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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Angiogram

The root term [-angi-] has Greek origins and means "vessel", as in a "container". The suffix [(o)gram] means "examination of", or a "record". An angiogram is the examination of a vessels using some type of viewing or recording device.

In an angiogram the physician will inject radiopaque contrast to make the vessels discernible in an X-ray machine.

The accompanying image is an angiogram of the right coronary artery. It can also be called a "coronariogram".

Right coronary artery angiogram
The image shows the right coronary artery and three key branches: the acute marginal artery, the posterolateral artery, and the posterior interventricular artery (PDA). Click on the image for a larger depiction. 
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Acute margin

The "acute margin" refers to the anteroinferior border of the heart. It is also known by its Latin name [margo acutus].

The name of this border or margin of the heart is quite descriptive. If you observe the angle formed between the anterior or sternocostal surface of the heart with the posterior or diaphragmatic surface of the heart, you can see that the angle between these two surfaces is less than 90 degrees, therefore an "acute" angle. The corresponding border between these two surfaces has to be called the "acute margin"!

In relation to the acute margin of the heart there is usually found one of the longest branches of the right coronary artery. This artery that runs alongside the acute margin, is the "acute marginal artery", In an angiogram, this artery clearly depicts the anteroinferior border of the heart.

Click on the image for a larger depiction. Here is a link to the article on the "obtuse margin" of the heart.

Acute margin of the heart. SVC= Superior vena cavaImage property of: CAA.Inc.Artist: Victoria G. Ratcliffe
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Posterolateral artery

The posterolateral artery, also known as the "retroventricular artery" is one of the two terminal branches of the right coronary artery. The other terminal branch is the posterior interventricular artery or PDA. This artery presents with many variations, from being absent to extremely long arteries with extensive branching that take some of the territory of the circumflex artery. The posterolateral artery extends from the crux cordis to the left side of the heart in the atrioventricular sulcus.

The AV node artery, which provides blood supply to the AV node (a component of the conduction system of the heart) may arise from the posterolateral artery instead of arising from the right coronary artery or the posterior interventricular artery.

When present, the posterolateral artery provides some posterior left ventricular branches and maybe some posterior left atrial branches. See the accompanying image, you may click on the image for more information. The image depicts a posterolateral artery slightly longer than usual.

Posteroinferior view of the heart. IVC=inferior Vena CavaImage property of: CAA.Inc. Photography: Efrain Klein

 
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Sir William Osler


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.
Sir William Osler (1849-1919). William Osler was born in Bond Head, Canada, in what today is known as Ontario, of English parents. He started his college studies to become a minister, but realizing his true vocation was in medicine, he entered the Toronto School of Medicine, earning his medical degree in 1872.

Osler completed postgraduate studies in Europe, returning as a Professor at the McGill University. In 1884 he moved to Philadelphia to the University of Pennsylvania. In 1889 he left to become Physician-in-Chief and one of the founders of the newly-built John Hopkins hospital. His contributions to this new hospital and the American medical education are innumerable. Dr. Osler initiated the residency programs used today, as well as the programs of third and fourth year medical students in bedside patient rounds.

A prolific writer, Dr. Osler penned over 1,500 articles, monographs, and books, some of which are famous. His “Principles and Practice of Medicine” was published for a record 17 editions and 76 years (1892 -1968)! One of his most famous addresses is “Aequanimitas”, which he delivered when leaving the University of Pennsylvania.

Sir William Osler
Original image courtesy of "Images from the History of Medicine" at  www.nih.gov
In 1905 Dr. Osler accepted the position of Royal Chair of Medicine at Oxford, in England, and in 1911 he was awarded the title of “Sir William Osler”.

Personal Note: In June 1999, I had the opportunity to visit the collection of the John Martin Rare Book Room at the University of Iowa Medical School. I was allowed to read and handle original copies of the Fabrica and the Epitome by Vesalius as well as other original and rare medical books, including De Muto Cordis, by William Harvey. The books I had the opportunity to review were placed on an antique desk that belonged to Sir William Osler. A moment that has stayed with me, as it was the confluence of great individuals: Andreas Vesalius, the anatomist; William Harvey, the physiologist, and Sir William Osler, the medical educator. Dr. Miranda

Sources:
“Sir William Osler, M.D., C.M.” Sarik, J. Yeo, Ch.Pinckney J. The American Surgeon78.4 (2012): 385-7.
“Sir William Osler and gastroenterology” Chaun H. Can J Gastroenterol (2010) 24:10 615-618
“Sir William Osler (1849-1919)” Haas, LF J Neurol Neurosurg Psychiatry 1999 67: 137
“Sir William Osler (1849-1919)”Christian, HA Proc Amer Acad Arts Sci (1922) 496-499

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Coarctation

Of Latin origin, the word [coarctatio] means "to press together", or to confine. It is used as a synonym with "stricture" or "stenosis".

The term [coarctation] is used today used mostly to describe a narrowing, stricture, or stenosis of blood vessels, such as "coarctation of the aorta"

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Pisiform

The pisiform bone is one of the four bones that comprise the proximal row of the carpus or carpal bones that form the wrist. It is the smallest of the carpal bones, is spheroidal in shape, and presents with only one articular surface (see image).

Its name originates from the Latin [pisum], meaning "pea". It is also known as "os pisiforme" or "lentiform bone", because some feel it is shaped like a lentil.

The pisiform bone articulates posteriorly with the triquetrum, and has on its anterior (volar) surface attachments to the transverse carpal ligament, and to the Abductor Digiti Quinti, and Flexor Carpi Ulnaris muscles.

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

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Scaphoid bone - anterior (volar) view of the wrist

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