The term [scalpel] arises from the Latin word [scalpellum], meaning “a small knife”. Celsus (c.25BC - c.50BC) in De Re Medicina, uses the term [scalpellus] to refer to a surgeon’s knike.

The use of knives in Medicine is very old. 10,000 year old Mesolithic skulls have been found with craniotomies made with flint stone knives. The first one to describe surgical knives in recorded history was Hippocrates of Cos (460 BC - 370 BC).

Surgical knives were developed in a multitude of shape and forms, some of them veritable works of art. These scalpels were made by cutlery makers on demand by surgeons and had a fixed blade that had to be sharpened constantly, as surgery requires a very sharp blade.

The invention of the disposable razor by King Gillette in 1904 changed this. In 1910, Dr. John Benjamin Murphy (1857 – 1916) invented a handle that could hold a single-sided or a double-sided safety razor blade.

The design was improved by the invention of a disposable, sterilized surgical blade that could be easily installed on a reusable, sterilizable metal handle. Today sterile, disposable handle-blade combination scalpels of varying shapes and sizes are available, ensuring the surgeon the sharpest scalpel every time.

Sources
1. “The surgical knife” Ochsner J. Tex Heart Inst J. 2009; 36(5): 441–443
2. "History of the Surgical Blade" Shuja, A. Indep Rev Oct-Dec 2012;14(10-12)
3. "Masters of the Scalpel: The History of Surgery"" Riedman SR, R MacNally 1962  
Images courtesy of Wikipedia

    Different scalpel models

The [ureters] are two long, thin, bilateral muscular tubes that extend from the pelvis of the ipsilateral kidney to the posteroinferior aspect of the urinary bladder. The ureters are retroperitoneal structures and their function is the transport of urine between the kidney and the urinary bladder.

The word arises from the Greek [ουρητήρ], meaning "urinary duct". The term was originally used to denote both the urethra (in its singular form) and the ureters (in its plural form). Because of the problems using the term, the word [urethra] was created.

The ureter is composed of three layers: a mucosa, a thick muscular layer, and an adventitia. The muscular layer is itself composed of an deep longitudinal layer and a superficial circular layer formed by spiral smooth muscle fibers. In the distal portion of the ureter there is a third layer added to the ones mentioned, a thick longitudinal layer that extends into the walls of the urinary bladder. Since the ureter is a retroperitoneal organ, in the areas where the ureter is in contact with the parietal peritoneum, it can be said that the ureter presents with a fourth layer. The muscular construction of the ureters in layers allows for peristalsis that helps the flow of urine.

    Longitudinal section of a kidney. 1-Renal pyramid, 3-Renal artery, 4-Renal vein, 5-Renal hilum, 6-Renal pelvis, 7- Ureter, 8-Minor calyx, 9-Renal capsule, 14-Minor calyx, 15- Major calyx, 16-Renal papilla, 17-Renal column .

In its trajectory the ureters descend anterior to the psoas major muscle, pass over the pelvic brim, just anterior to the origin of the internal iliac artery, then hug the lateral pelvic wall and enter the urinary bladder from a posteroinferior aspect. As it descends the ureters receive blood supply from different arteries: renal arteries, gonadal (testicular or ovarian) arteries, aorta, common iliac arteries, and the inferior vesical arteries. The ureters also receive sympathetic and parasympathetic innervation from the autonomic nervous system renal plexus.

Sources
1. "Gray's Anatomy"38th British Ed. Churchill Livingstone 1995
2. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
3. "The origin of Medical Terms" Skinner, AH, 1970
4. "Histology; a Text and Atlas" Ross MH 3rd Ed. Williams and Wilkins 1995
Images courtesy of Wikipedia

The root term [-mamm-] arises from the Latin [mamma] (Pl. mammae), meaning "breast".  The synonymous term [-mast-] arises from the Greek. This prefix is used in medical terms such as:

• Mammal: An animal with breasts or that feeds trough breast milk

• Mammary: Pertaining to the breast

• Mammoplasty: The suffix [-(o)plasty] is used to mean "surgical reshaping". Surgical reshaping of the breast. Can also be referred to as a mastoplasty

• Mammogram: The suffix [-(o)gram] means "to record", or "to write". The results of a breast examination, usually a film obtained with imaging technology

• Mammography: The suffix [-(o)graphy] means "to record", or "to examine". A breast examination, usually with imaging technology

Image property of: CAA.Inc. Photography: Efrain Klein

• Mammillary processes: Also known as the mammilary tubercles. These are small bony processes found in the transverse processes of the lumbar vertebrae

In 1846, Morton was able to successfully and painlessly extract a tooth from a patient under ether administration. To this effect he used an ether inhaler of his own invention that he called “Letheon”. This led to his now-famous demonstration of the use of ether as an anesthetic on October 1846 at the Massachusetts General Hospital. This is the first-ever recorded use of anesthesia as a way to reduce or eliminate pain in surgery, one of the revolutions in surgery, the other being Lister’s antiseptic technique.

Morton tried, unsuccessfully, to establish a patent on his discovery against Horace Wells (1815 – 1848). The litigation costs led him to poverty and he died with no money on 1868.

Sources
1. “William Thomas Green Morton (1819-1868” Keys. TE. Anesth and Analg (1973) 52: (2) 166
2. ” Morton, dentist, who first publicly demonstrated ether anesthesia; a short biography” Archer WH, William TG. J Am Dent Assoc. 1946 Dec 1;33(23):1528-32
3. “Horace Wells: Discoverer of Anesthesia” Jacobsohn PH. Anesth Prog (1995) 42:73-75
4. “The last days of William Thomas Green Morton” Vandam LD J Clin Anesth (1996) Sep;8(6):431-4334

A [lung] is one of the two main respiratory organs. It is an organ filled with minute air sacs or alveoli, giving its parenchyma the look and feel of a spongy tissue. Its function is the reoxygenation of blood.

Each lung is located on each side of the thoracic cavity, each one surrounded by a serosa membrane called "pleura". The pleura forms a sac that surrounds the lung and also lines the thoracic wall. The pleura that lines the thoracic wall is called "parietal pleura", while the pleura that lines the lung is called the "visceral pleura". An extension of the visceral pleura inferior to the pulmonary hilum forms the pulmonary ligament.

A lung has three surfaces and an apex. The inferior surface, base, or diaphragmatic surface; the medial surface or mediastinal surface, as if forms the lateral wall of the mediastinum; and the lateral or costal surface.

The lungs are also divided into lobes. The right lung has three lobes: superior, middle, and inferior while the left lung only has two lobes: superior and inferior. Because the heart has a left-sided tilt the left lung is slightly smaller than the right lung.

There are four structures that enter or leave the lung and they are found at the pulmonary hilum in the medial surface of the lung. These structures are: the main or primary bronchus, the pulmonary artery, and two pulmonary veins.

When examined, a lung will show the impressions of the organs that are in contact with it. Click on the accompanying image and you will be able to see the impressions left by the aorta and the heart

The medical word [atheroma], has the root term [-ather-] arising from the Greek [ath?ra] meaning "gruel", "porridge", or "groats". This refers to the consistency of the content of a soft atheromatous plaque. The suffix [-oma] means "mass", "growth" or "tumor". A mass of soft gruel-like substance. The plural form for atheroma is [atheromata].

An atheroma is abnormal edema and accumulation of cholesterol and fatty acids with varying amount s of macrophages, fibroblasts and connective tissue in the tunica intima of an artery. It is usually covered by a “cap” of thicker, drier, yellowish fibrous material. An atheroma is a cavity filled with a fatty gruel-like material covered by a cap. Atheromatous disease is characterized by a large number of these masses in the walls of the arteries of a patient.

The cap in an atheroma can be dislodged by the arterial blood flow in which case the content of the atheroma is emptied into the bloodstream becoming a fatty embolus. Since arteries become arterioles and then capillaries, this fatty embolus will flow distally to the point where it will lodge, blocking blood flow.

WARNING: The image of the pathology in this article is quite descriptive

The accompanying image is a clear depiction of this situation. This is a superior view of the ascending aorta. The patient in this case had an artificial aortic valve implanted and the aortotomy performed for the procedure is also indicated. The patient also had three coronary bypass grafts, one of which was clogged or non-patent. There are at least two atheromata with the cap still on. The image also shows at least one atheroma empty. This indicates that the content of the atheroma became a fatty embolus. Click on the image for a larger depiction.