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

Jean-Louis Petit

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674.  His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations.  In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance.  “Traite des Maladies des Os” ( A Treatise on Bone Diseases);  “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81


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Dr. Franz Kaspar Hesselbach


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.To search all the articles in this series, click here.

Franz Kaspar Hesselbach (1759 – 1816). German physician, surgeon, and anatomist. Hesselbach was born in Bavaria in 1759. At the age of 19 he became an apprentice to Karl Von Siebold (1736 - 1807), a German surgeon, obstetrician and anatomist. He worked with him as an unpaid assistant for six years until 1789 when he was hired as a prosector.

Hesselbach became a lecturer on anatomy at the University of W?rzburg and a surgical assistant at the Juliusspital at W?rzburg. Later Hesselbach became a professor of Surgery at the same university.

 Hesselbach’s name is eponymically tied to many structures, most of them related to hernia, an area where he is best known. In 1806 he published a treatise on hernia (Anatomisch-chirurgische Abhandlung ?ber den Urspurng der Leistenbr?che) “Anatomical and surgical treatise on the origin of Hernias”. These structures are:

• Hesselbach’s fascia: the cribriform fascia covering the saphenous hiatus of the thigh
• Hesselbach’s  ligament: also known as the interfoveolar ligament
 Hesselbach’s triangle: site for direct inguinal hernia
Hesselbach’s hernia: a femoral hernia protruding through the cribriform fascia

  Hesselbach's triangle Primary Image property of: CAA.Inc.
Artist: M. Zuptich.

Hesselbach also described the femoral hernia in 1798 and distinguished between direct and indirect inguinal hernias.

In 1807 Hesselbach’s contributions were acknowledged and he was conferred the degree of Doctor of Surgery. During his life Hesselbach published several books, treatises, and papers.

A depiction of Hesselbach has not been found (yet) so we publish an image of his eponymic “triangle”. If you click on the image, you will see an original image from Hesselbach's book.

Sosurces:
1. "Franz Kaspar Hesselbach (1759–1816): Anatomist and Surgeon" R. Shane Tubbs et al W J Surg (2008) 32:11 2527-2529

2. "Groin Hernia Anatomical and Surgical History" McClusky DA, et al Arch Surg. 2006; 141(10):1035-1042
3. "Eponyms in groin surgery" Ellis, H. Surgery (Oxford) (2006) 24:8, 257–259
4. "Franz Kaspar Hasselbach (1759–1816)" Agarwal, AK; Mukherjee, R. Indian J. Surg (2008); 70:96–98

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Version

The word [version] comes from the Latin [versum / vertere] meaning "to turn" or "to turn around" (see the use of this Latin root in the word "vertebra"). In anatomy, version is the angulation (or turning) of an organ or a structure as a unit. The term is also used to denote the "turning" of a fetus "in utero"  by active manipulation to allow proper birth.

Normally, the cervix of the uterus is anteversed or has an "anterior version".  This means that the body and uterine cervix are tilted anteriorly (as a unit). Because of this in a female in the anatomical position, the fundus of the uterus looks almost anteriorly, while the main axis of the cervix points towards the coccyx. See the accompanying image.

The opposite, pathological presentation, is retroversion, where the uterus as a unit is tilted posteriorly. The angulation between the main axis of the uterine body and the main axis of the cervix is normal, but the organ as a unit is tilted posteriorly. Varying degrees of retroversion can cause varying degrees of infertility, a condition known vernacularly as a "slippery uterus".

 Female pelvis, lateral view. c=cervix. The purple lines represent the main axes of the uterine body and the uterine cervix  Images property of: CAA.Inc.Artist:Dr. E. Miranda

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Forceps

The word [forceps] is used to denote a grasping-type surgical instrument.  The origin of the word has been heavily discussed. It seems that it arises from the combination of the Latin terms [formus], meaning "hot" and [capere]. meaning "to hold", a device to hold something hot. Originally, the word was first used by Roman blacksmiths and was a pair of articulated tongs.

In modern terminology, the singular and plural form for the word is the same: [forceps], although there is an older plural form that is sometimes used: [forcipes]

According to Skinner (1970) the first forceps used in the medical arena were dental extraction forceps. The number of surgical forceps has increased over time. Today there are many types of forceps. Following are some of them:

• Thumb forceps: Tissue (toothed) or dressing (serrated) forceps

• Hemostatic forceps: Forceps designed for hemostasis and dissection. These usually have a locking mechanism and are of the ring-handle type

• Obstetrical forceps: Articulated forceps use to deliver a fetus

• Sponge forceps: Forceps to be used with swabs and sponges

Anatomy of a hemostatic ring forceps
• Right-angle forceps: A family of forceps which have an angled jaw (not necessarily right-angled) used for dissection, hemostasis, and grasping

• Specialty forceps: Forceps that have been especially designed for use on an organ or a specific step of a surgical procedure, such as hysterectomy forceps, tenacula, lung forceps, liver forceps, etc.

Click on the image to see a better detail of the anatomy of a hemostatic forceps. 

Sources:
1. 
"The Origin of Medical Terms" Skinner 1970
2. Codman: Surgical Product Catalog 2000

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Posterior communicating artery

The posterior communicating artery is a bilateral artery that communicates the internal carotid artery with the posterior cerebral artery. This creates an anastomosis between the vascular arterial territory of the vertebral artery and that of the internal carotid artery, completing the arterial circle of Willis.

The posterior communicating artery has high variability in its diameter, which can be thin or extremely thick, including the fact that you can find a thin one on one side of the brain and a thick one contralaterally. It is one of the sites for intracranial aneurysm. For more information on the anatomical variations of the posterior communicating artery click here.

Arterial circle of Willis  (Wikipedia.en.com
Sources:
1. 
"An Overview of Intracranial Aneurysms" Keedy, A Mcgill J Med. 2006 July; 9(2): 141–146 
2. "Observations on the length and diameter of the arteries forming the circle of Willis" Kamath S 1981 J Anat 133; 3:419-423"
3. "Aneurysms of the posterior communicating artery and oculomotor paresis" Sonil, SR J Neurol Neurosurg Psych 1974;37(4): 475–484
Image modified from the 
original courtesy of Wikipedia.
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-cost-

The root term [-cost-] arises from the Latin [costa / costalis] meaning "rib". First used by Galen, this root term is used in medical words such as:

• Costochondral: A combination of root terms, adding [-chondr-] meaning "cartilage". Refers to the joint between the bony rib and its cartilage
• Costal margin: Refers to the lower anterior margin of the thorax formed by the cartilage of ribs 7 through 10
• Intercostal: The prefix [inter-] means "between". Between ribs
• Subcostal: The prefix [sub-] means "below". Below the rib
• Costovertebral joint: A joint between the head of a rib(s) and a vertebra(e)
• Costotransverse joint: A joint between the articular portion of the tubercle of a rib and the transverse process of a vertebra

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-chondr-

The root term [-chondr-] arises from the Greek [χόνδρος] or [chondros] meaning "cartilage" or "gristle". The Latin equivalent is [cartilago] giving us the synonymous root term [-cartilag-]. This root term is used in medical words such as:

• Chondroma: The suffix [-oma] means "tumor" or "mass". A cartilaginous tumor. Pl. Chondromata
• Chondroitin: A gelatinous substance obtained by boiling cartilage.
• Chondrosternal: A rib joint between the costal cartilage and the sternum.
• Chondrochondral: A joint in the thorax between two costal cartilages.

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