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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Fossa

This is a Latin word meaning a trench, a ditch, or an excavation. It arises from the Latine term [fodere] meaning "to dig". The plural form for "fossa" is "fossae".

There are many fossae listed in human anatomy, here are some of them:

fossa scaphoides: found in the pinna
fossa ovalis: found in the wall of the right atrium
fossa triangularis: found in the pinna
ischioanal fossa: a triangular fossa found in the perineum, inferior to the pelvic diaphragm and superior to the urogenital diaphragm, etc.

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Pre-

The prefix [pre-] has its origin in the Latin preposition [prae] meaning "anterior", "in front of", or "before". 

Applications of this prefix include:

precordial: anterior to the heart, as in "precordial pain"
preoperative: before the operation
preperitoneal: anterior to the peritoneum, referring to the region found outside and anterior to the peritoneal sac, an area containing fat, and important for preperitoneal laparoscopic surgery
presystolic: before systole
• preaortic: anterior to the aorta

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Posterior interventricular artery

The right coronary artery usually bifurcates in an area of the posterior aspect of the heart known as the "crux cordis" giving origin to two terminal branches: the posterior interventricular artery (anatomical term) and the posterolateral artery. The posterior interventricular artery is better know to clinicians as the "posterior descending artery" or PDA.

The PDA descends towards the apex cordis where it ends. It gives off several small ventricular branches, but its most important branches are the septal perforators. These branches dive deep and provide blood supply to the posterior 1/3rd of the interventricular septum.

The AV node artery, which provides blood supply to the AV node (a component of the conduction system of the heart) may arise from the PDA instead of arising from the right coronary artery.

The PDA may present with a number of anatomical variations, including:

Posteroinferior view of the heart. IVC=inferior Vena Cava

• arising from the circumflex artery (and absence of the posterolateral artery)
• arising from the first septal perforator of the anterior interventricular artery
• arising from the second diagonal artery
• arising from anterior interventricular artery
• being double, with one PDA arising from the circumflex artery, and another from the right coronary artery, etc.
Image property of: CAA.Inc. Photography: Efrain Klein
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Sunao Tawara, M.D.


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.
Sunao Tawara, M.D. (1873 - 1952) Sunao Tawara was born in the prefecture of Ooita, Kyushu, Japan. Adopted by an uncle (and physician), Tawara studied English and German, and went on to the University of Tokyo medical school, where he graduated an MD in 1901.

In 1903 he traveled to Marburg, Germany, where he started working with Dr. Karl Albert Ludwig Aschoff (1866-1942), a noted pathologist. Tawara’s work led him to the discovery of what today we call the “atrioventricular node” (AV node) and the connections of the AV node and the Bundle of His (the right and left bundle branch). His work with Aschoff led to the eponym of “node of Aschoff-Tawara” for the AV node. Tawara’s work also led to the understanding of the function of the Purkinje fibers. Tawara gave the entire system the name “Reitzleitungssytem” or the “conduction system” of the heart.

In 1906 Dr. Tawara published his discoveries in a German-language article entitled “The Conduction System of the Mammalian Heart — An Anatomicopathological Study on the Atrioventricular Bundle and the Purkinje Fibers”. The same year he returned to Japan and in 1908 became Professor of Pathology at the University of Kyushu until his retirement in 1933.

Dr. Sunao TawaraOriginal imagecourtesy of Wikipedia.
Sources:
1. "Sunao Tawara" Suma, K. Clin Cardiol (1991) 14; 442-443
2. "Sunao Tawara, A Cardiac Pathophysiologist" Loukas, M. et al Clinical Anatomy 21:2–4 (2008)
3. "Sunao Tawara: A Father of Modern Cardiology" Suma, K. J Pacing Clin Electrophysiol (2001) 24:1; 88- 96
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Circumflex artery

The [circumflex artery]  (CFX) is one of the two branches of the left coronary artery, the other one being the left anterior descending artery (LAD), also known as the anterior interventricular artery.

The prefix [circum-] means "around", while the root term [-flex-] means "to bend". This describes quite well the circumflex artery, which "bends around" the obtuse margin of the heart passing from the anterior surface to the posterior surface of the heart.

The circumflex artery lies deep to the epicardium in the subepicardial fatty layer. It gives off several branches, including small left atrial branches and one or two obtuse marginal arteries (OM1 and OM2)that provide blood supply to the left ventricle in its obtuse margin and posterior ventricular region, as well as a portion of the anterior papillary muscle related to the mitral valve.

Coronary Arteries. The [*] indicates the left coronary artery
There can be interesting anatomical variations in the coronary arteries of the heart. For a detail on these anatomical variations, click here. Heart and coronary artery anatomy is one of the many lecture topics presented by CAA, Inc.

Image property of: CAA.Inc.Artist: Victoria G. Ratcliffe

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Post-

The prefix [post-] has its origin as a Latin adverb meaning "after". There are two variations in the use of this Latin adverb. The first is in its use as "after" referring to the position of a structure. This use is limited and is the root for the term "posterior". The most common usage is for [post-] to be used in its true meaning of "after" referring to time.

Applications of this prefix include:

postoperative: after the operation
postmortem: from the Latin word [mortis] meaning "death". After death
postpartumfrom the Latin word [partum] meaning "birth". After birth
postprandial: [prandium] is a Latin word meaning "a midday meal". Used to denote "after a meal"
• posthumous: from the Latin word [humus] meaning "ground". Refers to activities performed after burial
• postbellum: after a war

When using pure Latin terms, the word can be used as shown in the listing above, or they can be used as separate entities, such as "post partum", "post mortem", "post bellum", etc. (no hyphens). This leads to interesting facts, such as the pharmacological abbreviation "p.c." which stands for "post cibum"; the meaning of [cibum] is similar to [prandium], so "p.c." means "after a meal"

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