Tag: outlanderanatomy

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Fun Fact: Manubriosternal Junction

Anatomy def: Manubriosternal junction is a prominent joint between manubrium and body of the sternum (breastbone). 

Outlander def: Wee Mary MacNab’s chest mound, sweetly straining toward the Dunbonnet. Surrender, Jamie! She kens they both need “this.” 😉

Learn about the manubriosternal junction in Anatomy Lesson #15, Crouching Grants –  Hidden Dagger. 

An adult sternum has three parts:

  • manubrium (top)
  • body (middle; a.k.a. gladiolus)
  • xyphoid process (tip)

These parts are typically fused into a single, elongated bony structure in adults.  Notably, the juncture between manubrium and body forms an elevated bump, the manubriosternal junction.

As this word is a real mouthful, many anatomists and clinicians use the term sternal angle, angle of Louis, or sternal angle of Louis, to supplant manubriosternal junction. (Why use one name when three will do?) <G> And, some anatomists push the envelop further, preferring the term, sternomanubrial joint. So many terms, so little time. Gah!

Taking an easier route, the sternal angle of Louis is a splendid topographical feature because it is easily palpated!  It is the site where costal cartilages of the second ribs attach to the sternum. The T4 – T5 intervertebral disc also lies at this level. And, that is not all. This angle is used to locate or define some 15 (!!!) clinically significant structures and/or compartments of the chest. A useful example: starting at the second ribs, a practitioner can count intercostal (between ribs) spaces to locate organs and evaluate normal anatomy. Lots of splendid stuff going on here!

Try this: Place your fingers at the top of your chest in the small bony divot (suprasternal notch); this marks the top of the manubrium. Run fingers downward about 2” or 5 cm and feel the raised knob of bone? This is your sternal angle of Louis. Run fingers to each side – these are your second ribs and their costal cartilages. Feel them? Yay!  

Here’s a useful hint: If you avoid heavy necklaces because they give you neck pain, choose one that sits above the sternal angle. This way, manubrium and clavicles help support the weight of the piece, easing pull on the neck.

Read about the sternum in Voyager book. Herself conjured this scene between Dr. Claire Randall and a dying Scottish patient (not filmed in S3): 

“I have been thinking,” Graham announced. The sound of his voice echoed tinnily through the earpieces of my stethoscope. “Have you?” I said. “Well, don’t do it out loud ’til I’ve finished here, that’s a good lad.” 

He gave a brief snort of laughter, but lay quietly as I auscultated his chest, moving the disc of the stethoscope swiftly from ribs to sternum. “All right,” I said at last, slipping the tubes out of my ears and letting them fall over my shoulders. “What have you been thinking about?” 

“Killing myself.”

Whoa! Best read the book to find out what happens to Graham (and Claire)!

See Mary’s sternal angle (red arrow) in Starz episode 302, Surrender.  Sweet, sweet Mary is so very slender, her sternal angle of Louis with its curved 2nd ribs and costal cartilages are plain as cave light. Way to rock it, Mary! Ye are a bonny lass!

The deeply grateful,

Outlander Anatomist

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Photo credit: Starz episode 302, Surrender

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Fun Fact: Melanin 

Anatomy Def: Melanin is a group of natural pigments found in animal skin, eyes, hair, feathers, scales or ink (the cephalopods). 

Outlander Def: That man – That hair! ‘Nuf said!

“Am I to wait all day?” 

As Jamie carefully cleans a horse’s hoof, Lords Ellesmere, spews rancor at the groom slowness. Adequate cleaning takes time –  the lad has a great work ethic.  Jamie, not Ellesmere! <G>

Ellesmere pouts and spouts:

“My god! If a child of mine had hair that color, I’d drown him before he drew a second breath.” 

Truer words! In a few short months, his Lordship very nearly slays his newborn son – a babe festooned with sprouts of golden-ginger hair!!!

Learn about melanin in Anatomy Lesson 6: Claire’s Hair – Jamie’s Mane or JHRC!

Melanin is the pigment of human skin, irises, hair and neurons. Three types are known: 

  • eumelanin  – brown, black pigment –  most common type
  • pheomelanin – golden yellow, red pigment –  the type in Jamie’s hair 
  • neuromelanin  – dark pigment – of some neurons, function unknown

Ergo, Jamie’s red hair receives its color by virtue of pheomelanin, a chemical variant of melanin! 

Less than 2% of the world’s population have red hair. More to the point, Scotland and Ireland enjoy the highest percentages of natural ginger heads in the world!

Read about Jamie’s hair in Voyager book. Clever Claire reflects on Jamie’s preparations for the governor’s ball in Jamaica. she quotes from a classic English scholar and poet:

“Oh who is that young sinner with the handcuffs on his wrists?

And what has he been after that they groan and shake their fists?

And wherefore is he wearing such a conscience-stricken air?

Oh they’re taking him to prison for the colour of his hair.”

Jamie put down the wig in his hand and raised one eyebrow at me in the mirror. I grinned at him and went on, declaiming with gestures:

“ ’Tis a shame to human nature, such a head of hair as his;

In the good old time ’twas hanging for the colour that it is;

Though hanging isn’t bad enough and flaying would be fair

For the nameless and abominable colour of his hair!”

“Did ye not tell me ye’d studied for a doctor, Sassenach?” he inquired. “Or was it a poet, after all?”

“Not me,” I assured him, coming to straighten his stock. “Those sentiments are by one A. E. Housman.”

Housman’s entire poem can be read here: https://www.poemtree.com/poems/OhWhoIsThat.htm  

See Ellesmere’s reprehensible behavior regarding the “abominable” color of Jamie’s hair in Outlander episode 304, Of Lost Things. At least, Lady Isobel seems displeased with the chortling auld men. Braw lassie!

The deeply grateful,

Outlander Anatomist

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Photo Credits: Sony/Starz