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 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

Self-portrait, Henry Vandyke Carter, MD (Public Domain)
Self-portrait, Henry Vandyke Carter, MD (Public Domain)

Henry Vandyke Carter, MD
(1831 – 1897)

English physician, surgeon, medical artist, and a pioneer in leprosy and mycetoma studies.  HV Carter was born in Yorkshire in 1831. He was the son of Henry Barlow Carter, a well-known artist and it is possible that he honed his natural talents with his father. His mother picked his middle name after a famous painter, Anthony Van Dyck. This is probably why his name is sometimes shown as Henry Van Dyke Carter, although the most common presentation of his middle name is Vandyke.

Having problems to finance his medical studies, HV Carter trained as an apothecary and later as an anatomical demonstrator at St. George’s Hospital in London, where he met Henry Gray (1872-1861), who was at the time the anatomical lecturer. Having seen the quality of HV Carter’s drawings, Henry Gray teamed with him to produce one of the most popular and longer-lived anatomy books in history: “Gray’s Anatomy”, which was first published in late 1857.  The book itself, about which many papers have been written, was immediately accepted and praised because of the clarity of the text as well as the incredible drawings of Henry Vandyke Carter.

While working on the book’s drawings, HV Carter continued his studies and received his MD in 1856.

In spite of initially being offered a co-authorship of the book, Dr. Carter was relegated to the position of illustrator by Henry Gray and never saw the royalties that the book could have generated for him. For all his work and dedication, Dr. Carter only received a one-time payment of 150 pounds. Dr.  Carter never worked again with Gray, who died of smallpox only a few years later.

Frustrated, Dr. Carter took the exams for the India Medical Service.  In 1858 he joined as an Assistant Surgeon and later became a professor of anatomy and physiology. Even later he served as a Civil Surgeon. During his tenure with the India Medical Service he attained the ranks of Surgeon, Surgeon-Major, Surgeon-Lieutenant-Colonel, and Brigade-Surgeon.

Dr. Carter dedicated the rest of his life to the study of leprosy, and other ailments typical of India at that time. He held several important offices, including that of Dean of the Medical School of the University of Bombay. In 1890, after his retirement, he was appointed Honorary Physician to the Queen.

Dr. Henry Vandyke Carter died of tuberculosis in 1897.

Personal note: Had history been different, this famous book would have been called “Gray and Carter’s Anatomy” and Dr. Carter never gone to India. His legacy is still seen in the images of the thousands of copies of “Gray’s Anatomy” throughout the world and the many reproductions of his work available on the Internet. We are proud to use some of his images in this blog. The image accompanying this article is a self-portrait of Dr. Carter. Click on the image for a larger depiction. Dr. Miranda

1. “Obituary: Henry Vandyke Carter” Br Med J (1897);1:1256-7
2. “The Anatomist: A True Story of ‘Gray’s Anatomy” Hayes W. (2007) USA: Ballantine
3. “A Glimpse of Our Past: Henry Gray’s Anatomy” Pearce, JMS. J Clin Anat (2009) 22:291–295
4. “Henry Gray and Henry Vandyke Carter: Creators of a famous textbook” Roberts S. J Med Biogr (2000) 8:206–212.
5. “Henry Vandyke Carter and his meritorious works in India” Tappa, DM et al. Indian J Dermatol Venereol Leprol (2011) 77:101-3

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Serratus anterior (magnus)

The serratus anterior or serratus magnus is a is a wide, thin muscle sheet situated on the posterolateral aspect of the thorax and extends between the ribs and the scapula. It is formed by well-defined separate muscular digitations that originate in the external surface and superior aspect of the first superior eight (or nine) ribs. These originating fibers also arise from the fasciae covering the intercostal muscles. This is especially true for the first or most superior digitation which arises from the first and second rib and the intervening external intercostal fascia.

These digitations cover the lateral aspect of the thorax, pass deep to the scapula and converge to insert on the deep aspect of the medial border of the scapula. Some of its fibers may even hug the medial border of the scapula and insert on its anterior aspect. The first digitation is inserted into a triangular area on the ventral surface of the medial scapular angle. The next two digitations spread out to form a triangular sheet, the base of which is directed posteriorly and is inserted into nearly the whole length of the ventral surface of the vertebral border. The lower five or six digitations converge to form a fan-shaped mass, the apex of which inserts into a triangular impression on the ventral surface of the inferior scapular angle. The lower four slips of the serratus anterior interdigitate with the superior five muscular slips of the external oblique muscle.

Serratus magnus muscle - Image modified from the original by Henry VanDyke Carter, MD. Public domain
Serratus magnus muscle.
Click on the image for a larger depiction 
This muscle receives its nerve supply from the long thoracic nerve, (ventral rami of C5-C7), arising from the roots of C5, C6, and C7 (sometimes absent) of the brachial plexus

The word “serratus” derivates from the Latin word [serro] meaning “saw”. Serratus means “serrated” referring to the multiple tooth-like anterior digitations of the muscle. The plural form for "serratus" is " serrati". The Latin term “magnus” means “great”, “large”, or “mighty”. It points to the fact that this is the largest of three muscles that carry the same name “serratus”. The other two are the serratus posterior superior and the serratus posterior inferior.

The serratus anterior is one of the 17 muscles that attach to the scapula.

Note: The image shown in this article is from “Gray’s Anatomy” by Henry Gray (1918) which is in the public domain. It depicts the serratus anterior in situ and shows the scapula retracted posteriorly.  The scapula is covered on its internal aspect by the subscapularis muscle (number 3 in the image). A better image can be found in “An Illustrated Atlas of the Skeletal Muscles” by Bowden (2015) which we cannot publish for copyright reasons.

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. “An Illustrated Atlas of the Skeletal Muscles” Bowden, B. 4th Ed. Morton Publishing. 2015

Image modified from the original by Henry VanDyke Carter, MD. Public domain