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Lower Extremity Dissection Human Cadaver Dissection Course Dr. Anne Geller San Diego Mesa College - 2012 Michael R. Dunbar

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Lower Extremity Dissection

Lower Extremity DissectionHuman Cadaver Dissection CourseDr. Anne GellerSan Diego Mesa College - 2012Michael R. Dunbar

Initial Observations Assigned lower extremity dissection of an adult male, approximate age determined in mid-late 50s. COD related to cardiovascular disease.Cadaver presented in supine position, dissection to begin on anterior thigh and transition to leg before rotating to posterior aspect.Approach determined, dissection guideline developed and submitted for approval.

Initial incision and removal of skin

Cutaneous Removal & Adipose Layer

Removal of skin to reveal subdermal adipose tissue determined to be tedious process Adipose tissue reveals multitude of cutaenous blood vessels and nerves

Anterior Thigh

Anterior thigh with cutaneous layer reflected to reveal adipose and fascia.Medial thigh. Observe: Great Saphenous Vein

Notable Superficial Landmarks

Supromedial superficial inguinal lymph nodeLateral femoral cutaenous nerve

Femoral Triangle

Once adipose is cleared from field of view, fascia must be removed. The Femoral Triangle is a common area with recognizable landmarks and a number of vital structures that pass through it.

Femoral Blood Vessels & Nerve

Anterior Leg

Utilizing similar techniques, now slightly refined compared to initial dissection, transition to anterior leg.

Anterior Leg

Observe the superficial nature of the Tibia; note directly lateral the Tibialis AnteriorNote the Extensor Hallucis Longus situated between the Tibialis Anterior and Extensor Digitorum Longus

Anterior Leg Continued

Observe the Anterior Tibial Artery

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Posterior Aspect While anterior aspect was compartmentalized; posterior dissection was performed on a broader scale due to time constraints; note that cutaneous layer is removed and adipose is being removed to reveal underlying musculature in its entirety

Posterior Thigh

Observe hamstrings, deep femoral artery, sciatic nerve

Posterior Thigh Interior CompartmentObserve Femoral artery and Superior Genicular ArteryNote that the Sciatic nerve branches into the Tibial and Common Peroneal Nerves

Posterior LegObserve the Gastrocnemius as it lays superficially to the SoleusNote the superficial, Posterior Tibial Artery

Posterior Leg - ContinuedObserve the Tibial Nerve laying beneath the head of the Gastornemius and Soleus

Posterior Leg Calcaneal TendonCalcaneal tendon was cut in order to reflect the superficial musculature away in order to see deep laying structures. Should be noted the thickness and density of the tendon was difficult to cut, even with scalpel.

Posterior Leg Deep StructuresWith Soleus partially reflected away, note Tibial nerve as it runs along the Flexor Hallucis Longus as well as the Lateral Sural Cutaneous nerve

Notes of OmissionIt should be noted that the knee dissection was omitted, this was factored at the beginning of the semester due to lack of dissection partner.Also note the foot dissection was omitted, this was also determined at the beginning of the semester due to the complexity of the foot and the small and delicate structures contained within.

End of Semester ObservationsTime may be the enemy, but discovering and preserving minor cutaneous nerves and blood vessels gives better appreciation for mechanics of biological functions.Anticipate to make mistakes, learn from themThis is an excellent learning experience, ensure the takeaway is worth it; work slow but steady, observe the major landmarks, but appreciate the small details that are often overlooked. Respect that a human being has chosen to give their body to science so the students as well as the medical community can broaden its understanding of human anatomy and physiology

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