The things we do to our bodies

When you study anatomy you develop this tendency to people watch.  Whether its looking at people who walk past the coffee shop and seeing how many people in high heels can actually straighten their legs or whether it is looking at artistic performers or movement specialists in wonder.

No where is this more prominent than in sport.  The things that sports people put their bodies through, or are able to do with their bodies can be just amazing.

The distinctive kicking style of Tayla Harris is nothing short of the full splits performed whilst sprinting, no break in stride.  Whilst recent pictures on social media have prompted some repulsive comments very few have risen to the challenge of recreating the photo of the kick.

On a recent trip to America I filmed this baseball player.  Just look at the position he gets into, effortlessly.

The problem, of course, is if you push yourself to the limits at some point you are going to find them and things are going to go wrong.

The various tests for knee ligaments are something that I have performed a few times.  The cruciate ligaments hold the knee joint in place.  The Anterior Cruciate ligament (ACL) stops the femur from moving too far backwards in the joint and the Posterior Cruciate ligament does the opposite.

You test the ACL with the anterior drawer test.  The knee is bent at right angles, the foot stabilised and, with the hands behind the joint to check the hamstrings are relaxed you gently see if the tibia will move forward in the joint.  There should be some movement but not much.

It’s the same problem as a lot of these tests.  They are usually demonstrated on someone who has in tact ligaments.  Its very similar to the cranial nerve tests which are usually demonstrate with someone who has functioning cranial nerves.  How do you know what the normal range of movement is?

This week a sports injury from 2014 almost ‘broke’ the internet.

In the 2014 rugby game where South Africa took on Wales, Jean de Villiers suffered a horrific knee injury.  I’m not going to post a video of the injury because it is shocking.  If you want to see it you can find it on the internet but it is not for the faint hearted.

It was thought he would never walk again.  He had numerous operations and he made it back to playing rugby.

This week he was demonstrating on instagram that his knee was a bit loose.

That is too much movement!  And yet he is walking around on it – the body finds a way.

In the week that we also lost Niki Lauda, and realise the things his body went through and he put it through during his recovery, it’s amazing to look at what some people are prepared to put their bodies through to pursue their dreams and equally amazing what the body is capable of.

Ears and Airplanes

I’ve just returned from a trip to the USA.  I was at an anatomy conference talking about my involvement with Anatomy Nights.

If you aren’t aware of it then go over to and consider coming along to our next event.

Anyway one of the first things I thought I would explain from this trip is why your ears pop when you go up and down in an airplane.  We have all experienced it, that muffling deafness and discomfort in your ears as you take off or land.  Your mother may have told you to yawn, your father may have told you to suck a sweet, your brother may have told you to hold your nose and mouth and blow.  They are all telling you to do the same thing – open your Eustachian tube.

We aren’t meant to use eponyms anymore in anatomy so to give it its proper name it is the pharyngotympanic tube, but if we did that I wouldn’t be able to tell you about the Italian Bartolomeo Eustachi who discovered the tube along with all the bones of the inner ear.  His greatest work, Anatomical Engravings, was finished in 1552 but not published, due to religious restrictions on anatomists until 1714, when it became a best seller, a century after he died!

Anyway, the tube connects the back of the throat with the middle ear, as seen in the diagram.  The pressure either side of the ear drum is usually the same but when we ascend rapidly the pressure inside the ear becomes greater than the cabin pressure and the ear drum is forced outwards.  As we descend the opposite happens with the pressure in the cabin becoming greater than that in the inner ear and the ear drum is pushed inwards.  This affects its ability to move when sound waves hit it and so your hearing become muffled and it might be painful.

The Eustachian is normally closed so to equalise the pressure either side of the ear drum we need to open the tube to allow air in or out.  This action is achieved by swallowing, hence the advice to suck on a sweet, or by yawning which moves the jaw allowing the tube to open.  Holding your nose and blowing forces air up the tube, achieving the same result by a slight less natural route.

Did you know that the back of your throat was connected to your ears?  Does it help explain why some people get ear infections when they have a cold or flu?  Anatomy can explain it all.

Love, Lust and naming structures

With Valentine’s Day approaching this post had to be something to do with Love, or lovematters of the heart.  Whilst there is a large window of opportunity for education around the sexual organs – you only have to listen to the popular pod cast “My Dad wrote a porno” to realise there are big holes in some people’s anatomical knowledge of that region, I thought I would go with something a little more romantic (maybe I’ll cover the other angle on Patreon).

The obvious post would have been about the depiction of the heart and how you would struggle to find anything approaching a traditional heart shape, unless you were dissecting a horse. So, I decided to go with something different!

Let’s have a look at adductors and abductors and see if we can find something romantic there.


Adductors move things towards the midline of the body (they add to the body).  The adductors of the hip bring the thighs towards the midline.  They bring the two legs together.  They used to be known as one muscle group rather than the three we known them as now. Von Hildebrandt referred to this muscle group as custos virginitalis for obvious reasons.


AbAbducens come from the Latin Ab, away and Ducere, to lead.  Abductors move things away from the midline of the body.  The abducent nerve gets its name because it supplies the lateral rectus muscle of the eye, which turns the eyeball outwards.  It was once known as musculus amatorius because of its contribution to proving the sidelong glances of lovers

The naming of anatomical structures is a mixing pot of people egos and preconceptions that always provides a story that adds to the richness of the subject.


Anatomical terms. Their origin and derivation. Field and Harrison 1947

Greeks Gods and pet peevs

I recently returned from a weekend away standing around on cold concrete in wellies.  I woke on the Monday with the inability to walk – I was diagnosed with tendonitis in the greatest tendon of all – The Achilles tendon (or the calcaneal tendon as we aren’t meant to name structures after people anymore).

So what does this tendon do and why is it named so.

In short, this tendon attaches the two muscles that make up the bulk of your calf to your foot, giving you the ability to walk.  The two muscles in your leg are the Gastrocnemius; named from the Greek muscmeaning the belly of the leg, and the Soleus; named not from the Latin for sole as the muscle does not attach to the sole of the foot but named after the latin Pleuronectes solea, a sort of flat fish that the muscle resembles in shape.  These two muscles give your calf the shape that it is and both insert into the calcaneal tendon which attaches to the calcaneus, which most of you will know as your heel bone.  It is arguably connected to the plantar fascia which runs into the sole of the foot but traditionally these have been viewed as two different structures.


Its possible to develop these muscles in the gym although the simple test as to their strength is somewhat easier to do – can you go up onto tip toe?  You ought to be able to do it on each foot independently.  On Monday I couldn’t get off of the ground on one side.


So- Why Achilles?  Your opinion of Achilles will vary depending on whether your source of information is the original Iliad  poem by Homer, the many myths that have achdeveloped afterwards or Hollywood blockbusters.  The most common myth is that he was invincible, made so by his mother dipping him into the river Styx when he was a baby.  She held onto him by his ankle and hence this part of his body was vulnerable.  It was literally his Achilles heel, the term we now use for a weakness that makes someone vulnerable.  Achilles died during the Trojan wars when Paris, one of the Trojan princes shot him in the heel with an arrow. (We need to gloss over the fact that many statues and paintings depict multiple arrows in Achilles at the time of his death and also the fact that Paris started the whole Trojan war when he took Helen of Troy away from her husband, the King of Sparta, after being promised her hand in marriage by Aphrodite after he judged the Godess the winner of a beauty competition between the Greek gods. Greek myths are never simple)

Tendonitis  is inflammation of the tendon- anything ‘itis’ means inflamed.  In this case the Achilles tendon which affected my ability to go up onto my tip toes and also my ability to bend my foot pact 90 degrees, which affects walking.  A week of rest and anti inflammatories and it’s all back to normal.

So – what’s the pet peev?

You see people stretching their calf muscles all the time.  There are two different stretches for the two different muscles.  Pet peev number one – you need to do both of them to stretch out your calf.


The soleus stretch is the one people often miss out.  Both legs are bent but you are stretching the back leg and that is the one the weight should be over.  You bring the knee forward until you can feel a stretch in the back of the ankle and you hold it there.  The heel needs to be down on the ground.  The leg is bent because the two muscles differ as to where they insert.  The soleus inserts into the leg below the knee joint and so you can stretch it with the knee bent.

gastroThe more common stretch that you see people doing is the gastroc stretch.  This is the one where the back leg is straight.  This is because the gastrocnemius actually inserts onto the femur above the knee joint.  If you bend the leg then you release one end of the muscle.

Both stretches should be performed because if you just do the gastroc stretch it may not be stretching the soleus at all – it depends which of your muscles is the tighter.  When you bend the leg for the soleus stretch you take the gastrocnemius out of the picture because you have release one end of the muscle by bending the knee. It should be impossible to feel a stretch in the gastrocnemius with a bent leg.

Pet peev number two – The thing is both of these stretches are for muscles that go down the back of your leg, straight down the back of your ankle and arguably into the sole of your foot. To do the stretches properly :- The Foot Must Be Facing Forwards!

Try it yourself, get up and do a gastrocnemius stretch with your foot facing forwards and then turn your foot outwards.  The stretch completely goes.  Do not go jogging around the park or do your hours exercise class and then stretch off with your foot to the side and think you have stretched out your muscles, because you haven’t!

If you want your calf muscle to help you be invincible then you need to take care of them. Make sure you put your back foot forwards!

Why drinking can make you act like a muppet.


I was going to post this article before Christmas but that seemed a bit too much like ‘being a kill joy’ so having over consumed during the festive period you can now read all about what it did to your body.


Drinking is something most people do during the Festive period.  Scientists argue as to why we drink – there is even the suggestion that it is the foundation stone of human civilisation.  To have pubs you have to have agriculture and cooperative working between several group of people and some form of economy.  There is some talk of reward centres in the brain but given the often bad effects of excessive drink, we do not seem to learn as a society and we regularly go out and over indulge.

We should all know that alcohol comes in units, but what is a unit?  In the UK it is 8g (about 10ml) of pure alcohol.  This is the amount of alcohol that your liver can detoxify in 1 hour (yep, alcohol is a toxin and your liver is your own detox unit – you do not need to live on blueberry smoothies for a month).  This equates to one 25ml measure of spirit, a third of a pint of beer and around half of a glass of wine.  If you drink any more than this then you are going to start to feel the effects of alcohol.

Alcohol can be absorbed through any of your mucus membranes (which has led to some very strange fraternity rituals in USA) so its absorption starts as soon as it enters your champagnemouth. Fizzy things gets absorbed quicker which explains why Champagne and Prosecco can go straight to your head.  It continues to be absorbed through your stomach but most will be absorbed in your small intestine.  Once in your blood stream you can start to feel the effects.

What are those effects?

The first one is you begin to feel relaxed.

This is because alcohol binds to GABA receptors.  GABA (Gamma Amino Butyric Acid) is a neurotransmitter in your brain.  Its exact role is complicated but it increases the amount of dopamine and serotonin in your system.  By binding to the same receptors, alcohol has the same effect; you feel relaxed and maybe sleepy.

Once in your brain, alcohol can also start to effect the feedback with your prefrontal cortex, the part of your brain that deals with analysing future consequences.  Your inhibitions disappear and you are more likely to partake in activities that you wouldn’t consider if you were sober.  Continue to drink and it can start to effect your cerebellum.  This ‘little brain’ at the back of your head is responsible for coordination.  You start to stumble around and you have to adopt a shuffling wide legged stance to enable you to walk.

The second effect is your need to pee.

Often put down to the volume that you are drinking, this is not the case.  How much you need to pee is controlled by a chemical called vasopressin.  This is an antidiuretic and works with your kidneys (another detox organ) to regulate the production of urine.  Alcohol switches off the production of vasopressin and therefore you need to pee all the time.

The last effect is the hangover.

No one is 100% sure what causes the hangover.  There was some belief that it was an imbalance of electrolytes but studies have shown similar levels in those with and without hangovers.  There is some belief that it is some residue in the drink and the higher quality the drink you consume the better you will feel afterwards.  There is some belief that certain combinations of drink can produce more of a hangover than others i.e.’don’t mix grain and vine’.  Its probably due to dehydration.  you just need to rehydrate.  You can’t sweat it out by going for a run, raw eggs have no effect, although, as a resident of Scotland I do have to say I have seen Irn Bru perform wonders.

The fact is that alcohol is a toxin and you need to be aware of that when you introduce it into your body.  1 in 3 men, and 1 in 6 women will develop a health issue that is related to drink.

You need to decide if you want to drink it or not.  Cheers.


Reindeer and Angels

It’s that time of the year.  A time to get a bit fanciful and so I thought we could look at Reindeer and Angels, maybe not as you know them.

For those of you who follow the blog, you will realise that both of these feed back into a pet project – flight with functioning forelimbs.

It is an interesting intellectual problem to try and establish an anatomy that would allow for functioning wings whilst still allowing forelimbs to work.  I’m not sure its possible with what we know about avian and mammalian anatomy.   Of course, anything with functioning wings and forelimbs wouldn’t be avian or mammalian and therefore might have an anatomy we are yet to discover (if such a winged thing existed.)

Reindeer are interestingly different to this whole story line.  We are quite prepared to accept that Reindeer can fly without the need for wings.  Obviously not actually accept it, but we are happy for stories to exist that don’t incorporate wings whereas we tend to put them onto other flying beings – some superheros excepted but you have to look at that whole thing with capes.) . This reindeer is an example from the BodyWorks exhibition.  Its not how we normally see Reindeer but even it is posed in flight.  This is just accepted – at Christmas, Reindeer fly.

There are a number of spoof scientific publications along the lines of ‘Why Rudolph’s nose is red’ and this year there is even a book out about the science of Christmas looking at how reindeer fly.

Although they don’t really fit into the Christmas story (unless you are watching TV this year), Dragons are the really interesting issue in this conundrum.  Their depiction differs.  Sometimes they have functioning forelimbs and wings or sometimes, as in Game of Thrones and Harry Potter, the producer has thought about it and depicts them like bats; where their forelimbs are actually their folded wings.  The really interesting thing about Dragons is that stories of them appear in every civilisation at almost the same time period.  There isn’t a lag that would have allowed stories to move across continents with travellers which means each civilisation independently came up with the same idea!  Isn’t that fascinating? (We shall gloss over the alternative theory)

Angels are another interesting topic with which, I have to say, I have an interest in their depiction.  The ones we see at Christmas are all peaceful and spreading good news.  In fact the word angelic sums up that sort of image.  I prefer this sort of depiction in the painting by Reni.  Much more feisty.  Either way, they always have wings.  I had an interesting discussion with an artist about this, who suggested it was more to do with early painting techniques.  It used to be hard to judge whether a small figure high up in a picture was actually angelic or simply far away (I’ll wait while you all think about Father Ted).  This problem could be solved by adding wings which then made it clear to the viewer how that figure should be viewed.

It’s hard to reconcile functioning arms with functioning wings with the anatomy that we know.

These are interesting puzzles to muse over but let’s not forget that we are dealing with mythical beings.


I wish you all a Merry Christmas and a prosperous New Year.  I have several projects on the go next year, amongst which is the publication of a fiction tale revolving around angels (optional wings).

Anatomy Nights

Last February, Kat Sanders and I launched Anatomy Nights.

The concept had actually been dreamt up at a conference dinner a few months before.  There is a big push for public engagement with science.  There were currently a few people around the UK doing odd things as festivals but no big, coordinated effort.  Rather than asking people to come to the University open days to engage with us, could we really take anatomy to them?

On February 14th 2018 we had 5 different UK venues sold out with anatomists from the local medical schools taking the public through an animal heart dissection in pubs (and a school).  It was proof that the public wanted to know more about their bodies and, from the data we collected, it was clear that this method worked; people left knowing more about their bodies.  Along the way we raised nearly £1000 for the British Heart Foundation.

We repeated the success in October with animal brain dissections.

Amanda Meyer is currently attending ANZACA (The Australian and New Zealand Association of Clinical Anatomists).  At the end of her talk yesterday she put up a slide Kat had prepared asking if they wanted to join in with Anatomy Nights in 2019.

Twitter lit up!

We’ve had dozens of people joining us wanting to be involved, not just from Australia and New Zealand but from Indiana, Philadelphia, across the whole world.  A push for UK and Europe is planned for next week.

2019 looks to be an interesting year.

Hectic October

This October has been a bit manic.  Mainly due to a local science festival.

I attended the Midlothian Science Festival to deliver a talk about Burke.  This was great – I love talking about the most infamous criminal in Edinburgh because although everyone thinks they know the story, they never know it all.  I’m not sure anyone knows it all, and they never will.

Burke continued to have an effect over the month as I got a request for his photo for a talk down south about body donation.  You might think that that is a strange link but it was partly due to the actions of Burke and Hare (committing murder to supply medical school with bodies) that the 1832 Anatomy Act was passed by parliament.  It’s this act that controlled how medical school obtained bodies and large parts of it are still in force today.

He also raised his head at a great project last week where a group of enterprising Spanish tour guides booked in for a session to ensure that they are telling the correct story about Burke and Hare.  We are getting the facts out there slowly.

Another talk I gave at the festival was about the neuroscience of zombies.  This was a really interesting talk to give.  There had been months of research, watching zombie films, looking through history books etc.  The concept was to take the characteristics of zombies and use classical neuroanatomy to try to work out which part of their brain had been damaged.  The research brought home how much neuro anatomy we know because of the less than perfect design of the military helmet.

We talked about Broca, Wernicke, Holmes, Von Economo, Bodamer, Posner, cerebral ataxia, neglect, telegraphia, Patient Tan, Patient S and A, interspersed with movie clips and relating conditions to the behaviour of zombies. A bunch of teenagers sat for over an hour.  It was great! Maybe not your typical engagement event but it seemed to work.

Its now only a couple of weeks until the next Anatomy Nights event – brains.

Tickets are available at ticketsource

Come and join me for a brain dissection!


Do we cry because we’re sad – or are we sad because we cry?

My recent foray towards the humanities exposed me to the William James quote above which got me thinking on a recent holiday.

On this holiday I found myself on the Island of Capri (I was just there, it wasn’t some sort of spiritual epiphany). The Island has two towns, Capri and Anacapri, the later been known for its chairlift to the top of the Island.

I don’t really do heights but to put that into context, I took up skiing for my Duke of Edinburgh because I knew if I got good enough I would have to tackle cable cars and chair lifts and I took up amateur dramatics because I hated public speaking so, don’t like things but definite tendencies towards feeling the pain and doing it anyway.

And so, having declared that I was not going to ride this chairlift, I found myself at the base station, ticket in hand and my fit bit telling me that my resting heart rate was 110 – it’s usually low 60’s.

It was at this point, in an effort to think about something else, that I was reminded of the blog post title, and my favourite derivation of it ‘Do we stop playing because we get old or do we get old because we stop playing?’

Was my heart rate 110 because I was scared or was I scared because my heart rate was 110.

Having had a trip the previous year to Adelboden where we went on half a dozen cable cars and my pulse was over 100 for the whole day, I can confirm that it makes you feel very ill and you start to worry that something serious is going to happen. That is the start of a vicious cycle that leads to a full blown anxiety attack. You don’t want to go there when you are hanging in a chair from a cable all on your own.

So, what was happening? I was perceiving the chair ride as a threat to my life and limb and so my body was going into ‘fight or flight’ mode.

The second I thought about the chair lift, I was hijacked by my amygdala. A small almond shaped part of my brain which posed the eternal question, ‘Should I stay or should I go now?’ (You will remember the tune to the well known song.)

Because either option is going to require energy, the amygdala kicks your adrenal glands into action to produce adrenaline. (They are also called your suprarenal glands because they sit on top of your kidneys and adrenaline is also called epinephrine but that doesn’t sound so logical.)

It isn’t that simple though, far from it. Your amygdala tells your hypothalamus that there is cause for concern. This then produces a hormone called Corticotropin releasing hormone (CRH) which acts on the anterior (front part) of the pituitary gland. This is only a few centimetres away from the hypothalamus but they communicate by releasing the hormone into the blood stream – so now everywhere knows there is cause for concern.

The anterior pituitary responds to this by releasing adrenocorticotropic hormone (ACTH) which tells the adrenal glands to produce adrenaline. This whole network is called the Hypothalamic-Pituitary-Adrenal network or HPA for short (because everyone has to get a mention).

The end result is that your body is flooded with adrenaline along with steroids, corticosterone and testosterone. Your likely to be more snappy and aggressive (just speak to anyone who has shared a cable car with me), your heart rate will increase, you will sweat and feel sick.

This whole process takes milliseconds. It has developed so that in situations of real danger you are ready to act. A chair lift is not a real danger. Most of our stressors today are not real dangers. Robert Sapolsky has written a great book on it called ‘Why zebras don’t get ulcers’. You should read it.

Standing there waiting to be scooped up towards oblivion the summit, I was able to pull my frontal cortex into play, the part of my brain that had been bypassed; the part responsible for rational thought.

There must have been a moment when my brain decided I needed to be scared and yet I didn’t have the symptoms. The symptoms were caused by my reaction to the chemicals that my brain had caused to be released. My brain had decided I needed to be ready to act and that had caused me to be scared. (This encroaches on whether I am more than my brain – which is a whole different blog post).

Speculating on this got my pulse down to 80 and saw me arrive at the top of the Island.

Weirdly I don’t get the same reaction on the way down where the risks are exactly the same – go figure. Neuro is weird!

This art by @DrRabbitHeart sums up the process. Thanks for letting me use it!