed needle. It can be very therapeutic at the end of a day.

The Netter image started with some wool and a piece of fabric.

The footprint of the image was shaped out using this core wool and felted to the fabric to create a layer of wool fibres on top of the fabric that other structures could be felted onto.

The structures of the collar bone and mandible were built up to mark out the area into which everything else had to fit.

The idea was to make all of the structures within the neck and to build it up like a reverse dissection.

This meant the blood vessels had to be made. I started out making these on pencils but as I progressed with the construction most things had to be trimmed down to size.

Muscles are not a solid block of colour and so three variations of ‘fleshy’ tones had to be mixed up to gives the muscles their colour.

The major blood vessels of the neck acted as landmarks for the other structures, so these were inserted first with a darker background to ensure no white would show through in the final image.

All of the muscles were constructed and then laid out to ensure everything would be close to the correct places before fixing.

Each muscles was then coloured with a selection of the three fleshy tones to give them extra shape and shading. Working from the deepest structure, the muscles were added onto the fabric.

The finer blood vessels and nerves were small strands of coloured topps wool that were anchored in place and then twisted to produce a fine fibre before tacking into position along the course with a fine felting needle.

The adding of the hyoid bones with the digastric attachments and the trapezius framed the rest of the dissection.

Wool can be felted into any shape. The direction of the needle stabs dictates which dimension will reduce in size. Utilising this it was possible to felt the reflected cut end of the sternocleidomastoid muscle and the innervation and blood supply on its deeper surface.

The collar bone and deltoid area was built up to finish the bottom of the picture and the submandibular gland, adipose layer and flesh finished the image at the top edge, before it was sprayed with hairspray, framed and sent off to its new home.

Crucifixion

There is one week of the year where it is fitting to talk about crucifixion and so as we enter Holy Week, I want to talk about the weirdest anatomical argument ever.

The year is 1801 and three member of the Royal Academy in London are arguing about the anatomical correctness of works of art. In particular the sculptor Thomas Banks and painters Benjamin West and Richard Cosway think that such greats as Michaelangelo had not accurately depicted the body of Christ on the cross.

There seemed only one way to settle this argument – they planned to crucify someone and see what it looked like! The three of them approached the surgeon Joseph Constantine Carpue to see about obtaining a body. This was in 1801 and the regulations about the use of human remains came into being in 1832. It was quite common to get casts made of human bodies that had been flayed to expose the first layer of muscles. These écorchés were considered important for artistic education. People look on these models now and wonder at the detailed work of the sculptors, not realising it is the cast of a dead person.

As it transpired, Carpue had a suitable subject.

In October, Carpue had been called to the Chelsea Hospital where an old Irish captain called James Legg had argued with another pensioner called Lamb. Legg had subsequently burst into Lamb’s room and challenged him to a duel. Lamb had thrown down the gun refusing to fight and Legg had shot him in the chest. Legg was clearly suffering from what we would now class as dementia but an insanity plea was not successful and he was to be executed for murder in November.

A building was erected close to the place of execution and as soon as the execution had taken place the still warm body was nailed to a cross and a cast made. It was important to the artists that the body was still warm and would sag as they felt some of Michaelangelo’s inaccuracies had come in from recreating crucifixions with stiff corpses.

Banks, Thomas; Anatomical Crucifixion (James Legg); https://www.royalacademy.org.uk/art-artists/work-of-art/O1350 Credit line: (c) (c) Royal Academy of Arts /

Once cool the body was removed to the surgeon’s rooms where the body was flayed and another cast made so that the positions of the muscles were visible.

The two casts were displayed in Thomas Bank’s studio before moving to the Royal Academy. In 1822 they were moved to Carpue’s anatomical museum and then to another sculptors studio. By 1917 the écorché cast had been returned to the Royal Academy. The location of the first cast is unknown.

I’m not sure what comments to make about this story other than to wonder that that was ever considered a suitable way to settle that argument. Does it matter if art is anatomically correct? I don’t recall anyone picking holes in a Picasso because it didn’t look like a face, or Dali because watches don’t actually melt.

Is it because some art is close enough to reality that the assumption is the artist was trying to be accurate and failed.

Does it matter? Does it matter enough to start crucifying people?

Reflection and Focus

It’s been a year today since the UK went into lock down for the COVID pandemic. There is a nation wide minute silence at midday.

It’s a time to reflect on things that have occurred over the past year. The changes we have had to made, the concept of having to do things before we are completely ready. We have made some changes which we will continue to adopt.

I’ve taken 2021 as a year to concentrate on growth, reflection and focus.

      When I started on my anatomical journey several years ago the plan was always to try and take anatomical knowledge back to the fitness industry and help improve knowledge of the human body.  It hasn’t been a straight journey.  Along the way I have moved into massage therapy, I’ve had some fantastic educational opportunities and I have met some fantastic people.  I would now describe myself as an atomists – I’m not sure that was ever the plan.

I’m now starting on a PhD project looking at why we have different understandings of the human body.  I’m going down rabbit holes I never knew existed.

For years I have only fed back to the fitness industry in odd articles, presentations, one or two workshops.  I couldn’t produce any more because I wasn’t ready.  I needed more time to get all my ducks in a row.

Not any more – lets start now.  Start small, its not great but if I wait until I’m completely ready I am never going to do anything.

Here it is – the first You Tube video looking at how some people are taught about the pelvis and why it might even be making it harder.

Bony Pelvis Video

Come to Life

I had to share this fantastic piece of work by Chris Rynn who has brought the cover of my book on William Burke to life.

Chris performed the original facial reconstruction of William Burke for my Book cover about the murderers who supplied bodies for anatomical dissection in the 1820’s in Edinburgh.

The reconstruction was based on the skull which is in the Anatomical Museum of the University of Edinburgh and also the life and death masks which are also held in the museum.

The new AI that was released last week has allowed a sense of life to be given to the reconstruction.

If you want to find out more about Burke you can get hold of the book on the shop page here or on amazon.

Lost in Translation

I suspect we all know by now that Tiger Woods has hurt his leg in a car accident.

We can all wonder at the fact that an accident which a decade ago might have resulted in amputation can now be fixed with metal rods and pins.

What a wondrous opportunity to engage the public in understanding a little more about their bodies.

This was the picture from the British press.

TIBULA!

He’s broken his Tibula!

I suppose we shouldn’t be too harsh at least there are two bones in there and they are the correct bones not like this unfortunate runner who is suffering from knee pain, mainly because that is an elbow joint in his leg.

 

The main bone in the leg is the Tibia. Before you correct me that it is the femur, remember there is a difference between the thigh and the leg.

Tibula was an ancient town in Sardinia according to Goggle but actually the same google search brings up several pictures of legs, an article on orthopaedic surgery and getty images, where a search for tibula will bring up clip art and stock images of leg bones.

Maybe as anatomists we ought to be out there being more vocal and acquainting people with the parts of their bodies.

What’s in a name?

This is an acetabulum.

It’s a wide open dish that is used to hold vinegar. This particular one came with a set of flavoured vinegars. Its open and wide so that you can dip your bread into it.

It may seem a strange object to link to anatomy but this highlights one of the things I love about anatomy – the language.

A lot of the terms in anatomy seem very complicated; muscles have big long names, and yet once you ‘crack the code’ those names tell you so much and there is not a single word wasted.

Is it long and straight? – it’s rectus. Does it contain the word superior? Then it will be closer to the head than a similarly named structure that will be called ‘inferior’. Is it anterior? Then there will be one behind it called posterior. Does it contain the phrase ‘levatator’? Then it will lift something.

Once you have cracked the code then you can guess the name of structure by knowing what it does and vice versa.

How does this relate to a dish for vinegar?

There are some structures in the body that are named after structures they look like.

The structure in the middle of this picture is an acetabulum.

It is the socket in the pelvis that the femur (thigh bone) sits in. Hopefully you can see the similarities between the two structures.

Anatomy is littered with these helpful cues that can be used to remember the names of structures. You could refer to the joint above as the hip socket – it wouldn’t remind you of the shape. Would it be easier? – maybe.

I’ve recently discovered that some people are taught about the pelvis in a way that I’m sure their instructors think is helpful. I’m not convinced. Join me in the next post where I’m going to look at the bony pelvis and some of the structures around it.