13. Do not look down on stroma.



Dr. Anatophil 762.BMPDr. Anatophil 762.BMP


If we suppose human body as a corporation, each part of the corporation can be divided as parenchyma and stroma. Parenchyma is the part that gives actual results, and is in charge of producing and selling products. Sales and production department are examples of it. Stroma is a part which aids parenchyma. Human resources department and accounting department are examples of it. Parenchyma differs per every corporation. Parenchyma of an electronics company and an automobile company show huge differences. However stromata of corporations do not differ much. Human resources and accounting department of corporations do not differ much.


763Dr. Anatophil 763.BMP


Tissues that form the human body can be divided into parenchyma and stroma. Parenchyma is the tissue that brings results. For example, parenchyma of gastrointestinal tract is the epithelium that secretes digestive fluids and absorbs digested foods, and parenchyma of brain is nervous tissue that transmits stimulation. Stroma is the tissue that holds the organ tight. Stroma of gastrointestinal tract hold epithelium to stay at where it is, and stroma of brain hold nervous tissue of the brain to stay at where it is. Parenchyma differs per organs, but stroma does not.


763Dr. Anatophil 763.BMP


Parenchyma and stroma are sorted out by microscopes, but there are cases where they are sorted out with bare eyes. Muscles that move the human body are parenchyma and subcutaneous tissue and the fascia that surround the muscles are stroma. Medical students spend more time dissecting stroma than parenchyma. That is, it does not take much time to cut muscles, but it takes a long time to peel subcutaneous tissues and fascia off.




Removing the subcutaneous tissue is a physical labor. When cadaver's subcutaneous tissues are thick, it becomes even harder, and then students pledge to themselves, "I will lose weight and then donate my body." If students do as what they pledged and start their diet, dissection practice can be seen as beneficial. However in reality, dissection practice is bad for student's health. This is because students eat more to relieve physical and mental stress.


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There are students who have plausible conversation with each other. "If we had a fluid that melts fat, then we can dissect subcutaneous tissues easily." "We can find it near us. Bile melts fat. So let's take the bile out of cadaver's gallbladder and put it on subcutaneous tissue." It may sound reasonable, but this is nonsense.

To clearly see each muscle's direction and range, you have to take off semi translucent fascia which covers the muscles. You have to take off muscle's outer fascia and inner fascia. When taking inner fascia off, you have to be careful not to damage arteries and nerves that go into muscles. In restaurants when they cook pork and beef, they do not peel fascia off. So, medical students are more precise than cooks.




Dissection of removing fascia is divided among students in a group. But in certain groups, a single student takes charge of it. When muscle appears during when the student is studying, the student rushes and removes fascia. Really, I think he dissects to marvel at the beauty of muscles. He looks like an artist who finds inner peace by making a work of art.

Parenchyma is the main actor and stroma is the supporting actor. Just like people who look at the main actor in a movie, there are students who only dissect parenchyma. They quickly dissect muscles and give rest of the work, which is dissecting subcutaneous tissue and fascia, to other students. The real dissection is dissecting the subcutaneous tissue and fascia carefully, and heartily feeling the human body with both hands. Students who dissect carefully get a reward when they become a doctor, especially a surgeon. Just like how you should not disvalue supporting actors in a movie, you should not look down on stroma when dissecting.