Cadaver Dissection Videotape Series: Scapulohumeral.

The purpose of this videotape series is to provide viewers with an understanding of gross anatomy of the spine, hip, pelvis, thigh, and shoulder. All of the tapes begin with a series of objectives that viewers should have no difficulty meeting after viewing.

In the low back videotape, superficial muscle layers and thoracolumbar fascia are the first structures dissected. Much detail and time is spent on the anatomy and function of thoracolumbar fascia. Relationships between this fascia and the anterior abdominal wall musculature, the latissimus dorsi and erector spinae muscles, and the lateral raphe are uniquely demonstrated.

Deep back musculature (ie, erector spinae and multifidus) are dissected next, and their functional and clinical relevance is addressed. A detailed description and demonstration of iliolumbar and intertransverse ligaments follows, along with their clinical function and significance.

The anatomy of intervertebral joints follows. A lumbar intervertebral disk is dissected to show its annulus fibrosus and nucleus pulposus. Apophyseal joints are then demonstrated along with an explanation of biomechanic rules governing these joints. Relationships between lumbar nerve roots and intervertebral foramen are then discussed, and dissections of this region are demonstrated.

This videotape closes with a short discussion on the close relationships between contractile and noncontractile low back tissue.

The videotape on the hips and pelvis presents the relationships between muscle and fascial systems of the abdomen, pelvis, and thigh. It spends a significant amount of time addressing deep fascia of the thigh (ie, fascia lata) along with the effects contractile forces have on it to produce stable environments for lower-extremity joints.

Posterior thigh musculature is first dissected and discussed, followed by superficial and deep buttock muscles. Dissection of the small hip rotator muscles (ie, piriformis, superior and inferior gemelli, obturator internus, and quadratus femoris) is excellent and easy to visualize.

Attention is then given to the sciatic nerve and its relationship to regional soft tissue structures and bony landmarks. Also, how various movements may affect the sciatic nerve and its associated nerve roots is demonstrated on the cadaver. The anatomy and function of deep posterior hip structures, such as the obturator externus muscle, the ischiofemoral ligament, and posterior aspects of the hip joint, are discussed, followed by dissection of anterior abdominal wall musculature (ie, external and internal obliques) and the rectus abdominis muscle.

Muscles and related soft tissue structures of the anterior thigh are then dissected and discussed. Sartorius, tensor fascia lata, and quadriceps femoris muscles are isolated and contained in three separate fascial envelops on the anterior thigh. This is a very unique way of demonstrating these three muscles.

Next, anteromedial thigh musculature is dissected and demonstrated along with deep anterior hip structures, such as the iliopsoas muscle, and anterior hip joint capsule structures, such as iliofemoral and pubofemoral ligaments. This videotape continues with the relationship of the iliopsoas to abdominal contents and is followed by a detailed dissection and description of the quadratus lumborum muscle, the lumbosacral plexus, and the sacroiliac joint. It provides an in-depth discussion of the sacroiliac joint functional anatomy, and how aging may affect this joint.

The purpose of the cervical and thoracic videotape is to systematically organize cervical and thoracic spine musculature. It begins with a dissection of superficial upper back and neck musculature. Relationships between musculature and function, along with stabilizing influences in the region, are highlighted. The authors review structures dissected as they return them to their original positions.

Next, fascial and muscular structures and palpation are considered. This topic would be especially helpful to clinicians, as the authors constantly orient viewers to anatomical structures that lie beneath their fingertips.

A dissection of intermediate thoracocervical muscle layers precedes a dissection and discussion of suboccipital muscles. The authors then provide an interesting demonstration of how different forces affect cervical apophyseal joints.

A detailed dissection and discussion of the spinal cord and its relationship to nerve roots follows. Viewing relationships of these structures would be helpful to clinicians. Anterior and posterior cervical triangles are dissected, and their relationship to the thoracic outlet is illustrated. The authors then demonstrate on a volunteer two popular clinical tests for thoracic outlet syndrome. They also demonstrate on a cadaver the anatomy involved in these tests. They also cover how forward head postures may compromise the thoracic outlet. The authors then use a unique means of demonstrating mechanical modeling of thoracocervical musculature by placing a Theraband[TM] over the bony attachments of different muscles to show how different postures may affect these muscles.

The purpose of the scapulohumeral videotape is to outline the anatomy and function of scapulohumeral musculature. It begins with a dissection and demonstration of posterolateral shoulder muscles (ie, latissimus dorsi, trapezius, deltoid, and teres major). It then proceeds to a dissection of posterior rotator cuff muscles and discusses their involvement in impingement syndrome. The authors then demonstrate several clinical tests for shoulder impingement on a volunteer, relating soft tissue and bony structures viewed in the dissection to tissues being stressed in the tests.

Scapulothoracic and glenohumeral mechanics are then demonstrated on a cadaver. On a split screen, a live subject moves through different scapulothoracic and glenohumeral movements while these same movements are demonstrated on a cadaver to further demonstrate joint mechanics.

The anterior shoulder (ie, anterior chest and axilla) is then dissected and discussed. The brachial plexus is demonstrated along with its relationship to the axillary artery and vein. Muscles associated with the axilla and lateral chest wall muscles are then dissected, followed by muscles in the flexor compartment of the arm. Deeper anatomical structures (eg, the glenohumeral joint capsule, biceps tendons, and glenoid labrum) are then dissected and discussed. This tape concludes with a demonstration of mechanical modeling of the scapulohumeral region using a Theraband[TM].

Interestingly, with the exception of the spinal cord, brachial plexus, and sciatic nerve, this videotape series does not include dissection and discussion of neural structures or innervation of dissected skeletal muscle. Except for the dissection and discussion on the axilla in the scapulohumeral videotape, vascular structures are also not present. This series, for the most part, involved only dissection of musculoskeletal anatomy. The authors did, however, briefly remind viewers to keep in mind those neural components involved in smooth execution of movement and stability.

Both authors are shown dissecting and presenting different structures throughout these videotapes. It would have been beneficial, however, for them to introduce themselves or have captions beneath to identify themselves.

Overall, this videotape series is interesting and would make an excellent teaching tool. For example, after the authors dissect superficial structures to expose deeper structures, they continually review the more superficial structures to allow the viewer to remain oriented. This is quite helpful.

Although nothing can completely substitute for hands-on cadaver dissection, this videotape series provides excellent video resolution of anatomical structures. It is easy to view, and orientation to structures is easy to follow. This videotape series would provide an excellent review for clinicians who do not have access to cadaver dissection or prosection material. it would also make an excellent teaching aid for students enrolled in a gross anatomy course to aid in their understanding of musculoskeletal anatomy and function.

James L Karnes, PhD, PT D'Youville College Buffalo, NY

Dr Karnes is assistant professor and assistant director in the physical therapy program, where be teaches gross human anatomy and neuroscience. His research interests include the transmission of topical medications through skin and morphological studies of the spine.