Tag: DianaGabaldon

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Fun Fact: Carpal Bone

Anatomy def: Carpals are eight small bones forming the wrist.

Outlander def: Rocking aboard the Artemis, Claire checks her soaring temperature with the back of wrist. Oh, the lass is on fire! … psst … so is Jamie! He, he!

Learn about carpal bones in Anatomy Lesson #22 Jamie’s Hand – Symbol of Sacrifice. If time is short for a full lesson, consider watching my quickie hand lesson, courtesy of Outlander After the Show. This lesson streamed June 1, 2015, just after the airing of ep 116, Wentworth Prison. The  lesson begins at 16:42 in the following video. Thanks to hosts Keetin, Jen and Ryan for inviting me to discuss the hand’s splendid engineering!

Eight oddly-shaped carpal bones are arranged in two rows to form the wrist. The near row abuts forearm bones and the far row articulates with metacarpal bones. Carpal bones are named for their shapes:

  • scaphoid (boat)
  • lunate (crescent-shaped)
  • triquetrum (three-cornered)
  • pisiform (pea)
  • trapezium (table)
  • trapezoid (quadrilateral)
  • capitate (head-shaped)
  • hamate (hook-shaped)

Carpal bones are arranged in a shallow arch traversed by 9 tendons and a nerve. Small repetitive movements or fluid retention can create pressure on the nerve (median) as it passes through the arch causing tingling and numbness, symptoms associated with carpal tunnel syndrome.

Read about  carpal bones in Outlander book, wherein Claire amuses herself by likening streets and lanes of Cranesmuir to bones of forearm and hand. That Claire – always the doc.  That Diana – always the scientist. We love them!

In fact, I had amused myself on the ride to the smithy by imagining an aerial view of the village as a representation of a skeletal forearm and hand; the High Street was the radius, along which lay the shops and businesses and the residences of the more well-to-do. St. Margaret’s Lane was the ulna, a narrower street running parallel with the High, tenanted by smithy, tannery, and the less genteel artisans and businesses. The village square (which, like all village squares I had ever seen, was not square at all, but roughly oblong) formed the carpals and metacarpals of the hand, while the several lanes of cottages made up the phalangeal joints of the fingers.

See Claire’s wrist in action as she self-diagnoses in Starz Episode 311, Uncharted! Continue watching the episode to see what Jamie does to douse her fever. Wink, wink!

The deeply grateful,

Outlander Anatomist

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Photo credit: Sony/Starz

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Fun Fact: Extensor Indicis

Anatomy def: Extensor indicis is a muscle of the extensor (back) forearm – its tendon extends (straightens) the index finger (pointer finger or forefinger).

Outlander def: Jamie’s pointer finger twitches madly as Claire and Jenny come face-to-face in their terse meet-and-greet. Tappity tap – a 20-year gap. Scary!

Learn about extensor indicis in Anatomy Lesson #23, Harming Hands – Helping Hands – Healing Hands.

Turns out, the index finger receives tendons from extensor indicis and extensor digitorum (covered in a earlier FF).  Both muscles lie in the back of forearm but the tendons cross the wrist and insert into bones of the index finger. The dual tendons straighten (extend) and lift the index finger, offering it greater strength in extension and more independent movement from the remaining three fingers.

Fun Fact: In US anatomy, the thumb is not counted as a finger, so index finger is the first. Across the pond, some European anatomists define the thumb as  the first finger, so index is counted as the second finger. Ergo, many surgeons prefer using: thumb, index, middle, ring and little fingers (or something similar) to omit possible mix-ups of finger numbers during surgery. Scary x2!

Rewatch Starz episode 308, First Wife, to see Jamie’s pointer finger flutter as he ponders the strain between first wife and big sista. Not good! 

Read about Jamie’s twitchy fingers in Voyager book. Actually, his tapping fingers appear in most of Diana’s books:  

I caught a quick glance passing between Ian and Jenny; and a longer stare, unreadable, exchanged between Jenny and Jamie. A stranger here in more ways than one, I kept my own eyes cast down, observing under the shelter of my lashes. Jamie sat to my left; I could feel the tiny movement between us as the two stiff fingers of his right hand drummed their small tattoo against his thigh.

See Big Red flutter his index finger in Starz episode 308, First Wife. Kebbie-lebbie at Lallybroch!

The deeply grateful,

Outlander Anatomist

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Photo credits: Sony/Starz

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Fun Fact: External Jugular Vein

Anatomy def: The paired external jugular veins are superficial vessels draining blood from the exterior cranium (Anatomy Lesson #60 Let’s Mull the Skull!) and deep facial structures toward the heart.  

Outlander def: Large neck veins often increasing in diameter as blood pressure rises – think of  a hotly contested stramash, such as “I will marry him” vs. “no, ye will not!!!” The neck veins tend to stand out. <G>

Learn about the external jugular vein (EJV) in Anatomy Lesson #12, Claire’s Neck or The Ivory Tower.

Each EJV descends through the neck from the angle of mandible (lower jaw) to middle of the clavicle (collar bone), collecting blood from the outer skull and deep face.

Try this: Turn your neck to one side and look in a mirror.  Can you see a blue line stretching from the angle of your jaw to your clavicle? This is the EJV. If you have no luck, try looking at a friend or family member. These veins are not always visible so don’t despair if you canna located them. 

BTW, although veins appear blue or green under the skin, they are neither color. Various factors including light absorption, light scattering and reflection, less oxygen in venous blood and veins being closer to the surface all help account for this odd color change, an phenom known as the Tyndall effect.

Read about the EJV in Drums of Autumn book.  Here the character’s name is not disclosed as the TV show has yet to catch up with the book (hurry, S4!). But, book readers will ken who Claire is doctoring. The pulsing vein Diana describes, is, indeed, the EJV! 

I didn’t need to check his heart; his head was turned, and I could see the huge vein that ran down the side of his neck, throbbing with a pulse slow and heavy as a hammer blow. I touched him, feeling his skin cool and damp. No fever, no signs of shock. The whole of his enormous person radiated peace and well-being.

Now, wait a sec!!! Arteries pulse, but do veins pulse like arteries? Generally speaking, not that we can see.  However, the right EJV may show a pulse because it lies very close to the right atrium of the heart. Put simply, as the right atrium contracts, blood pressure in the EJV may be seen as a pulse. Hence, Diana’s description is accurate. Score!

See Marsali’s external jugular vein in Starz ep 309, The Doldrums. Pugnacious lass that she is, she casts her stepdad a defiant look.  She will have Fergus no matter what da says!

The deeply grateful,

Outlander Anatomist

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Photo Credit: Sony/Starz