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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Crus / crura

The word [crus] is Latin (cruris) and refers to the leg, or region of the shin. It is commonly used to mean "leg" or "pillar". The plural form is [crura].

Several authors suggest a relation of [crus] with another Latin term [crux] meaning "cross" as if a cross is formed by two [crura] (legs).

The term crus is widely used in human anatomy:

- crus cerebri: there are two crus cerebri in the anterior aspect of the mesencephalon
- crura of the penis: the posterior aspect of the corpora cavernosa firmly attached to the ischiopubic rami
- crura of the clitoris:  the posterior aspect of the corpora cavernosa firmly attached to the ischiopubic rami
- crura fornix cerebrii: the posterior converging bands that form the fornix of the cerebrum

Special mention is deserved by the crura of the diaphragm. There are two pairs of diaphragmatic crura. The esophageal crura (right and left) which bound the passageway of the esophagus from the thorax into the abdomen, the esophageal hiatus. The esophageal crura have a muscular structure. The aortic crura (righ and left) allow for passage of the aorta into the abdomen, and although muscular superiorly, they are mostly tendinous. The accompanying image shows an anteroinferior view of the respiratory diaphragm. Click on the image for a larger picture.

Respiratory diaphragm - anteroinferior view (modified from bartleby.com) 1. Right tendinous aortic crus 2. Left tendinous aortic crus IVC=Inferior Vena Cava

1. Right tendinous aortic crus 2. Left tendinous aortic crus IVC= Inferior vena cava. Modified from the original image. Courtesy of www.Bartleby.com

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Luigi A. Galvani

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.To search all the articles in this series, click here.

Luigi A. Galvani (1737-1798). Italian anatomist, surgeon, and physiologist, Luigi Aloisio Galvani was born in Bologna in 1737. Although he started his studies to join the church, Galvani followed with medical studies at the University of Bologna, where he became a skilled anatomist and surgeon. On July 15, 1759 Galvani obtained his degree in medicine and philosophy.

He was interested in the effects of electricity on tissues and through observation and experimentation he postulated the existence of "animal electricity", that is, electricity generated within the tissues. He postulated the possibility that nerves carried electricity. His theories led to a passionate controversy with Volta, who denied Galvani's postulates. Galvani's theories would only be confirmed after his death. 

Galvani was deeply religious, and when forced by government officials to take an oath of atheism, he refused. He was stripped of his position and was lead to poverty. His position was restored close to his death. In his honor, Andre Ampere (1775-1836) named one of his inventions that measures electricity,  the "galvanometer". His name is also present in vernacular English, when we say that a rock star or a movie "galvanizes" an audience, meaning it was "electrifying"!

1. "Luigi Galvani" Haas LF J Neurol Neurosurg Psychiatry v.56(10); Oct 1993
2. "Luigi Galvani and the foundations of electrophysiology" Cajavilca C, Varonb,J,Sternbachc GL; Resuscitation 80 (2009) 159–162

Luigi Galvani

Original imagecourtesy of National Institutes of Health.

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The capitate bone is one of the four bones that comprise the distal row of the carpus or carpal bones that form the wrist. It is the largest of the carpal bones and is placed in the center of the wrist (see image).

Its name originates from the Latin [caput], meaning "head". The capitate bone presents a large, rounded area, called the "head". To complete the homology, the capitate bone also has a narrow segment called the "neck", the rest of the bone called the "body". It is also known as "os capitatum" or "os magnum"

The capitate bone articulates with seven bones, including the scaphoid, lunate, trapezoid, hamate, and the three central metacarpals (2nd, 3rd, and 4th).

The accompanying image shows the anterior (volar) surface of the wrist. Click on the image for a larger picture.

Scaphoid bone - anterior (volar) view of the wrist

Image modified from the original: "3D Human Anatomy: Regional Edition DVD-ROM." Courtesy of Primal Pictures

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The duodenum is a mostly retroperitoneal organ, part of the digestive tract, and the most proximal portion of the small intestine. This organ is approximately 10 inches in length (24.5 cm). It starts at the pylorus of the stomach, has a "C" shape, curving around the head and the neck of the pancreas, to end at the duodenojejunal junction.

The duodenum is described as having four segments of differing length, usually named numerically:

- First segment: about two inches in length, it is dilated and called the "duodenal ampulla", or "superior duodenum"
- Second segment: about three inches in length, it receives bile and pancreatic juice through the hepatopancreatic ducts and ampullae. It is also called the "descending duodenum"
- Third segment: about four inches in length, it crosses the midline, and is also known as the "horizontal" or "transverse duodenum"
- Fourth segment: one inch in length, this is the shortest segment, it ascends towards the duodenojejunal junction, which is tethered to the diaphragm by a fold of peritoneum around a fibromuscular band called the "ligament of Treitz". At this point the retroperitoneal duodenum becomes the intraperitoneal jejunum. This fourth segment is also called the "ascending duodenum"

Retroperitoneal organsImage property of:CAA.Inc.Artist:Dr. E. Miranda
The name of the organ is interesting. Most textbooks claim that is originates from the Latin [duodeni], meaning "twelve". The fact is that the duodenum was originally named in Greek [δώδεκα δάχτυλαν] meaning "twelve fingers". If you place both your hands together and add 1/4 of an inch to each side (as if you had an extra finger on each hand) that measures approximately 10 inches. The term was shortened by an incorrect translation to "twelve" by Gerard of Cremona (1114 - 1187) who called it "duodenum", a bad translation, as twelve fingers in Latin is [duodecim digitorum].

"Clinically Oriented Anatomy" Moore, KL. 3r Ed. Williams & Wilkins 1992
2. "The origin of Medical Terms" Skinner, AH, 1970 

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This prefix is derived from the Greek and means "slow". Most everybody knows about [bradycardia] meaning "slow heart", but there is a large number of applications of this prefix as follows:

• Bradytrophia: from the Greek [trophe] meaning "to feed" or "nutrition". Braditrophia is a slow nutritional process
• Bradypnea: from the Greek [pnoia], meaning "breath" or "air". Bradypnea is an abnormally slow breathing rhythm
• Bradylalia: from the Greel [lalein] meaning "to talk". Bradylalia is a slow articulation or formation of words, sometimes also known as [bradyarthria] or [bradyphasia]. See the article on aphasia and dysphasia here
Bradykinesia: from the Greek [kinesis], meaning "movement". Bradykinesia means "slow movement", also known as [bradypragia]
• Bradycrotic: from the Greek [krotos], meaning "pulse" "or pulsation" A bradycrotic agent slows down the patient's pulse or heart rate.
Bradytocia: from the Greek [tokos], meaning "birth". Bradytocia is a slow birthing process

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The word [bregma] is Greek and means "the front of the head". It is actually the point of intersection of the the coronal and sagittal sutures. The coronal suture is the articulation or joint between the frontal and parietal bones, and the sagittal suture is the median joint between both parietal bones. 

The term was first used in anatomy as a craniometric point by Paul Broca (1824 - 1880). The image shows a superior view of two heads and the location of the coronal and sagittal sutures. The bregma is the point of intersection of these two articulations.

Click on the image for a larger view. 

Original image courtesy of Wikipedia

1 = coronal suture 2 = sagittal suture 3 = lambdoid suture. The bregma is the point of intersection of 1 and 2

1 = coronal suture 2 = sagittal suture 3 = lambdoid suture. The bregma is the point of intersection of 1 and 2

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