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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Sulcus / gyrus

Sulcus / gyrus and Brain, lateral view (www.bartleby.com)
Sulcus/gyrus and brain, lateral view


These two different terms must be analyzed together. The Latin term [sulcus] means "groove or fissure". Its plural form is [sulci]. There are many anatomical sulci in the body, one of them being the costal sulcus in the ribs.

The second term [gyrus] is also Latin and means "circle or ring", as used in the words gyroscope or gyrations. In its adjective or descriptive form, [gyrus] is used to denote something "bent, curved, or broad-shouldered"1. The plural form is [gyri]. In the case of the brain a gyrus is formed as a mound or an elevation between the "valleys" of the sulci (see image). If you click on the image a secondary image depicting the lateral aspect of the brain will appear.

In the brain there are many sulci, the secondary image shows the lateral or Sylvian sulcus, and the central sulcus or sulcus of Rolando.

In relation to the central sulcus there are two gyri. The anteriorly situated precentral gyrus is considered the primary motor cortex and associated with voluntary motor activity (colored in green in the secondary image).  The postcentral gyrus (colored in blue) is situated posterior to the central sulcus and is the primary sensory cortex, associated with somatic (bodily) conscious sensation.

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
Initial image by:Albert Kok,courtesy of:Wikipedia.org. Second image modified from the original image by Henry Vandyke Carter, MD., courtesy of bartleby.com
Terms suggested by Sara Mueller.


Adam Christian Thebesius

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.

Adam Christian Thebesius
Adam Christian Thebesius

Adam Christian Thebesius (1686- 1732). German physician and anatomist, Thebesius studied in the University of Leiden, Netherlands, where he received his doctorate in 1708 with the thesis "De circulo sanguinis in corde" (on the circulation of the blood in the heart). In 1713 he became a member of the Royal Academy of Natural Scientists (Kaiserliche Akademie der Naturforscher), where he adopted the Latin name "Eyryphon". Besides his natural sciences and medical research, Thebesius developed an interest in astrophysics.

Extremely interested in coronary circulation, Thebesius injected dyes and fluids in the coronary arteries, veins, and coronary sinus. Along with Raymond Vieussens (1635-1713) , Thebesius described all these structures. Today his name is attached to the eponymic Thebesian veins (venae cordi minima), and the Thebesian valve guarding the exit of the coronary sinus into the right atrium of the heart. Both these structures were mentioned in his 1708 doctoral thesis

Sources:
1. “The Role of the Thebesian Vessels in the Circulation of the Heart” Wearn, J.T. J Exp Med. 1928 January 31; 47(2): 293–315
2. The Story Behind the Word. Some Interesting Origins of Medical Terms. Wain,H. 1958.
3. The Origin of Medical Terms. Skinner, H.A. 1970
Original image in the public domain, courtesy of the National Library of Medicine 


Ventricular system of the brain

The ventricular system of the brain is an interconnected system of cavities and ducts within the brain through which cerebrospinal fluid (CSF) circulates. The CSF is produced in the choroid plexuses located within the ventricles.

Ventricular system of the brain (www.bartleby.com)
Ventricular system of the brain

4th ventricle - Human brain dissection
Brain dissection - 4th ventricle

 There are two large curved lateral ventricles, each found within a cerebral hemisphere. They connect with the third ventricle via an opening called the "foramen of Monro". The third ventricle connects with the fourth ventricle by way of a slender canal called the "cerebral aqueduct" or the "aqueduct of Sylvius".

The third ventricle is found deep within the brain between the right and left diencephalic portion of the cerebrum.

The fourth ventricle is located between the pons of the brain stem anteriorly and the cerebellum posteriorly. This ventricle has a rhomboidal shape and it connects with the external aspect of the brain and the subarachnoid space. Failure of this CSF drainage from the ventricles to the subarachnoid space can lead to pathological accumulation of CSF within the ventricles and hydrocephalus.

The line drawn image shows a lateral view of the brain with a superimposed image of the ventricular system. If you click on this image, you will see a superior view of a cast of the ventricular system (by Retzius). 

The dissection image shows a posterior view of the brain stem and the cerebellum which has been opened in the median plane to expose the 4th ventricle. Click on the image to see a larger version.

Line images in the public domain by Henry VanDyke Carter, MD. (Gray's Anatomy) Dissection images property of CAA, Inc. Photographer E. Klein


Cerebrospinal fluid

The cerebrospinal fluid (CSF) is a colorless, transparent fluid produced from the arterial flow of blood by the choroid plexuses found within the ventricular system of the brain. The CSF exits the ventricular system and enters the subarachnoid space and its cisterns. It is then absorbed at the level of the arachnoid granulations into the venous component of the cardiovascular system.

The CSF has many functions, some of them being protection, the creation of a fluid environment where the brain 'floats", cleansing, and others. For a more detailed description of the CSF, click here.

The CSF is produced at an average rate of 550-700ml/day. It is absorbed at the same rate. An imbalance between production and absorption of CSF (as well as a blockage within the ventricular system) can lead to an accumulation of CSF within the brain, causing hydrocephalus.


Hippocrates of Cos

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.

HippocratesHippocrates

Hippocrates of Cos (460 BC - 370 BC). A Greek physician, Hippocrates was born on the Greek island of Cos (Kos) c. 460BC. Considered the "Father of Medicine" he removed Medicine from the realms of superstition and magic. He was the first to record medical writings and is considered the first one to use and maintain proper medical terminology. There are many writing attributed to Hippocrates, but there is no assurance that these were actually written by Hippocrates himself. Hippocrates changed the art of medical diagnosis by replacing supernatural precepts with observation-based methodology. Natural, rather than supernatural causes, would from here on explain all disease processes, what was known as Rational Medicine.

He is known for having set the oath that governs medical principles, the Hippocratic Oath, although there are many authors that contend that this oath was written long time after he died.

 

Sources:
1. "Hippocrates himself" JAMA. 1968;204(12):1138-1139

2. "Hippocrates: father of medicine" Tan, S Y (01/01/2002). Singapore medical journal(0037-5675), 43(1), p.5.


Atrioventricular sulcus

Anterior view of the thorax, showing surface relations of bones, lungs (purple), pleura (blue), and heart (red outline). P. Pulmonary valve. A. Aortic valve. B. Bicuspid valve. T. Tricuspid valve
Anterior view of the thorax, showing surface
relations of bones, lungs (purple), pleura (blue),
and heart (red outline).
P. Pulmonary valve. A. Aortic valve.
B. Bicuspid valve. T. Tricuspid valve


This is a combined word arising from terms [atrium], [ventricle], and [sulcus]. For the etymology of each word, click on the corresponding link.

The atrioventricular sulcus, also know as the "coronary groove" or "coronary sulcus" is an evident incomplete groove between the atria and ventricles of the heart. It is complete posteriorly and is separated anterosuperiorly by the roots of the aorta and the pulmonary trunk.  It contains the right coronary artery on the right side, and the circumflex artery on the left side, hence the name "coronary groove". These coronary arteries are not visible as they are usually covered by the epicardium and subepicardial fat.

The atrioventricular sulcus (and the corresponding coronaries) are also in relation to the deeper situated atrioventricular (AV) valves, the tricuspid valve on the right; and the mitral or bicuspid valve on the left side. The accompanying image depicts the location of the AV valves, and therefore the location of the AV sulcus. The image is an anterior view of the thorax, showing surface relations of bones, lungs (purple), pleura (blue), and heart (red outline). P. Pulmonary valve. A. Aortic valve. B. Bicuspid valve. T. Tricuspid valve 

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