How to use the Human Gross Anatomy Online Dissection Manual and make the most of your laboratory experience

This is a how-to guide for this dissector and complements the information about lab on the Course Information page. 

Note: This dissection manual was first written for the Gross Anatomy Course at Duke in the late 1960s. The text was first developed by Matt Cartmill and James Shafland. It was later expanded by Bill Hylander, Richard Kay, Ross McPhee, and Kathleen Smith. In the 1980s Mari Bouvier significantly edited and improved it. The manual was out of use from 2000-2010. An edited online version was created by Gross Anatomy teaching staff in 2011. That version is being revised steadily by the current staff of Gross Anatomy. 

This is an intensive, fast-paced, classical cadaver-based anatomy course. The laboratory portion of this course involves active dissection of a human cadaver and is designed to promote (1) an understanding of human anatomy through direct experience, (2) an understanding of human anatomical variation by examination of multiple cadavers, and (3) functional and clinical aspects of human anatomy through direct examination of associations of systems, and
team-based learning in an explicitly cooperative context through group work on the dissection including peer-to-peer teaching. All of these skills will help you in the practice of clinical medicine.

There are a lot of dissectors out there on the market. Some are wonderful. But they are also long and detailed. Duke students have found since the late 1960s that these dissectors are not suitable for everyday use in a fast-paced course like ours. But some students do find a formal dissector is helpful for preparation. If you feel that way, we recommend Grant’s Dissector (14th or 15th editions are very nice, but any old edition will do). 


Pre-Lab Preparation

There is some material that you should know before lab. Lectures will explicitly prepare you for the big concepts. But some of the smaller ones need to be dealt with before lab. For example, it is important to know the names and anatomy of bony structures before lab. You will have access to the skeletons in the lab and the bones in the model room. It is also important to know relevant microanatomy, physiology, and embryology concepts before lab. We will sometimes remind you of relevant facts in this section as well and refer you to relevant lectures. We may also provide connections between imaging and anatomy that will be helpful for preparation (although there will also be discrete modules for that throughout the course).

Before coming to the laboratory, read the relevant sections in your textbook and in the online dissection manual. Study the drawings in your atlas of the region to be dissected. Read any specific pre-lab material provided. Make sure that you understand the general developmental history of the structures in this region, and of the way in which blood supply and innervation reach them. (This last point is emphatically not the same thing as memorizing a list of paired anatomical names. This is really about making connections between anatomical parts that must work together and connecting that to what you are learning in other parts of this course). In short, please come as prepared as possible.

Pre-lab Exercises: This involves a formal pre-lab section on the web site (usually a review of the osteolgy and/or surface anatomy) and, of course, reading the dissector beforehand. How you use the dissector before lab and in lab will be very different.

Pre-lab Videos. For some days we will prepare pre-lab videos. You should watch these before lab and during lab. These videos are really how-to videos. There are certain sections that are harder to dissect than others and involve more complex topics. We provide short videos on how to proceed with those dissections. Students learn best by doing work for themselves. These do not serve as a prosection nor do they provide detailed anatomical knowledge. They are there to prepare you for the harder procedures. Some students turn also to professional videos (we provide links). Please know that these are professional videos done by anatomists with ideal cadavers and lots of time on their hands. Please do not try to follow their procedures (which are often complex and time-consuming) or assume that your dissection will look like theirs. All bodies are unique. Knowing that is key to your success in Gross Anatomy and as a doctor.


The Dissector

The dissector is your road map and your instruction manual. We provide straightforward directions (like a cookbook) along with warnings, hints, and context (like a really good cookbook). So it is organized in the following manner:

Objectives. A list of objectives and goals for the lab describing what you need to accomplish and the pace over which that might be accomplished (some objectives and tasks overlap lab days). These will be indicated in a number list. These are the goals for the specific lab.

Procedures. These will be generally in the form a bullet-point step-by-step guide. We will also note the kind of challenges that we know you will face with some of the procedures (not all procedures are equally easy) and some hints about how to get through those challenges.

Images. For each section of work (based largely on the objectives) there will be large images embedded directly in the text. These large images give an overview of the anatomy and/or illustrated instruction (i.e. where to make cuts). There will also be a few smaller thumbnail images that, when clicked on, will open in a new window and provide detailed information for a section. These are NOT a substitute for an anatomical atlas. Your table must have an atlas available and you should use it. Remember your group should buy one atlas (Grant Atlas 13th edition) for use in the lab (see other details on course requirements for further information).

Context. The anatomy dissection will seem irrelevant and take on a scavenger-hunt quality if not placed in context. So we will also provide Functional Anatomy sections that explain how the systems you are examining work together in the healthy body. At the end of the dissector on some days you will find clinical correlates for additional context.


General Lab Guidelines

Consult an articulated skeleton before beginning dissection (you may be asked to consult osteological material from the model room before lab as well) -- orient yourself and locate important landmarks on the bones. We also have an extensive bone collection in the “model room” and articulated skeletons throughout the lab. Ask your instructor to guide you on some of the key landmarks on the skeleton for the day’s dissection. 

Learn the terminology. Anatomical terminology can be a stumbling block, therefore whenever possible learn what components within the terms mean -- as in Triceps brachii muscle -- the three (Tri-)-headed (-ceps) muscle in the arm (brachii). Since there have been two major and several minor overhauls of the nomina anatomica since 1930, you may learn several alternative names for some structures. Older literature, older faculty, and comparative anatomists are going to go on retaining some of these older alternatives indefinitely. See the guide to anatomical terminology in the header of the webpages.

In dissecting and in reading, try to associate each structure you encounter with the largest structural and functional groups to which it belongs, and try to apprehend its peculiarities as a series of deviations from these general patterns. Thus, the Semimembranosus (at the back of the thigh) represents a variant of the general arrangement of the hamstring muscles (a muscle group many people know form tearing them); the hamstrings represent a variant of the general group of flexor muscles of the leg (they can flex your knee), which developed from the developmentally dorsal muscles of the developing limb; this is a specialization of the body-wall musculature, which in turn is developed from the hypaxial musculature, which arises from the myotome of the embryonic body segment. That sounds long and complicated but it actually helps make sense of what you see from a functional and developmental perspective. In this context, facts about origin, insertion, action, innervation, blood supply, and lymphatic drainage are more easily learned and retained far longer. When you have some knowledge of the structural logic of the human body, you can infer vast numbers of details from a few central facts. This is invaluable in guiding your dissection and organizing your reading.

Explore multiple ways of learning to find what works best for you and get different perspectives. Different people learn more easily in different ways; some students of anatomy will find pictorial material most useful, while others will rely on verbal descriptions, discoveries on the dissecting table, or impromptu lectures in the laboratory. Probably the best way to learn any large body of material is to try to explain it to someone else; you will benefit from searching out answers to questions raised by your partners in the laboratory. Anatomy lab is by definition a team-based exercise. Take advantage of that and learn with and from each other.

A good plan to follow when dissecting:
Most of the structures of the body have differentiated largely or wholly out of mesoderm, and they remain separated by thin layers of fascia--relatively unorganized mesodermal connective tissue. It follows that dissection is largely a matter of separating one structure from another along these fascial planes, using a blunt instrument. The most useful dissecting instruments are your fingers. This cannot be emphasized enough. Edged instruments--needles, blades, and scissors--are for use on structures too tough or too delicate to yield to blunt dissection.

Before transecting any structure, separate it from underlying tissues by blunt dissection, then insert an edged instrument underneath it and cut upwards. Scissors are generally more useful than blades. Try not to be finicky or over-meticulous in dissecting; more can be learned from a clean straight cut through a structure than from a surface that has been mangled by repeated cleaning attempts. When cutting and reflecting multiple parallel structures--e.g., the forearm flexor muscles--cut each one at a different point to facilitate replacement.

When you dissect, keep a couple of paper towels handy to receive detritus. Finally, make sure that all parts of the cadaver are kept well-moistened with water or preservative solution. This is particularly crucial in the head and the extremities. At the end of the each dissection period, replace the reflected structures in their proper positions and drape the wrappings over the cadaver. Moisten the sheet covering the cadaver thoroughly with preservative before you zip up the plastic body bag--and be sure to keep the head and extremities well moistened and tightly covered. We will provide more information on procedures and tools on the first day of class. Instructors will demonstrate techniques during the first lab. 


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Updated 09/17/15 - Zeininger