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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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Inferior vena cava

The inferior vena cava (IVC) in one of the great vessels. It brings deoxygenated blood from the lower extremities, pelvis, and areas of the abdomen to the right atrium of the heart.

As a side note, the blood returning from the digestive system does not usually enter the IVC. It has it its own venous subsystem converging into the liver by way of the portal vein.

The IVC is formed by the confluence of the right and left common iliac veins. This lower end of the inferior vena cava is found anterior to the L4-L5 intervertebral disc. The IVC covers the superior aspect of the body of L5.

The IVC ascends to the right of the abdominal aorta and anterolateral to the vertebral bodies. It receives several branches as it passes superiorly:

• Common iliac veins
• Lumbar veins
• Gonadal veins
• Renal veins
• Right suprarenal veins
• Hepatic veins
• Inferior phrenic veins

Anterior view of the IVC. Gray, 1918
Image modified from the original by Gray (1918)

As the IVC passes posterior to the liver, it is hugged by the mass of the posterior aspect of the liver, it will receive the hepatics veins, and pass through the IVC hiatus of the respiratory diaphragm, entering immediately into the right atrium of the heart. At this point the IVC will present an incomplete venous valve known as the Eustachian valve, named after Bartolomeo Eustachius (c1500 - 1574).

Sources:
1. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
2. "Gray's Anatomy" 38th British Ed. Churchill Livingstone 1995
3. "Reconstructive Anatomy: A Method for the Study of Human Structure: Arnold, M WB Saunders1968