medical illustration of the female pelvic floor showing the perineal membrane
medical sketch from Dr DeLancey of the female pelvic floor showing the perineal membrane

doctor's sketch

dissection sequential slices of the female pelvic floor highlighting the perineal membrane

cadaver references sent

medical illustration sketch of the female pelvic floor showing the perineal membrane

initial sketch & questions

medical illustration final corrections of the female pelvic floor showing the perineal membrane

final tweaks

Perineal Membrane


  • Client:
    University of Michigan
    Ann Arbor, MI
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 ... the opportunity was a golden one...

Tradition lives on!

When preparing this website, I wanted to make sure I included at least one series that showed the heart and soul of medical illustration. Throughout the site, I've mentioned that modern medical illustration is largely focused on concepts, and that drawing with accurate realism is no longer the primary focus.

Thankfully there are still opportunities to observe and draw with detail and accuracy in order to advance medical science. In this case, the opportunity was a golden one; a chance to work again with Dr. John DeLancey at the University of Michigan Medical School. Dr. DeLancey was an inspiration when I was studying at UofM, and throughout his truly distinguished career he has never given up his passion for anatomy, research and medical art.

anatomical sketch by Dr. John O. DeLancey highlighting the perineal membrane

Dr. DeLancey's sketch from the cadaver lab. Just one of a couple dozen visual references he sent me. Astonishing dedication.

A primary focus of Dr. DeLancey's career has been the pelvic floor; particularly how its anatomy influences physiology (i.e., form influences function). Understanding the structure of this complex area can unlock better approaches to treating maladies like incontinence and prolapse. The project at hand involved clarifying the structure and function of the perineal membrane, an important part of the pelvic diaphragm and thereby the pelvic floor. His purpose was to correct an error in our understanding of pelvic anatomy that has persisted since the Renaissance.

Dr. DeLancey supplied me with every possible form of reference: his drawing from dissection (above), a 12-slide PowerPoint he put together to show me the dissection views (too graphic to include here), his manuscript for the journal article he was preparing to submit, and several more slides and cross-sections like those below.

microscopic slide views showing tissue cross-ssections in the female perineal membrane

One of several slides and references supplied by Dr. DeLancey.

In pursuit of accuracy

The work went smoothly and relatively quickly, thanks to the copious references Dr. DeLancy had prepared. We went through a few rounds of changes, the last one being posted above (hint: it's the small red line, along with making some muscle look more fibrous). In about two week's time we had finished the drawing despite being about 900 miles apart and never meeting or speaking on the phone. Remarkable.

This type of anatomical illustration work is extremely rare today, as is a man like Dr. DeLancy. I'll finish with the closing paragraph from his manuscript:

"There’s much to be learned and re-learned from continued anatomical investigation. This process must be re-discovered by each generation. The tyranny of books over bodies that existed for over a millennium, wherein Galenic was taught by “anatomists” who read Galen’s book and had persons point out the anatomy to the audience. During this era the book was considered right and the body was considered wrong. Vesalius, who revolutionized anatomical teaching by teaching directly from the body, recognized the problems of book-based learning. The advent of modern imaging and wide availability of images of true anatomy should inspire us to constantly consult the body for the truth."

Congratulations on your AUGS Lifetime Achievement Award, Dr. DeLancey – well deserved indeed!

Exceptional Talent

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