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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William S. Halsted, MD
(1852 – 1922)
American anatomist, teacher, and surgeon, William Stewart Halsted was born in New York City, USA to a wealthy family of English origin. His father was involved in charitable work and Governor and trustee to a city hospital. Not a brilliant student initially, Halsted took an undergraduate in Liberal Arts in Yale, CT., after which he entered the Medical College of Physicians at the Columbia College, where he excelled.
As a second-year medical student Halsted applied and obtained a position in surgery at a local hospital. In here he learned about Lister’s antiseptic technique and became an adamant proponent of it to reduce infection. In 1877 Halsted obtained his MD. After a short time as House Physician at the New York Hospital, Halsted traveled to Europe to further his education studying for two years at the Universities of Vienna, Leipzig, and W?rzburg.
Besides being at the forefront of surgical and antiseptic techniques (introducing the use of rubber gloves in surgery), Halsted was extremely concerned with the way medical students were taught in the US. He pioneered bedside clinical round discussions with the medical students after two years of basic sciences studies. Halsted developed the idea of a patient chart; he also developed the residency program for medical students in use today.
Halsted is probably the most influential researcher and surgeon at the turn of the century. He dedicated time to the study of intestinal anastomoses and the use of silk as a suture material. His experimental work in 1887 proved that the inclusion of the submucosa layer in an anastomosis was mandatory, as well that a single layered anastomosis was enough to attain closure. Perhaps Halsted’s most important contribution was the application and use of the scientific method to surgical questions. Halsted’s principles set the standards used today in surgical suturing and surgical stapling.
He also pioneered the development and surgical techniques for radical mastectomy as a treatment for breast cancer.
As a side effect of this studied in anesthesia and the use of cocaine for anesthesia, Halsted became addicted to this substance, a problem that followed him through the years. Without impairing his capacity as a researcher and a surgeon, Halsted eventually recovered. He died in Baltimore in 1922 as a complication to surgery.
Sources:
1. Dubay, A. D., & Franz, G. M. (2003). Acute Wound Healing: The Biology of Acute Wound Failure. Surg Clin NA, 83, 463-481.
2. Halsted, W. S. (1887). Circular Suture of the Intestine - An Experimental Study. Am J Med Sci, 436-461.
3. “William Stewart Halsted: his life and contributions to surgery” Osborne, P. Lancet Oncol 2007; 8: 256–65
4. “William Stewart Halsted: Surgical pioneer” Burress, P Endoc Today (2010), 8: (2) 22
5. “William Stewart Halsted (1852–1922) Neurological stamp” Haas, LF J Neurol Neurosurg Psych 2000;69:641
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UPDATED: The brachiocephalic trunk (also known as the brachiocephalic artery) is the first branch that arises from the aortic arch. It is a short branch (1.2 - 1.5 cm in diameter and 2.8 - 3.5 cm in length)1 that ascends superiorly and to the right. It divides just posterior to the right sternoclavicular joint giving origin to the right common carotid artery and the right subclavian artery. The brachiocephalic trunk is a non-paired structure, as there is no contralateral homonymous structure. On the left side the left common carotid and the left subclavian arteries arise directly from the aortic arch.
The term brachiocephalic is mixed, formed by the Latin root [-brachi-] meaning "arm", the Greek root [-cephal-] meaning "head", the combining form '"o", and the adjectival suffix "ic". The brachiocephalic trunk provides oxygenated blood to the right side of the head and right upper extremity.
There is a common mistake perpetuated in many books. Many call this structure the "innominate artery". The term [innominate] means "without a name", and it does have one: brachiocephalic trunk. The aortic arch and its branches have many potential anatomical variations.
1. "Tratado de Anatomía Humana" Testut & Latarjet 8 Ed. 1943 Salvat Editores, Spain
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UPDATED: The choroid plexuses are highly vascular structures situated in the ventricular system of the brain. They are formed by convoluted capillaries surrounded by modified ependymal cells. The choroid plexuses are responsible for the constant formation of the cerebrospinal fluid (CSF), as well as part of the blood-brain barrier, which in this case should probably be called the blood-CSF barrier.
The choroid plexuses are found in each ventricle of the brain. The accompanying image shows a dissection of a human brain where the frontal, parietal, and occipital lobes, as well as the corpus callosum have been removed to expose the lateral ventricles. The trigone has been transected and reflected posteriorly and the choroid plexuses can be seen as a cluster of grape-like longitudinal masses in each lateral ventricle.
Choroid plexuses form when three elements come in contact within the brain: pia mater, ependymal epithelium, and blood vessels. This only happens in the ventricular system of the brain.
The etymology (word origin) of the term [choroid] is a bit complicated. The suffix [-oid] means "similar to", while the root term [chor-] derives from the Greek word [χορίου] pronounced (joríu), meaning "dermis", "skin", or "membrane". The reason for the use of this term is that the Greek used the term "membrane" referring to the highly vascularized membranes that invest a fetus.
The term "plexus" means a "mesh", so the term [choroid plexuses] means "similar to the vascular membranes that invest a fetus"
Sources:
1. "Medical Meanings, A Glossary of Word Origins" Haubrich, W.S. 1997. American College of Physicians, Philadelphia, PA.
2. "Elementos de Neuroanatomia" Fernandez, J.; Miranda, EA.
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The term is formed by the prefix [ento- or -intu] from the Latin word [intus], meaning "within" and the Latin root term [-susscept-] meaning "to take, receive". In this usually intestinal pathology a proximal intestinal segment "pushes in" or is "taken in" by a distal segment. Because of adhesions or inflammation, an intestinal obstruction can ensue. This pathology can escalate causing localized ischemia and even necrosis with the potential of intestinal perforation. Intussuception is more prevalent in the ileocolic region and is the most common cause for intestinal obstruction in children aged 3 months to 6 years.
In an intussuscepted segment, there are two components: the intussusceptus (A), that is the proximal segment that protrudes into the distal segment; and the intussuscipiens (B), which is the distal segment, receiving the intussusceptus.
In the accompanying image, the arrow indicates direction of flow.
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The [scapula] is a flat, triangular bone that forms the posterior portion of the shoulder girdle. It is described with two surfaces, three borders, and three angles. The scapula attaches to the clavicle by way of the acromioclavicular joint and ligaments. Seventeen muscles attach to the scapula providing stability and movement to the upper extremity.
The scapula has three well-defined borders. The medial border (vertebral border) is slightly convex. The superior border has a notch, the scapular notch, and a bony protuberance called the coronoid process. Where the superior and the lateral border (axillary border) meet there is a bony protuberance (the glenoid process) which has a shallow depression (the glenoid cavity), site of the glenohumeral joint or shoulder joint. Also, the lateral border presents with a small bony process just inferior to the glenoid process, the infraglenoid tubercle.
The scapula has two well-defined angles, the inferior and the superior angle, while the lateral angle is less defined because of the presence of the glenoid process.
The surfaces or the scapula are the anterior and posterior surface. The anterior or costal surface is slightly concave, fairly smooth with some oblique ridges. Being concave, this area is known as the subscapular fossa. The posterior surface is separated in two by an oblique bony process call the spine of the scapula. The scapular spine ends superolaterally in a bony process called the acromion. Also, the spine of the scapula divides the posterior surface of the scapula into a supraspinous fossa and an infraspinous fossa.
The image is an anterior view of the left scapula. Image in Public Domain, by Henry Vandyke Carter, MD - Gray's Anatomy
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This is a medical root term arising from the Latin word [seco] meaning "to cut". The term [section] is a derivative of the same from the Latin terms [sectio] and [sectionis]. In anatomy and histology the term [section] is used to denote "a slice".
- Section: "A slice"
- Transsection: To "cut across". This is the proper spelling of the word, although 'transection" is also accepted
- Dissection:To "cut apart".
- Resection: To "cut again", used to denote "removal"
- Venesection: To "cut a vein". This term was used in the times of bloodletting
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The term is a mix of two Greex root terms, [Pneum-] meaning "air" and [thorax] for "chest". The term [pneumothorax] means "air in the chest".
A pneumothorax occurs when the parietal pleura that lines the internal aspect of the chest and the visceral pleura that lines a lung are separated by a small amount of air that penetrates the thoracic cavity. This air causes the capillary action of the pleural fluid to fail, allowing for more air to enter the thoracic cavity and the lung to collapse.
Since the pleural cavities are separate, the collapse of one lung does not necessarily failure of the contralateral lung, except in a rare anatomical variation where both pleural cavities are communicated.
A pneumothorax can be spontaneous, with no apparent cause, or caused by trauma that allows the air to enter the thorax. If blood and air enter the thoracic cavity, the condition is then called a "pneumohemothorax".
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