clairerandall – Outlander Anatomy

March 31, 2015February 16, 2016

Anatomy Lesson 18: “Hallelujah Chorus Part Deux”

Hallo again! By the time many of you read this I will be on a plane headed for NYC to attend the Starz Mid-Season Premier of Outlander on April 1! I am so excited and deeply grateful to be attending this amazing event! Hope to see some of you there!

Once again, we are wedding guests looking at lots of applied anatomy from the 2^nd half of Starz episode 7, The Wedding. We start with another short Anatomy Lesson #18: Tensor Fasciae Latae.

After Lesson #18 it’s Q&A time because today is our midterm practical exam! Pssst. We will score it but don’t fash, no one is keeping track! So, pull out quill and paper. You will grade your exam on the honor system: open book, score your own paper AND it’s graded on a curve! You can check back to any Anatomy Lesson or elsewhere to find an answer. When you get an answer right, you will receive a wee Scottish badge. Oh, and just so you ken, a few gratuitous images have no Q or A; these are thrown in to keep us all wide AWAKE!

The questions in our practical exam will once again follow the sequence of anatomical structures as they appear in Starz episode 107, The Wedding; all but two images are from this episode.

Sort of Spoiler Alert: Included is a hint of a spoiler so before it comes up, there is a warning so you can skip if you choose. Watch for it!

Now for tensor fasciae later: you may recall from Anatomy Lesson #7 that anatomists divide the lower limb into thigh and leg: thigh is between hip and knee joints and leg is between knee and ankle joints. That lesson also revealed that thigh muscles are wrapped in the fascia lata (Photo A), a strong connective tissue stocking that blends with connective tissue overlying gluteus maximus (Photo A – red arrow) and leg (Photo A – blue arrow).

Photo A

At the side of the thigh, fascia lata is markedly thickened as the iliotibial (IT) tract or IT band which extends from ASIS and iliac crest (Anatomy Lesson #16) to tibia (Anatomy Lesson # 9).

Photo B

Now for the muscle of the day: tensor fasciae later (TFL). TFL arises from iliac crest and ASIS (Anatomy Lesson #7) and ends below the hip joint by inserting into the IT band (Photo C). TFL and Gluteus maximus (Anatomy Lesson #1) fibers also attach to the IT band along a shared boundary (Photo C – green arrow). TFL is an unsung hero muscle that gets little attention unless injured or overly tight. It is strengthened along with other hip muscles because it has several actions: as the name implies it places tension on the fascia lata. But, it also helps flex, abduct (move away from body) and medially rotate (turn inward) the thigh. But more importantly, it helps keep the pelvis level while standing, walking, or running. Runners especially should thoroughly stretch TFL after exercise to keep it supple and lengthened. An online search for TFL stretches yields some excellent options.

Photo C

Would you like to see a great example of the TFL? No surprise but Jamie is our model yet again! Aye, the man has an extraordinarily well-developed TFL (red arrow) extending from iliac crest (yellow arrow) above to just below the hip joint (blue arrow); the long groove (green arrow – color coded to match Photo C) is the IT band shared between TFL and gluteus maximus. As an anatomist, I’m AM duly impressed because this muscle is often overlooked in both identification and development! It is strengthened by leg presses and exercises such as running and climbing. Whew! Every one start breathing now…in 2, 3, 4, – out 2, 3, 4…..

Now where did we leave off in The Wedding, Part One? Ah yes, Jamie is busy trying to woo Claire by telling her that her hair is a real turn-on. Aye, he loves those curls. To prove it, here’s quote from Herself’s own quill (Outlander book):

“You’ve the loveliest hair,” said Jamie, watching me. “What? This? ” …“But it’s so … curly,” I said, blushing a little. “Aye, of course.” He looked surprised. “I heard one of Dougal’s girls say to a friend at the Castle that it would take three hours with the hot tongs to make hers look like that. She said she’d like to scratch your eyes out for looking like that and not lifting a hand to do so.”

So we return to the story line where we left off during practice practical (Anatomy Lesson #17) so let’s start the Q & A for our midterm exam. Aye, this one is for credit so do your very best!

Claire puts the kibosh on Jamie’s courting by commenting on his new kilt – a true Fraser- treasure! He squats down to pick up his Fraser colors and more story-telling ensues.

Q # 1: Name the taut structure at the side of Jamie’s left leg. (Anatomy Lesson #7)

A # 1: IT (iliotibial) band or tract. Right as rain. Pocket Jamie for you!

Jamie then recounts Murtagh Fitzgibbons Fraser’s role in collecting his wedding clothes. I LOVE this scene between Jamie and his faithful godfather because Murtagh always has Jamie’s back! Plus, he is verra fond of Claire: he rescued her from BJR and he actually talks to her while assiduously avoiding every other woman on the planet.

“What do you make of her” asks Jamie – “Mistress Beauchamp?” Murtagh takes pity on him saying “your mother had the sweetest smile. Warm a man all the way to the backbone. Claire’s smile is just as sweet.” Awww, it made my heart melt. Murtagh’s own smile is just as sweet as he polishes Jamie’s brooch. His beard is full and heavy; made of terminal hairs ye ken – a secondary sex characteristic in men.

Q #2: What hormone causes Murtagh’s beard growth? (Anatomy Lesson #6)

A #2: Testosterone (androgen is OK too). Excellent! A bearded Scottish thistle for you!

Then another two days of storytelling as Jamie recounts his cat-and-mouse wedding game with his ever-lovin’ Uncle Dougal. Uncle D was in such a hurry, but Jamie slowed him down with three conditions which Dougal eagerly supported with “Christ, it would be easier to kill you both!” The conditions are: 1) marriage in a kirk by a priest suffering with an 18^th century rhinovirus; 2) a ring made from sporran litter (not really) ; 3) and a nice ill-repute dress for Claire. Herself writes about Claire’s dress in Outlander:

Ned was carrying the dress in question, hanging from one hand like a dead animal. Smoothed out on the bed, it proved to be a low- necked gown ………..The innkeeper was half- buried in the petticoats he carried, his bristling whiskers barely visible over the foamy layers.

Ned got her dress from a what-house? Claire accuses Jamie of telling a big old whopper, but he says no way, Jose … I’m telling you the truth, the whole truth and nothing but the truth! Ned was ‘grinning like a taw-tailed dog” beaming about his visit to the pleasure palace. That Ned is an 18^th century stealth drone!

Q # 3: Name the muscle at the outside of Jamie’s thigh. (Anatomy Lesson #7)

A #3: Vastus lateralis. Oh, aye, it’s grand! Here’s a set of bagpipes for ye.

Although Claire is fair saturated in whisky, Jamie remembers “every moment – every second” of sun-drenched Claire in her beautiful wedding dress! And we ken why; a low-necked wedding dress indeed! Geez, if that amazing gown plunged any lower, we might be staring at Claire’s navel! But, she looks fantastic and her ever-gallant betrothed bows to his bride of astonishing beauty: “Your servant, Madam.”

A wee aside here: truth be told Jamie isna always a gallant gentleman. See what I mean (Starz episode 101, Sassenach)? He shoves her off the saddle! Help! She’s going over!

Back to our story…Dougal gets mighty bored and annoyed with their I-don’t-know-your-name chit-chat: “Well, if you two are quite finished let’s get on with it.” Geez Uncle D., give them a break. You are fiercely determined that Jamie marries an English woman so he canna become laird of clan MacKenzie and that Claire doesna spill the beans about Jacobite fund raising. At least let the lass hear her groom’s name before she swears her vows!

Q # 4: Name the muscle lifting Dougal’s eyebrows and wrinkling his forehead skin (Anatomy Lesson #11)

A #4: Frontalis. Good! Have a wee statue of Robert Burns, Scotland’s national bard.

It’s facetime in kirk and Claire plants three good ones on Jamie. This is a “when-you-kissed-me-like-that” type of kiss; it produces an audible smack and requires a wee bit of suction caused by a verra important mouth muscle. Remember it? You should all get this right as we’ve learnt it over and over and over!

Q # 5: Name the muscle that Jamie and Claire use to pucker up for this kiss. (Anatomy Lesson #14)

A #5: Orbicularis oris. Wow! You get a unicorn, the national animal of Scotland.

Next, as part of a blood vow, Dougal cuts Claire across the palmar surface of her wrist. Wow, Big D that’s a major slash; it’s going to leave a deep line across the base of her wrist! Mayhap ye feel a wee bit jealous?

“Blood of my blood, bone of my bone” … Sniff, my tears are pooling on the floor. Truly!

Q # 6: Yes or no. Did Dougal’s wrist slash cut Claire’s cephalic vein? (Anatomy Lesson #17)

A #6: No. The cephalic vein is on the sides of forearm and arm. The flag of Scotland for ye that got the correct answer!

Next Jamie recalls every moment – every second of the ceremony, which touches Claire’s heart. In thanks, she tells him to get his behind off that couch and take off his shirt. Huh? Jamie narrows his eyes: Ye want me to do whaaaat?

Q # 7: Name the muscles narrowing Jamie’s eyelids. (Anatomy Lesson #11)

A #7: Orbicularis oculi. Ye earned a shaggy highland coo!

She wants to look at you Jamie and he is most obliging: well why didn’t you say so in the first place? Soon, Claire’s doing a 360° scoping him from hither to thither: She likes what she sees to be sure. If ye didna notice during the 10^nth times ye watched this episode go back and take another look see: Jamie clenches his fist as Claire slowly waltzes around him. It takes him a few to relax that tight grip under her land grant survey. I’m thinking it might be tough to stand naked and still while someone you want to like you does a full inventory of your, ahem, body parts and passions.

Q # 8: Name the muscle under Claire’s left palm and forearm. (Anatomy Lesson #1)

A #8: Gluteus maximus. Aye, it does extend that far to the side. Have a pocket Murtagh!

Hey, sassy-lassie, what are ye looking at? Weel, we ALL looked! It’s even been on the back of a bus (think that was photoshopped)!

Q # 9: Name red region of Jamie’s lips. (Anatomy Lesson #14)

A #9: Vermillion zone (vermillion border is OK). You get the MacKenzie war chief!

Claire is so overwhelmed with the beauty of her gallant gent that she gently touches her nose to his back. She says to herself to herself says she: “I am NOT leaving this for hot running H₂0!”

Q # 10: Name the very powerful muscle in Jamie’s neck (Anatomy Lesson #12)

A #10: Sternocleidomastoid (SCM). If ye got it right how about a Scottish pillow to rest your weary heid after all that studying?

Okay, now fair’s fair, fair-Claire. Take off yours too! Jamie isn’t going to let you get away with ogling his beautiful bod and you not doing the same for him! Even-Stephen.

Q #11: Name the bony points of Jamie’s shoulders. (Anatomy Lesson #2 and Anatomy Lesson #3)

A #11: Acromions (points of shoulder). Wonder if JAMMF knows where his are? Here, have a dram! Whew, ye earned it!

Claire slowly and delicately (aye, the lass enjoys doing a strip-tease) unties the neckline of her shift. That Jamie, he don’t say nothing to nobody.

Q #12: Name the part of Jamie’s spine at the tip of the red arrow. (Anatomy Lesson #10)

A #12: Sacrum. Here’s a sassy Rupert for answering correctly.

Now time to put on my nit-pick hat: a wee comment about the whip lash scars shown in the image above. The lashes administered at Fort William (Starz episode #106, The Garrison Commander) didn’t descend below the level of Jamie’s kilt but this prosthesis surely does! I don’t want to quibble (well, mayhap I do) but during that scene Jamie’s kilt rides just below his navel (L3-L4 IV disc – green dashed line) but this prosthesis extends to about S4 level (yellow dashed line). Also, the scars would not cover the sacrum without also including the buttock skin; BJR wasn’t that skillful with his whip. Darn! This creates internal strife that keeps me awake at night and believe me, I need my beauty rest!

Okay, moving onward…Claire’s making progress on that ribbon but not fast enough for Jamie. Patience man!

Q #13: Name the midline bone in Jamie’s chest. (Anatomy Lesson #15)

A #13: Sternum (breast bone) Rah, Rah! Ye get your own Scottish Deerhound (loyal to the bone)!

Well, now, will ye look at that! Ever the fashion plate, Claire wears the latest in 19^th century undergarments. Marketed as the Convallaria majalis French corset, it is sold only at Victorious Secret, a new lingerie shop in Inverness. Order yours online. Careful though, it is poisonous! Claire’s torso is sinuous and her beautiful belly is flat and taut.

Q #14: Name the midline groove of Claire’s belly. (Anatomy Lesson #16)

A #14: Linea alba. Yessss; you win half a French corset (hey, at least it’s not made outta thistle)!

Then things start moving at warp speed: Beam me up Scottie! Jamie picks Claire up, she winds her legs around his torso and he sits them down on that yummy pelt comforter! He hugs her close and…

Spoiler alert!

Weel, sort-of-Spoiler Alert: The next image mentions a structure that may appear in future episodes. If you don’t want to read about it, best skip over the next paragraph and image.

Oh, you decided to stay after all? Well then, follow the red arrows and take a close look at Claire’s left arm. Look closely now…closer. What do you see? Aha! It’s Claire’s smallpox scar proving she came from the 20^th century. None of the Highlanders ken the scar or its meaning, but we do! Jamie, he’s paying no mind to that dinky little skin spot!

Continuing with the same theme, Jamie has his hands all over Claire’s skin. Well, Mrs. Fitz did say that with skin as fair as hers, Claire’s next hubby would be a lucky man (Starz episode 103, The Gathering). She straddles him with her thighs but – whistle and shout- it’s her (lower) leg I ask ye to consider. Recall the leg has two bones?

Q #15: Name one bone of Claire’s leg (Anatomy Lesson #9)

A #15: Tibia or fibula. Here’s your very own pocket Claire! Everyone needs a wee winsome Beaton!

Next, Jamie flips Claire over and gives her some well-deserved TLC! Yep, he finally makes it to home base. Claire, Jamie didna know that no woman could…well, could! Jamie, Claire had no idea this talented lad could…well, could! Aye, he’s a quick learner. Herself describes IT well in Outlander:

“I do not know if it will help, he said, quietly, but I will tell you this: it is a gift and a wonder to me, to know that I can please you – that your body can rouse to mine. I hadna thought of such a thing-beforehand.”

Aye, Jamie, there’s one steep learning curve in front of you – Claire has more secrets to teach you but we ken you are (throat clearing) up to the challenge!

Q #16: Name the vein at the red arrows (Anatomy Lesson #17).

A #16: Cephalic vein. Righto! Have a feisty Highlander and his glass of Spanish port!

The new DVDs from the first half of Starz Outlander season 1 feature a deleted wedding scene where in the sneezing priest tells Claire she must vow “to be meek and obedient in bed…” Ah….HUH? Obviously this naive man of the cloth hasn’t a clue about our Claire! Her gallant almost-hubby is a bit bemused himself! But the lass is appalled by such a barbaric notion! Her face glows with a thunderous expression as this outlandish idea echoes through her grey matter. Prompted again, she mutinously mutters the vow (It’s true: older Christian vows did include this statement. Look it up.). Verra soon Claire will break this promise, too! Take a wee keek at the next picture to see if Claire is meek and obedient in bed!

Herself explains it best in Outlander:

You are not going to hurt me,” I said impatiently. “And if you did, I wouldn’t mind.” Seeing puzzled incomprehension on his face, I decided to show him what I meant. “What are you doing?” he asked, shocked. “Just what it looks like. Hold still.” After a few moments, I began to use my teeth … ”Did I hurt you?” I asked “Yes. A little.” He sounded half-strangled. Do you want me to stop? “No!”

NO! NO! NO! J.H.R.C., don’t stop now!

Aye, she teaches him a few things that makes him one Happy Highlander. Like Mrs. Fitz, that Claire is.a.wonder!

Q #17: Teeth enamel is derived from what body organ? (Anatomy Lesson #5)

A #17: Skin (or mouth mucosa). The largest organ of the body! Have a couple of sign dubhs (to pick your teeth with).

Endorphins swirling through his cephalic veins, Jamie falls asleep in, oh, two nanoseconds: the lad smiles in his sleep, a sure sign he’s happy.

Q #18: Name the facial bone at the tip of the arrow. (Anatomy Lesson #8)

A #18: Zygomatic bone/arch (cheek bone). That was a difficult one. Here’s Jamie and Donas as yer reward!

Leaving her lovey hubby snoozing away, Claire zips downstairs for water. Mayhap a wee bit too much alcohol – she’s dehydrated! As Jamie’s sleeps the sleep of the innocent, Dougal swoops into the tap room and comes onto Mrs. Fraser offering her “other” pleasures. Hey! Claire isn’t into you Dougal man! Dinna ye recall what she did at Castle Leoch (Starz episode 104, The Gathering)? Aye, she slapped, kicked and hit you over the head! Get with the program. Buzz off – she hankers no one but her Bonny Beau!

Q #19: Name the pigment that colors Claire’s hair. (Anatomy Lesson #6)

A #19: Melanin (most accurately eumelanin). Excellent! Enjoy this really, superb book!

Rupert has perfect timing. He walks in, takes a gander at Claire and mutters “Jamie may be no experienced but that one looks well-rrrrrrridden.” Puir man he hasna a clue that Doreen-bedding Dougal just made a major lass-pass. Dougal being a totally temperate war chief punches faithful Rupert in the face telling him to git his arse out of there and tend to the horses.

Och, mayhap Rupert had the sight by observing that Clair had been out for a bare-back ride. Her lovely upswept wedding do is utterly destroyed: hair tumbling down over her shoulders and curling madly around her face. Wrapped in her new hubby’s kilt and sporting a magnificent new ring and rosy glow, she looks well-ridden indeed! Saddle up! Whinny and snort!

Do you ken that Claire mused on being ridden by Jamie way back at Castle Leoch (Starz episode 102) as she tended his gunshot wound? Crying for her not-yet-born Frank, Jamie comforts her against his warm broad chest. What did Claire think as Jamie was easing her loss? Weel, no need to guess: Herself tells us in Outlander book:

“My sobs lessened and I began to calm myself, leaning tiredly into the curve of his shoulder. No wonder he was so good with horses, I thought blearily, feeling his fingers rubbing gently behind my ears, listening to the soothing, incomprehensible speech. If I were a horse, I’d let him ride me anywhere.”

And she did! Rupert man, ye are clairvoyant!

Later, Jamie awakens and sees Claire musing before the fire.

Q # 20: Name the horizontal grooves on Jamie’s abdominal skin. (Anatomy Lesson #16)

A #20: Tentinous intersections of rectus abdominis. Have a Scotty dog…no, they’re not in the Outlander books but they’re really cute!

Jamie hones in on Claire like a beacon bringing her his mother’s Scotch pearls. Question #21 is a bonus question! Yesssss, a chance to get extra credit!

Q #21: Name the structure deep to the skin groove at tip of the red arrow. (Anatomy Lesson #16)

A #21: Inguinal ligament. Good work! Here is a reward for “giving us a wee bit of fun”…a regal Scottish stag.

Jamie, you dear, dear man: you really know how to turn a lassie’s head! Claire now that is a string of pearls – not that balderdash you fussed about at the beginning of episode 107 comparing your life with Frank to a string of pearls.

Here’s our last image: the cutest pair of she + he knees I ever kent. But, don’t fash, we will likely return to this episode for future anatomy lessons.

Our own joy ride is over. Darn! Time to grade your papers. How many icons did you get?:

0-5 badges = A

5-10 badges = A+

10-15 badges = A++

15-20 badges = A+++

15-20 badges + bonus = off the charts!

See: You all got at an A or better because we grade on the curve! (Talk about grade inflation.) Thanks for playing along as we suffered through droughtlander and pined away for April 4^th! It’s almost here and then a whole new set of episodes for anatomical dissection!

HALLEULJAH, HALLEULJAH, HALLELUJAH, HALLELUJAH ………HAL …..…LE…..…LU…………JAHHHHHH!

A deeply grateful,

Outlander Anatomist

image creds: Starz, Netter’s Atlas of Human Anatomy, 4^th ed., www.netalloy.com, www.kevie.co.uk, www.songerconsulting.net, www.johnnyautomatic.com , www.outlanderlife.com, www.pinterest.com, www.openclipart.com, http://wiki.vanessalionel.fr, http://corenominal.org, http://antumdeluge.wordpress.com/, http://maevevella.com ClipartsofLazur URH, Clipartsofanonymous, www.4vector.com, www.wikipedia

November 12, 2014February 12, 2021

Anatomy Lesson #6: “Claire’s Hair – Jamie’s Mane” or “Jesus H. Roosevelt Christ!”

Hallo again, friends of Outlander Anatomy! Today’s Anatomy Lesson #6: The Skin – Part 2, Hair, will continue with skin but, today, will focus on hair, hair follicles, arrector pili muscles and sebaceous glands, all of which you learned from Skin Part 1 are made by skin and are therefore appendages of this organ.

Now, before we get on with today’s lesson, I must confess that I did a quiet switcheroo on you in the last anatomy lesson. My first four lessons were confined to that part of human anatomy known as gross anatomy, the field revealed by human dissection.

Nay…not that kind of gross, Rupert! It is termed “gross” not because it is yucky, but because it deals with structures visible to the naked eye. In Anatomy Lesson #5, I switched (without telling) to another field of human anatomy, that of microscopic anatomy.

Microscopes are used to magnify structures too wee for us to see with eyes unaided by magnifying lenses. Many of today’s images are drawings made from images observed with a compound microscope such as this one (photo A):

photo A

Once again there are 3-D images taken with powerful SEM/scanning electron microscope (Photo B). I have used both types of microscopes many times in teaching and various research projects!

photo B

Now, getting in the mood for today’s Anatomy Lesson: Skin 2 – the Hair! As with skin, Herself often writes about hair in the Outlander books, offering her audience a more intimate glimpse into characters and situations through vivid use of this physical trait. So, once again, I begin our lesson with images from the Starz Outlander series and with words from the Outlander books.

Let’s begin with our heroine. Early in Starz episode 1, Sassenach, Claire emerges from the roadster standing in the picturesque village of Inverness. We can clearly appreciate her dark brown hair – very full and very curly.

Later, during a lighting storm, Herself writes

The wind was rising and the very air of the bedroom was prickly with electricity. I drew the brush through my hair, making the curls snap with static and spring into knots and furious tangles!

The humid air makes Claire’s hair wildly curly and disobedient (Starz, episode 101, Sassenach) to which she exclaims: Jesus H. Roosevelt Christ!!!

All the while, someone is awatching her futile struggles through the window of her room.

Nay, it isn’t a peeping tom, it is a keeking Jamie! Ha!

This next image of Claire always makes me laugh! In Starz episode 102, Castle Leoch, Mrs. Fitz unceremoniously rouses Claire from her sleep, seats her in a chair and hands her a cup ‘o brakfast fer her empty belly. Mrs. Fitz then whisks it away afore Claire even finishes! Look at Claire’s hair! It is absolutely fabulous! She certainly looks like the “wee milkweed” Jamie affectionately calls her later in the Outlander book.

“Fretful porpentine, was it?” he asked. He tilted his head, examining me inquisitively. “Mmm,” he said, running a hand over his head to smooth down his own hair. “Fretful, at least. You’re a fuzzy wee thing when ye wake, to be sure.” He rolled over toward me, reaching out a hand. “Come here, my wee milkweed.”

With these great images to set the mood, it is time for our anatomy lesson on hair and with it a lot of juicy tidbits to share!

First, the length of body hair varies a lot – from less than 1 mm (.04 in) on the forehead to well over 1 m (3.3 ft) with long scalp hair (Photo C)! But, the wee hairs of the eyelids (not the eyelashes) are so short they barely reach the skin surface! And, you should know that most hair grows very rapidly, about 0.3 mm/day or 1 cm/per month.

photo C

You should also know that hair does not grow straight out of the skin; it emerges at a slant (Photo D).

Try this: Check the angle of growth of your own hair: place your forearm on a flat surface with the palm down. Examine your forearm hairs and see that they are angled toward the little finger side of the forearm. That’s the slant I’m a talking about.

photo D

Hair is also denser in some skin areas than in others: the face has about 600 hairs/cm² (.16 in²) compared to about 60 hairs/cm² on the rest of the body.

Hair diameter also varies greatly but even the coarsest hair is only about .5 mm (.02 in) in diameter (Photo E). Even so, a scalp hair is strong enough to support the weight of 100 gm (3.5 oz)!

photo E

Another interesting tidbit: Human hair grows autonomously; each hair cycles at its own pace through periods of growth and periods of quiescence. If all our hair were on the same cycle, we would molt!

And sometimes our hair does unspeakable things and we just have to pull it outta the way like Angus here who does prefer a wee bit o’ purple ribbon fer his scalp hairs!

Now back to microscopic anatomy! Using the same image from Skin – Part 1, I’ll be reminding ye that skin is divided into a thin outer epidermis that overlies a thicker dermis. And, although not part of skin the hypodermis lies deeper still. The dermis and hypodermis also anchor structures that we’ll cover in this anatomy lesson: hair, hair follicles, arrector pili muscles, and sebaceous glands (Photo F).

photo F

Hairs emerge from hair follicles which are down growths of the epidermis (Photo G). The internal anatomy of each follicle is verra complex so I’m simplifying it: the hair and its follicle are divided into a hair root and a hair shaft. At the root is a bulb where cells divide and push older cells toward the surface to form the hair shaft!

photo G

Along the way, hair cells harden and get plastered together so by the time the hair clears the skin surface, the cells are dead, flat and stiff with their free edges pointing toward the hair tip. They also overlap each other like shingles on a roof (Photo H). This is a SEM image of a single hair!

Photo H

Ye should also ken that hair follicles are verra sensitive to the influence of hormones! These chemicals produce secondary sex characteristics such as hair distribution. In fact, the distribution of hair between the two sexes play an important role in socio-sexual communications!

In women, estrogens (oestrogens) cause most body hair to develop as short, thin vellus hairs that are anchored in the dermis. Both genders exhibit the coarse terminal hairs of scalp, eyelashes, eyebrows, axilla and pubis that are embedded deep in the hypodermis.

In men, androgens (testosterone being the most important) also convert facial and chest hairs into terminal hairs. Now then, isna this the right place to offer praises to Dougal MacKenzie who won Saturday’s Starz contest with his comely beard? Congrats! It looks mighty fine on ye, man! Tulach Ard!

And, no anatomy lecture is ever complete without at least one image of a half-dressed Jamie! So here is his chest hair just in case ye be forgettin’! No verra damn likely! Gawd!

Something else: When viewed by SEM, straight hair has a round shaft as seen in this photo of scalp hair (Photo I –computer generated color); the surrounding dead skin cells look like scatter leaves on a forest floor.

Photo I

Murtagh’s scalp offers a perfect example of straight hair – here he is explaining to Claire why Jamie is nowhere to be seen (Starz episode 5, Rent)! Plus, he has mighty fine eyes and braw eyebrows just in case ye been so focused on Jamie that ye havena been noticing!

Scalp hair that is curly like Claire’s…

…has a shaft that is flattened in cross-section as shown in this SEM image (Photo J). The flatter the shaft, the curlier the hair!

Photo J

Now, onto a couple of other structures associated with the hair follicle. First, stretched between the follicle and the dermis is a thin band of tissue, the arrector pili muscle. Second, between the hair follicle and the arrector pili muscle lays one or more sebaceous glands with ducts opening into the hair follicle (Photo K). Sebaceous glands produce sebum, a complex mixture of fats, waxes and other materials.

photo K

The arrector pili muscles are made of smooth muscle cells that are not under conscious control. They contract in response to cold or the fright, flight, fight reflex! Contractions of this muscle elevate the hair, forming goose bumps or goose flesh and help squeeze sebum from the sebaceous glands into the hair follicle and onto the hair shaft (Photo L).

Photo L

Contraction of the arrector pili muscles in animals traps air between the erect hairs to retain body heat or to help the creature appear more fierce (Photo M)! This adaptation isn’t of much use to us short haired humans but the release of sebum does help lubricate and protect the hair itself.

Photo M

Finally, on to hair color! Like the epidermis, hair color requires the presence of melanin; melanocytes in the hair bulb synthesize melanin and package it into granules that move up the hair shaft as it forms. Now, it turns out that there are a couple of different types of melanin!

Like Claire, most hair color is due to the presence of varying amounts of brown or black eumelanin. But, now, ye are in fer a BIG surprise! I bet ye dinna ken this! Flaming red hair in one such as our Great Scott, Jamie, contains a chemically different type of melanin known as pheomelanin and this molecule is red (or red-brown)! Thus, Jamie’s gorgeous mane of red hair is due to the presence of pheomelanin as seen from the back in this image (Starz episode 7, The Wedding)!

And just so ye won’t ferget it, here is Jamie’s hair from the front! We can literally see the words Herself wrote in Outlander about his hair:

…a mass of auburn, copper, cinnamon and gold all gleaming together in the morning sun…

And one last point fer yer eddycation: Check out both upper corners of Jamie’s forehead. See how the hair line is squared off? This is known as the temporal notch; it is a secondary sexual characteristic in men brought about by the influence of testosterone. Women typically have an oval hairline in the corresponding areas of the forehead!

And now, folks, our journey through the skin and its appendages has come to an end! I do hope you have enjoyed learning about the skin ye are in and that of the Outlander cast while we are at it! At some point in the future, I will post Skin 3 – The Breast.

In the meantime, I’ll be leaving ye with these lovely words from Herself in the Outlander book and an image from Starz episode 7 (The Wedding):

You’ve the loveliest hair,” said Jamie, watching me. ….”But it’s so .…curly,” I said, blushing a little….“Aye, of course.” ….He sat up and tugged gently on one curl, stretching it down so that, uncurled, it reached nearly to my breast…

And:

“Mo duinne?”…“It means ’my brown one.’ ”He raised a lock of hair to his lips and smiled, with a look in his eyes that started all the drops of my own blood chasing each other through my veins. Rather a dull color, brown, I’ve always thought,”….”No, I’d not say that, Sassenach. Not dull at all.” He lifted the mass of my hair with both hands and fanned it out. “It’s like the water in a bern, where it ruffles over the stones. Dark in the wavy spots, with bits of silver (auburn on Starz) on the surface where the sun catches it.”

Gah, this man has a way with words! Does he ever say anything wrong? Just look at the look on Claire’s face! She’s both enchanting and enchanted!

Psst…next time, I will be writing about someone’s thighs and knees (guess whose?)! Stay tuned!

The deeply grateful,

Outlander Anatomist

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Photo credit: Starz, Cat photo from goosecam Edmonton Journal, Goosebumps from genius.com, Basic Histology by Junqueira and Carneiro, 11^th ed., University of Leeds, Rochester education Foundation, Wikipedia, WebMD, Loyola University Dermatology website, Histology Guide, University of Leeds, Wikimedia.org. CSIR – Council for Scientific and Industrial Research, South Africa. OA archival photos, Aersol Research – Washington University St. Louis

November 7, 2014July 31, 2015

Anatomy Lesson 5: “Claire’s Skin” – “Ivory, Opal and White Velvet”

Greetings, followers of Outlander Anatomy! Today’s Anatomy Lesson #5: The Skin – Part 1 is extraordinarily important (as are all anatomy lessons) and ye wouldn’t want to get skinned for skipping what is vital to yer own well-being as we learn about our skin!

WARNING! This post includes spoiler alerts and the image of a dissected human body. If you are a bit squeamish about such images, you may want to skip it. Dougal will give ye a second warning just prior!

OK, now, about skin….Herself writes about skin throughout all of the Outlander books where it is used to define characters, enhance scenes, and provide a substrate for Claire’s practice of medicine. As ye ken, the Starz Outlander series and the books are told in the voice of Claire, our braw and lovely heroine! Thus, we must rely on images or observations made by others to inform us as about Claire’s skin which I will use to segue into today’s anatomy lesson!

Let us begin…

In Starz episode 1, Sassenach, we see Claire and Frank driving through the Scottish countryside. On a second honeymoon, they are trying to reconnect after serving apart in WW II. We see that Claire has very pale, clear skin framed by a mass of curly, brown hair.

Herself informs us through polished, sophisticated and urbane Frank that Claire’s ”…skin glows like ivory.” Then Frank makes love to Claire in the grass at the base of Craigh na Dun where he tells her that her skin is like white velvet. Because I don’t have images to match these descriptions, I substitute one from a later episode (Starz episode 6, The Garrison Commander), so along with Frank, we may witness Claire and her beautiful skin!

Next, in a very telling scene from Starz episode 3, The Way Out, Mrs. Fitz helps bathe and dry Claire despite to her protestations; Claire avers that she is able to tend to her own ablutions! But a persistent Mrs. Fitz kindly observes:

Such beautiful skin ya’ have! I’ve never seen a woman past 8 or 9 with skin so unmarked by injury or illness. Yer next husband will be a lucky man!

Aye, that he will…chuckle!

To me, Claire’s beautiful skin is most telling (Starz episode 8, Both sides Now) during the assault by the redcoat deserter. She wears virtually no makeup, nor is any required in my opinion! Her skin is very pale, very clear and her nose and cheeks are endowed with a faint sprinkle of freckles. Claire also looks very vulnerable, very young and absolutely LOVELY despite the unspeakable situation she finds herself in! I can say this without prejudice because I am an anatomist! Ye ken?

But, the ultimate proof comes from Jamie himself: in Outlander, he tells Claire that she has skin like an “opal” as he slowly traces a finger along her collar bone making her skin glow beneath his touch! And, again from our hero:

“Mo duinne,” he said softly. “But now I should say mo airgeadach. My silver one. Your hair is silver-gilt and your skin is white velvet. Calman geal. White dove”.

Again, no images to match the words, so let’s use this lovely substitute!

Hey! Mukker! Are ye still wit’ me?! One last image before we git on to our science lesson! In Starz episode 3, The Way Out, Claire is summoned by the MacKenzie. Colum removes his kilt asking her to massage his aching legs. He also asks Mistress Beauchamp if she sews as well as physicks to which Claire responds: “only flesh, a rather poor garment, I’m afraid.” My cue! Weel, I am athinkin’ that Claire’s answer to Colum was deliberately a wee bit coy and evasive because she would know that skin is NO a puir garment at all!

So, now we segue into Anatomy Lesson #5, The Skin…folks, I am here to tell ye that the skin is absolutely a remarkable garment! Ye will no be amiss to think of it as your own personal space suit that enables you to live a terrestrial rather than an aquatic life! It is also the major barrier between a rather inhospitable world and yer insides! Yes, it gets diseased and injured because we are mortal, after all. But, it serves us verra well so please read on!

If ye are squeamish, ye may wish to skip the next image or heed Dougal’s advice…

A few years back, German anatomist, Professor Gunther von Hagens brought his world-renown Body Worlds exhibit to my neck of the woods. I was privileged to deliver the key note lecture before the event and was Professor of Anatomy on opening night where I gave mini-lectures and answered questions posed by attendees. Of the many extraordinary figures at that exhibit was one of a man holding his own skin and gazing at it in awe (Photo A). I hope after reading this post, you too will view your own skin with the awe it so richly deserves!

Photo A

First off, skin is an organ. Yes, it is! It is also the heaviest organ of the human body! Really, ye say? Yup, it accounts for at least 8% of our body weight (some studies claim as much as 16%) and covers a surface area of about 20 ft² or 1.9 m²! Want to determine the weight of your own skin? It’s simple! Just multiply your weight in pounds or kilos by .08 – the answer is the approximately the weight of your own skin!

Skin also produces all of our body hair, fingernails, toenails, sweat glands, sebaceous glands, the female breasts and the male nipples and areolas. All of these appendages are skin derivatives and therefore part of the organ itself. Earlier, I mentioned Claire’s hair and now ye ken why because hair is part of the skin. But, as Claire’s hair makes for an interesting subject in its own right, I will address hair in my next post: The Skin – Part 2! And won’t it be fun to see the Outlander Starz results in it’s “hair as a character” poll this Saturday!

Ok, this next one is a gratuitous shot…sorry I just canna help it! Weel, not entirely gratuitous – it does show hair and skin and one other thing I havna yet told ye: the enamel of the teeth is derived from modified skin of the mouth. Geez, even his teeth are gorgeous! Get a grip prof! Focus!

Ahem…now, back to the lecture! Skin thickness varies throughout the body; some skin is thick for protection such as on the soles of our feet or thin as on our eyelids where thickness is not required. Skin is also more heavily pigmented in some areas (nipple and areola) than in others (belly). Most of the skin bears either fine or coarse hairs but some areas are completely devoid of hair: the so-called glaborous surfaces of the body such as the palms and soles where hair, if present, would interfere with grip.

Skin is composed of two important layers: a thin outer epidermis that sits atop a thicker inner dermis (See photo C). Deep to the dermis is the hypodermis; although not part of the skin, it is important because it helps anchor the skin to underlying structures such as muscle or bone (Photo B). In addition, some skin structures are actually anchored in the hypodermis.

Photo B

The epidermis is composed of skin cells and some other cell types. It also completely replaces itself about every four weeks, with new cells forming at the base and advancing toward the surface where they die and slough. So, cells at the skin surface are flat and dead – these cells exfoliate naturally (did ye know that a large portion of house dust is shed skin cells?) or ye pay for exfoliation by costly products or at expensive salons (Photo C – this 3-D image was taken with a powerful scanning electron microscope or SEM)! The supporting dermis houses two types of sweat glands, sebaceous glands, blood vessels, hair follicles, and special microscopic endings for sensation.

Photo C

So what about sweat glands? The skin actually includes two different types: apocrine sweat glands are present only in the arm pits (axilla in anatomy, remember?) and our private regions (perineum in anatomy). The thicker sweat from these glands is initially odorless but when acted on by skin bacteria, it develops a pungent, acrid smell. This is the unwashed male that Claire muses on while sharing Jamie’s mount (Outlander book) – although females most certainly battle the same issue! A second type, the eccrine sweat gland, is ubiquitous throughout the remaining skin; sweat from this gland is watery and usually exudes an ammonia smell. Photo D shows the multiple openings (pores) of eccrine sweat glands on the finger pad.

Photo D

The process of sweating from eccrine sweat glands is captured in Photo E. Here, following exercise, blue sweat droplets bead on skin from the back of the hand. This 3-D photo was again taken the powerful SEM. The colors, however, are not real – they were computer generated.

Photo E

As fer the sebaceous glands, I’ll be leaving those until my next post: The Skin – Part 2! Next, a question commonly asked by students: what causes the wide variation in human skin tones (see Photo F)?

Photo F

Weel, it turns out that there are a number of reasons for our individual skin color. One cause is the number of blood vessels in the dermis and the color of blood surging through them (bright red arterial blood versus duskier venous blood). Just fer fun, let’s compare and contrast the color of Claire skin wit’ that of Jamie’s in this image from Starz episode 1, Sassenach. We clearly see Claire’s naturally cool and pale complexion but partly because she is royally pissed, holding herself aloof from all the male funnin’ goin’ on around her. But, Jamie’s skin is strikingly different! Although Jamie is splattered in blood and he has naturally ruddy skin, it is enhanced in this scene having exerted himself in battle and during Claire’s recapture so ye can bet at this point there’s a whole lot of bright red arterial blood circulating through the vessels of his dermis!

Another contribution to overall skin color depends on how much carotene we consumed in our diets: carotene is an orange pigment prevalent in fruits and veggies such as cantaloupe, sweet potato and carrot (Photo G). Carotene absorbed from our food gets deposited in the epidermis where it adds to skin color and also helps protect epidermal cells from damage by UV light.

Photo G

But, the most significant contribution to skin color comes from special cells of the epidermis, the melanocytes (Photo H). These scattered squid-like cells produce and package the pigment, melanin, into granules that are released into surrounding skin cells. Interestingly, the number of melanocytes in a given region of the skin is the same regardless of skin tone or gender. So, differences in skin color are due mainly to differences in the number and size of the melanin packets produced and this in turn is determined by genetics! In darker skins, the melanin granules are larger, more numerous, persist longer and are distributed throughout the epidermis. Pale skin has fewer, smaller melanin granules that are confined to cells at the base of the epidermis and degrade more quickly.

Photo H

Ye can deliberately increase the production of melanin granules and darken existing melanin in yer own skin by exposure to UV light either from the sun or from tanning beds. I ken the beds are a very popular trend, but I want to WARN ye: For some very sound medical reasons, ye should NOT expose yer skin to UV light from tanning beds and ye should also be judicious about tanning from the sun’s rays too, especially if ye are fair of skin like Claire! I urge ye to get informed about it!

Now, ye are all are probably aware of albinism (Photo I), a condition affecting animals (humans, spiders, snakes, apes, etc.) where the sufferer lacks an enzyme needed to make melanin (albinism occurs in plants too but is due to an absence of chlorophyll). Albinos (Latin: albus for white) do NOT make any melanin in the skin, hair or the irises of the eyes! This is a difficult condition because their eyes are highly sensitive to light (photophobia) and they have difficulty tracking the eyes normally. The skin is also highly susceptible to skin cancers! It is a condition which, at present, has no cure but there are steps that can be taken to protect the skin and aide the eyes.

Photo I

Finally our skin has a battery of sensory endings specialized to detect changes in our environment and transmit these to our nervous system. The fingertips alone have about 2500 of these receptors per cm² (about 0.2 in²) of skin! I’ll not show pictures of these endings because they are a wee bit too technical. In summary, then, here is a short list of what skin does for Claire and for us all!

It is an anatomical barrier against pathogens and damage.
It provides sensation in the form of pain, touch, pressure, heat, cold and vibration.
It regulates our body temperature by dilating or constricting blood vessels in the dermis and cooling the skin by the evaporation of sweat.
It helps control fluid loss.
Helps synthesize vitamin D via UV radiation.
It aids in excretion of waste products.
It aids in communication: others assess our mood, physical state or attractiveness by the state of our skin.

Impressed yet? I know I am and I’ve been teaching this subject for a verra long time!

Speaking of mood, let’s close wit’ this touching image from Starz episode 7 The Wedding, where Jamie pays homage to the skin of his bride of astonishing beauty with a soft murmur and a tentative touch!

Aye, Jamie, ye are ready! And, so is Claire – she sure took long enough! Snort!

I do hope ye have a better understanding and appreciation of the skin ye are in and have an increased desire to take verra good care of it!

A wee note of explanation: I will also continue my convention of typically using the character’s names rather than the names of the actors. This gives the cast at least one degree of separation and a wee bit o’ respect as I dissect their bodies on a blog! I hope ye all understand.

The deeply grateful,

Outlander Anatomist

Images are from Starz Outlander series. Microscopic images and drawings from Netter’s Atlas of Human Anatomy, 4^th ed., Bailey’s Textbook of histology, 10^th ed. or Bloom & Fawcett’s Concise Histology, 2^nd ed, and the National Geographic, Skinned man from Body Worlds exhibit (sans the fig leaf), CGI image of epidermis and dermis from Loyola University Dermatology website, Baby photo from an older United Colors of Benneton ad, Photo of carrots from Gov. of West Australia and fig leaf from ClipArt, Archival photo of albino man taken by an unknown photographer – beginning of the 20^th century.