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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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Midclavicular line

The midclavicular line is one of the surface reference lines used in surface anatomy of the thorax.

It is a parasagittal vertical plane that passes halfway through the body of the clavicle. The lateral portion of the clavicle is close to the highest point of the shoulder joint (the acromioclavicular joint), while the head (medial aspect) of the clavicle is found just lateral to the jugular notch of the sternum, a depression in the superior aspect of the sternal manubrium.

Although it was originally used as a thoracic reference point, the continuation of the midclavicular line into the abdomen is used today as a reference for laparoscopic procedures, to indicate the location where a trocar must be introduced into the abdomen. As an example, in a laparoscopic cholecystectomy, one of the four trocars (in this case a 5mm trocar) is introduced into the abdomen on the right midclavicular line four fingerbreadths inferior to the costal margin (the lower border of the ribs).  This trocar is used to manipulate the gallbladder and is placed in the gallbladder infundibulum.

It is also one of the lines used to describe the abdominal regions.

Sources:

1. "Clinical Anatomy" Brantigan, OC 1963 McGraw Hill
2. "Tratado de Anatomia Humana" Testut et Latarjet 8th Ed. 1931 Salvat Editores, Spain


Abdominal regions - Modified from the original Davis, 1910