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
Original image courtesy of "Images from the History of Medicine" at www.nih.gov
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The prefix [post-] has its origin as a Latin adverb meaning "after". There are two variations in the use of this Latin adverb. The first is in its use as "after" referring to the position of a structure. This use is limited and is the root for the term "posterior". The most common usage is for [post-] to be used in its true meaning of "after" referring to time.
Applications of this prefix include:
- postoperative: after the operation
- postmortem: from the Latin word [mortis] meaning "death". After death
- postpartum: from the Latin word [partum] meaning "birth". After birth
- postprandial: [prandium] is a Latin word meaning "a midday meal". Used to denote "after a meal"
- posthumous: from the Latin word [humus] meaning "ground". Refers to activities performed after burial
- postbellum: after a war
When using pure Latin terms, the word can be used as shown in the listing above, or they can be used as separate entities, such as "post partum", "post mortem", "post bellum", etc. (no hyphens). This leads to interesting facts, such as the pharmacological abbreviation "p.c." which stands for "post cibum"; the meaning of [cibum] is similar to [prandium], so "p.c." means "after a meal"
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The prefix [retro-] has a Latin origin and means "posterior", "backwards", or "behind". The main use of this prefix in human anatomy and surgery is "posterior".
Applications of this prefix include:
- retroesternal: posterior to the sternum, such as the heart or the internal thoracic vessels
- retropharyngeal: posterior to the pharynx, as in the "retropharyngeal space", a potential space found posterior to the pharynx
- retroperitoneal: posterior to the peritoneum, referring to abdominal organs found outside and posterior to the peritoneal sac, such as the aorta and kidneys
- retrogastric: posterior to the stomach, as in the "retrogastric space", an area also known as the "lesser bursa"
- retroversion: a posterior rotation or turn. Usually refers to the posterior rotation of the uterus or a joint
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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.
François Poupart
François Poupart (1661-1709). Physician, zoologist, entomologist, and anatomist, Francois Poupart was born in Le Mans, France. His origins were very humble and he studied Medicine in Paris as a very poor student. He had great interest in entomology, studying the anatomy of insects. Poupart obtained his MD a the University of Reims and was a surgeon at the H?tel (hospital) Dieu. A naturalist, Poupart is known for having written a monograph on the anatomy of the leech.
His life is mostly unknown. Poupart died at the age of 48. His name is eponymically associated with the inguinal ligament, which he described in detail in 1705. Although this structure was originally described by Gabrielle Fallopius, it was Poupart who stated the function of the inguinal ligament as an attachment for the three lateral muscles of the abdominal wall.
*: There is no known image of Francois Poupart that we could find. If you have any source, please let us know through our "Contact Us" form.
Sources:
1. "Two eponymous surgeons: Cowper and Poupart" Ellis, H. Brit J Hosp Med 2009 701:4 225
2. "The Anatomical History of the Leech" Poupart, F. Phil Transact 1697 19:722-726
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The word [pinna] is Latin and means "feather". It also means "wing". The variation [penna] as in the case of [pennate], means "winged". It refer to the external ear, or auricle. It appears that the use of the term [pinna] for ear arises from the ear-like or winged extensions of Viking and medieval helmets.
The ear has three components, the internal, middle, and external ear. The external ear is composed of the external acoustic canal and the pinna. The pinna is composed of fibrocartilage covered with skin, and has several ligaments and small muscles related to it. These muscles are extrinsic (between the pinna and the skull) and intrinsic (within the pinna) All these muscles have limited capabilities in the human.
The pinna receives blood supply from the anterior and posterior auricular arteries, and a small branch of the occipital artery. The nerve supply is by way of the great auricular nerve, the auricular branch of the vagus nerve, the auriculotemporal branch of the mandibular nerve, and the lesser occipital nerve.
The external (lateral) anatomy of the pinna is complicated and very detailed, with potential anatomical variations. Click on the image for a higher detail. The medial aspect of the pinna presents elevations which correspond to the depressions (fossae) on its lateral surface and they are named, eminentia conchae, eminentia triangularis, eminentia scaphoides, etc.
Image property of: CAA, Inc. Artist: Dr. Miranda
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The prefix [circum-] is Latin and means "around" or "about". It is used in medical terms such as:
- Circumcision: the root term [-cis-] meaning to "cut". To cut around
- Circumflex: the root term [flex] for [flexion] meaning to "bend". Bends around, as in "circumflex artery"
- Circumambulation: a patient that walks in circles
Also in everyday terms such as:
- Circumlocution: to talk around a subject
- Circumnavigation: To sail or navigate around
- Circumscribe: to write in circles or around a subject
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The word [flexion] comes from the Latin [flexere] meaning "to bend". In anatomy, flexion is the reduction in the angle between two bodily components that are communicated by a type of joint.
By contrast, [extension] refers to the opposite action, that is, the increase in the angle between two bodily components that are communicated by a type of joint.
The image shows flexion of the head, the upper extremity, and the lower extremity. Hover over the image to see extension of the same structures.
Excessive flexion (hyperflexion) or extension (hyperextension) of a joint can lead to potential pathology as would be the case of hyperextension of the neck as a result of a car crash (whiplash injury)
Note that in a human in the anatomical position, flexion of the upper extremity is an anterior movement, while flexion of the lower extremity is a posterior movement. You could make a case that in these image the upper extremity is performing an anteflexion (anterior flexion) while the lower extremity is performing a retroflexion (posterior flexion).
In the upper and lower extremities there are whole groups of muscles that, because of their action, are called flexors or extensors.