CAM102 Dissection Schedules - Modifications and lists of structures 2014

Page 1 of 14
CAM102 Dissection Schedules 2014
Lists of structures to identify, and modifications to instructions
Derek Choi-Lundberg

The dissection manual used at UTAS in the MBBS course (in CAM102, 201, 202, and 304) is
Hansen JT, Essential Anatomy Dissector Following Grants Method, 2
nd
ed.

The lists of structures which follow should be cleaned and identified during dissections, and
identified at tutorials. Follow the instructions in the Hansen manual, along with any
modifications to the instructions contained in this document. Unless otherwise instructed, you
should do the dissections on both sides of the body, with one side kept more superficial (do
not cut and reflect muscles, except perhaps the most superficial ones, but do clean and
separate them and neurovascular structures), and the other side deeper (following the
instructions do not cut or remove structures unless instructed to do so).

A note on skin flaps: I recommend removing skin flaps. This gives you more room to dissect,
and helps to keep the dissection area and entire table neat & tidy. Place the skin flaps in the
labeled bin under your cadaver table, along with other tissues you remove. Be sure to spray
these exposed areas with tissue spray to prevent them from drying out.

You may visit other tables to identify the structures on more than one cadaver, to observe
anatomical variations amongst people, or if some structures have been lost or inadequately
cleaned on your cadaver.

In addition to identification of structures, you should consider the following:

Muscles: the compartment to which it belongs, its action/s, innervation, major
anatomical relationships, and brief summary of proximal and distal attachments
(from what bone to what bone, and joint/s crossed detailed descriptions of
proximal and distal attachments are not expected except where specifically
highlighted in clinical skills or gross anatomy lectures)
Nerves: structures supplied (particularly muscle compartments and specific muscles, and
areas of skin), any named branches, origin and termination (if it divides into 2
other nerves, for example, the sciatic nerve terminates by dividing into the tibial
nerve and common fibular/peroneal nerve), major anatomical relationships, spinal
nerve roots which contribute to the nerve
Arteries: structures supplied (particularly muscle compartments, not individual muscles),
named branches, origin and termination, major anatomical relationships, pulse
points (usually where the artery is not deep to muscles and where it may be
compressed against a bone)
Veins: structures drained (particularly muscle compartments for deep veins, or areas of
skin and superficial fascia for superficial veins), named tributaries, origin and
termination, major anatomical relationships, venipuncture points. Generally, deep
veins accompany arteries of the same name.
Lymph nodes: structures drained (muscle compartments and/or areas of skin and
superficial fascia) and pathway of lymph back to bloodstream (additional sets of
lymph nodes and named lymph vessels through which lymph flows)
CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 2 of 14
Lower Limb
Dissection 5-I Anterior and medial thigh

Modifications to instructions:
A. Remove skin from the anteromedial thigh and the proximal leg to about the level of
the tibial tuberosity, but NOT from the rest of the leg and foot at this time. Note that
there is little superficial fascia around the knee, so keep your skin incisions shallow
here. The common fibular nerve is immediately deep to the deep fascia near the head
of the fibula just distal to the knee joint on the lateral side, and the sartorius and
gracilis muscles are immediately deep to the deep fascia on the medial side of the
knee.
B. (as is)
C. Also clean the iliopsoas muscle in the superior thigh.
D. (as is)

List of structures:
Muscles:
Tensor fasciae latae (tensor of fascia lata) muscle note that this is a muscle of the
gluteal region, but is located quite anteriorly
Sartorius muscle
Quadriceps femoris muscles
-Vastus lateralis muscle
-Vastus medialis muscle
-Vastus intermedius muscle
-Rectus femoris muscle
Patellar tendon (or ligament)
Iliopsoas muscle
Pectineus muscle
Gracilis muscle
Adductor longus muscle
Adductor brevis muscle
Adductor magnus muscle
Obturator externus muscle (the pectineus needs to be reflected to see this muscle)
Nerves:
Saphenous nerve (a cutaneous branch of the femoral nerve)
Femoral nerve
Obturator nerve (anterior and posterior divisions)
Arteries and veins:
Great saphenous vein
Femoral artery and vein
Deep femoral artery and vein (profunda femoris artery and vein)
Lateral and medial circumflex femoral arteries (and veins)
Miscellaneous:
Deep fascia (fascia lata) of thigh
Iliotibial tract or band
Femoral triangle boundaries and contents
Adductor (subsartorial) canal boundaries and contents
(Femoral sheath and canal removed to clean femoral vessels)
Inguinal ligament
Superficial and deep inguinal lymph nodes if found
Adductor hiatus of adductor magnus muscle
CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 3 of 14
Lower Limb
Dissection 5-II Gluteal region and posterior thigh and 5-III A Popliteal fossa

Modifications to instructions:
A. Also remove skin from the posterior thigh and popliteal fossa. Make a vertical
incision along the middle of the posterior thigh and popliteal fossa, and a horizontal
incision just inferior to the knee (at the level of the head of the fibula). Note that there
is little superficial fascia around the knee, so keep your skin incisions shallow here,
especially laterally near the head of the fibula, where the common fibular nerve is just
deep to the deep fascia.
B. When reflecting the gluteus maximus, try not to cut the sacrotuberous ligament (one of
the proximal attachments of the muscle) and the sciatic nerve, which is deep to the
muscle, inferior to the piriformis.

List of structures:
Muscles:
Gluteus maximus muscle
Gluteus medius muscle
Gluteus minimus muscle
Piriformis muscle
Superior gemellus muscle
Obturator internus muscle (tendon)
Inferior gemellus muscle
Quadratus femoris muscle
(obturator externus muscle or tendon)
Tensor fasciae latae (tensor of fascia lata) muscle
Semitendinosus muscle
Semimembranosus muscle
Biceps femoris muscle (long and short heads)
Adductor magnus muscle
Vastus lateralis muscle
Gastrocnemius
Plantaris
Soleus and popliteus (might not be identified at this session)
Ligaments:
Sacrotuberous ligament
Sacrospinous ligament
Nerves:
Sciatic nerve
Inferior gluteal nerve
Superior gluteal nerve
Pudendal nerve
Tibial nerve
Common fibular (common peroneal) nerve
Arteries and veins:
Inferior gluteal artery and vein
Internal pudendal artery and vein
Superior gluteal artery and vein
Popliteal artery and vein
Genicular arteries

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 4 of 14
Miscellaneous:
Greater sciatic foramen
Lesser sciatic foramen



Lower Limb
Dissection 5-III B-D Leg, ankle, and dorsal foot
Modifications to instructions:
If the cadaver is prone (face down), begin with section D (posterior leg), then proceed to C
(lateral leg) and B (anterior leg).
A. The popliteal fossa should have been dissected in the previous session. Finish
cleaning the neurovascular structures of the fossa if not adequately cleaned by the
previous group. Do not separate the two heads of the gastrocnemius from each other
(see D.2. below).
B and D. Remove skin from the leg and dorsum of foot but leave it on the sole of the foot
at this time. Make a vertical incision along the middle of the leg and a horizontal
incision just inferior to the malleoli. Make an incision longitudinally along the middle
of the dorsum of the foot, and a transverse incision just proximal to the toes. Reflect
the skin flaps laterally and medially. Note that there is little superficial fascia around
the ankle and on the dorsum of the foot, so keep your skin incisions very shallow.
D.2. The Achilles tendon may be cut on both sides and the gastrocnemius and soleus
reflected superiorly. However, only cut the soleus as described on one side, and also
cut the medial head of gastrocnemius near its origin from the medial epicondyle of the
femur on this side. Clean the popliteal vessels and their branches, and the tibial nerve,
from the popliteal fossa to and through the posterior leg.

List of structures:

Muscles and their tendons:
Pes anserinus tendons
-Sartorius
-Gracilis
-Semitendinosus
Gastrocnemius muscle (medial and lateral heads)
Plantaris muscle
Soleus muscle
Calcaneal tendon (Achilles tendon)
Popliteus muscle
Flexor hallucis longus muscle
Flexor digitorum longus muscle
Tibialis posterior muscle
Fibularis (peroneus) longus muscle
Fibularis (peroneus) brevis muscle
Tibialis anterior muscle
Extensor hallucis longus muscle
Extensor digitorum longus muscle
Fibularis (peroneus) tertius muscle
Extensor hallucis brevis muscle
Extensor digitorum brevis muscle

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 5 of 14
Nerves:
Tibial nerve
Common fibular (peroneal) nerve
Superficial fibular (peroneal) nerve
Deep fibular (peroneal) nerve
Arteries and veins:
Popliteal artery and vein
Posterior tibial artery and veins
Fibular (peroneal) artery and veins
Anterior tibial artery and veins
Dorsalis pedis artery (and veins)
Miscellaneous:
Tarsal tunnel and contents (structures deep to flexor retinaculum, posterior & inferior to
medial malleolus of tibia)
Superior and inferior peroneal retinacula, lateral malleolus of fibula
Superior and inferior extensor retinacula




Lower Limb
Dissection 5-IV Sole of the foot

Modifications to instructions:
B. Do not cut the plantar aponeurosis longitudinally; rather, cut it transversely near the
calcaneus and reflect it anteriorly. As you do this you will need to cut the attached
intermuscular septa that separate the medial, central, and lateral compartments.
Reflect skin around the ankle on the medial side and follow the tendons and
neurovascular structures through the tarsal tunnel, and deep to the abductor hallucis
(cut this muscle posteriorly from its origin and reflect anteriorly) into the sole of the
foot. Also reflect the skin from the lateral side of the ankle and trace the fibularis
brevis tendon to its insertion into the base of the 5
th
metatarsal.
C. Proceed with the dissection of the first and second layers on both sides. On the side
with better neurovascular structures, do not perform steps D and E.
D. Cut the quadratus plantae and flexor digitorum longus (FDL) tendon transversely,
proximal (posterior) to where the FDL tendon divides into four parts.
E. Trace the fibularis longus (FL) tendon to its insertion into the first metatarsal and
medial cuneiform (cut the long plantar ligament along the course of the FL).


List of structures:

Muscles and tendons:
Flexor digitorum brevis muscle
Abductor hallucis muscle
Abductor digiti minimi muscle

Quadratus plantae muscle (flexor accessorius muscle)
Lumbrical muscles (4)
Flexor digitorum longus tendon

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 6 of 14
Flexor hallucis brevis muscle
Adductor hallucis muscle (oblique and transverse heads)
Flexor digiti minimi brevis muscle
Flexor hallucis longus tendon

Tibialis posterior tendon
Fibularis (peroneus) longus tendon

Plantar interossei muscles (3)
Dorsal interossei muscles (4)

Nerves:
Tibial nerve
Medial plantar nerve
Lateral plantar nerve

Arteries and veins:
Posterior tibial artery and veins
Medial plantar artery and veins
Lateral plantar artery and veins
Deep plantar arterial arch

Miscellaneous:
Plantar aponeurosis

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 7 of 14
Back
Dissection 4-I Back and 4-II A, B1, D Deeper back muscles of cervical region

Modifications to instructions: None.
Note that section 4-I B mentions three groups of back muscles: superficial, intermediate, and
deep (or intrinsic). Table 4.1 lists only the deep layer (intrinsic back muscles), which are in
turn rather confusingly subdivided into superficial, intermediate, deep and minor deep layers.
(Table 4.1 should have been placed in dissection 4-II.) The superficial back muscles
(latissimus dorsi, trapezius, rhomboid major and minor, and levator scapulae) are listed in
Table 6.1. The intermediate back muscles (serratus posterior superior and inferior) are also
dissected in this schedule.
4-II D. Perform the dissection of the suboccipital region on one side only.

List of structures:

Muscles and tendons:
Trapezius muscle
Latissimus dorsi muscle
Rhomboid major muscle
Rhomboid minor muscle
Levator scapulae muscle
Serratus posterior superior muscle
Serratus posterior inferior muscle
Splenius capitis and cervicis
Semispinalis capitis
Suboccipital triangle muscles
-Inferior oblique of the head (obliquus capitis inferioris)
-Superior oblique of the head (obliquus capitis superioris)
-Rectus capitis posterior major
-Rectus capitis posterior minor

Nerves:
Dorsal rami of spinal nerves
Spinal accessory nerve (cranial nerve XI)
Greater occipital nerve (cutaneous branch of dorsal ramus of C2 spinal nerve)
Suboccipital nerve (dorsal ramus of C1 spinal nerve) may be difficult to find

Arteries and veins:
Occipital artery
Vertebral artery (both of these arteries may be difficult to find)

Miscellaneous:
Triangle of auscultation (borders: latissimus dorsi, trapezius, and rhomboid major)
Lumbar triangle (borders: latissimus dorsi, external abdominal oblique, and iliac crest)
Thoracolumbar fascia
Ligamentum nuchae (nuchal ligament)

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 8 of 14
Back
Dissection 4-II Deeper back muscles and spinal cord

The muscles you will be dissecting are summarised in Table 4.1, which is in section 4-I.

Modifications to instructions:
C. When performing the laminectomy, your cuts should only be about only about 0.5 cm
lateral to the spinous processes (or a bit less in small cadavers). Use a saw initially,
and then chisel and mallet. An electrical circular saw may be available.

List of structures:

Muscles and tendons:
Splenius capitis and cervicis muscle
Semispinalis capitis
Erector spinae muscle group
-Iliocostalis muscles
-Longissimus muscles
-Spinalis muscles
Transversospinalis muscle group (paravertebral muscles)
-Semispinalis muscles
-Multifudus muscles
-Rotatores muscles

Nerves:
Dorsal rami of spinal nerves

Arteries and veins:
Vertebral artery

Miscellaneous:
Supraspinous ligaments
Interspinous ligaments
Ligamenta flava (singular: ligamentum flavum)
Extradural space with adipose tissue and vertebral venous plexus
Dura mater
Arachnoid mater
(subarachnoid space)
Spinal cord (with pia mater on its surface)
Denticulate ligaments
Dorsal (posterior) and ventral (anterior) roots of spinal nerves
Dorsal root ganglia (DRG) = spinal ganglia
Conus medullaris of spinal cord
Cauda equina
Filum terminale

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 9 of 14
Upper Limb
Dissection 6-I Shoulder, and 6-II-B-1 posterior arm

As part of this dissection, review the superficial back muscles (listed below).

Modifications to instructions:
A. At this time, only remove skin from the posterior arm: incisions C and D in posterior
view of Figure 6.2, but make incision D at the level of the elbow joint. Do not remove
skin from the posterior forearm and hand, nor the anterior surface of the entire upper
limb at this time. Keep you incision superficial around the elbow; particularly, watch
out for the ulnar nerve, which is just deep to the deep fascia on the posteromedial side
of the elbow (posterior to the medial epicondyle of the humerus). Do not reflect skin
too far anteriorly; you shouldnt be dissecting the brachial artery and median nerve
during this dissection.

List of structures:

Muscles:
Trapezius muscle
Latissimus dorsi muscle
Rhomboid major muscle
Rhomboid minor muscle
Levator scapulae muscle
Deltoid muscle
Triceps brachii muscle (long, lateral, medial heads)
Teres major muscle
Rotator cuff muscles
- Supraspinatus muscle
- Infraspinatus muscle
- Teres minor muscle
- Subscapularis (wont be seen at this time on anterior surface of scapula)

Nerves:
Axillary nerve
Radial nerve
Suprascapular nerve

Arteries and veins:
Posterior circumflex humeral artery and vein
Deep brachii artery and vein (profunda brachii vessels)
Suprascapular artery and vein

Miscellaneous:
Quadrangular space borders and contents

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 10 of 14
Upper Limb
Dissection 1-I-A to D2 (Thoracic wall)

Modifications to instructions:
If this dissection is already completed (i.e., if the thorax has been dissected by the second
year students), read this part of the schedule, identify the structures, and clean them
further if necessary. If you need to do this dissection, do not make the incision B-C, nor
encircle the nipple, as shown in Figure 1.1. Rather, just cut C-A-B-D and reflect the skin,
superficial fascia, and breast laterally.
C. Do not do the dissection of the female breast. This will be done in CAM201. Retain
the removed breasts and surrounding tissues on the dissection table (wrap in a damp
cloth).
D1. Cut the pectoralis major from its origin (the clavicle, sternum, and ribs) and reflect it
laterally, leaving it attached only to its insertion into the humerus.

List of structures:

Muscles:
Pectoralis major muscle
Pectoralis minor muscle

Nerves:
Lateral pectoral nerve
Medial pectoral nerve

Arteries and veins:
Cephalic vein
Thoracoacromial artery

Miscellaneous:
Deltopectoral triangle
Calvipectoral fascia

Note: you should also begin the next dissection, 6-II (Axilla and Arm). See below.



Upper Limb
Dissection 6-II Axilla and anterior arm

Modifications to instructions:
A. Reflect skin from the anterior arm, but not forearm and hand at this time. Note that
there is little superficial fascia near the elbow joint and cubital fossa region, so keep
your skin incisions shallow. Remove the skin from the axilla, and dissect carefully
through the loose connective tissue to reach the borders and contents of the axilla.
B. 1. The posterior compartment of the arm should have already been dissected (with
schedule 6-I). Clean the radial nerve and deep brachial artery entering the posterior
compartment of the arm just inferior to the axilla.
2. Do not cut the biceps brachii as described. Rather, lift and displace it medially or
laterally to visualise the lateral cutaneous nerve of the forearm.

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 11 of 14

Upper Limb
Dissection 6-II Axilla and anterior arm
CONTINUED (modifications on previous page)

List of structures:
Muscles:
Pectoralis major muscle
Pectoralis minor muscle
Latissimus dorsi muscle
Teres major muscle
Subscapularis muscle
Serratus anterior muscle
Biceps brachii muscle (long and short heads)
Coracobrachialis muscle
Brachialis muscle

Nerves:
Brachial plexus and its component parts
If the neck has been dissected by 3
rd
year students, identify the C5-C8 & T1 ventral
rami (roots of the brachial plexus), trunks (superior, middle, inferior), and
divisions (anterior and posterior, from each trunk).
Lateral, medial, and posterior cords of brachial plexus
Musculocutaneous nerve
Lateral antebrachial cutaneous nerve (lateral cutaneous nerve of the forearm)
Median nerve
Ulnar nerve
Radial nerve
Axillary nerve
Medial antebrachial cutaneous nerve (medial cutaneous nerve of the forearm)
Upper and lower subscapular nerves
Thoracodorsal nerve
Long thoracic nerve
Lateral and medial pectoral nerves
Arteries and veins:
Axillary vein
Axillary artery
Branches of axillary artery: (superior thoracic), thoracoacromial, lateral thoracic,
subscapular, posterior circumflex humeral, (anterior circumflex humeral) arteries
(those in parentheses are usually quite small)
Brachial artery and vein
Deep brachial artery and vein
Ulnar artery and vein
Radial artery and vein
Miscellaneous:
Walls of the axilla (anterior, posterior, medial, lateral) and the muscles that comprise
them
Axillary lymph node groups (anterior/pectoral, posterior/subscapular,
lateral/brachial/humeral, central, apical)
Cubital fossa borders and contents

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 12 of 14
Upper Limb
Dissection 6-III Flexor region of the forearm

Modifications to instructions:
A. Reflect skin from the anterior forearm. Note that there is little superficial fascia in the
distal half of the forearm, so keep your skin incisions shallow in this area, especially
near the wrist.
C. 2. On one side, also cut and reflect the pronator teres near its distal attachment to the
radius and pull it and the flexor digitorum superficialis medially. Trace the median
nerve between the two heads (proximal attachments to the humerus and ulna) of the
pronator teres. Also trace the ulnar artery, deep to both heads of the pronator teres.
Find the common interosseus artery, which arises from the ulnar artery a few cm
inferior from its origin, and find where the common interosseus artery divides into
anterior and posterior interosseus arteries.

List of structures:

Muscles and tendons:
Pronator teres
Flexor carpi radialis
Palmaris longus (sometimes absent)
Flexor carpi ulnaris
Flexor digitorum superficialis
Brachioradialis (a muscle of the posterior compartment of the forearm)
Supinator (a muscle of the posterior compartment of the forearm)
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

Nerves:
Median nerve
Ulnar nerve
Radial nerve and superficial and deep branches
(deep branch of radial nerve changes names to the posterior interosseus nerve)

Arteries and veins:
Brachial artery and vein
Radial artery and vein
Ulnar artery and vein
Common interosseus artery and vein
Anterior interosseus artery and vein
Posterior interosseus artery and vein

Miscellaneous:
Carpal tunnel borders and contents
Flexor retinaculum
CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 13 of 14
Upper Limb
Dissection 6-IV Palm

Modifications to instructions:
A. Reflect skin from the palms of the hands and at least two fingers.
F. On each hand, on one of the fingers, dissect only down to the digital fibrous sheath.
On another finger, open the sheath to expose the tendons.
G. Only perform this deep dissection on one hand. Also look for palmar metacarpal
arteries, which arise from the deep palmar arterial arch.

List of structures:

Muscles and tendons:
Palmaris brevis
Flexor digitorum superficialis tendons
Flexor digitorum profundus tendons
Flexor pollicis longus tendon
Flexor carpi radialis tendon
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Abductor digiti minimi (quinti)
Flexor digiti minimi (quinti)
Opponens digiti minimi (quinti)
Lumbricals (4)
Adductor pollicis
Palmar interossei (3)
Dorsal interossei (4)

Nerves:
Median nerve and its recurrent branch
Ulnar nerve and its deep branch
Common palmar digital nerves
Proper palmar digital nerves

Arteries and veins:
Superficial palmar arterial arch (and accompanying vein)
Common palmar digital arteries and veins
Proper palmar digital arteries and veins
Deep palmar arterial arch (and accompanying vein)
Palmar metacarpal arteries and veins

Miscellaneous:
Palmar aponeurosis
Flexor retinaculum
Carpal tunnel borders and contents
Thenar eminence
Hypothenar eminence
Fibrous digital sheaths

CAM102 Dissection Schedules - Modifications and lists of structures 2014
Page 14 of 14
Upper Limb
Dissection 6-V Extensor forearm and dorsal hand

Modifications to instructions:
A. Reflect skin from the posterior surface of the forearm (Thursday group) and hand
(Friday group). There is little superficial fascia on the distal half of the forearm and
posterior hand, so keep your skin incisions shallow.
B. Also look for the dorsal carpal arterial arch branching from the radial artery, and the
dorsal metacarpal and dorsal digital arteries, although these may be very small.
C. Cut the extensor carpi radialis longus and brevis, extensor digitorum, and extensor
digiti minimi on one side only. Cut each muscle or its tendon at a different location
proximally-distally, and reflect them to identify the deep muscles including the
supinator. Clean the posterior interosseus nerve, artery, and veins.

List of structures:

Muscles and tendons:
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Dorsal interossei (considered muscles of the palm, but visible from the posterior side of
the hand)
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi (quinti)
Extensor carpi ulnaris
Anconeus
Supinator
Extensor indicis
Extensor tendons (tendons of extensor digitorum, extensor digiti minimi, extensor
indicis) joined by tendons of lumbricals and interossei, forming dorsal digital
expansions (extensor expansions)

Nerves:
Radial nerve and its superficial branch and deep branch
Posterior interosseus nerve (continuation of the deep branch of radial nerve)

Arteries and veins:
Radial artery and vein
Posterior interosseus artery and vein
Dorsal carpal arterial arch
Dorsal metacarpal arteries and veins
Dorsal digital arteries and veins

Miscellaneous:
Anatomical snuff box borders and contents
Extensor retinaculum