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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-cheil-

The root term [-cheil-] derivates from the Greek word [χείλος (keilos]] meaning "lip". There are other medical root terms that also mean lip, but they arise from the Latin words [labellum, labrum, and labra].  There are many medical terms that include the root [-cheil-]:

• Cheilitis: The suffix [-itis] means "inflammation". Inflammation of the lips

• Cheilitis simplex: A very medical way of saying "chapped lips". See accompanying image.

• Cheiloplasty: The suffix [-(o)plasty] means "surgical reshaping". A surgical reshaping or plastic surgery of the lips

• Angular cheilitis: Inflammation of the angle of the mouth, sometimes causing a fissure

• Cheilognathopalatoschisis: This wors combines several roots: [-cheil-], meaning "lip", [-gnath-] meaning "jaw", [-palat-], meaning "palate", while the suffix [-schisis] means "to split". A split or separation of the lip, jaw, and the hard and soft palate.
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Laparotomy

The root term  [-lapar-] arises from the Greek word [λαπάρα] which means "flank or "loin"". It refers to the lateral region of the abdomen between the costal margin superiorly and the iliac crest inferiorly. In its pure etymological meaning the root term [lapar], as in "laparotomy" or "laparoscopy" should be used to denote a surgical action in only two of the abdominal regions, the right and left lumbar abdominal regions (or flank regions). The suffix [-otomy] originates from the Greek [τέμνω] (tomos) which means "to cut" or "to open".

The first modern use of the term [laparotomy] referring to "an abdominal incision" was in January, 1878 by Thomas Bryant, FRCS in his book "A Manual for the Practice of Surgery". This of course caused an upheaval with language purists, as a true laparotomy is a flank incision only. Nonetheless the meaning of the term as suggested by Bryant has been in use since. Today any abdominal incision is a laparotomy.

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Giovanni Domenico Santorini

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.

Giovanni Domenico Santorini
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Giovanni Domenico Santorini (1681 – 1737). Italian anatomist, Santorini was born in 1681 in Venice. The son of an apothecary, Santorini studied medicine at Bologna and Padua, receiving his doctorate in Pisa in 1701. He was appointed Public Professor of Anatomy at the Physicomedical College of Medicine when he was 22 years of age.

Santorini was praised for the clarity of his lectures and his dexterity as an anatomist.  He used magnifying glasses to study minute anatomical details, allowing him to clearly describe small structures hitherto unknown. Most of Santorini’s biographical data was written by Michael Girardi (1731 – 1797), one of his students. Girardi published Santorini’s work posthumously in 1775 in the book “Anatomici Summi-Septendecim Tabulae”.

Santorini’s himself wrote “Opuscula medica de structura” (Minute Medical Structures) in 1705. His most important book was “Observationes anatomicae”, published in Venice in 1724. One of the most interesting chapters in this book was “De mulierum partis procreationes datis” (Data on the female procreational structures ), making him a pioneer in the teaching of obstetrics. Santorini was physician to the Spedaletto (Hospital) of Venice, where he taught midwifery.

Santorini died in 1737 because of an infection he acquired during the dissection of a cadaver. At that time the rationale for infection and cadaver embalming were unknown.

With his posthumous publications, Santorini’s name and teachings became popular. Today his name is eponymically tied to several structures in the human body:

• Duct of Santorini: An accessory pancreatic duct that opens into a secondary duodenal papilla in the second portion of the duodenum
• Santorini’s valves: Mucosal folds found in the lumen of the primary duodenal papilla (of Vater) or hepatopancretic ampulla
• Santorini’s muscle: Risorius muscle • Santorini’s cartilages: The laryngeal corniculate cartilages
• Santorini’s veins: A plexus of vesicoprostatic veins found in the retropubic space) of Retzius
• Santorini’s concha: The superior nasal turbinate

Sources:
1. “The Dorsal Venous Complex: Dorsal Venous or Dorsal Vasculature Complex? Santorini’s Plexus revisited” Power NE, et al. BJU Inter (2011) 108: 930-932
2. “Giovanni Domenico Santorini: Santorini’s Duct” Edmonson, JM Gastrointest Endosc (2001) 53:6; 25A
3. "Santorini of the duct of Santorini" Haubrich, WS  Gastroenterol 120:4, 805
4. “Wirsung and Santorini: The Men Behind the Ducts” Flati, G; Andren-Sandberg, A. Pancreatology (2002)2:4-11
5. "A Historical Perspective: Infection from Cadaveric Dissection from the 18th to the 20th Centuries" Shoja, MM et al. Clin Anat (2013) 26:154-160


Conjoint tendon

The [conjoint tendon] (sometimes called the conjoined tendon] is the common tendinous attachment of the internal oblique muscle and the transverse abdminis muscle into the pubic tubercle. Some of these tendinous attachments extend also to the pectineal (Cooper's) ligament, the inguinal ligament, and the superior ramus of the pubic bone. In the classical anatomical description these tendons mix to the point that they cannot be separated one from the other, hence the term [conjoint tendon].

The conjoint tendon is important in open hernia repair, where some surgical techniques require the surgeon to pass a surgical needle and suture through this tendinous structure, to attach or close the gap between the conjoint tendon and the inguinal ligament.

In spite of being described in many anatomy books, a true "conjoint tendon" is only found in about 4% of the cases (varying from 3 to 6%, depending on the author). What is usually found are slightly tendinous discrete structures that attach to the pubic tubercle. Because of this,  Skandalakis, et al proposed to change the name to the "conjoined area". 

Sources:
1. "Le Tendon Conjoint: Memoire realise dans le cadre du certificat d'anatomie, d'imagerie et de morphogenese" Leroux, H. Universit? D' Nantes, 2005
2. "Hernia; Surgical Anatomy and Techniques" Skandalakis, J. et al. 1989 McGraw Hill
3. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain

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Hyaline

Horizontal section of the eye. Image modified from the original by Henry VanDyke Carter, MD. Public domain
Horizontal section of the eye

The word "hyaline" is a derivate of the Greek [υαλώδης] (yalódis) meaning "glassy". It refers to a glassy, transparent substance. Although it is usually associated with hyaline cartilage, this term can be used by itself in daily English.

Galen of Pergamon used the term [hyaloid] (glassy, or similar to glass) to refer to the vitreous humor of the eye. As a result of this early anatomical term, today we have the following:

• Hyaloid membrane: also known as the vitreous membrane. It is a collagenous membrane separating the vitreous humor from the rest of the structures of the eye
• Hyaloid artery: a branch of the opthalmic artery which dissapears before birth
• Hyaloid canal: a small membranous canal in the vitrous humor extending between the lens and the optic disc. This can be seen in the accompanying image of a horizontal section of the eye.

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. "The Origin of Medical Terms" Skinner, HA 1970 Hafner Publishing Co.
Image modified from the original by Henry VanDyke Carter, MD. in the book "Grays's Anatomy" by Henry Gray FRS. Public domain

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


Anular epiphysis

[Anular] means "ring" or "ring-shaped". The word [epiphysis] is composed of the preffix [epi-] meaning "outer" or "above", while [-physis] means "growth". The term [anular epiphysis] means the "outer ring-shaped growth".

The [anular epiphysis], sometimes also called the [anular apophysis], is a bony ring found on the superior and inferior aspect of the vertebrae.  This outer ring is formed by thickened cortical bone and leaves a central depression which has a more porous surface. In this central depression the vertebrae present with a thin layer of hyaline cartilage, which forms part of the vertebral endplate.

In a lateral view the presence of the anular epiphysis causes the superior and inferior borders of the vertebral body to protrude. This protrusion is called by some anatomists the "lips" of the vertebrae. To see these "lips" click here.

Image property of:CAA.Inc.Photographer:David M. Klein

Superior view of a thoracic vertebra

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