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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Aphasia

Broca and Wernicke's areas in the dominant brain hemisphere
Click for a larger image

The term [aphasia] has Greek origins and means "without speech". This pathology was first described by Paul Broca who called it "aphemia".

Aphasia is a total and complete loss of speech. Lesser presentations of this condition should be called [dysphasias) from the prefix [dys-] meaning "abnormal", and  [phasia], meaning "speech".

Aphasia is the lack of spoken  speech due to cerebral cortex damage in the dominant brain hemisphere, usually the left side in right-handed individuals. There are two main areas of the brain involved in speech: Broca's and Wernicke's. Broca's area is responsible for speech expression (the spoken and written word). Damage to this area causes expressive or motor aphasia (or dysphasia).

Wernicke's area is responsible for the comprehension of speech, the understanding of language. Damage to this area causes receptive or sensory aphasia (or dysphasia). Broca's and Wernicke's areas are connected by an intrahemispheric tract known as the arcuate fasciculus (see image).

pathologies are:

  • Agraphia / dysgraphia: Incapacity / difficulty in writing
  • Anomia / dysnomia: Incapacity / difficulty in naming objects
  • Aphrasia / dysphrasia: Incapacity / difficulty forming phrases or sentences. The patient can communicate with single words, but cannot form sentences.

Image under copyleft agreement courtesy of The Brain from Top to Bottom 


Scaphoid

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

The scaphoid is one of the proximal carpal bones that form the wrist. The name arises from the Greek [scaphe], meaning "boat"; and [-oid], meaning "similar to". The scaphoid bone roughly resembles a rowboat. It is also known as the navicular bone (from the Latin [navis] meaning "boat"), and os naviculare manus.

Proximally, the scaphoid bone articulates with the radius. Distally, the scaphoid articulates with the trapezium and trapezoid bones. On its medial  aspect, the scaphoid bone has two articular surfaces for the lunate and the hamate bones. The scaphoid bone also has very strong ligamentous connections with the lunate bone by way of the scapholunate interosseous ligament

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


Medial / lateral

Medial / Lateral
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The terms [medial] and [lateral] are opposing anatomical relationship terms that indicate the location of a structure or structures in relation to the midline or median plane. The accompanying image depicts the median plane.

The term "midline" is a bit of a misnomer, as this is a plane and not a line, although if you look at the median plane from the anterior or posterior aspect of an individual in the anatomical position, you would have a line, ergo, midline! Look at this article on the anatomical position to see an explanation and image of this concept.

The term [medial] means "closer to the midline". An example of the use of this term is: "the head of the clavicle is medial to the shoulder joint", that is, the head of the clavicle is closer to the midline than the shoulder joint.

The term [lateral] means "further from the midline". An example of the use of this term is: "the wrist joint is lateral to the elbow joint", that is, the wrist joint is further away from the midline than the elbow joint.

Click on the image for a visual explanation of the concepts of "medial" and "lateral".

 


 

Images property of: CAA.Inc. Artist: Victoria G. Ratcliffe


Inion

External view of the occipital bone. Public domain
External view of the occipital bone


The term [inion] is Greek [ινιον] and originally referred to the posterior aspect of the neck or occiput and its musculature and strength, as mentioned in the Iliad.

The term fell in disuse for hundreds of years, until it was resurrected by Peter Paul Broca (1824-1880) as a craniometric point. The inion is the midline protuberance in the posteroinferior aspect of the external surface of the occipital bone. Today, in most anatomy texts the inion is referred to as the "external occipital protuberance"

The inion is found at the intersection of three bony lines that are easily palpable, the bilaterally situated superior nuchal line, and the median nuchal line. It is labeled "Ext. occip. protuberance" (see accompanying image). There is a corresponding internal occipital protuberance in the internal aspect of the occipital bone.

Sources:
1. "The Origin of Medical Terms" Skinner, HA 1970 Hafner Publishing Co.
2. "Medical Meanings - A Glossary of Word Origins" Haubrich, WD. ACP Philadelphia
3 "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
4. "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


Sesamoid

Foot X-ray. Sesamoid bones
Click for a larger image

The word [sesamoid] means "similar to a sesame". First used by Galen c.180AD, he describes small ovoid bones that are "similar to a sesame seed", referencing the seed of the plant sesamum indicum, the oil of which was used as a laxative at that time. 

Sesamoid bones are found in the tendons of some muscles and are mostly inconstant. Largey and Bonnet proposed a classification for these bones as: accessory, capsuloligamentous, intratendineous, and mixed.

Of special interest to this article are the sesamoid bones found within the two tendons of the flexor hallucis brevis muscle in the base of the foot (see accompanying X-ray image). These bones, especially the medial sesamoid bone, was attributed religious, mystical, and magical powers since ancient times. This is due to the fact that this small bone is highly resistant to natural decomposition. A Hebrew medical text dated 210 BC, attributed to Ushaia presented a small bone he called "luz" as the "depository of the soul". Many other authors, including Vesalius (who called it Albadaran), believed that upon resurrection, the whole body could reform from this "seed" bone.

This belief was later reinforced by religious texts into the early Renaissance which stated that this bone was indestructible and its presence was enough to guarantee resurrection for believers. 

Note: The original X-ray was published here courtesy of Wesley Norman, PhD in his website. The website is no longer available, so the image is now in the public domain via www.archive.org.

Sources:
1. "Les os sesamoides de l’hallux : du mythe a`la fonction" Largely,A; Bonnel, BE Med Chir Pied 2008 24: 28–38
2. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
3. "De Humani Corporis Fabrica" Vesalius, Andrea. 1543 Oporinus
Thanks to the first year medical students at the University of Cincinnati who inspired this article. Dr. Miranda


Ignaz Semmelweis

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.

Ignaz Semmelweis
Ignaz Semmelweis

Ignaz Semmelweis, MD (1818- 1865). Born in Budapest as Ign?c F?l?p Semmelweis, he started his university studies as a lawyer, but changed to Medicine and in 1844, at the age of 26, attained his MD degree. in 1847 he was appointed as an assistant in Obstetrics, almost at the same time of the death of a friend (Kolletschka, a pathologist) who died of what appeared to be "puerperal fever", also known as "childbed fever" after being accidentally stabbed by a knife during the autopsy of a female who had died of that disease. Semmelweis reasoned that the disease somehow was transmitted via the wound and started a crusade to have surgeons and students clean their hands with a carbolized solution before examining a healthy pregnant woman.

Although the obstetric wards under his care reduced the rate of this disease to almost nothing, Semmelweis endured criticism from his teachers, colleagues, and peers, and he did not make any friends by calling "murderers" those who did not follow his ideas.  murderers".  An excerpt of a letter to one of this detractors reads: "I denounce you before God and the world as a murderer and the history of puerperal fever will not do you an injustice when for the service of having been the first to oppose my life-saving technique it perpetuates your name as a medical Nero". He did not publish his findings until later in life, and then received even more criticism.

In 1865 was committed to an mental asylum only to die a few days later. He was only 47 years old. The same year he died Joseph Lister performed the first operations using antiseptic technique.

Sources:
1. Newsom S." Pioneers in Infection Control - Semmelweis, Ignaz Philipp". The Journal of hospital infection. 1993-03-01;23:175-187.
2. Ellis, H. (2008). Ignaz Semmelweis: tragic pioneer in the prevention of puerperal sepsis. British Journal Of Hospital Medicine (London, England: 2005), 69(6), 358 
3
. " A Corner of History: Ignaz Philipp Semmelweis" Wynder, EL  Prev Med 3" (4) Dec 1974, 574-580
4. "Ignaz Semmelweis; a hand-washing pioneer" P. Rangapa JAPI May 2010 58:328
Original image courtesy of Images from the History of Medicine