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A Brief Insight into the Living Anatomy Course

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It is difficult to imagine medical students studying anatomy without the traditional cadaver - that is, the body of a deceased person who has generously donated their remains to medical science. However, the anatomy of the deceased, although useful, is not all there is to studying the anatomy of the body. After all, doctors examine the living, so it seems only right that the study of anatomy encompasses both that of the cadaver, and also that of the healthy, living human body.

The source of the cadaver for the study of anatomy has already been outlined, but for the living, who does the class examine? For this, you look towards yourself with fresh eyes, and find that the best source for such willing individuals is in fact closer than one may originally imagine, for the best source of healthy, living specimens for anatomical examination are the medical students1 themselves.

The Beginning of the Course

... or 'You don't really expect us to do that!'

Unless the foolish medical student is destined to be a surgeon, medics tend not to deal literally with insides so often since the advent of scanning technology. However, clinical skills such as feeling for a liver or spleen require knowledge of what are known as 'surface markers'2. An easier one is that of the 'apex beat' - the lowest point at which the contractions of the heart can be 'palpated' - the medical term for 'feel'.

The easiest to find by far is listening for breath sounds through the stethoscope. However, what with the lungs being in the chest, and hearing being such a sensitive sense, this can't be done through clothes. So either male or female, off comes the top (but on remains the bra). However, at this point, as everyone is very nervous, all will only go as far as unbuttoning their tops, hoping no-one will see.

The class is then paired off with very nervous medical students not wishing to expose themselves any more than is really necessary. One of the pair has the stethoscope, and the other student will be breathing deeply through their mouth to emphasise the sound of air coming into their lungs.

As time goes on though, and the students progress through examination of the lungs, heart and abdomen, a strange thing happens.


... or 'Would you like my top off for this?'

After six weeks of being poked about, the students become accustomed to walking, lying or even bending over semi-naked while having various areas of surface anatomy examined by other students and lecturers - bra and other associated undergarments remaining on, of course. This now means that the whole class, from men to women are all walking around with only sufficient clothes to allow for examination, without anyone so much as batting an eyelid.


... or 'I know - you want my top off for this...'

Fun though it may sound to the non-medic, it becomes a terribly tedious exercise of poking about with cold hands and stethoscope bells, or even literally surface marking the outline of the heart on each other with red Conté  pencil3. Compare this with the literal cut and thrust of dissection (which becomes arguably much more interesting, even to those who don't want to do surgery eventually): the latter is essential for knowing where things are in relation to each other4. However, the study of living anatomy is still an important tool in introducing clinical skills and also introduces some sort of empathy in knowing what it must be like from the patient's point of view.

1The term 'healthy' is of course used in its broadest sense, as the total alcohol consumption of first-year medical students in a small college is probably enough to sustain a medium-sized brewery in considerable profit.2For instance the axilla, more commonly known as the armpit.3The stuff of nightmares as this refuses to be scrubbed off, even with the most determined use of showers.4Even if you are not a surgeon, this is essential knowledge for reading scans from the simplest X-ray to the most complex Magnetic Resonance Image.

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