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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A Moment in History

Andreas Vesalius Bruxellensis (1514- 1564)

A Flemish anatomist and surgeon, Andreas Vesalius was born on December 31, 1514 in Brussels, Belgium. He is considered to be the father of the science of Anatomy. Up until his studies and publications human anatomy studies consisted only on the confirmation of the old doctrines of Galen of Pergamon (129AD - 200AD). Anatomy professors would read to the students from Galen's work and a demonstrator would point in a body to the area being described, if a body was used at all. The reasoning was that there was no need to dissect since all that was needed to know was already written in Galen's books. Vesalius, Fallopius, and others started the change by describing what they actually saw in a dissection as opposed to what was supposed to be there. 

Vesalius had a notorious career, both as an anatomist and as a surgeon. His revolutionary book "De Humani Corporis Fabrica: Libri Septem" was published in May 26, 1543. One of the most famous anatomical images is his plate 22 of the book, called sometimes "The Hamlet". You can see this image if you hover over Vesalius' only known portrait which accompanies this article. Sir William Osler said of this book "... it is the greatest book ever printed, from which modern medicine dates" 

After the original 1543 printing, the Fabrica was reprinted in 1555. It was re-reprinted and translated in many languages, although many of these printings were low-quality copies with no respect for copyright or authorship.

The story of the wood blocks with the carved images used for the original printing extends into the 20th century. In 1934 these original wood blocks were used to print 617 copies of the book "Iconaes Anatomica". This book is rare and no more can be printed because, sadly, during a 1943 WWII bombing raid over Munich all the wood blocks were burnt.

One interesting aspect of the book was the landscape panorama in some of his most famous woodcuts which was only "discovered" until 1903.

Vesalius was controversial in life and he still is in death. We know that he died on his way back from a pilgrimage to Jerusalem, but how he died, and exactly where he died is lost in controversy. We do know he was alive when he set foot on the port of Zakynthos in the island of the same name in Greece. He is said to have suddenly collapsed and die at the gates of the city, presumably as a consequence of scurvy. Records show that he was interred in the cemetery of the Church of Santa Maria delle Grazie, but the city and the church were destroyed by an earthquake and Vesalius' grave lost to history. Modern researchers are looking into finding the lost grave and have identified the location of the cemetery. This story has not ended yet.

For a detailed biography of Andreas Vesalius CLICK HERE.

Personal note: To commemorate Andrea Vesalius' 500th birthday in 2014, there were many scientific meetings throughout the world, one of them was the "Vesalius Continuum" anatomical meeting on the island of Zakynthos, Greece on September 4-8, 2014. This is the island where Vesalius died in 1564. I had the opportunity to attend and there are several articles in this website on the presence of Andreas Vesalius on Zakynthos island. During 2015 I also attended a symposium on "Vesalius and the Invention of the Modern Body" at the St. Louis University. At this symposium I had the honor of meeting of Drs. Garrison and Hast, authors of the "New Fabrica". Dr. Miranda


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Dacryocystolithiasis

This complex medical word is formed by the combination of two root terms: [dacry-] meaning "tear" and [-cyst-], meaning "sac". The combined root [dacryocyst-] means "tear sac" or better, "lacrimal sac" (the Latin word [lacrima] means "tear"). This medical word also has a combined suffix: [-(o)lith], meaning "stone", and [-iasis], meaning "disease or condition".

The word [dacryocystolithiasis] means then, "a condition or pathology of stones (calculi) in the lacrimal sac". The procedure to remove the stones would then be called a [dacryocystolithectomy].


Hamate

Hamate bone - anterior (volar) view of the wrist
Click for a larger image

The Hamate bone is one of the four bones that comprise the distal row of the carpus or carpal bones that form the wrist. The name arises from the Latin [hamatus], meaning "hooked". The hamate bone has a distinct hook-like bony process in its volar (anterior) surface, known as the hamulus. This bone is also known as the "unciform bone" (from the Latin [uncus], also meaning "hook") or the os hamatum.

The lunate bone has a wedge-like shape and six surfaces (as a die). It articulates with five bones, including the lunate bone, capitate, triquetrum, and the fourth and fifth metacarpal bones.

The hook of the hamate bone is one of the distal boundaries of the carpal tunnel and serves as a pulley for the tendons of the fourth and fifth flexor tendons. It also serves as one of the points of muscular attachment for the following muscles: flexor carpi ulnaris, flexor digit minimi, and opponens digiti minimi. Because of its projection into the palm of the hand, the hamulus is involved in injuries in sports that require the athlete to use an accessory, as in racquetball, tennis, baseball, golf, etc.

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


Phlebotomy

Phlebotomy


The word itself arises from the Greek. The root term [-phleb-] derives from [φλέβα] (phleba) meaning "vein", and the suffix [-otomy], meaning "to cut" or "to open". Let's not forget that the suffix component  [-y] means "process of". So [phlebotomy] is the "process (or action) of cutting open a vein"

For centuries a standard practice in medicine was to "bleed" a patient, by opening a vein under controlled conditions and letting some blood flow. The practice was known as "bloodletting" or phlebotomy. Not in use today, it is said that excessive bloodletting contributed to the death of George Washington, having removed 5 pints of blood in one day!. Today the professionals who draw blood are called "phlebotomists"

The image (circa 1860) depicts one of the only known three photographs of a bloodletting procedure. Observe the lack of aseptic technique.

 


Image in the public domain, by The Burns Archive, courtesy of Wikipedia.org.




 

Iliopubic tract

Inguinal ligament
Click for a larger image

The iliopubic tract is a thickening of the transversalis fascia found in direct relation, immediately posterior to the inguinal (Poupart's) ligament. As the inguinal ligament, the iliopubic tract extends between the anterior superior iliac spine (ASIS) superolaterally, and the pubic tubercle inferomedially. 

This obscure structure has been brought up to light because it is one of the anatomical landmarks used in laparoscopic herniorrhaphy. When securing a mesh to reinforce the posterior abdominal wall, and also prevent mesh migration, the surgeon will place sutures, tacks, or staples in this structure. Since the iliopubic tract (posteriorly) and the inguinal ligament (anteriorly) are so close together, they are both secured when doing this procedure.

The image shows the location of the inguinal ligament. The iliopubic tract is immediately posterior to it. 

Image property of: CAA, Inc. Artist: David M. Klein 


Clavicle

Left clavicle, superior surface. Public domain
Left clavicle, superior surface

The clavicle is part of the anterior portion of the shoulder girdle. It is an elongated bone with an "italic S" curvature. The Latin term for clavicle is [clavicula], and it has two root terms: [-clavic-] and [-clav-]. This is why we have the terms [subclavicular], and [subclavian] both meaning the same: "inferior to the clavicle".

The clavicle articulates medially with the manubrium of the sternum (see image on this article) by way of the sternoclavicular joint. This joint contains a meniscus. Laterally, the clavicle articulates with the acromial process or acromium of the scapula.

The clavicle has the muscular insertions of several muscles: sternocleidomastoid, trapezius, pectoralis major, deltoid, subclavius, and sternohyoid.

Sources:
1. "The Origin of Medical Terms" Skinner, HA 1970 Hafner Publishing Co.
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 by Henry Vandyke Carter, MD., courtesy of bartleby.com


Foramen transversarium

Cervical vertebra, superior view
Cervical vertebra, superior view

 

The term [foramen transversarium] is Latin for "transverse foramen". It refers to bilateral foramina (openings) found lateral to the vertebral body in the cervical vertebrae. These foramina are found only in cervical vertebrae and serve as a good way to identify them.

Through the foramina transversaria (plural form) pass the vertebral artery and vertebral vein. The vertebral artery is one of the first branches to arise off the subclavian arteries. While the vertebral vein passes through all seven foramina transversaria, the vertebral artery does not pass through the foramen transversarium of the seventh cervical vertebra (vertebra prominens).

 

Image property of:CAA.Inc.Photographer:David M. Klein