Sponsor   

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.

Click on the link below to subscribe to the MTD newsletter. If you think an article could be interesting to somebody else, click on the mail link at the top of each article to forward it. 

You are welcome to submit questions and suggestions using our "Contact Us" form. The information on this blog follows the terms on our "Privacy and Security Statement"  and cannot be construed as medical guidance or instructions for treatment. 


Click here to subscribe to the Medical Terminology Daily Newsletter

fbbuttons sm

We have 195 guests and no members online


A Moment in History 

Title page of Anathomia Corporis Humanis by Mondino de Luzzi. Image courtesy of the National Library of Medicine
Title page of "Anathomia Corporis Humanis" by Mondino de Luzzi

Alessandra Giliani

 
(1307 – 1326

Italian prosector and anatomist. Alessandra Giliani is the first woman to be on record as being an anatomist and prossector. She was born on 1307 in the town of Persiceto in northern Italy.

She was admitted to the University of Bologna circa 1323. Most probably she studied philosophy and the foundations of anatomy and medicine. She studied under Mondino de Luzzi (c.1270 – 1326), one of the most famous teachers at Bologna.

Giliani was the prosector for the dissections performed at the Bolognese “studium” in the Bologna School of Anatomy. She developed a technique (now lost to history) to highlight the vascular tree in a cadaver using fluid dyes which would harden without destroying them. Giliani would later paint these structures using a small brush. This technique allowed the students to see even small veins.

Giliani died at the age of 19 on March 26, 1326, the same year that her teacher Mondino de Luzzi died.  It is said that she was buried in front of the Madonna delle Lettere in the church of San Pietro e Marcellino at the Hospital of Santa Maria del Mareto in Florence by Otto Agenius Lustrulanus, another assistant to Modino de Luzzi.

Some ascribe to Agenius a love interest in Giliani because of the wording of the plaque that is translated as follows:

"In this urn enclosed are the ashes of the body of 
Alessandra Giliani, a maiden of Persiceto. 
Skillful with her brush in anatomical demonstrations 
And a disciple equaled by few, 
Of the most noted physician, Mondino de Luzzi, 
She awaits the resurrection. 
She lived 19 years: She died consumed by her labors 
March 26, in the year of grace 1326. 
Otto Agenius Lustrulanus, by her taking away 
Deprived of his better part, inconsolable for his companion, 
Choice and deservinging of the best from himself, 
Has erected this plaque"

Sir William Osler says of Alessandra Giliani “She died, consumed by her labors, at the early age of nineteen, and her monument is still to be seen”

The teaching of anatomy in the times of Mondino de Luzzi and Alessandra Giliani required the professor to be seated on a high chair or “cathedra” from whence he would read an anatomy book by Galen or another respected author while a prosector or “ostensor” would demonstrate the structures to the student. The professor would not consider coming down from the cathedra to discuss the anatomy shown. This was changed by Andreas Vesalius.

The image in this article is a close up of the title page of Mondino’s “Anothomia Corporis Humani” written in 1316, but published in 1478. Click on the image for a complete depiction of this title page. I would like to think that the individual doing the dissection looking up to the cathedra and Mondino de Luzzi is Alessandra Giliani… we will never know.

The life and death of Alessandra Giliani has been novelized in the fiction book “A Golden Web” by Barbara Quick.

Sources 
1. “Books of the Body: Anatomical Ritual and Renaissance Learning” Carlino, A. U Chicago Press, 1999 
2. “Encyclopedia of World Scientists” Oakes, EH. Infobase Publishing, 2002 
3. “The Biographical Dictionary of Women in Science”Harvey, J; Ogilvie, M. Vol1. Routledge 2000 
4. “The Evolution of Modern Medicine” Osler, W. Yale U Press 1921 
5. “The Mondino Myth” Pilcher, LS. 1906 
Original image courtesy of NLM
 


 "Clinical Anatomy Associates, Inc., and the contributors of "Medical Terminology Daily" wish to thank all individuals who donate their bodies and tissues for the advancement of education and research”.

Click here for more information


Rare & Collectible Books at AbeBooks.com


 

Azygos venous system

The azygos venous system drains the posterior aspect of the thorax via the posterior intercostal veins It also connects the vascular territories of the superior vena cava and the  inferior vena cava, and is the superior continuation of the lumbar veins. The azygos system was first described by Bartolomeo Eustachius (c1500 - 1574).

The name azygos comes from the Greek [ζεύγος] and means “unyoked” or better “asymmetrical”. This system is different on each side of the body, also having important anatomical variations.

The azygos vein (Lat: vena azygos major) is the larger vein of the azygos system and is found on the right side of the body. It begins at the level of the first or second lumbar vertebra as a continuation of the right ascending lumbar vein; sometimes by a branch from the right renal vein or from the inferior vena cava. It enters the thoracic cavity through the aortic hiatus of the respiratory diaphragm, and ascends along the right side of the vertebral column to level of the fourth thoracic vertebra, where it arches forward over the root of the right lung, at this point the vein is called the azygos arch, which terminates in the posterior aspect of the superior vena cava (SVC) just superior to the point where the SVC enters the pericardium.

In the thorax, the azygos vein is found to the right of the thoracic duct on the right side of the descending aorta; it lies upon the intercostal arteries and is partly covered by the parietal pleura.

The azygos vein receives the right subcostal vein, nine or ten right posterior intercostal veins, the hemiazygos vein, the accessory hemiazygos vein, the right superior intercostal vein, and several minor esophageal, mediastinal, and pericardial veins.

The left side of this system is more complex and presents with more anatomical variations. Its main component is the hemiazygos vein (Lat: vena azygos minor), also known as the left lower azygos vein. It is a continuation of the left ascending lumbar vein, and it sometimes may arise from the left renal vein and passes into the thorax usually through the left aortic crus of the respiratory diaphragm. It ascends to the level of the 7th or 8th thoracic vertebra where it crosses the midline posterior to the esophagus, descending aorta and thoracic duct to empty into the right-sided azygos vein.  It receives the left subcostal vein and three to four lower posterior intercostal veins, and some esophageal and mediastinal veins.

1. Right brachiocephalic vein 2. Right supreme intercostal vein 3. Superior vena cava 4. Right superior intercostal vein 5. Hemiazygos vein 6. Right subcostal vein 7. Right ascending lumbar vein 8. Left brachiocephalic vein 9. Left internal jugular vein 10. Left supreme intercostal vein 11. Left superior intercostal vein 12. Left posterior intercostal veins 13. Accessory hemiazygos vein 14. Left subcostal vein 15. Left ascending lumbar vein 16. Inferior vena cava
  1. Right brachiocephalic vein
  2. Right supreme intercostal vein
  3. Superior vena cava
  4. Right superior intercostal vein
  5. Hemiazygos vein
  6. Right subcostal vein
  7. Right ascending lumbar vein
  8. Left brachiocephalic vein
  9. Left internal jugular vein
  10. Left supreme intercostal vein
  11. Left superior intercostal vein
  12. Left posterior intercostal veins
  13. Accessory hemiazygos vein
  14. Left subcostal vein
  15. Left ascending lumbar vein
  16. Inferior vena cava
The second component of the left azygos system is the accessory hemiazygos vein, also known as the left upper hemiazygos. This component varies in size depending on the third venous drainage component of the left posterior thoracic wall. This is the left superior intercostal vein (see attached diagram).

The accessory hemiazygos, similar to the hemiazygos vein will cross the midline posterior to the esophagus, descending aorta and thoracic duct to empty into the right-sided azygos vein. It may do so by a common vein or by a separate vein as shown in the attached diagram. If there is a common vein the hemiazygos is considered to be the inferior component and the hemiazygos is considered to be the superior component.

The left superior intercostal vein receives three or four posterior intercostal veins, and empties into the left brachiocephalic vein. In rare cases of absence of the hemiazygos vein, this left superior intercostal vein will extend as low as the fifth or sixth intercostal space.

Although not considered to be part of the azygos system, the drainage of the posterior thoracic wall is completed by the right and left supreme intercostal veins which empty the posterior aspect of the first intercostal space into the left and right brachiocephalic veins respectively.

The azygos system of veins constitute an important collateral venous circulation pathway which can be seen in action in cases of blockage of the superior or inferior vena cavae.
 
Sources:
1. “Gray’s Anatomy” Henry Gray, 1918
2. "Tratado de Anatomia Humana" Testut et Latarjet 8th Ed. 1931 Salvat Editores, Spain
3. "Gray's Anatomy" 38th British Ed. Churchill Livingstone 1995

4. "Reconstructive Anatomy: A Method for the Study of Human Structure: Arnold, M WB Saunders1968
Image modified from the original from Arnold (4)