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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Ligament of Treitz

The ligament of Treitz is a fold of peritoneum over the suspensory muscle of the duodenum. This muscle is also known as the "muscle of Treitz" or "musculus suspensorius duodenii". This muscle was first described in 1853 by Dr. Václav Treitz. 

The muscle has an unusual in structure in that it is formed by a tendon with two muscular ends (see image #1) of dissimilar embryological origin and function. The superior muscular component is skeletal (voluntary) muscle and arises as a slip of muscle (Hilfsmuskel) from the right esophageal crus of the respiratory diaphragm, as well as muscular and ligamentous fibers arising in the region of origin of the celiac trunk and superior mesenteric artery. The inferior portion of the muscle is smooth (involuntary) muscle and has been described as continuous with both the longitudinal and circular muscle layer of the intestine at the duodenojejunal junction.

The ligament of Treitz is an anatomical landmark used by anatomists and surgeons to denote the duodenojejunal junction and the point where the small intestine passes from retroperitoneal duodenum to intraperitoneal jeunum. Surgeons use the ligament of Treitz to measure the jejunum to decide where to perform an anastomosis.

Suspensory muscle of the duodenum 1. skeletal muscle 2. tendon 3. smooth muscle
Click on the image for a larger version
Original image by Dr. Vaclav Treitz
Click on the gray bar below the image to see the original sketch published by Dr. Václav Treitz in his 1853 publication "Ueber einen neuen Muskel am Duodenum des Menschens" (On a new muscle in the duodenum of man). The 'muscle of Treitz" is marked by an arrow.

Clinical anatomy, pathology, and surgery of the gastrointestinal tract are some of the many lecture topics developed and delivered to the medical devices industry by Clinical Anatomy Associates, Inc.

Sources:
1.
"Clinically Oriented Anatomy" Moore, KL. 3r Ed. Williams & Wilkins 1992
2. "The origin of Medical Terms" Skinner, AH, 1970
3. "The suspensory muscle of the duodenum and its nerve supply" Jit, I.; Singh, S. J. Anat. (1977), 123, 2, pp. 397-405
4. "Anatomical and functional aspects of the human suspensory muscle of the duodenum." Costacurta, L. Acta Anat (Basel). 1972;82(1):34-46
Image property of:CAA.Inc. Artists:Dr. E. Miranda and D.M. Klein