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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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Duodenum

The duodenum is a mostly retroperitoneal organ, part of the digestive tract, and the most proximal portion of the small intestine. This organ is approximately 10 inches in length (24.5 cm). It starts at the pylorus of the stomach, has a "C" shape, curving around the head and the neck of the pancreas, to end at the duodenojejunal junction.

The duodenum is described as having four segments of differing length, usually named numerically:

- First segment: about two inches in length, it is dilated and called the "duodenal ampulla", or "superior duodenum"
- Second segment: about three inches in length, it receives bile and pancreatic juice through the hepatopancreatic ducts and ampullae. It is also called the "descending duodenum"
- Third segment: about four inches in length, it crosses the midline, and is also known as the "horizontal" or "transverse duodenum"
- Fourth segment: one inch in length, this is the shortest segment, it ascends towards the duodenojejunal junction, which is tethered to the diaphragm by a fold of peritoneum around a fibromuscular band called the "ligament of Treitz". At this point the retroperitoneal duodenum becomes the intraperitoneal jejunum. This fourth segment is also called the "ascending duodenum"

Retroperitoneal organsImage property of:CAA.Inc.Artist:Dr. E. Miranda
The name of the organ is interesting. Most textbooks claim that is originates from the Latin [duodeni], meaning "twelve". The fact is that the duodenum was originally named in Greek [δώδεκα δάχτυλαν] meaning "twelve fingers". If you place both your hands together and add 1/4 of an inch to each side (as if you had an extra finger on each hand) that measures approximately 10 inches. The term was shortened by an incorrect translation to "twelve" by Gerard of Cremona (1114 - 1187) who called it "duodenum", a bad translation, as twelve fingers in Latin is [duodecim digitorum].

Sources:
1.
"Clinically Oriented Anatomy" Moore, KL. 3r Ed. Williams & Wilkins 1992
2. "The origin of Medical Terms" Skinner, AH, 1970