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, also known as "Halsted's Rules of Surgery", 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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The pisiform bone is one of the four bones that comprise the proximal row of the carpus or carpal bones that form the wrist. It is the smallest of the carpal bones, is spheroidal in shape, and presents with only one articular surface (see image).
Its name originates from the Latin [pisum], meaning "pea". It is also known as "os pisiforme" or "lentiform bone", because some feel it is shaped like a lentil.
The pisiform bone articulates posteriorly with the triquetrum, and has on its anterior (volar) surface attachments to the transverse carpal ligament, and to the Abductor Digiti Quinti, and Flexor Carpi Ulnaris muscles.
The accompanying image shows the anterior (volar) surface of the wrist.
Image modified from the original: "3D Human Anatomy: Regional Edition DVD-ROM." Courtesy of Primal Pictures
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This is a Latin word meaning a trench, a ditch, or an excavation. It arises from the Latine term [fodere] meaning "to dig". The plural form for "fossa" is "fossae".
There are many fossae listed in human anatomy, here are some of them:
- fossa scaphoides: found in the pinna
- fossa ovalis: found in the wall of the right atrium
- fossa triangularis: found in the pinna
- ischioanal fossa: a triangular fossa found in the perineum, inferior to the pelvic diaphragm and superior to the urogenital diaphragm, etc.
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The prefix [pre-] has its origin in the Latin preposition [prae] meaning "anterior", "in front of", or "before".
Applications of this prefix include:
- precordial: anterior to the heart, as in "precordial pain"
- preoperative: before the operation
- preperitoneal: anterior to the peritoneum, referring to the region found outside and anterior to the peritoneal sac, an area containing fat, and important for preperitoneal laparoscopic surgery
- presystolic: before systole
- preaortic: anterior to the aorta
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The right coronary artery usually bifurcates in an area of the posterior aspect of the heart known as the "crux cordis" giving origin to two terminal branches: the posterior interventricular artery (anatomical term) and the posterolateral artery. The posterior interventricular artery is better know to clinicians as the "posterior descending artery" or PDA.
The PDA descends towards the apex cordis where it ends. It gives off several small ventricular branches, but its most important branches are the septal perforators. These branches dive deep and provide blood supply to the posterior 1/3rd of the interventricular septum.
The AV node artery, which provides blood supply to the atrioventricular node (a component of the conduction system of the heart) may arise from the PDA instead of arising from the right coronary artery.
The PDA may present with a number of anatomical variations, including:
- arising from the circumflex artery (and absence of the posterolateral artery)
- arising from the first septal perforator of the anterior interventricular artery
- arising from the second diagonal artery
- arising from anterior interventricular artery
- being double, with one PDA arising from the circumflex artery, and another from the right coronary artery, etc.
Image property of: CAA, Inc. Photographer: E. Klein
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![Coronary Arteries. The [*] indicates the left coronary artery](/images/MTD/LargeImages/coronaryarterieslabels_lg.jpg "Anterior view of the heart")
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The [circumflex artery] (CFX) is one of the two branches of the left coronary artery, the other one being the left anterior descending artery (LAD), also known as the anterior interventricular artery.
The prefix [circum-] means "around", while the root term [-flex-] means "to bend". This describes quite well the circumflex artery, which "bends around" the obtuse margin of the heart passing from the anterior surface to the posterior surface of the heart.
The circumflex artery lies deep to the epicardium in the subepicardial fatty layer. It gives off several branches, including small left atrial branches and one or two obtuse marginal arteries (OM1 and OM2)that provide blood supply to the left ventricle in its obtuse margin and posterior ventricular region, as well as a portion of the anterior papillary muscle related to the mitral valve.
There can be interesting anatomical variations in the coronary arteries of the heart. For a detail on these anatomical variations, click here. Heart and coronary artery anatomy is one of the many lecture topics presented by CAA, Inc.
Image property of:CAA.Inc.Artist:Victoria G. Ratcliffe