Author: Outlander Anatomist

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Fun Fact: Leech

Anatomy Def: The leech is a segmented parasitic worm, closely related to the earthworm. Leech also means a doctor or healer. Who knew? 😜

Outlander Def: “Get-them-off!” William Ransom, eighth Earl of Ellesmere, demands Claire free his limbs of the ghastly creatures!

Learn about blood, the sumptuous repast of leeches, in Anatomy Lesson #37, “Outlander Owies Part 3 – Mars and Scars.”

Ahhhh, now you may think leeches boring, if so, I think you could be wrong. Here are fascinating fun facts about leeches:

      • More than 700 species
      • Soft, muscular bodies that lengthen and shorten during movement
      • Most have front and back suckers
      • Three sharp blades to cut flesh sit under front sucker
      • Saliva contains  hirudin, anticoagulant peptide (short amino acid chain)
      •  Used in bloodletting for at least 2,500 yrs
      • Hemaphrodite – each has one female organ and 9 pairs of testes. 😳
      • Appear in Proverbs 30:15 as an archetype of insatiable greed!

Bloodletting via leech is a time-honored practice dating to ancient Greece and India. Throughout Europe, the medicinal leech, Hirudo medicinalis, was used on ailing patients to rebalance body humors.

Yet more reasons this episode was titled “Blood of My Blood!!!” 😱

In 18th and 19th century Britain, leech-gatherers travelled the marshes gathering leeches from the wild. The practice became so widespread, the population was decimated in many areas. Bloody little buggers! 😈

In Old English, lǣce, was not only the name of the animal but also referred to a physician, and lǣcecraft or leechcraft described the art of healing. Hum….

Beginning in about 1980, leeches enjoyed a resurgence in modern medicine. Today, many hospitals stock them to treat:

      • Joint disease such as epicondylitis and osteoarthritis
      • Vein diseases of the extremities
      • Microsurgery
      • Blood-clotting disorders using hirudin

WARNING! If you sport a strong wame, watch this PBS video of how a leech attaches, how it feeds and its use in modern medicine. Watch at your own discretion.  There will be blood!!!  😷

Important! A leech can be removed by breaking the seal of front and back suckers with a fingernail or other flat, blunt object, flicking the leech away. Irritating the leech with a cigarette, vinegar, salt or soap may cause it to regurgitate stomach contents into the wound and transmit pathogens to its victim. Not common, but it has been reported. 

Read about leeches in The Drums of Autumn as Lord John Grey and his “son,” William Ransom, arrive unannounced at Fraser’s Ridge. Make no mistake, Claire recognizes Jamie’s get! 😉

Blundering out of the stream, I shoved my way through the tangled branches, and burst through into the clear space beyond. A boy was dancing on the bank above me, slapping madly at his legs and howling as he hopped and fro.

“What—?” I began, and he glanced up at me, blue eyes wide with startlement at my sudden appearance.

…“Leeches,” I said, professional calm descending by habit over personal tumult. It couldn’t be, I was telling myself, at the same time that I knew it damn well was. “It’s only leeches. They won’t hurt you.” 

“I know what they are!” he said. “Get them off me!” He swatted at his calf, shuddering with dislike. “They’re vile!” 

“Oh, not so terribly vile,” I said, beginning to get a grip on myself. “They have their uses.” 

“I don’t care what use they are!” he bellowed, stamping in frustration. “I hate them, get them off me!” 

“Well, stop whacking at them,” I said sharply. “Sit you down and I’ll take care of it.” 

He hesitated, glaring at me suspiciously, but reluctantly sat down on a rock, thrusting his leech-spattered legs out in front of him. 

“Get them off now!” he demanded.

See leeches feasting on Willie’s blood in Outlander episode 406, Blood of My Blood. 🚫 Leeches for this Lord!

The deeply grateful,

Outlander Anatomist

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Photo and Video Credits: Sony/Starz, PBS

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Fun Fact: Posterior Median Furrow

Anatomy Def: Midline vertical depression in the surface of the back (red arrows).

Outlander Def:  Deep, lovely groove of Jamie’s back!  

Get in the groove and Learn about Jamie’s back furrow by reading Anatomy Lesson #10, Jamie’s Back!

The posterior median furrow (PMF) literally means “back middle groove.” This vertical depression is most visible in thoracic and lumbar regions of the back. It tends to be shallow in the cervical region, diminishes over the sacrum and is continuous with the gluteal cleft (Aye, the sweet cheeks! <G>).

PMF is most visible in those with robust para-spinal (erector spinae) muscles. These muscles flank the vertebral column; the more developed the muscles, the deeper the PMF.

PMF is useful during physical exam because the vertebral spines can be palpated and counted in the groove. Specific vertebral spines mark levels for anesthesia delivery, location of abdominal organs, and vascular anatomy. For example, C3 marks the level of the hyoid bone (wink, wink to book readers).

More Fun Facts: English is replete with idioms about the back. These are  a few of the many:

  • Back away
  • Back me up
  • Back and forth
  • Back to square one
  • Back in the day
  • Back to the drawing board
  • Back down from
  • Back the wrong horse
  • Back to back
  • Back in circulation

Read about Jamie’s posterior median furrow in Outlander book. Yes, Herself describes it! 👏🏻👏🏻👏🏻

Compassionate Claire notes the groove as she describes Jamie’s badly damaged back: 

He sat patiently, not moving as I circled behind him and inspected his back…I was appalled…The scars covered his entire back from shoulders to waist. While many had faded to little more than thin white lines, the worst formed thick silver wedges, cutting across the smooth muscles. I thought with some regret that it must have been quite a beautiful back at one time. His skin was fair and fresh, and the lines of bone and muscle were still solid and graceful, the shoulders flat and square-set and the backbone a smooth, straight groove cut deep between the rounded columns of muscle that rose on either side of it…I tried not to imagine the muscular arms raised…ropes cutting into wrists, the coppery head pressed hard against the post in agony…Involuntarily, I reached out, as though I might heal him with a touch and erase the marks with my fingers. He sighed deeply, but didn’t move as I traced the deep scars, one by one, as though to show him the extent of the damage he couldn’t see.

Och! See Jamie’s PMF in Outlander, episode 105, Rent, after Uncle Dougal rends Jamie’s sark to expose BJR’s handiwork! 😱 Back off, Dougal!

The deeply grateful,

Outlander Anatomist

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Photo Credit: Sony/Starz

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Fun Fact: Tendinous Intersection

Anatomy Def: Tendinous intersections are fibrous bands crossing the rectus abdominis muscles and marked by overlying skin grooves (curved red arrow).

Outlander Def: Belly grooves defining Jamie’s six-pack. Woot!

Learn about tendinous intersections (TAs) in Anatomy Lesson #16, Jamie’s Belly or Scottish Six-Pack.

Skin grooves overlying TAs are typically visible only in the lean and fit. Most humans have three pair:

    • Pair near tip of breastbone (xiphoid process),
    • Pair at navel
    • Pair midway between xiphoid and navel

Anatomical Variations:

  • TAs may be  horizontal, zigzag, arched or oblique
  • TA may be offset relative to its partner
  • Partial TAs are common (see Jamies top L groove)
  • 4th (& 5th) TA pairs may occur but usually incomplete
  • Extra TA pairs produce  an eight-pack

Question: Why do we have TAs? Are they for beauty or are they useful? Turns out, they are extremely useful.

As rectus abdominis muscles contract, the torso draws nearer the lower body. This is forward flexion. TAs allow rectus abdominis muscles to contract in segments permitting greater control over the degree of forward flexion.

Without TAs, there would be one long rectus abdominis on each side. Reduced strength can be predicted along with reduced control over the degree of forward flexion.

Does this ever happen? There is one report in the literature of a man who died at 64. Subsequent dissection revealed he had no TAs in either rectus abdominis muscle, so clearly, one can survive without these interesting structures.

Fun Fact:  are studied because the rectus abdominis muscle is used in reconstructive surgeries, especially those involving the breast.

Read about Jamie’s belly in Outlander book. Here’s Claire’s “frank” (Isn’t he 200 years away?) appraisal of Jamie on their wedding night:

“Take off your shirt,” I said, sitting up and pulling at the hem of the garment.

“Why?” he asked, but sat up and obliged. I knelt in front of him, admiring his naked body.

” ‘Because I want to look at you,’ I said.

He was beautifully made, with long graceful bones and flat muscles that flowed smoothly from the curves of chest and shoulder to the slight concavities of belly and thigh.”

See Jamie’s beautiful belly with its tendinous intersections in the above  publicity photo.

‘Nuff said!

The deeply grateful,

Outlander Anatomist

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Photo Credit: Sony, Entertainment Weekly