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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Andreas Vesalius Bruxellensis

 Andreas Vesalius Bruxellensis (1515-1564) is considered to be the father of modern anatomy, remembered because an illustrious life and by his book “De Humani Corporis Fabrica, Libri Septem” published first in 1543. Scores of books, translations, articles, and analyzes of his work have been published in the over 500 years since his birth.

With such an incredible pedigree we would expect his name to be attached to more than a few anatomical structures, many of which were first described in his opus magnus, the “Fabrica”, I wonder why this is not so. It is true that modern anatomy is trying to move from eponyms to more descriptive anatomical terms. Still, there are many that will not go away, as is the famous ligament of Treitz, or the sphincter or Oddi.

Today there is only one recorded eponym for Andreas Vesalius, the os vesalianum, a rare accessory bone in the foot located proximally to the base of the fifth metatarsal. It is usually asymptomatic, but in rare cases it can cause pain. It is formed by the failed fusion of the secondary ossification center of the fifth metatarsal.

Reviewing history, I was able to find other references to Andreas Vesalius eponyms or potential eponyms, now in disuse or misnamed:

      • Suspensory ligaments of the mammary gland. Although first described by Vesalius in the Fabrica, these structures are named after Sir Astley Paston Cooper (1768 -1841), almost 300 years after being described by the great anatomist, who called them a “fleshy membrane” that stretched between the pectoral fascia and the skin.

      • The vermiform appendix. Although called by many just “the appendix”, this structure is mentioned, but not named, by Jacobo Berengario da Carpi in 1524. It was Andreas Vesalius who first described it as an appendix, suggested it looked like a worm (Lat: vermis) calling it the “vermiform appendix”.

      • The ligamentum suspensorium Vesalii or crural arch. First described by Giovanni Baptista Morgagni (1682-1771), it was named in honor of Vesalius by Dr. Laurentii (Lorenz) Heisters in his “Compendium Anatomicum” published in 1756. Other authors point to Gabrielle Fallopius as the first to describe this structure in 1561, although he did publish later than Vesalius (1543). Although named after Vesalius, it was later named after Francois Poupart who described it in 1695. You probably know this structure as the inguinal ligament.

      • The ligamentum teres femoris. The round ligament of the femur was also first described by Vesalius in 1543.

NOTE: If you have other structures that have been named after Vesalius, please let me know by clicking here

Sources:
1. “A Rare Cause of Foot Pain with Golf Swing. Symptomatic Os Vesalianum Pedis—A Case Report” Petrera, M et al. Sports Health. 2013 Jul; 5(4): 357–359.
2. “Andreas Vesalius’ 500th Anniversary: First Description of the Mammary Suspensory Ligaments” Brinkman RJ, Hage, JJ. World J Surg (2016) 40:2144–2148
3. “Compendium Anatomicum” Heisters, L. 1756 (German)
4. “Anatomy: An Encyclopedic Reference to the Language of Anatomy and Neuroanatomy. It Provides the Fascinating Origin of Terms and Biographies of Anatomists/Physicians Who Originated Them” Bergman, RA, Afifi, AK 2016