Medical Terminology Daily (MTD) is a blog prepared by Clinical Anatomy Associates, Inc. as a service to the medical community, medical students, and the medical industry. We will post a workweek daily medical or surgical term, its 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 
Vieussens1
Raymond de Vieussens 
(c.1635 – 1715) 

French anatomist and physician. His exact date and place of birth are uncertain, some place him being born in the area of Le Vigan in France and the date for some authors as late as 1641.

What we do know is that he studied at the University of Montpellier where he graduated from his medical studies in 1670. He became a physician at the Hôtel Dieu Saint-Eloi in Montpellier. He later became head physician at the same hospital and apparently maintained this position for the rest of his life. His studies on the anatomy of the heart and lymphatic system were pioneers for the time, as were his studies on the anatomy of the nervous system.

Vieussens was a prolific writer. Among his works in 1706, he published “Nouvelles Découvertes sur le Coeur” (New Discoveries on the Heart) followed by “Traité Nouveau de la Structure et Des causes du Mouvement Naturel du Coeur” (New Treaties on the Structure and Cause of the Natural Movement of the Heart) in 1715. In these books he presented detailed anatomy of the lymphatic system and blood vessels of the heart, as well as his theories on the movement of the heart. In his work, he did the first accurate description of mitral stenosis and aortic disease.

One of his greatest works was “Neurographia Universalis”, published in 1684 in Lyons, France. In this book Vieussens describes the structure of the nervous system with emphasis on the pathways of the white substance, which we know today is formed by bundles of neuronal axons. He accurately described the internal structure of the cerebellum and other structures that today bear his name. Unfortunately Vieussens attempted to describe the physiology of the brain with little factual support, developing wild theories, including the statement that he had found the “fluid of the nerves”.

Some of Vieussens’ work was published posthumously by his family and colleagues. Today, many eponyms remember Vieussens’ name, here are some of them:

• Valve of Vieussens: A valve found at the distal end of the great cardiac vein, where it empties into the coronary sinus
• Ring of Vieussens: Name for and anatomical variation in the heart, an anastomotic communication between two conal arteries, one arising from the right coronary artery, the other arising from the left anterior descending artery (LAD)
• Centrum of Vieussens: A term that describes the mass of white matter at the center of each cerebral hemisphere
• Ring of Vieussens: Eponymic term for the limbus fossa ovalis, a raised muscular ring surrounding the fossa ovalis in the heart
• Valve of Vieussens (2): A thin veil of tissue between the superior cerebellar peduncles, forming part of the roof of the 4th ventricle. This is known as the superior medullary vellum and may have some sparse cerebellar tissue on it
• The ventricle of Vieussens: The name of a cavity found in the case where the septum pellucidum is double. The septum pellucidum is a membrane that separates the lateral ventricles of the brain in the midline

If you hover with your mouse over the image of young Vieussens you will see another image of Vieussens at 65. 

Original images courtesy of National Library of Medicine.


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Corona Mortis

Important for inguinal hernia anatomy and surgery, this term is Latin from [corona] meaning "crown' and [mortis] meaning "death'; the "crown or circle of death". The corona mortis (blue arrow) refers to an anatomical variation1, a vascular anastomosis between the obturator and the external iliac vascular systems that passes over Cooper's pectineal ligament and posterior to the lacunar (Gimbernat's) ligament. 

In some cases, the corona mortis is the actual obturator artery that arises from the inferior epigastric artery instead of the internal iliac artery. It can also arise from the external iliac artery. In both cases, it has been called an "aberrant obturator artery". This could be a misnomer, as this anatomical variation can be present in up to 25% of the cases. When present, the corona mortis  can be injured when a surgeon looks to enlarge the femoral ring by opening the lacunar ligament. This vascular structure could even be endangered in a laparoscopic procedure for inguinal of femoral hernia repair and a staple or tack is driven blindly into the pectineal (Cooper's) ligament.

Corona Mortis (A)Image property of: CAA.Inc.Artist: M. Zuptich

Berberoglu states that "although these tiny anastomoses... have been described in classical anatomy textbooks, these texts neglect to mention that theses anastomoses can be life-threatening".

In some rare cases, the corona mortis (aberrant obturator) artery coexists with the normal obturator artery.  Although called a [corona], this anatomical structure is an incomplete circle. In the image, the [corona mortis] is labeled "A".

Sources:
1. Rusu et al: "Anatomical considerations on the corona mortis" Surg Radiol Anat (2010) 32:17–24
2. Berberoglu et al: "An anatomic study in seven cadavers and an endoscopic study in 28 patients" Surg Endosc (2001) 15:72-75