Medical Terminology Daily - Est. 2012

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 George Bachman

Jean George Bachmann
(1877 – 1959)

French physician–physiologist whose experimental work in the early twentieth century provided the first clear functional description of a preferential interatrial conduction pathway. This structure, eponymically named “Bachmann’s bundle”, plays a central role in normal atrial activation and in the pathophysiology of interatrial block and atrial arrhythmias.

As a young man, Bachmann served as a merchant sailor, crossing the Atlantic multiple times. He emigrated to the United States in 1902 and earned his medical degree at the top of his class from Jefferson Medical College in Philadelphia in 1907. He stayed at this Medical College as a demonstrator and physiologist. In 1910, he joined Emory University in Atlanta. Between 1917 -1918 he served as a medical officer in the US Army. He retired from Emory in 1947 and continued his private medical practice until his death in 1959.

On the personal side, Bachmann was a man of many talents: a polyglot, he was fluent in German, French, Spanish and English. He was a chef in his own right and occasionally worked as a chef in international hotels. In fact, he paid his tuition at Jefferson Medical College, working both as a chef and as a language tutor.

The intrinsic cardiac conduction system was a major focus of cardiovascular research in the late nineteenth and early twentieth centuries. The atrioventricular (AV) node was discovered and described by Sunao Tawara and Karl Albert Aschoff in 1906, and the sinoatrial node by Arthur Keith and Martin Flack in 1907.

While the connections that distribute the electrical impulse from the AV node to the ventricles were known through the works of Wilhelm His Jr, in 1893 and Jan Evangelista Purkinje in 1839, the mechanism by which electrical impulses spread between the atria remained uncertain.

In 1916 Bachmann published a paper titled “The Inter-Auricular Time Interval” in the American Journal of Physiology. Bachmann measured activation times between the right and left atria and demonstrated that interruption of a distinct anterior interatrial muscular band resulted in delayed left atrial activation. He concluded that this band constituted the principal route for rapid interatrial conduction.

Subsequent anatomical and electrophysiological studies confirmed the importance of the structure described by Bachmann, which came to bear his name. Bachmann’s bundle is now recognized as a key determinant of atrial activation patterns, and its dysfunction is associated with interatrial block, atrial fibrillation, and abnormal P-wave morphology. His work remains foundational in both basic cardiac anatomy and clinical electrophysiology.

Sources and references
1. Bachmann G. “The inter-auricular time interval”. Am J Physiol. 1916;41:309–320.
2. Hurst JW. “Profiles in Cardiology: Jean George Bachmann (1877–1959)”. Clin Cardiol. 1987;10:185–187.
3. Lemery R, Guiraudon G, Veinot JP. “Anatomic description of Bachmann’s bundle and its relation to the atrial septum”. Am J Cardiol. 2003;91:148–152.
4. "Remembering the canonical discoverers of the core components of the mammalian cardiac conduction system: Keith and Flack, Aschoff and Tawara, His, and Purkinje" Icilio Cavero and Henry Holzgrefe Advances in Physiology Education 2022 46:4, 549-579.
5. Knol WG, de Vos CB, Crijns HJGM, et al. “The Bachmann bundle and interatrial conduction” Heart Rhythm. 2019;16:127–133.
6. “Iatrogenic biatrial flutter. The role of the Bachmann’s bundle” Constán E.; García F., Linde, A.. Complejo Hospitalario de Jaén, Jaén. Spain
7. Keith A, Flack M. The form and nature of the muscular connections between the primary divisions of the vertebrate heart. J Anat Physiol 41: 172–189, 1907.


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Fleischner
Felix Fleischner, MD

 
One of the current challenges in medical sciences is to achieve a common and universal language that allows establishing, promoting the understanding and communication between people of different cultures and nationalities.

The use of anatomical and radiological terms in the chest is not exempt from this theme. An adequate terminology allows describing findings and unifying concepts that facilitate communication, teaching, research, in brief, the transmission of knowledge.

From the radiological point of view, ignorance of appropriate terminology creates confusion and may eventually lead to inaccuracies and misdiagnoses. Therefore, reaching consensus in terminology is an attempt to minimize the effects of language vices, which are unfortunately passed on to future generations.

On the other hand, in recent years, technical advances in radiology have improved the capture, recording and storage of images, which in turn has involved the need for a new language to explain new concepts.

Within this context, the Fleischner Society, an international and multidisciplinary medical society for thoracic radiology, was founded in 1969 in memory of Dr. Félix Fleischner. Among the objectives of this society is the publication of formal statements that have been adopted for several years, as standards in the field of chest radiology, generating an important point of discussion and consensus around this issue.

Thus, as in 1971 a proposal for initial terminology was made, which was consolidated in 1984 and 1996 with the publications of the Fleischner Society glossary for Chest X-rays and Tomographies respectively. In 2008 (Radiology 2008; 246: 697-722) this glossary is finally updated using new terms, modifying or eliminating some of those that have become obsolete and others in which their meaning has changed.

Sources:
1. Austin JHM, Müller NL, Friedman PJ. Glossary of Terms for CT of the Lungs: Recommendations of the Nomenclature Committee of The Fleischner Society. Radiology 1996; 200:327-30.
2. Fraser RS, Müller NL, Colman N, Pare PD. Diagnosis of diseases of the Chest. 4th ed. Philadelphia: WB Saunders Company, 1999.
3. Tuddenham WJ. Glossary of Terms for Thoracic Radiology: Recommendations of the Nomenclature Committee of The Fleischner Society. Am J Roentgenol 1984; 143:509-17.
4. Souza Jr AS, Araújo Neto CA, Jasinovodolinki D,Marchiori E, Kavakama J, Irion KL et al. Terminologia para a Descrição de Tomografia Computadorizada do Tórax (Sugestões Iniciais para um Consenso Brasileiro). Radiol Bras 2002; 35:125-8.
5.David M. Hansell, Alexander A. Bankier, Heber MacMahon, Theresa C. McLoud, Nestor L. Müller, and Jacques Remy Fleischner Society: Glossary of Terms for Thoracic Imaging Radiology 2008 246:3, 697-722


This article belongs to the series "Glossary of Terms for Thoracic Imaging" by Prof C. Uribe, MsC. This series is based on the "Glossary of Terms for Thoracic Imaging" by the Fleischner Society