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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 post anatomical, medical or surgical terms, their 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 

Martin Naboth, title page of De Sterelitate Mulierum 

Martin Naboth
(1675 – 1721)

Not much is known about this German physician and anatomist. He was born in 1675 in Calau, a town in Southern Brandenburg, Germany. He studied medicine at the University in Leipzig, receiving his doctorate in Philosophy in 1701 and his MD in 1703. Although his interests were based in chemistry, Naboth became an avid anatomist, with interest in the anatomy of the female reproductive system.

His main publication in 1707 was “De Sterilitate Mulierum” (On Sterility in Women). In this book he refers to small pearl-like transparent structures found in the uterine cervix. Believing that he had discovered the way women store eggs, he called these “ovarium novum” (new ovaries). His discovery was accepted by many and these structures came to be known as “Ovula Nabothii “. Only later were to understand these structures as cysts created by clogging of the opening of the glands found around the uterine cervix. These mucus-producing glands are known as the [cervical glands] and also as Nabothian glands. These cysts, which are common and do not represent a sign of cervical cancer, are known today as Nabothian cysts.

Naboth had only rediscovered these cysts first described in 1681 by Guillaume des Noues (1650 – 1735), although the eponym records Naboth’s name.

Naboth died in Leipzig in 1721 leaving a large anatomical collection. We have not been able to find an image of Naboth, so we are depicting the title page of his 1707 “De Sterilitate Mulierum”. If you click on the image you can see a larger depiction.

Sources
1. “Histoire de la M?decine, depuis son origine jusqu'au dix-neuvi?me si?cle” A. J. L. Jourdan ; E. F. M. Bosquillon  1815
2. “The Origin of Medical Terms” Skinner HA 1970 Hafner Publishing Co.


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Triangle of "doom"

UPDATED: The "triangle of doom" is a name given to a roughly triangular area in the posterior aspect of the anterior wall of the lower abdominopelvic region. It is used by surgeons repairing an inguinofemoral hernia with a mesh and they want to avoid large vascular structures, namely the external iliac artery and vein. The "triangle of doom" will be highlighted when you hover your cursor over the image.

The so-called "triangle of doom" is a misnomer perpetuated by the first laparoscopic surgeons who observed the anatomy of the inguinofemoral region from the posterior aspect. It is neither a triangle (as it only has two boundaries), nor is it an eponym (no such person - that is why is should not use uppercase). It does indicate an area where it is extremely dangerous to place staples or sutures during laparoscopic hernia surgery.

The "triangle of doom" is an inverted "V" shaped area with its apex at the internal (deep) inguinal ring. The "triangle of doom" is bound laterally by the gonadal vessels, and medially by the vas deferens in the male, or the round ligament of the uterus in the female. Within the boundaries of this area you can find the external iliac artery and vein.

Triangle of "doom"
It should be pointed out that although the "triangle of doom" landmark does protect the surgeon from damaging the external iliac vessels, a portion of these vessels lie outside of this area. In fact, there are several other areas of concern for neurovascular damage when performing a laparoscopic herniorrhaphy.

The image also depicts other structures of anatomical importance for laparoscopic herniorrhaphy:

Arcuate line (b)
Hesselbach's triangle (in yellow)
Aberrant obturator artery (Corona Mortis) (a)
• Inferior (deep) epigastric artery (c)

Image property of:CAA.Inc.Artist:M. Zuptich.


Clinical anatomy of the inguinofemoral hernias, as well as abdominal and perineal hernias are some of the lecture topics developed and delivered to the medical devices industry by Clinical Anatomy Associates, Inc.