33. Surface anatomy
After learning anatomy, you can assume what is inside a living human body as you look at and touch cadavers. You can know where muscle, bone, artery, and vein are placed under the skin, and where liver and other organs are placed. This is called surface anatomy. Surface anatomy is important in clinical medicine. When a patient in pain is pointing at a spot, a doctor must know what is placed underneath that spot. A patient who is alive can¡¯t be dissected.
For example, if you stretch out your thumb strongly, two tendons pop out. These tendons are tendons of extensor pollicis longus muscle and extensor pollicis brevis muscle. There is a pit between these two tendons and this is called the anatomical snuff box. Apparently, tobacco dust used to be placed in the pit and inhaled. The radial artery runs across the anatomical snuff box and you can feel the pulse. The radial artery which you can feel at your wrist takes a curve to run to the back of your hand. It may seem difficult to understand, but it is easy for a student with experience in dissection.
When a male med student goes to a swimming pool and sees ladies in their bikinis, it is not necessarily fun. For an ordinary male, he can see the skin under the bikini if he concentrates. Without concentration, he sees nothing. For a male med student, he can also see the skin under the bikini if he concentrates. Without concentration, he sees muscles and bones under the skin. This is because he can¡¯t erase anatomy from his eyes and mind. I consider this a study disease, not occupational disease.
As I teach surface anatomy, I strongly tell my students to touch their own bodies. If you can feel the structure by touching your own body, then you can feel the same structure by touching the patient¡¯s body. I tell a fat student who is having trouble locating structures within his body to touch a thin student. A thin student becomes popular and arrogant. ¡°Get in line! Take your turn!¡± ¡°Pay a dollar to touch. Ten touches give you one touch free; bringing another customer gets you another touch free.¡±
Different structures of different sex are difficult to study in surface anatomy. For example, vas deferens can be touched on both sides of male pubis, but a thin ligament can be touched at the same spot for a female. I ask students to touch them both. A week later, I ask the students how it went. A female student says she touched her nephew. A male student complains, ¡°A female touching a male¡¯s body is okay, but it¡¯s a sexual harassment the other way around. I felt sex discrimination.¡± ¡°I was planning to make a girlfriend and to touch her pubis, but I had neither time nor money to do so. This is part of the anatomy course so the school should provide money for this.¡±
For surface anatomy, I could touch the body of others, but I could make the others touch my body. By this I mean massage. Getting a massage is easy but it requires money. Ordinary people relax when they get massage, but I can¡¯t relax. ¡°I can know which muscle is being pressed. A joint is being twisted to extend a ligament. It seems this person has studied anatomy considering muscles and ligaments are massaged in an organized fashion.¡±
I suggested creating a massage club in med school for educational purposes, but the idea was rejected. I think the rejection was due to corrupted massage clubs. Anyway, surface anatomy requires seeing and touching which is fun.