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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Avascular

The medical word [avascular] means "without vessels" and refers to structures that do not have vessels providing it with blood supply. Avascular structures, like hyaline cartliage, receive their oxygen and nutrients by diffusion from nearby structures.

The preffix [-a-] means "without", and the root term [-vascul-] means "vessels"..

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Hyaline cartilage

Hyaline cartilage. Image courtesy of Dr. Stephen Gallik
Hyaline cartilage

Hyaline cartilage is a type of cartilage characterized by a very homogenous avascular matrix. It is the most common type of cartilage.  Hyaline cartilage has a bluish glassy look to it, hence the name.

Within the matrix of hyaline cartilage there are spaces called "lacunae" wich contain chondrocytes. These produce and maintain the extracellular matrix. Hyaline cartilage is found covering articular surfaces allowing for effortless sliding of the articular surfaces one against the other. Hyaline cartilage is avascular.

The accompanying image is a histology slide of hyaline cartilage. For more information on hyaline cartilage, read the article "The Importance of Hyaline Cartilage"by Dr. Stephen Gallik.

The word "hyaline" is a derivate of the Greek [υαλώδης] (yalódis) meaning "glassy".

Thanks to Dr. Stephen Gallik for the mage and links. For more information on mammalian hystology, you can visit Dr. Gallik's website here.

Note: Google Translate includes the symbol (?). Clicking on it will allow you to hear the pronunciation of the word.


Sacrocolpopexy

This term has two roots terms and a suffix. [-sacr-] means "sacred" , but in this case refers to the sacral bone or sacrum. [-colp-] means "vagina", and the suffix [-opexy] means "fixation", "surgical fixation", or "suspension". As always, the [-o-] between the initial two root terms means "and". Following the rules to combine root terms, the word [sacrocolpopexy] means "fixation of the sacrum and vagina". The term "sacrocolposuspension" is synonymous with "sacrocolpopexy"

The fixation or suspension can be attained by the use of sutures, surgical staples, bone tacks, mesh, etc. or a combination of these devices. A sacrocolpopexy can be needed in the case of a weakened or damaged pelvic diaphragm that can lead to urinary incontinency and recurrent urinary infections, among other problems. The image shows a sacrocolpopexy using Bard Medical's ALYTE® Mesh Graft.

• For a pdf file with patient information click here

• For information on a mesh used for sacrocolpopexy click here

• For a procedural video of mesh implantation click here 

Bard Medical  ALYTE Mesh Graft

Thanks to Bard Medical for providing images, procedural information, and links.

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Mondino de Luzzi


This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.
Mondino de Luzzi (ca.1270 – 1326). Italian anatomist, born Raimondo de Luzzi in the city of Bologna circa 1270.  He was also known as Mondino, Remondino, or Mundinus de Leutiis, de Lentiis, de Lucci, and other variations of his name. His father Nerino Franzoli was an apothecary, and Mondino also started working as such.

In 1290 he enrolled in the Medical School at the University of Bologna obtaining his medical degree circa 1290. Mondino stayed at the university, where he continued to teach until his death in 1326.

His major publication is “Anothomia Corporis Humani”, written circa 1316 and found only in manuscript form. It was finally printed in movable type in 1478, making it easily available to the public. While some authors like Singer, 1925 contend that this is his only publication, others discuss the possibility that Mondino de’ Luzzi wrote other books that have been adjudicated to other authors as at the time the name “Mondino” was very common.

“Anothomia Corporis Humani” is the first anatomical book based on actual dissections, and the book was organized almost as a dissection manual, explaining dissection techniques to visualize specific structures. Initially this book had no illustrations, but some were added in later publications.

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
With over 40 editions, the last one in 1668, this book was used for almost 250 years. Mondino restarted human dissections in medical schools almost 1,500 years the medical school of Alexandria, leading many to call Mondino the “restorer of anatomy”.

It is said that Leonardo da Vinci (1452 – 1519) used one of Mondino’s books as a dissection manual to guide his own. Because Mondino followed Galen’s dictums and teachings, he was harshly criticized for his errors by Andreas Vesalius (1514 – 1564).

Although it is not clear if Mondino himself performed the actual dissections (he says he did), it is clear that he directed them. We know of two of his assistants:  Otto Agenio Lustrolanus and Alessandra Giliani, the first woman prosector and anatomist. When Mondino died the same year as Alessandra Giliani, the expectation was that his assistant would continue the work of the master. Sadly Otto Agenio Lustrolanus died before he was 30 years old.

In the introduction to “Anothomia” Mondino says: "A work upon any science or art-as saith Galen-is issued for three reasons: First, that one may satisfy his friends. Second, that he may exercise his best mental powers. Third, that he may be saved from the oblivion incident to old age. Therefore, moved by these three causes, I have proposed to my pupils to compose a certain work on Medicine.”

"And because a knowledge of the parts to be subjected to medicine (which is the human body, and the names of its various divisions) is a part of medical science, as saith Averrhoes in his first chapter, in the section on the definition of medicine, for this reason among others I have set out to lay before you the knowledge of the parts of the human body which is derived from anatomy, not attempting to use a lofty style, but the rather that which is suitable to a manual procedure."

Sources:
1. “Mondino de' Luzzi's commentary on the Canones Generales of Mesue the Younger” Welborn, MC. Isis  , 22: 1 (1934) , 8-11
2. “Medieval neuroanatomy: the text of Mondino dei Luzzi and the plates of Guido da Vigevano” Orly R. J Hist Neurosci. 1997 6 (2):113-123
3. “Mondino de Luzzi (1270-1326) Restaurador de la Disecci?n Anat?mica” Rever?n, RR. Informe Medico 2007; 9 (12):589-592
4. “The history and illustration of anatomy in the Middle Ages” Gurunluoglu, R, et al. J Med Biogr 2013 21: 219 – 229
5. “The Mondino Myth” Pilcher, LS. 1906
Original image courtesy of NLM

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Cartilage

Cartilage is a type of avascular tissue with a highly specialized extracellular matrix that contains chondrocytes.  The condrocytes produce and maintain the extracellular matrix. The root term meaning [cartilage] is  [-chondr-], which originatesfrom the Greek [χόνδρος] or [chondros] meaning "cartilage" or "gristle". The Latin equivalent is [cartilago] giving us the synonymous root term [-cartilag-], from which [cartilage] arises.

The matrix contains large amounts of glicosaminoglycans, which allows for easy diffusion of substances from surrounding structures and blood vessels. Being avascular, cartilage does not have its own blood supply. The extracellular matrix also has large quantities of hyaluronic acid, which allows cartilage a weight-bearing capacity. This is why cartilage is particularly useful in bony joints and covering articular surfaces.

There are three types of cartilage present in the human body:

• Elastic cartilage: This type of cartilage is characterized by elastic fibers, usually in layers or lamellae

• Fibrocartilage: This type of cartilage is characterized by large bundles of collagen, making it lok and feel fibrous

• Hyaline cartilage: This type of cartilage is characterized by an homogenous amorphous matrix

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