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 

Ignaz Semmelweis, MD 
(1818- 1865) 

Born in Budapest as Ignác Fülöp 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.

Original image courtesy of Images from the History of Medicine

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 Semmeweis; a hand-washing pioneer" P. Rangapa JAPI May 2010 58:328


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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