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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Conus medullaris

The conus medullaris is the lowest portion of the spinal cord, where it ends in a sharp cone at about the level of L1-L2. The conus medullaris continues inferiorly with a thin cord called the filum terminale (end thread) which attaches to the sacrum.

The fact that the spinal cord is shorter than the corresponding exit of the spinal nerves, causes the corresponding dorsal and ventral roots to create a structure that resembles a horse's tail inferior to the conus medullaris, called the cauda equina.

See the accompanying image. Click on the image for a larger version.

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

Spinal cord dissection, posterior view

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Johannes Veslingius


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.

Johannes Veslingius Mindanus (1598 – 1649). German surgeon, anatomist, botanist, and pharmacologist. Johann Vesling (mostly known by his Latinized name “Johannes Veslingius”) was born in a catholic family in Minden, Westphalia. He studied medicine in Leyden and Bologna. He later moved to the Venice medical college, where he became a professor of Anatomy in 1627. Veslingius had an interest in botany, which he pursued his whole life. Although German-born, Veslingius did most of his work and career in Italy. 

In 1628 he traveled to Egypt and Jerusalem as a personal physician of Alvise Cornaro, the Venetian consul in Cairo. In 1632 he became a professor of anatomy and surgery at the University of Padua, in Italy, forcing his return from Jerusalem. At Padua, Veslingius became part of the long list of anatomists that followed Andreas Vesalius’ position.

Veslingius was the first to describe the arterial circle of the brain, eponymically tied today to Thomas Willis, and he was the first to name the soleus muscle, as it resembles the sole fish. In his words: “soleus, a figura piscis denominatus” translated “soleus, named for its fish shape”. Apparently, he was also the first to describe the pancreatic duct which lead to controversy with Wirsung. Veslingius was also the first to describe the four pulmonary veins, described as four of the great vessels.

Johannes Veslingius in the front page of Syntagma Anatomicum. Image courtesy of the National Library of Medicine
Original image  courtesy of NLM  

Veslingius published his most important work, “Syntagma Anatomicum, publicis dissectionibus in auditorum usum diligenter aptatum”, in 1641. This work, which originally had no images, was republished in 1647 with full images in copper plates. This original work is important as it leaves the Vesalian tradition of posing the anatomical images with backgrounds and landscapes, dedicating the image solely to the anatomical information; in fact this is the first book to publish original images not copied or inspired from Vesalius’ Fabrica.  This book was the first to influence Japanese anatomy.

Incredibly, Veslingius was accused of murdering Johan Georg Wirsung (1589 - 1643) with whom he had academic conflicts. Veslingius was acquitted of the accusation, and the name of Wirsung is today eponymously attached to the pancreatic duct.

The accompanying image is from the “Syntagma Anatomicum” and shows Veslingius with the following Latin words around him: “Ioannes Veslingius Mindanus Eques Hieros In Patauino Gymnasio Anatom. et Phar. Profess. Primarius” translated as: Johannes Veslingius Mindanus, Knight of Jerusalem, Primary Professor of Anatomy and Pharmacology of the School of Padua.

Below the image you can read: “Talis Apollinea floret Veslingius Arte. Purpureus nives pectore fulget Honor”, translated as:  Veslingius flourishes by the art of Apollo who honors him by shining purple snow on his chest. Click on the image for a larger depiction and to see the Latin text.

Personal note: I am proud to have in my library catalog one of Veslingius’ original prints: “Tavole Anatomiche del Veslingio – Spiegate in Lingua Italiana” (Anatomical images from Veslingius, written in Italian), published in 1745 by Giovanni Battista Conzatti. Dr. Miranda

Original image  courtesy of NLM

Sources:
1. “The Fabric of the Body. European Tradition of Anatomical Illustration” Roberts KB, Tomlinson JDW (1992) Oxford: Clarendon.
2. “The evolution of anatomical illustration and wax modelling in Italy from the 16th to early 19th centuries” Riva, A. et al. J. Anat. (2010) 216, 209–222
3. “The Anatomical School of Padua” Porzionato, A. et al. Anat Rec (Hoboken). 2012 Jun; 295(6):902-16
4. “The Origin of Medical Terms” Skinner, HA. 1970 
5. "Johann Vesling (1598–1649):Seventeenth Century Anatomist of Padua and His Syntagma Anatomicum" SK Ghosh J Clin Anat 2014 Soon-to-be published

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Lacunar (Gimbernat's) ligament

The [lacunar ligament] is a half-moon shaped ligament that extends between the inguinal  ligament (Poupart's ligament) superiorly and the pectineal ligament (Cooper's ligament) inferiorly.  The lacunar ligament is at its narrowest at the point where the inguinal ligament and the pectineal ligament meet at the pubic tubercle where all three ligaments insert. The lacunar ligament is the medial boundary of the femoral ring.

The lacunar ligament was first described in 1765 by Don Antonio de Gimbernat y Arbós (1734 - 1816), who also described the importance of this ligament in the reduction of a strangulated femoral hernia.

In the anterior (open) approach to a strangulated femoral hernia, there is very little space at the femoral ring to enlarge it and allow reduction of the hernia contents. What Gimbernat did was to carefully cut the ligament from lateral to medial, enlarging the femoral ring and allowing reduction of the hernia. This was against the technique practiced at the time, which was to cut trough the inguinal ligament.

Lacunar (Gimbernat's) ligament
Image property of: CAA.Inc.Artist: David M. Klein
One of concerns when using this technique is the presence of the Corona Mortis, an anatomical variation in the area. Since the Corona Mortis is found posterior to the lacunar ligament, it can be unknowingly transected when repairing a femoral hernia from the anterior aspect.
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Cardiac base (contd.)

As previously described, the cardiac base is one of the surfaces of the heart, opposite to the cardiac apex.

The cardiac base is formed mostly by the left atrium, which is flanked by the four pulmonary veins. The thoracic esophagus is located posterior to the left atrium, separated from the heart only by the pericardium. This is important for a transesophageal echocarcardiogram (TEE) where there are only soft tissues between the esophageal transducer and the heart. In the accompanying image, two dotted lines show the approximate area of location of the thoracic esophagus.

Other structures that form the cardiac base are a segment of the posterior aspect of the ascending aorta, the superior and inferior vena cavae, and the posterior aspect of the right atrium.

Click on the image for a larger picture.

Human heart - Posterior view showing the cardiac base. P=posterior; S=superior;R=right;L=left; PV=pulmonary vein
Image property of: CAA.Inc. Photographer:David M. Klein
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-clast-

The root term [-clast] arises from the Greek [κλαστός / klastes] meaning "to break". The root term [-clast-] is used in medical terminology to mean "to destroy", or 'to break down". Variations of this term are the suffix [-(o)clasis] and the suffix [-(o)clasia].

A vernacular example of its use is in the word [iconoclast], meaning "to break down icons, images, or idols. Another great example comes from vulcanology (study of volcanoes). The word [pyroclastic] includes the prefix [pyro-] meaning "fire". It refers to a wall of hot gases and ashes spewed from a volcano moving up 450 miles per hour destroying and igniting everything in its path.

Examples of its use in medical terminology are:

• Osteoclast: The root term [-oste-] means "bone". A destroyer of bone
• Osteoclastocyte: The suffix [-(o)cyte-] means "cell". A better way to denote a cell that destroys or breaks down bone
• Osteoclasis: The action of osteoclastocytes

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-blast-

The root term [-blast] arises from the Greek [blastos] meaning "a germ", "seed" or "a sprout". The equivalent term in Latin is [germen], as in "germination". The root term [-blast-] is used in medical terminology to mean "germinative" and "to build". Because of the connotation of "seed" the term is widely used in embryology. Examples of its use are:

• Osteoblast: The root term [-oste-] means "bone". A bone germinative cell
• Odontoblast: The root term [-odont-] means "tooth". A tooth germinative cell
• Fibroblast: The root term [-fibr-] is used to mean "fiber", referring in this case to collagen and connective tissue. A cell that buils tissue with collagen fibers
• Fibroblastocyte: The suffix [-(o)cyte-] means "cell". A better way to denote a cell that buils tissue with collagen fibers

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