Visceral Manipulation 2: Dissection & Anatomy Companion Course (5 CE/HR)

Course Outline (Detailed)

The materials for this course are divided into sections, each containing videos, study guides, review quizzes, and other learning materials. For planning purposes, the video durations are noted (HH:MM:SS).

Review quiz times are estimated based on completing one multiple choice question per minute. Reading is estimated at the rate of 150 words/minute.

Pyloric Bypass: Learning from Stomach Surgery (King) - 6:47

In this video, we have the unique opportunity to witness the effects of a pyloric bypass surgery from our donor form, King. King's unique presentation provided Gil with quite a mystery for a day or two! In this video, Gil unravels the mystery and shares his findings. Along the way, Gil will landmark the cardiac portion of the stomach. 

• 00:40: Orientation to form
• 1:05: Running of the bowel
• 1:45: Intestinal scar and jejunum
• 2:48: Fundus of stomach
• 2:55: Esophageal hiatus of diaphragm and esophagus
• 3:40: The missing pylorus
• 4:50: Superior mesenteric artery and portal vein
• Review Quiz - 1:00

Hepatorenal Relationship (King) - 1:54

In this video, Gil tours the liver, gallbladder and kidneys and identifies the hepatorenal ligament. King’s intestines have been removed, offering a unique view of these structures in situ.

• 00:20: Liver and gallbladder
• 00:30: Inferior vena cava and renal vein
• 00:45: Glisson’s capsule and connection of visceral fascial of liver to kidney (hepatorenal ligament)
• Review Quiz - 1:00

Kidneys, Vasculature and Fasciae (King) - 14:23

In this video, Gil will look at King's kidneys in situ and identify key structures such as the renal arteries and veins, hilum, peri and par renal fat, the renal fascia (aka renal capsule), the ureters and bladder.

• 00:10: Overview of kidneys
• 00:35: Overview of the space
• 00:55: Orientation: liver, inferior vena cava
• 1:24: Left renal vein and right renal vein compared
• 2:00: Abdominal aorta
• 2:43: Left testicular vein empties into left 
• 3:50: Looking for kidneys
• 4:15: Subserosal fascia, aka perirenal and pararenal fat
• 5:25: Renal capsule
• 6:05: Kidney removed from capsule
• 6:36: Renal vein branching into hilum
• 7:15: Renal artery branching from hilum
• 7:35: Aorticorenal plexus
• 8:13: Ureter exiting from kidney
• 8:40: Ureter path to bladder and relationship to mesocolon, psoas, testicular vein, fascia of deep pelvis
• 10:56: Recap of left side: bladder, ureter, kidney, renal vein, renal artery, hilum, vasculature differences
• 11:15: Right kidney, renal vein
• 11:30: Cyst 
• 13:00: Recap of right side: kidney, renal artery, renal vein, ureter
• 13:28: Relationship of ureter to common iliac artery and psoas
• Review Quiz - 5:00

Adrenal Glands (King) - 5:57

In this video, Gil locates King’s kidney glands and explores their relationships to the surrounding tissues. This video illuminates the connection between the adrenals and the kidneys, vena cava, adrenal veins, adrenal arteries and liver and showcases how the adrenal gland is related and connected to the fatty tissue of the kidney.

• 00:10: Mystery of the adrenal glands
• 00:50: Locating the adrenals: pancreas, spleen, renal vein
• 1:20: Adrenal vein and locating the adrenal gland
• 2:05: Adrenal gland revealed
• 3:10: Adrenal artery
• 3:35: Kidney, adrenal vein, vena cava, liver and adrenal gland relationships on right side
• Review Quiz - 2:00

Spleen (King) - 4:46

In this video, Gil explores the key structures and relationships of the spleen, including its typical orientation in the body, surrounding structures, and size.

• 00:45: Orientation to locating spleen
• 1:15: Spleen revealed
• 1:40: Spleen size
• 1:52: Spleen and rib relationship
• 2:10: Gastrosplenic ligament (greater omentum)
• 2:30: Relationship of spleen to diaphragm
• 2:50: Spleen surgery stories and spleen regeneration
• 4:10: Splenic flexure
• Review Quiz - 3:00

Pancreas, Duodenum, Portal Vein, Superior Mesenteric Artery (King) - 6:53

In this video, we continue our exploration of King and focus on the pancreas and its surrounding structures, such as the mesentery, vasculature, duodenum, portal vein, spleen, aorta, and sphincter of Odi.

• 00:15: Description of pancreas as retroperitoneal structure and orientation to tissues
• 00:45: Vascular root of the mesentery
• 1:35: The duodenum
• 2:15: The head of the pancreas
• 2:50: The sphincter of Odi
• 3:12: The tail of the pancreas
• 3:25: Length of pancreas revealed
• 3:45: Pancreas as meandering organ
• 4:02: Relationship of pancreas to hilum of spleen and splenic artery
• 4:38: Relationship of head of pancreas to superior mesenteric artery and portal vein
• 5:05: King’s unusual duodenum
• 5:55: Recap
• Review Quiz - 5:00

Gallbladder, Hepatoduodenal Ligament; Cystic, Common Bile and Hepatic Ducts, Portal Vein, Hepatic Artery, Hepatic Plexus (King) - 16:07

In this tour of King, we identify the gallbladder and the hepatoduodenal ligament. Gil dissects the hepatoduodenal ligament to reveal the portal vein, hepatic artery, common bile duct and hepatic plexus. We also have the opportunity to note gallbladder stones as well as the cystic and hepatic ducts.

• 00:30: Liver
• 00:45: Gallbladder position and stones
• 2:45: Epiploic foramen of lesser omental bursa and the hepatoduodenal ligament with its included viscera and nerves
• 4:20: Dissection of hepatoduodenal ligament to reveal its contents: hepatic artery, hepatic plexus, common bile duct, cystic duct
• 7:18: Fundus of gallbladder and cystic duct
• 11:45: Reveal of cystic duct and common bile duct, reference of sphincter of Oddi
• 12:50:Reveal of right and left hepatic duct
• 13:41:Reveal of hepatic artery
• 14:19: Reveal of portal vein
• 14:50: Review of revealed structures
• Review Quiz - 3:00

Greater Omentum, In-Situ Overview (A) - 8:47

This video is from Anatomy from A-Z, Course 14: Abdominal Viscera.

This video explores the greater omentum and details its relationships to its surrounding structures, including the transverse colon, greater curvature of the stomach, and spleen.

• 00:00: Overview of the greater omentum
• 1:45: Overview in situ and relationship to transverse colon; adhesions
• 3:49: Relationship to greater curvature of the stomach
• 4:50: Vasculature of greater omentum
• 5:15: Adhesion of greater omentum to parietal peritoneum
• 5:40: Spleen
• 6:35: Contemplations on variations in greater omentum presentation
• Review Quiz - 4:00

Lesser Omentum, In-Situ Overview (A) - 4:21

This video is from Anatomy from A-Z, Course 14: Abdominal Viscera.

In this video, Gil explores the lesser omentum and details its neighbors, including the hepatoduodenal ligament, stomach, liver, and identifying the epiploic foramen and lesser omental bursa. 

• 00:15: Orientation to lesser omentum
• 00:45: Overview and relationship to greater omentum
• 1:00: Finding the lesser omentum and lesser curvature of the stomach
• 1:55: Thinness of lesser omentum
• 2:15: Hepatoduodenal ligament, identified as the peritoneal tissues wrapping the hepatic artery, portal vein and common bile duct
• 4:00: Epiploic foramen and lesser omental bursa
• Review Quiz - 2:00

Greater Omentum, Dissection From Greater Curvature of Stomach (A) - 15:25

This video is from Anatomy from A-Z, Course 14: Abdominal Viscera.

In this video, Gil completes the dissection of the greater omentum away by dissecting it away from the greater curvature of the stomach. Along the way, we will note the layers of the greater omentum and its connection to the peritoneum. We will also note relationships to the transverse colon, spleen, gastrophrenic ligament, the splenic flexure of the large intestine, the pancreas, pyloric valve and duodenum. 

• 00:25: Overview
• 1:00: Variability in thickness of greater omentum
• 1:30: Relationship to transverse mesocolon
• 2:00: Connection to stomach (review)
• 2:10: Lesser omentum and lesser curvature of the stomach
• 2:27: Dissection begins
• 3:05: Two layers of greater omentum demonstrated at greater curvature of the stomach
• 5:00: Demonstration of two layers of peritoneum coming off of stomach to create two layers of greater omentum
• 7:05: Spleen
• 9:00: Gastrosplenic ligament
• 9:20: Transverse colon and splenic flexure
• 11:15: Pancreas, pylorus
• 12:00: Pyloric sphincter and duodenum
• 12:55: Vasculature of greater omentum
• 13:20: Adhesions with liver, missing gallbladder
• 14:00: Greater omentum ex-situ
• Review Quiz - 2:00

Greater Omentum, Ex-Situ Comments (A) - 6:12

This video is from Anatomy from A-Z, Course 14: Abdominal Viscera.

Following the dissection of the greater omentum, we will take a look at this remarkable structure ex-situ, noting the echoes of other abdominal structures as well as an unusual surgical artifact. 

• 00:30: Seeing echos of abdominal viscera in the greater omentum
• 00:40: Layers of greater omentum
• 1:00: Remnant of surgical intervention and stitches
• 2:15: Flipping to see posterior side
• 2:46: Greater omentum as fatty apron
• 3:38: Greater omentum as echo of superficial fascia
• 4:25: Greater omentum as clay poultice
• 4:50: Vasculature
• 5:25: Note on coloration
• Review Quiz - 1:00

Integral Anatomy Series ~ Video: Vol. 3, Pt. 1: Dissection of Membranes and Diaphragm - 53:11 

This video is from the Integral Anatomy Series, Volume 3.

In this video, we will do a thorough inventory of the fascia of the thoracic and abdominal space to demonstrate the relationship of the fibrous and membranous layers of the viscera to their named organs and other structures such as the diaphragm and lungs. 

• 0:27 Intention of this part of the course, and of the layer-by-layer dissection
• 1:30 Gratitude to donors and their families
• 2:03 Review of onion-tree model, layers as present in the viscera
• 4:48 Explanation of the fibrous and membranous layers of the viscera
• 5:51 First, fibrous layer of viscera (e.g. dura, fibrous pericardium)
• 6:50 Membranous layer that doubles back on itself to form an inner, visceral layer and an outer, parietal layer
• 10:16 Exploring the thoracic viscera and diaphragm
• 10:46 Endothoracic fascia
• 11:39 Diagram of the fibrous and membranous layers of the thorax
• 12:10 Parietal pleura
• 13:42 Where the parietal pleura doubles back at the 12th rib
• 15:20 Four named aspects of the parietal pleura; relationship of the pleura to the ribs, mediastinum, and diaphragm
• 17:48 Diaphragm visible deep to ribs
• 18:55 Diaphragm with ribs reflected
• 19:45 Diaphragmatic pleura
• 21:15 Lungs, posterior view
• 21:20 Joint of lobes of lung
• 22:25 Looking at posterior view of diaphragm and orienting to posterior abdominal viscera
• 23:31 Montage of dissection of thorax from posterior, presented in reverse sequence (from viscera to skin)
• 24:00 Exploring the abdominal viscera
• 24:00 Montage of dissection of abdomen thus far (from skin to transversalis fascia)
• 24:39 Transversalis fascia as adherent to parietal peritoneum
• 26:10 Continuity of transversus abdominis with diaphragm
• 27:35 De-adhering the anterior parietal pleura from the endothoracic fascia    
• 28:13 View of abdominal organs as “held” by the diaphragm in continuity with the peritoneum
• 28:49 Removing the rib cage, shoulder girdle and upper extremities as one
• 29:43 Inside the chest wall
• 29:46 Internal thoracic (mammary) artery and vein
• 30:10 Evidence of lung tissue that had adhered to the chest wall as a result of open heart surgery
• 30:41 Endothoracic fascia
• 31:34 Thoracic and abdominal viscera in situ with ribcage, shoulder girdle and upper extremities removed
• 31:55 Membranous layers of lungs
• 32:33 Parietal and visceral pleura adhered at left lung
• 35:02 Elasticity of lung tissue
• 35:36 Carbon deposition in the lymphatic vessels of the lung
• 35:54 Differentiating visceral pleura from parenchyma of lung
• 36:39 Comparing visceral pleura, parietal pleura, and parenchyma
• 38:13 Fibrous and membranous layers of abdominal viscera
• 39:58 Differentiating parietal peritoneum from transversalis fascia
• 43:01 Diaphragm differentiated from parietal peritoneum
• 43:28 Model illustration of the continuity of the diaphragm with the transversalis fascia
• 45:10 Model illustration of the dissection of the transversalis fascia and diaphragm away from the parietal peritoneum
• 46:37 Diaphragm as “pleuroperitoneal muscle”
• 47:47 Peeling the diaphragmatic pleura
• 48:18 Fiber direction of diaphragm shown as perpendicular to fiber direction of transversus abdominis
•  49:00 Differentiating the posterior parietal peritoneum from psoas major without disrupting the abdominal viscera
• 52:25 Connection between diaphragm and psoas

Review Quiz - 6:00

Visceral Membranes: Pleura, Peritoneum, Fascia Propria, Transversalis Fascia, Dissection from Diaphragm (A) - 20:50

This video is from Anatomy from A-Z, Course 14: Abdominal Viscera.

In this video, we take a closer look at the visceral membranes, including the relationships between the peritoneum, fascia propria, transversalis fascia, and diaphragm.

• 00:00: Overview of layer of visceral membranes
• 00:25: Parietal pleura and parietal peritoneum
• 00:40: “Parietal”
• 1:00: Parietal pleura
• 2:20: Parietal peritoneum
• 2:45: Fascia propria, transversalis fascia, peritoneum
• 4:25: Peritoneum
• 9:00: Diaphragm and peritoneum
• 10:05: Perifascia between diaphragm and peritoneum/transversalis fascia, the “pleuralperitonial muscle”
• 11:00: Relationship between diaphragm and transversus abdominis
• 12:10: Transversalis fascia vs. parietal peritoneum: distinguishing the two layers in the abdominal space
• 14:15: Peeling the transversalis fascia and parietal peritoneum away from the diaphragm
• 17:45: Relationships: note that the transversalis fascia and parietal peritoneum are fused together (adherent) in the upper abdominal space, however they have an intervening fatty layer in the lower abdominal space
• 20:20: Summary
• Review Quiz - 5:00

Transversalis Fascia and and Parietal Peritoneum Relationship (Z) - 7:55

This video is from Anatomy from A-Z, Course 14: Abdominal Viscera.

In this video, we take a closer look at the relationships between the following layers of the abdominal wall and how they vary in different locations: parietal peritoneum, fascia propria and transversalis fascia.

• 00:00: Overview
• 00:30: Layers: transversus abdominis, transversalis fascia, fascia propria, peritoneum
• 3:00: Differentiating fascia propria from peritoneum and acknowledging differential movement between these layers laterally
• 3:40: Moving towards the midline: changing relationship between the peritoneum and transversalis fascia (there is no longer an intervening layer of fascia propria, and these layers are more adherent relationship)
• 6:50: Relevance for therapists and importance of individual variation
• Review Quiz - 2:00

Transversalis Fascia: Differentiating From Diaphragm, Identifying Fascia Propria & Descending Colon (Z) - 18:50

This video is from Anatomy from A-Z, Course 14: Abdominal Viscera.

In this video, we take a closer look at the transversalis fascia in Z and dissect it away from the diaphragm. Along the way, we identify the central tendon, descending colon, and location of the spleen.00:00: Overview

• 00:30: Transversalis fascia remnant over peritoneum
• 00:45: Transversalis fascia and transversus abdominis
• 1:40: Following transversalis fascia to the underside of the diaphragm
• 2:20: Dissecting the transversalis fascia away from the diaphragm/transversus abdominis
• 10:40: Identification of central tendon
• 10:25: Fascia propria, aka “epiperitoneal adipose”
• 13:50: Descending colon revealed
• 17:15: Spleen identified
• 17:30: Peritoneal vs. retroperitoneal structures
• Review Quiz - 2:00

Transversalis Fascia: Differentiating From Diaphragm (Z) - 10:34

This video is from Anatomy from A-Z, Course 14: Abdominal Viscera.

In this video, we continue to dissect the transversalis fascia from the diaphragm in Z, this time along the right side. Along the way, we identify the central tendon, liver, and pleura.

• 00:00: Overview
• 00:35: Xiphoid process
• 1:35: Right side: differentiating transversalis fascia and diaphragm
• 5:30: Liver
• 6:20: Viewing diaphragm through rib spaces; seeing pleura
• 7:20: Seeing diaphragm from below, identification of central tendon
• 9:15: Recap an identification of pleura, diaphragm, transversalis fascia/peritoneum, costal margins, xiphoid process
• Review Quiz - 2:00