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
Original image courtesy of "Images from the History of Medicine" at www.nih.gov
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The root terms [-corp-] and [-corpor-] both arise from the Latin word [corpus] which means "body". The term corpus is used in human anatomy with the same meaning. Examples are:
• corpus vertebrale: The corpus or body of a vertebra
• corpus gastricum: The corpus or body of the stomach
• corpus callosum: A thick structure in the brain that communicates the cerebral hemispheres across the midline
The plural form is [corpora] as in the corpora cavernosa a pair of erectile bodies in the human genitalia.
In English both these roots can be found in words such as corpse, corporation, corporal, corpulent, corpuscle, etc.
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The word [fundus] is Latin and originally means "bottom", "base", or "foundation". The English root term [-found-] is derived from fundus in words such as "founder", "foundation", and "profound", as in "bottomless". Another derived root is [-fund-] with the meaning of "base capital".
Further evolution of the term lead to ancillary meaning of the term [fundus] as "pocket" as in the "bottom of a pocket". In fact, even today in Spanish, one of the word for "pocket" is "fundillo". This is the meaning that is used in human anatomy.
A fundus is a pocket-like segment or extension of an organ, such as the fundus of the stomach, the fundus of the gallbladder or the fundus of the uterus.
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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.
Prof Dr. Eric Muhe
Prof. Dr. Eric Mühe (1938 - 2005) Much has been written about who gets the glory of having performed the first laparoscopic cholecystectomy. Many famous names are in the annals of Surgery listed as pioneers in this field: Perissat, Berci, Mouret, Dubois, Sepulveda, Reddick, McKernan, Saye, Lizana, and others. Prof. Dr. Eric Mühe was usually not mentioned, but there is no doubt that on September 12, 1985, Dr. Mühe performed a laparoscopic cholecystectomy using a device of his own design (Galloscope) which lifted the anterior abdominal wall, maintained pneumoperitoneum, and doubled as a laparoscope.
Dr. Mühe was an avid cyclist and built and repaired his own bicycles. He once told me that he was looking at bicycle metal tube, and when looking through it, he thought that he could obtain access to the abdomen and the gallbladder with minimal changes. I am privileged to have known him and I was sad to learn that he passed in 2005. Dr. Miranda
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The [transverse processes] are two lateral bony processes found in most vertebrae, with the exception of the coccygeal vertebrae.
Transverse processes have regional variations. The transverse processes in the cervical vertebrae are heavily modified with anterior and posterior roots forming the boundaries of the foramina transversaria. They are "gutter-shaped" to accommodate the spinal nerves, and angled at 60 degrees anteriorly with a 15 degree inferior tilt.
In the thoracic region the transverse processes point posterolaterally and present with an articular facet (costal facet) for the costal tubercle of a rib, forming the costotransverse joint. The transverse processes of T11 and T12 do not have a costal facet.
The transverse processes in the lumbar region point slightly posterolateral, and they are larger. The longest transverse processes in the lumbar region are those of L3. The transverse processes of L5 are atypical in that they also point superolaterally at almost 45 degrees. This is because these transverse processes are attached to the posterior superior iliac spine and iliac crest by the iliolumbar ligament, contributing to the prevention of forward displacement of L5 over S1.
The sacral transverse processes contribute to the larger mass of the sacrum fusing to form the intermediate sacral crest on its posterior surface.
Thanks to Dr. Mary M Tuchscherer for her comments and improvement of this article.
Image property of: CAA.Inc. Photographer: David M. Klein
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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.
Michael Severtus
Michael Servetus (1511 -1553) was a Spanish theologian, physician, and anatomist. He is also known as Miguel Servet, Miguel Serveto, and Michel de Villeneuve. Servetus had studies in a multitude of fields, including catography, mathematics, pharmacology, astronomy, etc. He was born in 1511 in Aragon, Spain. Servetus started his studies in law in 1531and Medicine in 1536, where he excelled as an anatomist. Just as Andreas Vesalius and William Harvey, he clashed with the Galenic vision of anatomy and physiology. He correctly stated the theory of pulmonary circulation, but with no logical proof as Harvey.
Servetus was openly critical of the catholic church, publishing three books that openly questioned the Holy Trinity dogma. Servetus published his findings on pulmonary circulation in a controversial book "Cristianismi Restitutio", where pulmonary circulation was only one of the points he made which were mostly his position on the Holy Trinity and questioning the idea that everyone was predestined, as the catholic church professed at that time. His anatomical views were the least of his problems; because of this open criticism of Galen and the church. Servetus was burnt at the stake in Geneva on October 27, 1553.
Original image courtesy of National Library of Medicine.
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The [vertebral endplate] is the term used to denote a structure formed by the superior (and inferior) aspect of the vertebral body and a layer of hyaline cartilage related to it. The vertebral endplate is formed by the cortical bone of the anular epiphysis, the central depression and the hyaline cartilage that fills the depresssion.
The vertebral endplate is important for the health of the intervertebral disk (IVD). Since the IVD loses its blood supply early in life all the nutrition to the IVD has to pass through the cortical bone and the hyaline cartilage. Note that hyaline cartilage is avascular. Separation of the components of the vertebral endplate due to trauma or other pathology can cause the IVD to become pathological.
The vertebral endplate also plays an important role in the biomechanics of spine movement. Being slightly incurved, the endplate acts as a shock absorber, bending up to 1/2 mm. Damage to the endplate can reduce this function and set the stage for failure of the endplate and a potential vertebral fracture.
Sometimes the IVD can herniate through the endplate causing what is known as "Schmorl's bodies".
Image property of: CAA.Inc.Photographer: David M. Klein