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Jean George Bachmann
(1877 – 1959)
French physician–physiologist whose experimental work in the early twentieth century provided the first clear functional description of a preferential interatrial conduction pathway. This structure, eponymically named “Bachmann’s bundle”, plays a central role in normal atrial activation and in the pathophysiology of interatrial block and atrial arrhythmias.
As a young man, Bachmann served as a merchant sailor, crossing the Atlantic multiple times. He emigrated to the United States in 1902 and earned his medical degree at the top of his class from Jefferson Medical College in Philadelphia in 1907. He stayed at this Medical College as a demonstrator and physiologist. In 1910, he joined Emory University in Atlanta. Between 1917 -1918 he served as a medical officer in the US Army. He retired from Emory in 1947 and continued his private medical practice until his death in 1959.
On the personal side, Bachmann was a man of many talents: a polyglot, he was fluent in German, French, Spanish and English. He was a chef in his own right and occasionally worked as a chef in international hotels. In fact, he paid his tuition at Jefferson Medical College, working both as a chef and as a language tutor.
The intrinsic cardiac conduction system was a major focus of cardiovascular research in the late nineteenth and early twentieth centuries. The atrioventricular (AV) node was discovered and described by Sunao Tawara and Karl Albert Aschoff in 1906, and the sinoatrial node by Arthur Keith and Martin Flack in 1907.
While the connections that distribute the electrical impulse from the AV node to the ventricles were known through the works of Wilhelm His Jr, in 1893 and Jan Evangelista Purkinje in 1839, the mechanism by which electrical impulses spread between the atria remained uncertain.
In 1916 Bachmann published a paper titled “The Inter-Auricular Time Interval” in the American Journal of Physiology. Bachmann measured activation times between the right and left atria and demonstrated that interruption of a distinct anterior interatrial muscular band resulted in delayed left atrial activation. He concluded that this band constituted the principal route for rapid interatrial conduction.
Subsequent anatomical and electrophysiological studies confirmed the importance of the structure described by Bachmann, which came to bear his name. Bachmann’s bundle is now recognized as a key determinant of atrial activation patterns, and its dysfunction is associated with interatrial block, atrial fibrillation, and abnormal P-wave morphology. His work remains foundational in both basic cardiac anatomy and clinical electrophysiology.
Sources and references
1. Bachmann G. “The inter-auricular time interval”. Am J Physiol. 1916;41:309–320.
2. Hurst JW. “Profiles in Cardiology: Jean George Bachmann (1877–1959)”. Clin Cardiol. 1987;10:185–187.
3. Lemery R, Guiraudon G, Veinot JP. “Anatomic description of Bachmann’s bundle and its relation to the atrial septum”. Am J Cardiol. 2003;91:148–152.
4. "Remembering the canonical discoverers of the core components of the mammalian cardiac conduction system: Keith and Flack, Aschoff and Tawara, His, and Purkinje" Icilio Cavero and Henry Holzgrefe Advances in Physiology Education 2022 46:4, 549-579.
5. Knol WG, de Vos CB, Crijns HJGM, et al. “The Bachmann bundle and interatrial conduction” Heart Rhythm. 2019;16:127–133.
6. “Iatrogenic biatrial flutter. The role of the Bachmann’s bundle” Constán E.; García F., Linde, A.. Complejo Hospitalario de Jaén, Jaén. Spain
7. Keith A, Flack M. The form and nature of the muscular connections between the primary divisions of the vertebrate heart. J Anat Physiol 41: 172–189, 1907.
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The adjectival term [epiploic] arises from the Greek term [επίπλουν] (pronounced “epiploun”) which is synonymous with the Latin term [omentum], referring to two abdominal peritoneal membranes, the lesser omentum and the greater omentum. For more information on the word [omentum] click here.
The word itself is used in Greek in the expression [επιπλέουν πάνω] (epiploun pano) which means “to float upon”, referring to the fact that the fatty omental apron “floats” or “drapes” upon the abdominal viscera. Hippocrates of Cos (460 BC - 370 BC) referred to the greater omentum as epiploon. This anatomical name evolved towards the Latin version, which is used today. In spite of this there are other languages where the Greek root is still used. As examples, in Spanish the terms are “epiplón mayor” and “epiplón menor”, and in French they are “grand epiploon” and “petit epiploon”.
Because of the presence of fat in the greater omentum, the medical adjectival term [epiploic] has also evolved to mean “fatty”, such as in the case of the epiploic appendages, a series of fatty appendages found in the colon.
Images property of:CAA.Inc.. Photographer:D.M. Klein
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Aaron Ruhalter, MD, FACS
I am sad to let everybody know that Dr. Ruhalter passed on yesterday January 25th, 2016. A good friend, guide, and mentor, Dr. Ruhalter was always reminding me to keep on using drawings and sketches to teach human anatomy, a subject he loved, and at which he excelled. I will miss him dearly. May he rest in peace. Dr. Miranda
Dr. Aaron Ruhalter was for many years the Executive Director of Medical Education at the Johnson & Johnson Endo-Surgery Institute in Cincinnati. Dr. Ruhalter is a Professor of Anatomy and a former Professor of Surgery at the Robert Wood Johnson Memorial Hospital in New Jersey. He was also one of the founding members of the American Association of Clinical Anatomists (AACA).
His review on the surgical anatomy of the parotid gland, submandibular triangle, and floor of the mouth is outstanding. This review was published in 1997 in the book "Mastery of Surgery", third edition, by Drs. Lloyd M. Nyhus, Robert J. Baker, and Josef E. Fischer.
Dr. Miranda worked with Dr. Ruhalter for several years, both at the Endo-Surgery Institute and at the University of Cincinnati College of Medicine. The picture above shows both of them preparing an anatomy blackboard session at the Institute, back in 1994.
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Refers to the internal lining of an artery or a vein. The tunica (layer) intima is composed of an inner layer known as endothelium (inner fabric or inner layer) and a subendothelial layer.
Also known as the [tunica intima vasorum], Latin for intimal (inner) layer of the vessels, the tunica inima is also known as "Bichat's tunic"
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The term [bruxism] arises from the Greek [βρυγμός] (vrygm?s), meaning “a gnashing of the teeth”, or “bruxism”.
Bruxism is usually a subconscious problem, presenting most of the times at night while the individual is asleep, and does not continue into the waking hours. In some people bruxism does continue into the day and the person is constantly gnashing the teeth, but not conscious of the activity. Awake bruxism is sometimes called [bruxomania].
Bruxism is usually idiopathic (of unknown origin) or it can be secondary to other medical conditions.
Patients with bruxism usually present with damage to the teeth by the constant attrition of the teeth by laterally grinding of the teeth of the maxilla against the teeth of the jaw. This can lead to severe tooth damage with exposure of the dentin through and absent, fractured, or damaged enamel. A secondary problem is misalignment of the teeth. The accompanying image shows misalignment and tooth damage.
Note: The links to Google Translate include an icon that will allow you to hear the pronunciation of the word.
Image by DRosenbach (en:Image:Deviated midline.JPG) [Public domain], Wikimedia Commons
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Abdominal regions
The transtubercular plane (also called the transtubercular line) is one of the surface reference lines used in surface anatomy and surgery to delineate the abdominal regions.
It is a horizontal or transverse plane that passes through the iliac tubercles, small elevations found in the iliac crest of the iliac bone. These tubercles can be palpated in a thin person, but their location can be approximated if you take the distance between the transpyloric plane and the superior aspect of the pubic symphysis and divide it in half.
The transtubercular plane marks the location of the body of the fifth lumbar vertebra and the location of the confluence of both common iliac veins to form the inferior vena cava.
Sources:
1. "Clinical Anatomy" Brantigan, OC 1963 McGraw Hill
2. "Tratado de Anatomia Humana" Testut et Latarjet 8th Ed. 1931 Salvat Editores, Spain
3. Davis, Gwilym G. "Applied Anatomy: The Construction of the Human Body Considered in Relation to Its Functions, Diseases, and Injuries"; Philadelphia: J.B. Lippincott Co., 1910
Image modified from the original Davis, 1910
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UPDATED: If you came to this article directly, you should probably start reading the first one here: "The landscape panorama of Vesalius' muscle men (1)", then come back.
I had always looked at these panorama images as only one, the one that is formed by the anterior views (and one lateral view) of the muscle men plates which I shared with you in the first article. The image in the first article is what Harvey Cushing (1943) called the "eight-series". It was not until my friend Pascale Pollier sent me an interesting BBC article that I looked at the panorama formed by the posterior view images of the muscle men, called by Cushing the "six-series". After some work with original images that I own, I made the image shown here. If anything this panorama is even better!To see Cushing's original template click here.
In the enlarged version that appears when you click on the image on this article you can see how some houses' roofing and arches are shared between plates. Towards the right side of this panorama you can clearly see a meandering stream that passes through several plates. Another incredible fact of this masterpiece by Jan Stephan Van Calcar (the artist) and Andrea Vesalius (the anatomist).
The image shown here was done using original images from Vesalius’ Fabrica and composed using Adobe Fireworks CS5. Click on the image for a larger depiction. The larger image is 1800px wide.
Sources:
1. “A New View of the Vesalian Landscape” Cavanagh, GST Med Hist 1983, 27: 77-79
2. “The Panorama of Vesalius: A 'Lost' Design From Titian's Studio” Skandalakis, JE JAMA May 28, 1997, Vol 277, No. 20
3. “A Drawing for the Fabrica; and some Thoughts Upon the Vesalius Muscle-Men” Kemp. M. Med Hist. Jul 1970; 14(3): 277–288
4. “Andreas Vesalius: The Making, the Madman and the Myth” Joffe, SN. Persona Publishing 2009
5. "A Bio-Bibliography of Andreas Vesalius" Cushing, H. (1943) Schumann's