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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

Sources:
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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Surgery

From the Greek [kheirurgia], a compound word meaning "a work done by hand". The Greek word [kheir/cheir] means "hand", and [ergon] means "work". The intent of the word is that of a medical treatment that is realized by the use of the hands and/or hand instrumentation.

Technology has advanced the evolution of surgery. Today minimally invasive surgical procedures, videoscopic procedures,  and robotic-enhanced surgery are commonplace

Images and links courtesy of: www.wikipedia.com

Cardiovascular bypass surgery (www.wikipedia.com)

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Arcuate line

The arcuate line is the arch-shaped (hence the name) inferior border of the posterior sheath of the rectus abdominis muscle. This structure is seen in a laparoscopic (posterior) view (see image, label "B") and represents the transition from a superior area with well-formed aponeurotic posterior rectus sheath to an area devoid of the posterior rectus sheath.

At this point, the inferior (deep) epigastric vessels (see image, label "C") pass from deep to superficial, under the arcuate line and continue superiorly providing blood to the rectus abdominis muscle.

The arcuate line also represents a transition from a well-formed and stronger wall posterior to the rectus abdominis muscle to a weaker region, covered only by deep muscle fascia and transversalis fascia. This allows a surgeon to enter the preperitoneal region using a Totally Extraperitoneal (TEP) approach for a laparoscopic herniorrhaphy.

Label "A" shows the "corona mortis" anatomical variation 

Image property of: CAA.Inc.Artist: M. Zuptich

Arcuate line (B)
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Inguinal ligament

The inguinal (Poupart's) ligament has always been described as a separate, discrete,  distinctive ligamentous structure. This is not so. The inguinal ligament is the thickened, incurved, lower free border of the external oblique aponeurosis. This structure extends between the anterior superior iliac spine (ASIS) superolaterally, and the pubic tubercle inferomedially. The inferomedial portion of the inguinal ligament send fibers towars the pectineal ligament (Cooper's ligament) and forms the lacunar (Gimbernat's) ligament.

Inferior to the inguinal ligament is an open region (subinguinal space) that allows passage of structures between the abdominopelvic region and the femoral region. Some of these structures are: Iliacus muscle, psoas major muscle, femoral nerve, lateral femoral cutaneous nerve, femoral artery, femoral vein, etc.

Inguinal ligament
Although described by Vesalius, Fallopius, and others it was the French anatomist and surgeon Francois Poupart (1661-1708) who described this structure in relation to hernia in his book "Chirurgie Complete" published in 1695.

Image property of: CAA.Inc.. Artist: D.M. Klein

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-itis

The suffix [-itis] originates from the Greek and means "inflammation". This suffix is also used to mean "infection", although inflammation is only one of the signs of infection. The symptoms and signs of infection are:

• Edema - localized swelling (tumor)
• Redness- Localized (rubor)
• Localized raise in temperature - Fever (calor)
• Pain - (dolor)
• Localized functional impairment

Examples of uses of this suffix are:

Hepatitis: Inflammation or infection of the liver
Pancreatitis: Inflammation or infection of the pancreas
Cholecystitis: Inflammation or infection of the gallbladder [chole-]="gall'; [cyst]="sac" or "bladder"
Rhinitis: Inflammation or infection of the nose
Pharyngotracheitis: Inflammation or infection of the pharynx and trachea

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-oid

The suffix [-oid] originates from the Greek [oeides], meaning "similar to", "like", or "shaped like". This suffix can be found the the medical terms [sigmoid] meaning "similar or shaped like a sigma"; [sphenoid], meaning "shaped like a wedge"; [cricoid], meaning "shaped like a ring", and [arytenoid] also from the Greek [arytaina], meaning "similar to a ladle".

This suffix is also used in daily conversation, as the following examples illustrate:

Android - "similar to a human", from the Greek [andros] human
Anthropoid - similar to a man, from the Greek [anthropos], "man"
Asteroid - "similar to a star", from the Greek [aster], "star"
Arachnoid - "similar to a spider", from the latin [arachnid], spider. It refers to the spider-web look of this menynx

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Coronary

The term [coronary] comes from the Latin root [corona] meaning "crown", therefore [coronary] is used to denote a structure that surrounds another as a crown or a garland. In the heart, the coronary arteries and their branches form a crown that surrounds the heart at the level of the atrioventricular sulcus. There are two coronary arteries, the right coronary artery (RCA), and the left coronary arteryartery (*). The two main branches that arise from the left coronary artery are the circumflex artery (CFX) and the left anterior descending artery (LAD).

There can be interesting anatomical variations in the coronary arteries of the heart.

Although not in use anymore, the gastric arteries used to be called the "gastric coronaries" as the right and left gastric arteries and the right and left gastroepiploic arteries form a garland of arteries that surround the stomach. The term still does apply to the left gastric veins.

Coronary arteries
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