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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Georg Eduard Von Rindfleisch
(1836 – 1908)
German pathologist and histologist of Bavarian nobility ancestry. Rindfleisch studied medicine in Würzburg, Berlin, and Heidelberg, earning his MD in 1859 with the thesis “De Vasorum Genesi” (on the generation of vessels) under the tutelage of Rudolf Virchow (1821 - 1902). He then continued as a assistant to Virchow in a newly founded institute in Berlin. He then moved to Breslau in 1861 as an assistant to Rudolf Heidenhain (1834–1897), becoming a professor of pathological anatomy. In 1865 he became full professor in Bonn and in 1874 in Würzburg, where a new pathological institute was built according to his design (completed in 1878), where he worked until his retirement in 1906.
He was the first to describe the inflammatory background of multiple sclerosis in 1863, when he noted that demyelinated lesions have in their center small vessels that are surrounded by a leukocyte inflammatory infiltrate.
After extensive investigations, he suspected an infectious origin of tuberculosis - even before Robert Koch's detection of the tuberculosis bacillus in 1892. Rindfleisch 's special achievement is the description of the morphologically conspicuous macrophages in typhoid inflammation. His distinction between myocardial infarction and myocarditis in 1890 is also of lasting importance.
Associated eponyms
"Rindfleisch's folds": Usually a single semilunar fold of the serous surface of the pericardium around the origin of the aorta. Also known as the plica semilunaris aortæ.
"Rindfleisch's cells": Historical (and obsolete) name for eosinophilic leukocytes.
Personal note: G. Rindfleisch’s book “Traité D' Histologie Pathologique” 2nd edition (1873) is now part of my library. This book was translated from German to French by Dr. Frédéric Gross (1844-1927) , Associate Professor of the Medicine Faculty in Nancy, France. The book is dedicated to Dr. Theodore Billroth (1829-1894), an important surgeon whose pioneering work on subtotal gastrectomies paved the way for today’s robotic bariatric surgery. Dr. Miranda.
Sources:
1. "Stedmans Medical Eponyms" Forbis, P.; Bartolucci, SL; 1998 Williams and Wilkins
2. "Rindfleisch, Georg Eduard von (bayerischer Adel?)" Deutsche Biographie
3. "The pathology of multiple sclerosis and its evolution" Lassmann H. (1999) Philos Trans R Soc Lond B Biol Sci. 354 (1390): 1635–40.
4. “Traité D' Histologie Pathologique” G.E.
Rindfleisch 2nd Ed (1873) Ballieres et Fils. Paris, Translated by F Gross
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Last Friday April 17, I prepared and delivered a lecture on "Surgical Sutures, Needles, and Knots" which included a hands-on workshop on knots and wound closure on simulated tissue.
This was presented at the invitation of the Pre-Health club of the Mount Saint Joseph University in Cincinnati, OH. I am always glad to be invited to do these presentations as they allow me to maintain contact with the future generation of Health Care Professionals.
Of course this is a very short presentation compared to the longer course that Clinical Anatomy Associates, Inc. delivers for medical companies, but it shows these future professionals the complexity of the world of wound closure, healing, surgical sutures, needles, and knots.
We ended the lab with the challenge to do a two-layer closure of a simulated wound. Most of the attendees did a pretty good job. Congratulations!
My personal thanks to Dr. Eric Johnson who coordinated the meeting, and to the Pre-Health Club for their invitation. For more pictures of the meeting, see the Facebook album page of "Medical Terminology Daily"
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Gallbladder and cystic duct
The cystic duct is a tubular structure that connects the neck of the gallbladder to the extrahepatic ductal system. It is 2-4 cm. in length and its lumen is about 2.6 +/- 0.7 mmm. The shape of the cystic duct varies, as it can be straight, angled, or acutely curved.
The mucosa of the cystic duct presents with 2-10 crescent-shaped folds that create a spiral-shaped inner structure referred to as the "Valve of Heister", first described by Lorenz Heister in 1732. These folds become smaller and scarcer towards the distal portion of the duct.
The cystic duct can present with several anatomical variations, from total absence where the neck of the gallbladder empties directly in to the common bile duct, to duplication, and even rare occasions where the cystic duct empties separately into the duodenal lumen.
The cystic duct is an important surgical landmark as it is one of the boundaries of the cystohepatic triangle or "Triangle of Calot", described by Jean-Francois Calot (1861 - 1944), which determines the location of the cystic artery, a critical structure that needs to be ligated and transected during a cholecystectomy.
Sources:
1 "Cystic Duct and Heister’s “Valves” Dasgupta,C, Stringer, MD, Clin Anat (2005) 18:81–87
2. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
3. "Anatomy of the Human Body" Henry Gray 1918. Philadelphia: Lea & Febiger
Image modified by CAA, Inc. Original image courtesy of bartleby.com
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The root term [-phor-] arises from the Greek word [φέρω] meaning “to bear”, “well”, and “healthy”. The meaning of the word today in medical terminology is “well-being”. The addition of the adjectival suffix [-ia] meaning “pertaining to” add to form [-phoria] meaning “pertaining to well-being” or “feeling well”. It is used in terms such as:
• Euphoria: The prefix [eu-] means “good”. The sensation of feeling good, of good well-being
• Dysphoria: The prefix [dys-] means “abnormal”. Abnormal feelings of well-being. In psychiatry these dysphoric moments can be seen in bipolar patients.
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The term [intervertebral] means "between vertebrae", and [foramen] means "opening". The intervertebral foramina are bilateral openings between adjacent vertebrae. Each intervertebral foramen is found between adjacent pedicles ("P" in the large image), bound by the inferior vertebral notch and the superior vertebral notch of adjacent pedicles.
Although the term [intervertebral foramen] has been used for a long time, the concept has evolved to a more modern "intervertebral canal" or as some clinicians call it, the "lateral canal". The reason for this is that the intervertebral foramen is actually a tunnel whose length is determined by the width of the pedicles. This intervertebral canal has marked differences between the lateral, middle, and medial structures contained in the intervertebral canal.
Some of these structure are nerve roots, the dorsal root ganglion, the initial portion of the spinal nerve, dural sac, arteries, veins, recurrent nerves, fat, and a complex system of transforaminal and intraforaminal ligaments1. The structures contained in the intervertebral foramen can be compressed if the height of the intervertebral discs is compromised, or by a herniation of the intervertebral disc. The diameter of the intervertebral canal can also be reduced by bone and joint pathology.
If you hover over the image, the intervertebral foramen will be highlighted. For a larger version click on the image.
Images property of: CAA.Inc. Photographer: D.M. Klein
1 Thoracic and lumbar intraforaminal ligaments Akdemir, G.; J Neurosurg Spine 13:351-355, 2010
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A cyst is a sac-like structure filled with fluid. One of the many types of cysts that can be present in the human body is a Nabothian cyst.
Nabothian cysts are found on the uterine cervix, and are caused by the clogging of the cervical glands, also referred to as the Nabothian glands. These small cysts are usually found in two types of presentations. The first are serous filled cysts, and are seen as clear fluid-filled sacs on the surface of the cervix. In the accompanying image, these are depicted with a yellow circle.
The second type of Nabothian cysts are sacs filled with a yellowish, more dense and mucous-like fluid on the surface of the cervix. In the accompanying image, there is only one of these cysts and is depicted with a red circle.
The presence of Nabothian cysts is quite normal, they are not dangerous and are not cancerous. When present and when large, they may impede a gynecological exam and obscure the cervical os, the entrance to the uterus through the cervical canal. In the image the cervical os is indicated by a blue arrow. A gynecologist may need to open and drain these cysts prior to performing a Pap smear (named after Dr. George Papanicolau).
Nabothian cysts are named after Dr. Martin Naboth (1675 - 1721), a German physician and anatomist. His main publication in 1707 was “De Sterilitate Mulierum” (On Sterility in Women). In this book he refers to small pearl-like transparent structures found in the uterine cervix. Believing that he had discovered the way women store eggs, he called these “ovarium novum” (new ovaries). His discovery was accepted by many and these structures came to be known as “Ovula Nabothii“. Today we know this is not true, but his name remains attached eponymically to these structures.
My personal thanks toDr. Sanford Osher and his patient who volunteered and provided the image for this article. Dr. Miranda
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This prefix originates from the Greek word [περί] (per?) meaning “about” or “around”. In medical terminology we use it to mean “around”.
Some uses of the term are:
- Pericardium: The root term [-card-] means “heart”, while the suffix [-ium] means “layer” or “membrane”. The layer or membrane around the heart.
- Periodontal: The root term [-odont-] means “tooth”, while the adjectival suffix [-al] means “pertaining to”. Around a tooth.
- Perineurium: The root term [-neur-] means “nerve”, while the suffix [-ium] means “layer” or “membrane”. The layer or membrane around a nerve. Also known as the epineurium.