Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. 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

Jean-Louis Petit

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674.  His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations.  In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance.  “Traite des Maladies des Os” ( A Treatise on Bone Diseases);  “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81


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Sphincter of Oddi

The [sphincter of Oddi]  is a complex system of smooth muscles that controls flow of bile and pancreatic juice into the duodenum. Although known by its eponym, this structure has the anatomical name of "sphincter of the hepatopancreatic ampulla". Although described previously by others, it was Ruggero Oddi (1864-1913) who described not only its structure, but also its function.

The hepatopancreatic ampulla or "ampulla of Vater" is a dilation found at the conjunction and end of the common bile duct and pancreatic duct. The presence of the hepatopancreatic ampulla creates a nipple-like elevation of the duodenal mucosa called the "duodenal papilla".

The sphincter of Oddi has several components:

Cutaway view of the second portion of the duodenum showing the sphincter of OddiImages property of:CAA.Inc. Artist:Dr. E. Miranda
• Sphincter papillae: This portion of the sphincter surrounds the papillary and intramural portion of the hepatopancreatic ampulla
• Sphincter choledochus: This portion of the sphincter surrounds the most distal portion of the common bile duct. It must be noted that this is the narrowest portion of the common bile duct, allowing for potential lodging of bile stones, cause for choledocholithiasis
 Sphincter pancreaticus: This portion of the sphincter surrounds the most distal portion of the pancreatic duct and prevents reflux of bile from the hepatopancreatic ampulla to the pancreatic duct.

The duodenal muscular layer parts to allow passage of the complex formed by the hepatopancreatic ampulla and the sphincter of Oddi, creating a window called the "choledochal window". Longitudinal fibers from the duodenal muscularis externa pass and join to the sphincter of Oddi.

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