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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Ipsi-

The prefix [ipsi-] arises from the Latin [ipse] meaning "self" or "same". In medical terminology this prefix is used in the words "ipsilateral" and ipsilaterally" to denote an organ or structure in the "same side of the body" (left or right) as another structure that is being referred to.

A synonym for ipsilateral is [homolateral]; the antonym for the term is [contralateral].

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Anterior cerebral artery

The anterior cerebral arteries are one of the two paired terminal branches of the internal carotid artery. Each anterior cerebral artery supplies arterial blood to the brain beyond the arterial circle of Willis. The vascular territory of the anterior cerebral artery supplies the medial surfaces of the frontal and parietal cerebral lobes as well as the medial border of the same lobes.

The anterior cerebral artery gives off the orbitofrontal artery and then divides into two callosal arteries, the pericallosal artery and the callosomarginal artery. From these arteries arise all the other branches that form the vascular territory of the anterior cerebral artery.

There are many anatomical variations of the anterior cerebral artery, as described here.

Anterior cerebral artery (ACA). a: artery; post: posterior; int: internal; sup: superior; inf:inferior. (Sobotta, 1945)
Clinical anatomy, pathology, and surgery of the brain and spinal cord are some of the lecture topics developed and delivered by Clinical Anatomy Associates, Inc.

Image modified from the original (in the public domain) by Sobotta (1945)

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Thrombus

The medical term thrombus arises from the Greek [θρόμβος] (pronounced thrombos) meaning "a lump", "a piece of milk curd", or a "clot". This Greek term was later adopted in Latin [thrombus] and is used in this unchanged form today. The plural for thrombus is [thrombi].  A synonymous Latin term is [coagulum] (pl. coagula).

In medicine, a thrombus is a blood clot that has the connotation of being stationary, fixed to a vessel wall. If this blood clot were to be freed and start moving with the blood flow, then the clot should be called an "embolus" (Lat; pl. emboli).

Because of its anatomical characteristics. in the presence of atrial fibrillation, the left atrial appendage is particularly prone to the formation of thrombi, which can embolize and cause brain strokes.

The root term for this word is [-thromb-]. Examples of its use are:

 Thrombosis:  The suffix [-osis] means "condition" with the connotation of "many". A condition of multiple thrombi
• Thrombocytopenia: A combination of root terms; the root term  [-cyt-] means "cell" and the suffix [-(o)penia] means "a deficiency". A deficiency of platelets (the "clotting" cells)

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

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Trachea

Tracheobronchial tree. Modified from Gray's Anatomy
Tracheobronchial tree

The trachea, vernacularly known as the "windpipe",  is in the adult a 4 inch (10.1 cm) membranous tube which contains incomplete, almost circular rings of cartilage. Some authors describe between fourteen to sixteen of these incomplete rings of cartilage in the trachea.

These semicircular rings are open-ended posteriorly, where the trachea only has a membrane, thus being flattened posteriorly. This posterior aspect of the trachea is in close anatomical relationship with the thoracic esophagus.

The trachea begins at the inferior end of the larynx, just about the level of the sixth cervical vertebra, and descends in the superior mediastinum to the level of the sternal angle (of Louis) close to the superior border of the fifth thoracic vertebra, where it divides into two main bronchi, each entering the ipsilateral lung at the level of the pulmonary hilum.

The word [trachea] arises from the Greek [trakhus] meaning "rough". This is because in the original description of this structure there was the belief that all arteries were full of air (Lat. air = ar/aria). The trachea, being rough was called the "rough artery" or "tracheartery", which was later amended, eliminating the "artery" part. In Latin the term used for the trachea was [arteria aspera], also meaning "rough artery".

The internal lower border of the bifurcation of the trachea into the left and right main bronchi is knows as the carina, where the carinal lymphatic nodes are found.

Sources:
1 "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
2. "Anatomy of the Human Body" Henry Gray 1918. Philadelphia: Lea & Febiger
Image modified by CAA, Inc. Original image courtesy of bartleby.com


Descending (thoracic) aorta

Posterior view of the contents of the thoracic cavity. The descending aorta is highlighted in red
Posterior view of the contents of the thoracic cavity.
The descending aorta is highlighted in red.

The descending aorta, also known as the thoracic aorta is the third portion of the aorta. It is found distal to the aortic arch in the posterior portion of the inferior mediastinum, and proximal to the abdominal aorta.

The descending aorta is situated between the lungs and has a close relation with the thoracic esophagus and the thoracic duct.

The descending aorta gives off 10 pairs of posterior intercostal arteries. The first intercostal artery, known as the supreme intercostal artery arises as a branch of the costocervical trunk of the subclavian artery. The last pair of arteries to arise from the descending aorta are the subcostal arteries, which pass under the 12th rib. The descending aorta also gives a number of smaller branches to the esophagus and the main stem bronchi.

The descending aorta ends at the aortic hiatus, where it continues as the abdominal aorta.

Sources:
1 "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
2. "Anatomy of the Human Body" Henry Gray 1918. Philadelphia: Lea & Febiger
Image modified by CAA, Inc. Original image courtesy of bartleby.com


Etiology

First used by Galen of Pergamon (129AD - 200AD) the word [etiology] is of Greek origin. [α?τία] or [aitia], meaning "cause", and [λογία] or [-ology], meaning "study of". Etiology is the "study of cause". In medicine this word I used to denote the study of the causes for a pathology, disease, or condition.

Because of its Greek origin, Skinner (1970) states that the proper way of spelling this term should be ?tiology, but the initial "a" has been discarded through use.

There are many pathologies of unknown origin. In this case the word to use would be [idiopathic] or [idiopathy] meaning "of unknown cause"

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