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Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community, medical students, and the medical industry. We will post a workweek daily medical or surgical term, its meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Antoine Louis
(1723–1792)

French surgeon, anatomist, and physiologist. Following his medical studies and a long career as a physiologist, Antoine Louis was named Permanent Secretary of the Royal French Academy of Surgery. His other titles were those of Professor of the Royal Academy, Consultant Surgeon of the Armies of the King, member of the Royal Society of Sciences of Montpellier, Inspector of the Royal Military Hospitals, and Doctor in Law of the University of Paris. As a member of these academies Louis was instrumental in the design and construction of the guillotine. Initially called the "Louisette", this device was later named after another French physician in the same committee, Dr. Joseph-Ignace Guillotin.

Antoine Louis' name is better know to history as the eponymic origin of the "sternal angle" also know as the "Angle of Louis" and synonymously (probably by misspelling or translation) the "angle of Lewis", and "angle of Ludwig". This anatomical landmark is extremely important as it serves as a superficial landmark for important anatomical occurrences (click here).

As a point of controversy, there are some that contest the history of this eponym adjudicating it to Pierre Charles Alexander Louis (1787-1872), another French physician dedicated to the study of tuberculosis.

Sources:
1. Srickland, N; Strickland A Angle of Louis, More Than Meets the Eye. MedTalks:
2. Ramana, R. K., Sanagala, T. and Lichtenberg, R. (2006), A New Angle on the Angle of Louis. Congestive Heart Failure, 12: 197–199
3
. "The origin of Medical Terms" Skinner, HA; 1970


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Hernia

UPDATED: The definition of hernia is "the protrusion of a deep structure through a superficial weakness of defect".

Herniation has many etiologies, but in all cases a weakness of a superficial containing wall  (usually layered) or a normal or abnormal opening (defect) must be present. A true hernia usually has a deep sac or hernia sac which contains the herniated viscus or viscera. Repair of a hernia is called a hernioplasty or a herniorrhaphy.

Although with exceptions, a herniation with only weakening of the walls and no hernia sac can be called a "prolapse", the suffix for prolapse (or hernia sometimes) is [-ocele].

Indirect inguinal hernia
• Omphalocele: From the Greek [omphalos] meaning "umbilicus", an omphalocele is a herniation through the umbilicus.
• Cystourethocele: A prolapse of the urinary bladder and urethra with a weakened vaginal wall

There are also "internal' hernias, between bodily compartments. Examples are:

Esophageal hiatus hernia: Known as a "hiatal hernia", this hernia is a protrusion of a peritoneal sac with abdominal visceral content into the thorax.
Perineal hernia: The protrusion of abdominopelvic content into the perineal region through a defect in the pelvic diaphragm (levator ani)

A hernia is usually named for the superficial region where it protrudes. An example of this would be a femoral hernia, which starts as an abdominopelvic extrusion, but it ends protruding in the area of the thigh (femoral region). Abdominal or ventral hernias are named according to the abdominal region through which they protrude.

in older times the word "rupture" was used as a synonym for "hernia", as can be seen in a letter written by Dr. Ephraim McDowell in 1829. The image shows an example of an indirect inguinal hernia. 

Original Image courtesy of: nih.gov