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 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

Self-portrait, Henry Vandyke Carter, MD (Public Domain)
Self-portrait, Henry Vandyke Carter, MD (Public Domain)

Henry Vandyke Carter, MD
(1831 – 1897)

English physician, surgeon, medical artist, and a pioneer in leprosy and mycetoma studies.  HV Carter was born in Yorkshire in 1831. He was the son of Henry Barlow Carter, a well-known artist and it is possible that he honed his natural talents with his father. His mother picked his middle name after a famous painter, Anthony Van Dyck. This is probably why his name is sometimes shown as Henry Van Dyke Carter, although the most common presentation of his middle name is Vandyke.

Having problems to finance his medical studies, HV Carter trained as an apothecary and later as an anatomical demonstrator at St. George’s Hospital in London, where he met Henry Gray (1872-1861), who was at the time the anatomical lecturer. Having seen the quality of HV Carter’s drawings, Henry Gray teamed with him to produce one of the most popular and longer-lived anatomy books in history: “Gray’s Anatomy”, which was first published in late 1857.  The book itself, about which many papers have been written, was immediately accepted and praised because of the clarity of the text as well as the incredible drawings of Henry Vandyke Carter.

While working on the book’s drawings, HV Carter continued his studies and received his MD in 1856.

In spite of initially being offered a co-authorship of the book, Dr. Carter was relegated to the position of illustrator by Henry Gray and never saw the royalties that the book could have generated for him. For all his work and dedication, Dr. Carter only received a one-time payment of 150 pounds. Dr.  Carter never worked again with Gray, who died of smallpox only a few years later.

Frustrated, Dr. Carter took the exams for the India Medical Service.  In 1858 he joined as an Assistant Surgeon and later became a professor of anatomy and physiology. Even later he served as a Civil Surgeon. During his tenure with the India Medical Service he attained the ranks of Surgeon, Surgeon-Major, Surgeon-Lieutenant-Colonel, and Brigade-Surgeon.

Dr. Carter dedicated the rest of his life to the study of leprosy, and other ailments typical of India at that time. He held several important offices, including that of Dean of the Medical School of the University of Bombay. In 1890, after his retirement, he was appointed Honorary Physician to the Queen.

Dr. Henry Vandyke Carter died of tuberculosis in 1897.

Personal note: Had history been different, this famous book would have been called “Gray and Carter’s Anatomy” and Dr. Carter never gone to India. His legacy is still seen in the images of the thousands of copies of “Gray’s Anatomy” throughout the world and the many reproductions of his work available on the Internet. We are proud to use some of his images in this blog. The image accompanying this article is a self-portrait of Dr. Carter. Click on the image for a larger depiction. Dr. Miranda

1. “Obituary: Henry Vandyke Carter” Br Med J (1897);1:1256-7
2. “The Anatomist: A True Story of ‘Gray’s Anatomy” Hayes W. (2007) USA: Ballantine
3. “A Glimpse of Our Past: Henry Gray’s Anatomy” Pearce, JMS. J Clin Anat (2009) 22:291–295
4. “Henry Gray and Henry Vandyke Carter: Creators of a famous textbook” Roberts S. J Med Biogr (2000) 8:206–212.
5. “Henry Vandyke Carter and his meritorious works in India” Tappa, DM et al. Indian J Dermatol Venereol Leprol (2011) 77:101-3

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Lumbar vertebra

The lumbar region of the spine is composed by five lumbar vertebrae. Although sharing characteristics common to all vertebrae, a lumbar vertebra can be differentiated by the following:

• The vertebral body is large, tall, and when viewed from superior, the vertebral body has a longer transverse diameter and a shorter anteroposterior diameter. Most anatomists describe the vertebral body as being “kidney-shaped”. The massiveness of the vertebral body is due to the larger weight that each consecutive vertebra has to bear in the lumbar region. Because of this, lumbar vertebrae have larger anular epiphyses, and the vertebral body is hourglass-shaped with a “waist”.  As with other vertebrae, the body of a lumbar vertebra has vertebral endplates, nutritional foramina, and in its posterior aspect they present with basivertebral foramina.

• The pedicles in the lumbar vertebrae are larger, course in a mostly anteroposterior direction, and have a oval cross-section where the superoinferior diameter is longer and the transverse diameter is shorter. This is important for transpedicular procedures for vertebroplasty or kyphoplasty.

• The transverse processes are also larger than other vertebrae. Of interest are the facts that the transverse process of the third lumbar vertebra is the longest of all lumbar vertebrae and that the transverse process of the fifth lumbar vertebra courses superolaterally at an angle of  almost 45 degrees because of the presence of the strong iliolumbar ligament. The lumbar transverse processes have a small tubercle called the mammillary process.

• The lumbar spinous processes are large and have a square shape.

Again, because of the larger weight bearing capacity of the lumbar vertebrae, they have strong ligaments and their zygapophyseal joints and articular facets tend to be oriented with their surfaces in a transverse plane. This has two consequences: The rotational mobility of the whole lumbovertebral region is limited and they tend not to have anteroposterior displacement.

Lumbar vertebra - lateral view
Lumbar vertebra - Lateral view.

Lumbar vertebra - inferior view
Lumbar vertebra - Inferior view.

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

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