Days Seven - Ten: The abdomen.

When you open up an abdominal wall for dissection you make three large cuts; one along the midline of the abdomen, skirting around the bellybutton then two additional cuts from the bellybutton to the side of the body, creating four quadrants of fascia, fat, and skin. After examining what occupies that space above the muscles during day seven, (and uncovering a textbook external inguinal ring, round ligament, and ilioinguinal nerve I shall add) we dove deeper past muscle fibers, tendons, and more facia on day eight. This needed to be done carefully too because what lies beneath these layers, though in principle identifiable, could be all to unmistakably horrid and rancid. DO NOT CUT THE INTESTINES!!! We did not cut the intestines but we were still incredibly confused by what we found yet AGAIN!

Normally a relatively large sheet (greater-omentum) of fat and other tissue with a network of blood vessels passing through it blankets the majority of the gut tube. So we were confused to see no such sheet covering Penny’s contents. We prodded a greenish-blobular mess in the upper right quadrant and we all thought it could be the gallbladder – an ENORMOUS gall bladder – but we were at a loss to find the liver which should be right next to it… Hmmm??? Turns out that for some unexplained reason, Penny’s greater omentum was reflected superiorly over her stomach and liver, shielding it from our view. We were poking at her cecum, aka large intestines, and that could have been bad… very bad.

I really enjoyed this lab but had a hard time grasping all of it so I went back the next day (Saturday) to review and re-pin all the structures we needed to know. I learned A LOT that way and was again fascinated by the vascularization of the body – there is something stupendously satisfying about tracing the course of blood flow throughout the body; deciphering the roads most often traveled and those taken when driven off course – the abdomen is filled with an astonishing network of conduits what are not prepared to give up easily, but alas, they will fail if you treat your body poorly – I’m not saying you have hemorrhoids because you drink like a fish and eat like salt like a deer on a hunting range… but if you do, think twice… I hear those things are painful. By day nine I was familiar with the alimentary tract and it’s innervations – after cutting it out of the body it became more difficult to conceptualize though. With mesentery in place, tracing the path your food takes post-stomach is a lot more difficult on a lunch tray than it is when connected to the body properly…

Day ten we were finally past the ‘guts of the course’ and on to striated muscles and nerves again. What a lesson in variation this lab was. Lumbar nerves are NOT textbook. Nor are the arteries and veins that descend and ascend the trunk and legs. It took me two days to clean Penny’s vessels and didn’t I find some tricky situations. Lesson learned – look to where the vessel goes, not where it came from. (As I write this post exam I say assuredly, people lost points on Penny because they pinned the obturator artery on her – and she don’t have a normal branching obturator at all – fortunately for me, I know my body).