FACULTY OF MEDICINE UPH

LIPPO VILLAGE KARAWACI TANGERANG - BANTEN

MANUAL OF ORGAN DISSECTION
Bernard SM Hutabarat; dr, PAK
MORTUI
V I V OS D O C E N T
( THE DEAD TEACH THE LIVING )
ABDOMINAL CAVITY ( SYSTEMA DIGESTIVA )
INSPECTION / ORIENTATION:
1. Proc. Xiphoideus
2. Arcus costarum

3. Crista iliaca
4. S I a s

5. Symphysis osseum pubis

6. Umbilicus

SKIN INCISION
1. Proc. xiphoideus to symphysis ossium pubis, circling the umbilicus
2. Proc xiphoideus laterally along the arcus costarum.
3. Symphysis ossium pubis to Spina iliaca anterior superior ( sias ) along the lig. Inguinale
Pouparti.
4. Fold the skin from medial to lateral, be careful not to take umbilicus with the opening
flaps.
ABDOMINAL WALL
1. Clean the fascia abdominalis superficialis
2. Clean the fascia abdominalis profunda ( fascia innominata Galaudeti )
3. Make incision at lamina anterior vagina m. Rectus abdominis 3 cm lateral to linea alba
parallel to linea mediana anterior. Do it on both sides.
4. Cut the m. Rectus abdominis approximately at the height of umbilicus then fold the
muscle parts cranially and caudally.
5. Clean the m.Obliquus externus abdominis till the muscle fibers can be seen clearly.
Draw a line at the muscle as follows :
5.1.
From craniomedial angle to sias. Make incision along the line from lateral border
of m. Rectus abdominis.
5.2.
Make incision caudomedially from point 5.1. parallel to muscle fibers.
5.3.
Fold the parts accordingly
6. Carefully separate m. Obliquus externus abdominis from m. Obliquus internus
abdominis.
7. Clean the m. Obliquus internus abdominis.
8. Make incision at the m. Obliquus internus abdominis like 5 . Be Careful not to destroy
canalis inguinalis.
DISSECTION TO OPEN THE ABDOMINAL CAVITY
1. Make vertical incision along the linea alba 1 cm to the left of midline to avoid injury to
lig. Teres hepatis. Circle the umbilicus from the left side.
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2.
3.
4.
5.

Below the umbilicus continue the incision caudally 5 cm to the left of midline.
Make incision from proc. xiphoideus caudolaterally along arcus costarum on both sides.
Make incision from symphysis ossium pubis craniolaterally to sias on both sides.
Open the abdominal wall, Pay attention that abdominal viscera covered by omentum
majus.
DISSECTION OF .ABDOMINAL VISCERAL ORGANS

1. Make 2 ligations at junctura ileocaecalis ( ileocecal junction ) :

1.1.
The 1st 5 cm proximally.
1.2.
From the 1st ligation squeeze the terminal ileum 2 cm proximally ( be careful
not to rupture it ) to empty ileum terminalis. Make the 2nd ligation at the spot.
2. Cut part of the ileum terminalis between the 1st and 2nd ligation.
3. Make 2 ligations ( with 2 cm distance ) exactly proximal to the rectum with the same
mechanism as point 1 . Cut the part between those 2 ligations.
4. Set caecum and appendix verniformis free from surrounding tissues, then continue to
distal for colon ascendens up to sigmoid. Measure the length of intestinum crassum.
5. Open the intestinum crassum ( at its insertion to mesocolon ) then clean the content. DO
NOT CLEAN CONTENT OF COLON DIRECTLY TO THE SINK.
6. Cut the mesenterium of intestinum tenue mesenteriale ( jejunum and ileum ) 1 cm from
its insertion.
7. Set intestinum tenue mesenteriale free from surrounding tissue, proximalward. Look for
the possibility of diverticulum ilei Meckeli ( remnants of ductus vitellinus/
omphalomesentericus ) that usually located 1 m proximal to junctura ileocaecalis.
8. Make ligation at junctura duodeno-jejunalis ( duodeno-jejunal junction ) as follows:
8.1.
1st ligation 5 cm from junctura duodeno-jejunalis
8.2.
2nd ligation 2,5 cm from the 1st.
Cut the part between those ligations.
9. Remove the intestinum tenue mesenteriale then clean it by opening at its mesenteric
insertion. Measure the length of intestinum tenue mesenteriale.
10. Make ligation on oesophagus exactly distal to hiatus oesophagicum ( esopagal
hiatal ),then the 2nd ligation 2 cm distally. Cut the part between the 2 ligations.
11. Make 2 ligations at the distal part of the gaster. The 1 st ligation exactly distal to pylorus,
the 2nd ligation 2 cm distally.
12. Remove the gaster , open at its insertion of omentum minus ( curvatura ventriculi
minoris ), then clean it.
13. Cut all the ligaments that form fixation of hepar, sequentially :
13.1. Lig. Falciforme hepatis
13.2. Lig. Coronaria hepatis
13.3. Ligg triangulares hepaticae dextra et sinistra
14. Cut the liig. Hepatoduodenale and the triad hepatica ( A/V hepatica and ductus
choledochus ) covered by the ligament.
15. Luxate the hepar free.
16. With blunt method incision set the pancreas and duodenum free and take them out.
EQUIPMENT :
1. Cadaver
2. Anatomy dissecting set
3. Atlas anatomy
2

SOURCE :
Bernard SM Hutabarat : Diktat dan Penuntun Praktikum Systema digestiva ; Bagian
Anatomi FKUKI ( English translation )
DISSECTION OF .PELVIC VISCERAL ORGANS
INSPESTION / ORIENTATION.
1. Pelvic bones boundaries.
2. Symphysis ossium pubis
3. Apertura pelvis superior
SKIN INCISION
1.
2.
3.
4.

Middle of sacrum to os coccygealis, circling the anus.

Between both tuberae ischiadicae dextra et sinistra
Clean the skin so that fascia perinei superficialis can be seen.
Clean the m. Levator ani.

DISSECTION OF ORGANA VISCERALES PELVICUS

NOTE ; Removal of Organa viscerales pelvicus including distal part of Systema
digestiva perform by abdomino-perineal approach.
1. Resectio abdominalis ( abdominal approach )
1.1.

With blunt method resection with fingers, set the kidney ( ren ) and gld.
Suprarenalis free from surrounding tissues.
1.2.
Set ureter free from surrounding tissue then cut A/V renalis near to hilus renalis.
1.3.
Dissect diaphragm pelvis from pelvic wall as follows :
1.3.1. Dissect diaphragma urogenitalis from its attachment at os pubis.
1.3.2. Dissect m. Levator ani from arcus tendineus, os ischium, os pubis, os
coccygeus and spina ischiadica.
1.4.
Cut all nerves and vascular vessels that originated from pelvic wall, namely :
1.4.1. A/V pudenda interna
1.4.4. A/V vesicalis superior
1.4.2. N. pudendus
1.4.5. A/V vesicalis inferior
1.4.3. Aa/Vv ovarica et uterine ( )
1.4.6. A/V haemorrhoidalis superior
2. Resectio perinealis ( perineal approach )
2.1.
2.2.
3.
4.
5.
6.
7.
8.

Turn the cadaver into prone position.

Cut from outside diaphragm pelvis, sequentially begin from its insertion to
symphysis ossium pubis, then circling dorsally back to symphisis ossium pubis.
With luxation method , take out organa urogenitalia and rectum, be careful not to
severe the ureter.
Open the ren by making incision through linea Brdel.
Make incision at medial wall of rectum from cranial to caudal.
Make incision with scissor exactly in the middle of vesica urinaria
Make midline incision at the skin of dorsum penis, fold laterally.
Make transversal incision at dorsal wall of uterus toward tuba uterine Fallopii.
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9. Make the 2nd incision vertically to transversal incision.

10. Make incision at lateral wall of vagina from vestibulum vaginae cranially.
EQUIPMENTS
1.
2.
3.

Cadaver
Anatomy dissecting set
Atlas anatomy

SOURCE :
Bernard SM Hutabarat : Diktat dan Penuntun Praktikum Systema urogenitalia ; Bagian
Anatomi FKUKI ( English translation )
DISSECTION OF THORACIC CAVITY ( CAVUM THORACALIS )
INSPECTION / ORIENTATION.
1. Clavicula
2. Acromion

3. Sternum
4. Artic. Sternoclaviculare

5. Costae
4. Arcus costarum

DISSECTION OF THE LUNGS

1. Cut every rib cartilages 2 cm medial to juncturae costochondrales, begin from junctura
costochondralis 2 caudally
2. Set the sternum free from clavicula by cutting at artic. Sternoclavicularis.
3. Set the sternum free from mediastinum anterius.
4. Make vertical incision at pleurae parietales dextra et sinistra.without destroying the
vessels.
5. Clean radix pulmonalis from surrounding tissues.
6. Put your hand at the surface of pulmones and set the lung free from possible adhesions.
7. Put your hand inside cavum pleurae between lung and mediastinum.
8. With the hand inside cavum pleurae lift pulmo laterally so that facies mediastinalis
pulmonalis, radix pulmonalis and lig. Pulmonale can be seen
9. With the other hand use scissor to cut the parts sequentially from cranial to caudal.
Beware that you dont cut the mediastinum.
10. With luxation method take the lungs out.

DISSECTION OF THE HEART ( COR )

1. Make vertical incision at the lateral borders of pericardium exactly ventral to N.
phrenicus.
2. Connect the caudal parts of vertical incision ( point 1 ) with transversal incision 2,5
cm cranial to diaphragm.
3. Cut the Aorta and truncus pulomonalis
4. Cut the V. cava inferior
5. Cut the V. cava superior 1 cm cranial to its orifice at atrium dextra
6. Lift the heart ventrocranially at its apex. The cut the 4 Vv pulmonales
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7. Set the heart free from the attached pericardium the remove it.
OPENING THE HEART
1. Atrium dextra ( right atria ) :
1.1.
Make incision through Vv cavae superior et inferior
1.2.
Make the 2nd incision vertically to the 1st , then continue along right border of the
heart toward septum atrioventriculorum.
1.3.
Fold the result of the incisions.
2. Ventriculus dextra
2.1.
Fold outward parts of the wall of atrium dextra
2.2.
Continue the incision of Vv cavae sup et inf toward ventricle between cuspis
anterior and cuspis posterior along the right border of the heart.
2.3.
With scissor cut the wall of ventricle dextra along septum interventriculare toward
A.pulmonalis between cusps anterior et posterior valvulae semilunaris.
3. Atrium sinistra
3.1.
Make incision according to line between Vv pulmonales dextra et sinistra.
3.2.
Make incision cranially vertical to the 1st incision.
3.3.
Fold outward parts of atrium sinistra so that reveal cuspis anterior et posterior
valvulae bicuspidalis.
4. Ventriculus sinistra
4.1.
Continue vertical incision ( point 3.2. ) through dorsal wall of ventriculus
sinistra between the two cuspes to apex cordis.
4.2.
From apex cordis continue through anterior wall of ventriculus sinistra near
septum interventriculare.
4.3.
Continue towards arcus aortae.
EQUIPMENTS
1.
2.
3.
4.

Cadaver
Anatomy dissecting set
Household knife
Atlas anatomy

SOURCE :
Bernard SM Hutabarat : Diktat dan Penuntun Praktikum Systemae respiratoria et
cardiovascularia. ; Bagian Anatomi FKUKI ( English translation )
DISSECTION OF THE HEAD & BRAIN
ORIENTATION & PALPATION
1.
2.
3.
4.

Arcus superciliaris / supercilium

5. Pinna ( Auricula )
Glabella.
6. Proc. mastoideus
Nasion
7. Protuberantia occipitalis externa ( Inion )
Layers of Scalp ( reminder ) :
8. Vertex cranii : highest point of calvaria
4.1.
S(kin)
4.2.
C(losed subcutaneous tissue )
4.3.
A(poneurosis epicranialis ; galea aponeurotica ).
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4.4.
4.5.

L(oose subaponeurotic tissue )

P(ericranium )

DISSECTION OF SCALP
1. Method of 4 flaps :
1.1.
1.2.
1.3.

Make incision from nasion to inion through vertex cranii lateral to sutura sagittalis
/ sinus sagittalis superior.
Make the 2nd incision from vertex cranii to both sides of the head till a point
exactly anterosuperior to pinna.
Fold the four flaps of scalp , set m. Temporalis free if necessary by using
rasparatorium.

2. Method of 2 flaps :
2.1.
2.2.

Make incision from proc. mastoideus dextra vertex cranii - mastoid sinistra.
With the help of rasparatorium fold the scalp anterior and posteriorly.

NOTE : DO THE INCISION ON THE SCALP WITH THE SHARP SIDE OF

SCALPEL FACING IN UPWARD DIRECTION.
DISSECTION OF CALVARIA AND BRAIN.
1. Clean the periosteum that attached to calvaria with the help of rasparatorium and
scalpel.
2. Mark with supidol or string the line as guidance circling the head from 1 2 cm
cranial to margo supraorbitalis dorsally 2 cm cranial to inion.
3. With hacksaw cut the calvaria circling along the guidance marker. Be careful not to
saw the duramater.
Do not forget to occasionally pour water during the sawing.
4. After reaching the tabula interna use chisel or T-rasparatorium to set calvaria free.
REMOVAL OF THE BRAIN.
1. Using scissor cut the duramater along the side of the skull till near to inion.
2. Using scissor cut the falx cerebri from crista galli then retract it craniodorsally thence
reveal the encephalon ( brain ).
3. With left hand lift lobi frontales a little till N. Olfactorius ( I ) can be seen. Cut the nerve
and while doing so lift lobi frontales to cut N. Opticus ( II ).
4. Remove your left hand to lobus temporalis sinistra, lift it a little then cut Nn.
Oculomotorius ( III ) et Trochlearis ( IV ). Do the same with the other side.
5. Cut the tentorium cerebelli ( separate cerebellum from lobus occipitalis ) as close as
possible to its insertion at os petrosus then continue dorsally.
6. Sequentially cut the other cranial nerves :
6.1.
N. Trigeminus ( V )
6.2.
N. Abducens ( VI )
6.3. Nn. Facialis ( VII ) et Acusticus ( Cochlearis; VIII )
6.4.
N. Glossopharyngeus ( IX )
6.5.
N. Vagus ( X )
6.6.
Nn. Accessorius ( XI ) et Hypoglossus ( XII )
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7. Cut the medulla oblongata as far as possible inside the foramen occipital magnum.
8. Set the brain free from basis cranii.
EQUIPMENTS
1.
2.
3.
4.
5.
6.

Cadaver
Anatomy dissecting set
Rasparatorium
T. rasparatorium
Household knife
Atlas anatomy

SOURCE :
Bernard SM Hutabarat : Diktat dan Penuntun Praktikum Systema nervsum centrale. ;
Bagian Anatomi FKUKI ( English translation )