Cutting-Edge Anatomy

by By Amy Derbedrosian | September 28, 2015

Human anatomy class uses time-tested cadaver dissection plus 3-D imaging.

Four students station themselves at each of three gurneys bearing body bags. Inside are intact human cadavers awaiting incisions. As the students open the bags, the smell of embalming fluid fills the room. Now they’re ready to start. The students run their eyes and hands over the cadaver, looking for anything clearly unusual. Then, scalpels in hand, they make shallow cuts. Their tools are sharp, the skin thin. Carefully, they peel back skin from the upper body, exposing the underlying tissue.

That’s just the first day of Professor Greg Smith’s Advanced Human Anatomy class at Saint Mary’s College.

Though not for the squeamish, the course Smith introduced five years ago is so popular among biology majors interested in health care careers that some have come to Saint Mary’s specifically to take it. Only 12 students are admitted to the course each semester—a restriction based on the number of available cadavers—and the workload is demanding. But the opportunity it gives undergraduates to fully dissect a human cadaver is a rarity, especially at an institution without a medical school affiliation. The experience can also provide an early edge for those who continue on to medical school, where most of their classmates will encounter a cadaver for the first time.

“Professor Smith is someone who can break down the concepts and vocabulary into components so you don’t just memorize them, you understand them. I think it will stay with me through the rest of my life,” said Zach West ’15, a biochemistry major currently applying to medical school, who took Smith’s course this spring.

Among the students who chose SMC because of the course is Nikita Chaudri ’15. Now in dental school at the University of the Pacific in San Francisco, she said, “I didn’t realize how interesting it would be to dissect a body. We all have the same organs and systems, but there are so many variations. I’m so thankful and grateful to have had this opportunity.”

“The most surprising part was opening the abdominal cavity and seeing all the tissue and organs inside. It’s amazing how complicated the human body is. I gained a lot of respect for all the tissue in our body,” West said.

Another student in the class, Ryan Keane ’15, has since started medical school at Georgetown University. He said of his dissection experience, “It’s so different seeing slides of muscles and the torso and actually laying your hands on them.”

Before they start dissecting, most students in Smith’s course are ex- cited but nervous. Kathleen Lundeberg ’16 had never taken an anatomy class or seen a dead body. Keane tried to ignore his jitters about working with a human cadaver. Jennifer Tolcher ’15, who assisted Smith in class this spring after taking the course in 2014, asked her pediatrician father what it would be like.

Smith prepares students for the first cut. Weeks ahead, he sends them emails with a clear message: Appreciate that a person chose to give students access to a body. Once in class, he teaches important basics, including how to attach the scalpel blade and use the instrument safely. To alleviate fears, he advises the students to think of the cadavers as anatomical models.

“He didn’t just open the body bag and say ‘Here we go.’ He talked about how to respect and take care of the bodies. After that, it felt normal,” Lundeberg said.

Lundeberg’s growing ease is typical of Smith’s students. “This requires them to think about death and dying. That’s not something a 21-year-old usually does,” said Smith, a member of the state anatomy advisory board that oversees a program for donating bodies to science. “But when they begin to dissect, they’re focused on a task, using the tools, and learning. Only after the first class will they say, ‘I can’t believe what I did today.’ ”

At the start of the semester, Smith also presents the students with a question: What did the body on the gurney experience in life? Smith said, “The mystery of what they’ll see and find is another one of their motivations to take the class. I have the death certificate but don’t share it with them until the end.”

He does, of course, teach them to understand what they will see. Smith’s lectures, which he organizes by regions of the body, teach students about anatomical structures and functions. For example, they learn about the blood vessels, nerves, and muscle tendons in the axilla area—the armpit—and how an injury can lead to motor and sensory loss. When the topic is the skull, Smith talks about the vasculature entering the cranial cavity where the brain is located and how the nerves of the brain exit the skull to travel to the parts of the body they control.

Tolcher, who calls the course her favorite at Saint Mary’s, explained, “Learning about the muscles and bones, their damage and repair, was fascinating to me. It definitely helped shape my career path. I was originally thinking about pediatric nursing, but now I’m interested in sports medicine.”

Keane sees invaluable connections between the course lectures and labs. He said, “You can’t learn through dissections alone. The lectures inform what structures you dissect and isolate. Often, we’d talk about something Monday morning and then see it in the lab in the afternoon.” Even breaks during lab periods offer opportunities to learn. That’s when Smith tells everyone to stop their dissections and join in what he terms “Walk and Talk.” Crossing campus wearing their trademark scrubs, the students present abstracts related to anatomy and take questions from their classmates and professor. Just as they do when one group makes an unexpected discovery during a dissection, the students learn from each other.

“The class was great because you learn not only human anatomy, but also how to work with peers,” Keane said.

This spring, Smith introduced another learning tool to the mix: sophisticated stereoscopic software that provides 3-D images of anatomical structures. Though the students already could refer to an anatomy application on gurney-mounted iPads while dissecting, the new software shows structures in far greater depth.

Now, the students wear 3-D glasses while Smith projects images on a screen. With the technology, he can make small structures larger than life and isolate images to provide an even closer view.

“I use the 3-D software as a precursor to understanding,” Smith said. “For example, when students learn the locations of openings in the skull, I can rotate an image and give them an appreciation of how these relate to other structures. That’s like having a skull in their hands, but they’re looking at a computer image. When they go to dissect, they know what to anticipate.”

The combination of lectures, labs, learning from peers, and technology produces results: Smith said students in his class do well in medical school and other graduate programs. “The course is very rigorous and requires a lot of time outside class,” he said. “We cover a lot of material, but they can do it. This background serves them well in graduate school.”

The students are motivated to do the work, in part because of Smith. Chaudri said, “When your professor loves anatomy and teaching the subject, it makes you want to work hard.”

Even after all that’s asked of them during the semester, some students are eager to continue learning about anatomy. Keane wanted to do additional heart dissections, so Smith let him keep the keys to the cadaver storage room after final exams ended. Keane said, “He not only allowed me to remove the cadaver’s heart, but also to open windows into all four of its chambers. He encouraged us to keep exploring and was patient in guiding us.”

Lundeberg’s exploration of anatomy will extend even longer. She’ll work independently with Smith in the fall to dissect and learn more about the body’s pelvic region.

For some students, even that’s not enough anatomy education. West said, “I wish the course could be two semesters long so we could go into even more depth and more parts of the body. Friends had told me that this was one of the best classes that prepared them for medical school, but it still exceeded my expectations.”

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