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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

Thomas Willis, MD
Thomas Willis
(1621-1675)

An English physician and anatomist, Willis was born on his parents' farm in Great Bedwyn, Wiltshire, where his father held the stewardship of the Manor. He was a kinsman of the Willys baronets of Fen Ditton, Cambridgeshire. He graduated M.A. from Christ Church, Oxford in 1642. In the Civil War years he was a royalist, and was dispossessed of the family farm at North Hinksey by Parliamentary forces. In the 1640's Willis was one of the royal physicians to Charles I of England. He obtained his medical degree in 1646.

Thomas Willis might well be one of the greatest physicians of the 17th century.He is one of the founders of the Royal Society of London. He is remembered by his many publications, especially "Cerebri Anatome: Cui accessit Nervorum Descriptio et Usu", where he describes the arterial anastomoses at the base of the brain. This work is also the first detailed description of the vasculature of the brain. Willis described nine cranial nerves.

He is considered as the father of Neurology as a discipline. He used the term "neurology" for the first time in 1664. He described several neurological conditions

The Arterial Circle of Willis is a famous eponymous structure found at the base of the brain. It represents an anastomotic roundabout that connects the right and left sides as well as the carotid and vertebral arterial territories that supply the brain. Named after Thomas Willis, this structure was known well before him, but it was Willis who described its function.  If you click on the image or here, you will be redirected to a detailed description of this structure.

Sources:

1. "The legendary contributions of Thomas Willis (1621-1675): the arterial circle and beyond" Rengachary SS et al J Neurosurg. 2008 Oct;109(4):765-75
2. "Thomas Willis, a pioneer in translational research in anatomy (on the 350th anniversary of Cerebri anatome)" Arraez-AybarJournal of Anatomy, 03/2015, Volume 226, Issue 3
3. " The naming of the cranial nerves: A historical review" Davis, M Clinical Anatomy, 01/2014, Volume 27, Issue 1
4. "Observations on the history of the circle of Willis". Meyer A, Hieros, R.Med Hist 6:119–130, 1962


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Abdominal Regions

UPDATED: In surface anatomy the abdomen can be divided into nine regions by named lines (or planes): transpyloric, transtubercular, and midclavicular. These regions have specific visceral content.

• Hypochondriac regions (right and left): [Hypo]="below"; [chondr]="cartilage"; [iac]=”pertaining to”. In this context, the term means “below or deep to the cartilage (of the ribs)". The right hypochondriac region contains the liver, gallbladder, portal vein, and the right colic flexure. The left hypochondriac region contains the stomach, spleen, tail of the pancreas, and left colic flexure. For a detail on how the name of this region relates to a mental disorder, click here.

• Epigastric region: [Epi]="above"; [gastr]="stomach”; [ic]=”pertaining to". The term means “above the stomach”. This region contains mostly stomach and abdominal esophagus

• Lumbar regions (right and left): Right and left lumbar regions. The term [lumbar] refers to the area of the loins. The right lumbar region contains the ascending colon and part of the right kidney. The left lumbar region contains the descending colon and part of the left kidney

• Umbilical region: Centered around the umbilicus, this region contains mostly small intestine, abdominal aorta, and greater omentum


Abdominal regions - Modified from the original Davis, 1910 

• Inguinal regions (right and left): From the Latin [inguen]=”groin". Gaius Plinius Secundus aka “Pliny” (23-79 AD) first used this term naming after a plant (inguinalis) which he used to treat hernias of the groin. The right inguinal region contains the cecum and small intestine. The left inguinal region contains the sigmoid colon. In older days, as shown in the sketch, these regions were called the "iliac regions".

• Hypogastric region: [Hypo]="below"; [gastr]="stomach”; “ic”=”pertaining to. The term means “below the stomach”. The hypogastric region contains mostly small intestine and greater omentum. This region used to be called the "pubic region"

A clinical importance of these abdominal regions is that a ventral hernia is usually named by the anatomical region where it protrudes. Based on the image, you will see then why a hernia can be umbilical, inguinal, lumbar, epigastric, or hypogastric.

Sources:
1. "Applied Anatomy" Davis, GG 1910 JBL Co. Philadelphia
2. "The Origin of Medical Terms" Skinner, HA 1970 Hafner Publishing Co.