frank netter – Page 7 – Outlander Anatomy

April 14, 2015August 9, 2018

“To Arms, Too Arms, Two Arms!”

Welcome to Anatomy Lesson #19: The Arm. Wonderful arms of all types inhabit the Outlander books and the Starz series including BJR’s “long arm of the law” (he has too many arms; the blackguard is a heartless squid), Jamie’s willingness to “give an arm or a leg,” anything to be free of that mad Captain of Dragoons, the highlanders who are frequently “up in arms” fetching Claire from her scrapes and Claire’s efforts “to keep at arm’s length” the teenage witch, Laoghaire (Lass, stay away from me and my hubby!). An anatomy lesson on this topic serves us well!

Let’s review…In Anatomy Lesson #4, you learned that anatomists divide the upper limb into shoulder, arm, forearm and hand (Photo A). The shoulder extends from base of neck to shoulder joint (Anatomy Lesson #2). The arm extends from shoulder joint to elbow joint. The forearm is between elbow and wrist joints. The hand lies distal to (away from) the wrist. The human upper limb enjoys a high degree of mobility with the ability to grip, strike and conduct fine motor skills. Although many of these abilities are rightfully credited to the hand, the shoulder joint is the most mobile joint of the entire human body and thus adds its credentials to upper limb versatility.

Photo A

We’ll begin the lesson with dem bones (shades of Joe Abernathy): The bony skeleton of the upper limb provides the foundation for its functions. Anatomy Lesson #2 and Anatomy Lesson #3 discussed three bones of the upper limb that are important again today: clavicle, scapula and humerus (Photo B). Each upper limb contains 32 bones but the remaining 29 bones will be postponed for later lessons.

Photo B

First, the clavicle: As noted in previous lessons, human clavicles act as struts holding each upper limb away from the torso and allowing for increased range of motion. Viewed from the front (Photo B) the clavicles appear to be straight bones but this is not so. Viewed from above (Photo C – superior surface) each clavicle is S-shaped: The sternal half curves toward the viewer, the acromial half curves away from the viewer and the acromial end curves forward again to complete the S-shape.

Due to muscle pull, the clavicle curves more deeply in athletic individuals or manual laborers such as our hard-working farm-lad, JAMMF. The sternal end articulates with the manubrium at the sternoclavicular joint (Anatomy Lesson #15). The acromial end articulates with the acromion at the acromioclavicular joint (Anatomy Lesson #2). Both joints are typically visible in the lean and fit.

Try this: Demonstrate the S-shape by placing fingers on the sternum and following one clavicle towards the shoulder point. Near the sternum, the clavicle is subcutaneous, but nearer the side it becomes more difficult to palpate because it curves backward; at the acromioclavicular joint, it curves forward again.

Photo C

For our viewing pleasure, Claire presents us with a perfect pair of, erm, sternoclavicular joints (Starz episode 107, The Wedding)!

And, several students have asked if the knobs on Jamie upper chest are due to prior injuries (Starz episode 107, The Wedding). No, these are normal acromioclavicular joints.

The next bone is the weird-looking scapula which on side view resembles a ship’s propeller (Photo D). The red arrow marks the acromion or point-of-shoulder; the green arrow shows the pear-shaped glenoid cavity for articulation with the humeral head; the yellow arrow marks the inferior angle.

Photo D

Each scapula is large, thin and triangular in shape (Photo E – posterior view). The medial border lies parallel to the vertebrae. A large scapular spine arises near the medial border and ends as the acromion. The inferior angle lies at the 7^th intercostal space and is used as a clinical landmark. The small glenoid cavity is at the side. Like puzzle pieces, acromion and clavicle meet at the acromioclavicular joint (green arrow) and the humeral head glides in the glenoid cavity at the glenohumeral joint (red arrow); strong ligaments and muscles stabilize these bony interactions.

Try this: Only a few scapular landmarks are readily palpable. Feel the subcutaneous acromion or point of shoulder. Cop a yoga pose or choose a partner and feel the long medial border and inferior angle. Follow the scapular spine which is mostly subcutaneous. You cannot palpate the glenoid cavity because it lies too deeply.

Photo E

Clad only in her low-backed shift, trim Claire is our beautiful model for her right scapula (Starz episode 107, The wedding). The long medial border (red arrow) lies parallel to the vertebral spines, the scapular spine lies mostly horizontal (green arrow) and her shift covers the inferior angle (yellow arrows).

Together clavicles and scapulae form the pectoral girdle, an incomplete bony ring that supports both upper limbs. An aerial view (Photo F) shows the pectoral girdle sans skull and humeral bones (Can you identify the dens of C2 vertebra?). The sternum (yellow arrow) stabilizes both clavicles (blue arrows) at the sternoclavicular joints (green arrows). Scapular spines are marked by the red arrows. Clavicles articulate with acromia at the acromioclavicular joints (pink arrows).

Hopefully this visual clarifies how the clavicles serve as struts holding upper limbs away from the torso and how both upper limbs hang from the bony pectoral girdle. Lastly, force from a blow to either arm is transmitted along the clavicle to the sternum where it is absorbed by the bony thorax. It’s quite an ingenious and elegant design from which to hang our arms, ye ken?

Photo F

Radiograms increase understanding so this x-ray (Photo G) shows a left pectoral girdle including clavicle (blue arrow) and scapular spine (red arrow). The yellow arrow marks the articulation between head of humerus and glenoid cavity of scapula at the glenohumeral joint. The humeral shaft is stretched to your right.

Photo G

Despite his well-muscled physique, Jamie’s pectoral girdle (Starz episode 109, The Reckoning) can be appreciated from Claire’s perspective. The red arrow marks the medial upper border of scapula, yellow arrow points to acromioclavicular joint and green arrow marks scapular spine. We can be certain that while we might value this anatomical perspective we all know that Claire is most appreciative and well-deserving and all that…ahem and amen! Gah, what a sublime pectoral girdle and bonny hair!

Each arm contains only one bone, the humerus (Photo H); its large head glides within the small, shallow glenoid cavity at the glenohumeral joint (GHJ). A ball and socket joint, the GHJ is highly moveable but not very stable because of the size differential between head and socket although a cartilage labrum (lip) helps deepen the socket and ligaments and muscles help stabilize the joint. Just below the humeral head is an anatomical neck. The region marked surgical neck is noteworthy because it is the mostly likely site to sustain a fracture to the upper humerus. A bony elevation halfway down the humeral shaft is the deltoid tuberosity. The lower end of humerus helps form the elbow joint but it will be covered in a later lesson.

Photo H

Being a ball and socket joint, the glenohumeral joint is multi-axial meaning the humeral head moves with many degrees of freedom inside the glenoid cavity. Basic movements are shown in Photo I but other movements of the arm are combinations of these basics. Flexion draws the arm forward. Extension draws the arm backward. Abduction moves the arm away from the body midline. Adduction moves the arm toward the body midline. Lateral rotation turns the arm outward and away from the body center. Medial rotation turns the arm inward and toward the body center. Circumduction is a circular motion of the arm as in back stroke or baseball pitch, a movement that may be performed clockwise or counterclockwise. A bent elbow joint is not required to perform these motions.

Try this: execute each of these movements with one arm.

Photo I

Can we see these arm movements in the Starz Outlander episodes? Oh, to be sure!

This is a wonderful example of a horrible man “up in arms” when things don’t go his way. BJR’s arm is in flexion as he fires an empty musket at Jamie. Surprise! (Starz episode 109, The Reckoning)!

And this is a great example of humeral extension at the start of the best make-up-sex-ever-filmed (Starz episode 109, The Reckoning)! Jamie canna wait to remove his sark. Both arms are draw backwards as he sheds that garment…off ye damn shirt!

Try this: extend both arms behind your back. Most people can extend the arms to a 45° angle. If ye are flexible, extend arms behind your back and interlock fingers. Gently lift your arms more than 45° but not if it hurts. Good job!

Handsome Dougal is next (Starz episode 109, The Reckoning). Yes! An army of leddies have been clamoring for more of our bold Highland war chief! Both arms are drawn against his sides in full humeral adduction as he awaits Colum’s tongue-lashing. I love this scene! With little more than a sideward glance, a twitch of the ‘stache and some brow crunch, Dougal conveys fierce frustration with his meddling Laird-bro.

Next, Claire offers a fine example of humeral abduction with arms akimbo awaiting Professor Angus’ stabbing lesson (Starz episode 108, Both Sides Now). Two arms are drawn away from the body midline although bent elbows aren’t required for this action. Doesna that gown look fantastic on her trim torso?

Now, I dinna want to rekindle a fire storm with this next image, but Laoghaire offers (weel, it’s not all she offers) an excellent example of lateral rotation of the arms (Starz episode 109, The Reckoning). Here she sheds her cape while aiming her 16 year-old charms at new hubby Jamie. Two arms are turned outward and away from the body center. She knows this position gives her better advantage to show off her, um, well to show off! Geez, where did she find that corset with the wee side vents? Mayhap she raided Granny Fitz’s hidden trunks where Claire’s awesome closet resides (kudos to Terry & Co on another unique costume that tells a story all its own)!

Here are contracted arrector pili muscles. Mmmphm, must be a tad chilly by the burn! Oops, wrong lesson! Goose flesh belongs wit’ the skin in Anatomy Lesson #6. But, if ye ken yer anatomy verses, ye can pretty much identify anything! Moving on….

I always laugh at this image of our elegant Claire caught in a not-so-elegant squat (Starz episode 105, Rent). As she hikes up her skirts to pee in the pot, her right arm is turned inward and towards the body center as in medial rotation. Geez, Angus you buamastair (oaf), knock next time! Who knew wild women waulked wool?

Finally, Dougal’s guilty rampage over the death of his not-so-bonny wife Maura presents several outstanding displays of humeral circumduction (Starz episode 110, By the Pricking of My Thumbs). The image below shows counterclockwise circumduction (as in pitching baseball). Watch the entire scene again to see his arm movements; they are fantastic! Dougal is a sad Shakespearean mess in this scene but his acting chops are top shelf. Good thing Nurse Claire ministers one of her Spanish potions before he slices and dices everyone and everything in the hall brawl!

Now that we ken arm movements, let’s discuss arm muscles: a whopping 17 muscles per side move the shoulder and arm. Eight of these muscles move the pectoral girdle which indirectly alters humeral position. Nine muscles directly move the humerus. Any wonder humans enjoy such versatility in shoulder and arm movement? There is no way 17 muscles can be covered in a single lesson so today we will review trapezius, latissimus dorsi and pectoralis major and learn a new muscle, the deltoid.

Trapezius was discussed in Anatomy Lesson #2 and Anatomy Lesson #3 (Photo J). This muscle acts directly on the shoulder joint and indirectly on the humerus. Arising from skull and vertebrae, it inserts on scapular spine, acromion and clavicle. Upper fibers lift the shoulder joint dragging the humerus along for the ride; middle fibers retract (pull back) shoulder joint and humerus and lower fibers depress (pull down) shoulder joint and humerus. The bottom line: more shoulder movements = more arm movements. Trapezius creates the web between base of skull and acromion and is most prominent in the muscular.

Figure0407A trapezius 01 KLS edited

Photo J

Here’s a delightful example of Claire’s beautiful trapezius as she reaches for Jamie’s mouth (Starz episode 109, The Reckoning). Jamie was out to master Claire but discovers there’s a price to pay. Sorry laddie, every coin has its flip side. Herself’s magic pen strikes again (Outlander book):

“Oh, aye, Sassenach,” he answered a bit ruefully. “I am your master … and you’re mine. Seems I canna possess your soul without losing my own.”

The next review muscle is latissimus dorsi (Anatomy Lesson #10). These large flat fan-shaped muscles arise from vertebrae, sacrum and hip bones via the thoracolumbar fascia. Fibers wrap around the body, converge and insert into each humerus (Photo K). Latissimus is the only human muscle connecting upper and lower limbs, making it a potential powerhouse for lifting body weight!

Photo K

As latissimus dorsi nears the armpit (axilla), it turns tendinous before inserting on the humerus (Photo L – front view). It extends, adducts and medially rotates the arm. Latissimi dorsi (pl.) are the pull up (palms face forward) and chin up (palms face backward) muscles.

Photo L

Jamie is our poster boy for latissimus dorsi (Starz episode 106, The Garrison Commander). Here his left muscle clearly sweeps from the lumbar spine, around the body and upward to end on the humerus. Captain Randall is our poster boy for the maddest-baddest villain in literary and TV history!

The third review muscle is pectoralis major (Photo M). It has two heads: one from the clavicle and a second from sternum and ribs (Anatomy Lesson #4). A wee slip comes off abdominal structures but anatomists often ignore it. Muscle fibers converge as they approach the humerus where they insert near latissimus dorsi. Pec major flexes, adducts and medially rotates each arm.

Oh, and many students ask the name of the large vein traversing the arm and disappearing between deltoid and pectoralis major muscles. This is the cephalic vein, so named because it carries blood in a headward direction. And, the groove it runs in between deltoid and pectoralis major is the deltopectoral triangle.

Photo M

Half-clad Jamie is our model yet again (Starz, episode 105, Rent). Well-developed pec majors are clearly visible under the skin. Red arrows mark clavicular and sternocostal heads. Puir lad, he dinna get no Dougal R-E-S-P-E-C-T!

The fourth and last muscle is the deltoid, named because it resembles an inverted capital delta Δ, 4th letter of the Greek alphabet. Viewed from the side, the shape is clear: broad at the top narrowing to an apex at the bottom. Each deltoid arises from clavicle, acromion and scapular spine (Photo N) and inserts on the deltoid tuberosity of humerus (Photo H). Middle fibers contract to abduct the arm; front fibers flex and back fibers extend the arm.

Photo N

The next image shows Jamie’s fantastic right deltoid when he and Claire are still vertical (Starz episode 109, The Reckoning). The posterior border is marked by a red arrow, anterior border by a green arrow and insertion (hehe) on the deltoid tuberosity (hehe) by a blue arrow (canna help it, anatomists have a ribald sense of humor).

Okey-dokey, we are done with the arm muscles. For fun, let’s examine images from Starz episode 109, The Reckoning, for more arm movements. See if you can you identify the arm positions – some are combos.

1: Name the position of Jamie’s right arm and of his left arm.

Answer: Jamie’s right arm is flexed and his left arm is abducted. Get the idea? I knew ye would like it – this is gobs of fun!

2: Next, for our viewing pleasure, BJR has just taken an assisted face plant on the desktop and is out for the count: 10-9-8-7-6 …… name the position of his left arm.

Answer: flexion

Let’s take a keek-peek at our first couple’s first fight! Whew, as much passion here as on the mattress, um, floor! Claire’s aboot to knock some brains into that hard-as-an-iron-pot highland skull!

3: Name the movements of Claire’s left arm (there are two).

Answer: Abduction and flexion.

No question here, but I call this “the slap heard round the world!” Ouch Jamie, she wallops you in front of yer three best bros? Whew, they are going at it “hammer and tongs.”

In the next image, Jamie’s right arm is lifted up, up and away from the body midline (his button line). Aye, he is blistering Claire’s bum with his doubled belt. Weel, Claire, ye did put the entire party in peril and you promised Jamie you would be at the grove when he returned. Och, dinna make promises ye canna or willna keep. Herself explains Claire’s view of the spanking (Outlander book):

I felt deeply betrayed that the man I depended on as friend, protector, and lover intended to do such a thing to me. And my sense of self- preservation was quietly terrified at the thought of submitting myself to the mercies of someone who handled a fifteen- pound claymore as though it were a flywhisk.

4: What movement is performed by Jamie’s right arm?

Answer: vertical abduction (as in “Reach for the sky, partner!”). The downward smack is adduction.

Here, Jamie tap dances for his beloved (mayhap he enjoyed that abduction/adduction a bit too much?). Lad, if ye ever want to do the horizontal boogie with Claire again ye better buckle on those show-biz shoes and get on wi’ it! You’ve done considerable damage spanking yer new wife. Herself explains (Outlander book):

“Whatever the justice of the situation—and I had to admit that at least some of it lay on his side—my sense of amour-propre was deeply offended….”

Ohhhh, she is royally pissed – in such a cold fury she brushes that same curl at least 200 strokes and we all ken that 100 does the trick!

5: Name the position of Jamie’s arms.

Answer: the begging position…Hah. No, both arms are abducted.

Good job with identifying arm movements! Before this lecture ends, I canna help but offer a few wee anatomical observations from Starz episode 109. We ken well that Jamie was shot through his right trapezius so I was happy-happy to see scars! First we see the exit wound (blue arrow)….

and we also see the entrance wound (red arrow)! Yessss, the special effects folks remembered that Jamie’s gunshot wound must have two scars!

Whaaat? – Entrance wound in back and exit wound in front? Well yes, Herself being the final arbitrator of such supreme-court issues (from Outlander book)!

No, when we were running from the English, I realized we were near the edge of the Fraser lands, and I thought I’d take my chances there. So I spurred up and cut to the left, around Dougal and the rest. There was a good deal of shooting goin’ on, mind ye, but the ball that hit me came from behind. Dougal, Rupert, and Murtagh were back of me then. And the English were all in front—.“

In the afterglow of bliss-land, our newly-wed redhead looks a bit worse for wear after Claire extracted her own measure of justice! We book readers expect cheek scratches but did ye ken his neck gouges (red arrows)? Herself writes (Outlander book):

It had been a most unpleasant night. My reluctant acquiescence had lasted precisely as far as the first searing crack of leather on flesh. This was followed by a short, violent struggle, which left Jamie with a bloody nose, three lovely gouges down one cheek, and a deeply bitten wrist.

Weel, if ye bed a vixen … Come here vixen and bite me again!

To arms! To arms! While not anatomy-related, did ye see the mushroom-shaped cloud over Fort William – proof that toxic waste in the form of BJR resides inside that stony edifice!

This last image is verra funny. Jamie’s right arm is in fine fettle as he sends many rocks artfully skipping across the burn. But as soon as Laoghaire sidles up, his verra next toss goes kerplunk! The stone drops like, well, like a rock. Let that rock-flop be a warning to ye laddie; she is NO a good girl … she’s armed, dangerous and on a stealth mission!

To Arms! Too Arms! Two Arms! That’s it for the bones, muscles and movements of the arms. Raise yours in grateful joy! Aren’t they grand?!

A deeply grateful,

Outlander Anatomist

Photo creds: Starz, Gray’s Anatomy, 39^th ed., Netter’s Atlas of Human Anatomy, 4^th ed., Clinically Oriented Anatomy, 5^th ed., Hollingshead’s Textbook of Anatomy, 5^th ed., www.bestperformancegroup.com, www.ceessentials.net/article31.html, www.wikipedia.com

April 13, 2015

Anatomy Lesson #19 Tomorrow!

“To arms, to arms!” All about the arms tomorrow in Anatomy Lesson #19 (April 14th)!

The deeply grateful,

Outlander Anatomist

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