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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 will post a workweek daily medical or surgical term, its 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

Thomas Willis, MD
Thomas Willis
(1621-1675)

An English physician and anatomist, Willis was born on his parents' farm in Great Bedwyn, Wiltshire, where his father held the stewardship of the Manor. He was a kinsman of the Willys baronets of Fen Ditton, Cambridgeshire. He graduated M.A. from Christ Church, Oxford in 1642. In the Civil War years he was a royalist, and was dispossessed of the family farm at North Hinksey by Parliamentary forces. In the 1640's Willis was one of the royal physicians to Charles I of England. He obtained his medical degree in 1646.

Thomas Willis might well be one of the greatest physicians of the 17th century.He is one of the founders of the Royal Society of London. He is remembered by his many publications, especially "Cerebri Anatome: Cui accessit Nervorum Descriptio et Usu", where he describes the arterial anastomoses at the base of the brain. This work is also the first detailed description of the vasculature of the brain. Willis described nine cranial nerves.

He is considered as the father of Neurology as a discipline. He used the term "neurology" for the first time in 1664. He described several neurological conditions

The Arterial Circle of Willis is a famous eponymous structure found at the base of the brain. It represents an anastomotic roundabout that connects the right and left sides as well as the carotid and vertebral arterial territories that supply the brain. Named after Thomas Willis, this structure was known well before him, but it was Willis who described its function.  If you click on the image or here, you will be redirected to a detailed description of this structure.

Sources:

1. "The legendary contributions of Thomas Willis (1621-1675): the arterial circle and beyond" Rengachary SS et al J Neurosurg. 2008 Oct;109(4):765-75
2. "Thomas Willis, a pioneer in translational research in anatomy (on the 350th anniversary of Cerebri anatome)" Arraez-AybarJournal of Anatomy, 03/2015, Volume 226, Issue 3
3. " The naming of the cranial nerves: A historical review" Davis, M Clinical Anatomy, 01/2014, Volume 27, Issue 1
4. "Observations on the history of the circle of Willis". Meyer A, Hieros, R.Med Hist 6:119–130, 1962


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Bregma

The word [bregma] is Greek and means "the front of the head". It is actually the point of intersection of the the coronal and sagittal sutures. The coronal suture is the articulation or joint between the frontal and parietal bones, and the sagittal suture is the median joint between both parietal bones. 

The term was first used in anatomy as a craniometric point by Paul Broca (1824 - 1880). The image shows a superior view of two heads and the location of the coronal and sagittal sutures. The bregma is the point of intersection of these two articulations.

Click on the image for a larger view. 

Original image courtesy of Wikipedia

1 = coronal suture 2 = sagittal suture 3 = lambdoid suture. The bregma is the point of intersection of 1 and 2

1 = coronal suture 2 = sagittal suture 3 = lambdoid suture. The bregma is the point of intersection of 1 and 2


Marie-Francois Xavier Bichat


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.

Marie-Francois Xavier Bichat (1771 - 1802). French physician, surgeon, anatomist and physiologist, Marie-Francois Xavier Bichat was born in the village of Thoirette. His father was a physician, influencing his early instruction and vocation. In Lyon he studied anatomy and surgery. At 28 years of age Bichat was appointed physician to the Hôtel (Hospital) Dieu. His life was influenced by his mentor, Pierre-Joseph Dassault (1738 - 1795). Upon his mentor's death Bichat took upon him to continue and finish his work, while supporting his mentor's family.

Bichat is know for the concept of the body composed of distinct tissues, which he originally called "membranes". Without the aid of the microscope Bichat described 21 different tissues and is considered the founder of the science of histology. His name is preserved in many eponymic structures such as Bichat’s fossa (pterygopalatine fossa), Bichat’s buccal fat pad, Bichat’s foramen (cistern of the vena magna of Galen), Bichat’s ligament (lower fasciculus of the posterior sacroiliac ligament), and Bichat’s tunica intima (tunica intima vasorum). 

Xavier Bichat also contributed to a newer description of the humoral physiological theory, later becoming the basis of hematology. He was also interested in the description of life and death, proposing the existence of an "organic life" and an "animal life". An interesting note is that Bichat died because of an infection he acquired while dissecting a cadaver. Remember that at the time, no embalming was used!

Today Bichat's name is almost forgotten, although in some countries the buccal fat pad is still called "Bichat's fat pad" In many Spanish-speaking countries this structure is referred to as "la bola grasa de Bichat", and many still refer to the removal of this fat pad as "Bichectomy". For an image of the before and after of the procedure, click here.

Sources:
1. "Marie-Fran?ois Xavier Bichat (1771-1802) and his contributions to the foundations of pathological anatomy and modern medicine" Shoja M.M., Tubbs R.S., Loukas M., Shokouhi G., Ardalan M.R.(2008) Annals of Anatomy, 190(5),413-420
2. "Physiological Researches on Life and Death" Bichat, Marie-Francois Xavier, 1827. Translated from French by F. Gold. Richardson and Lord, Boston.
3. "A Historical Perspective: Infection from Cadaveric Dissection from the 18th to the 20th Centuries" Shoja, MM et al. Clin Anat (2013) 26:154-160 

Marie_Francois Xavier Bichat

Original image courtesy of
Images from the History of Medicine


Dacryocystolithiasis

This complex medical word is formed by the combination of two root terms: [dacry-] meaning "tear" and [-cyst-], meaning "sac". The combined root [dacryocyst-] means "tear sac" or better, "lacrimal sac" (the Latin word [lacrima] means "tear"). This medical word also has a combined suffix: [-(o)lith], meaning "stone", and [-iasis], meaning "disease or condition".

The word [dacryocystolithiasis] means then, "a condition or pathology of stones (calculi) in the lacrimal sac". The procedure to remove the stones would then be called a [dacryocystolithectomy].


Hamate

The Hamate bone is one of the four bones that comprise the distal row of the carpus or carpal bones that form the wrist. The name arises from the Latin [hamatus], meaning "hooked". The hamate bone has a distinct hook-like bony process in its volar (anterior) surface, known as the hamulus. This bone is also known as the "unciform bone" (from the Latin [uncus], also meaning "hook") or the os hamatum.

The lunate bone has a wedge-like shape and six surfaces (as a die). It articulates with five bones, including the lunate bone, capitate, triquetrum, and the fourth and fifth metacarpal bones.

The hook of the hamate bone is one of the distal boundaries of the carpal tunnel and serves as a pulley for the tendons of the fourth and fifth flexor tendons. It also serves as one of the points of muscular attachment for the following muscles: flexor carpi ulnaris, flexor digit minimi, and opponens digiti minimi. Because of its projection into the palm of the hand, the hamulus is involved in injuries in sports that require the athlete to use an accessory, as in racquetball, tennis, baseball, golf, etc.

The accompanying image shows the anterior (volar) surface of the wrist. Click on the image for a larger picture.

Scaphoid bone - anterior (volar) view of the wrist

Image modified from the original: "3D Human Anatomy: Regional Edition DVD-ROM." Courtesy of Primal Pictures

 


Phlebotomy

The word itself arises from the Greek. The root term [-phleb-] derives from [φλέβα] (phleba) meaning "vein", and the suffix [-otomy], meaning "to cut" or "to open". Let's not forget that the suffix component  [-y] means "process of". So [phlebotomy] is the "process (or action) of cutting open a vein"

For centuries a standard practice in medicine was to "bleed" a patient, by opening a vein under controlled conditions and letting some blood flow. The practice was known as "bloodletting" or phlebotomy. Not in use today, it is said that excessive bloodletting contributed to the death of George Washington, having removed 5 pints of blood in one day!. Today the professionals who draw blood are called "phlebotomists"

The image (circa 1860) depicts one of the only known three photographs of a bloodletting procedure. Observe the lack of aseptic technique.


Image by The Burns Archive, courtesy of Wikipedia.org.


Iliopubic tract

The iliopubic tract is a thickening of the transversalis fascia found in direct relation, immediately posterior to the inguinal (Poupart's) ligament. As the inguinal ligament, the iliopubic tract extends between the anterior superior iliac spine (ASIS) superolaterally, and the pubic tubercle inferomedially. 

This obscure structure has been brought up to light because it is one of the anatomical landmarks used in laparoscopic herniorrhaphy. When securing a mesh to reinforce the posterior abdominal wall, and also prevent mesh migration, the surgeon will place sutures, tacks, or staples in this structure. Since the iliopubic tract (posteriorly) and the inguinal ligament (anteriorly) are so close together, they are both secured when doing this procedure.

Inguinal ligamentImage property of: CAA.Inc.Artist: D.M. Klein
The image shows the location of the inguinal ligament. The iliopubic tract is immediately posterior to it.