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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William S. Halsted, MD
(1852 – 1922)
American anatomist, teacher, and surgeon, William Stewart Halsted was born in New York City, USA to a wealthy family of English origin. His father was involved in charitable work and Governor and trustee to a city hospital. Not a brilliant student initially, Halsted took an undergraduate in Liberal Arts in Yale, CT., after which he entered the Medical College of Physicians at the Columbia College, where he excelled.
As a second-year medical student Halsted applied and obtained a position in surgery at a local hospital. In here he learned about Lister’s antiseptic technique and became an adamant proponent of it to reduce infection. In 1877 Halsted obtained his MD. After a short time as House Physician at the New York Hospital, Halsted traveled to Europe to further his education studying for two years at the Universities of Vienna, Leipzig, and W?rzburg.
Besides being at the forefront of surgical and antiseptic techniques (introducing the use of rubber gloves in surgery), Halsted was extremely concerned with the way medical students were taught in the US. He pioneered bedside clinical round discussions with the medical students after two years of basic sciences studies. Halsted developed the idea of a patient chart; he also developed the residency program for medical students in use today.
Halsted is probably the most influential researcher and surgeon at the turn of the century. He dedicated time to the study of intestinal anastomoses and the use of silk as a suture material. His experimental work in 1887 proved that the inclusion of the submucosa layer in an anastomosis was mandatory, as well that a single layered anastomosis was enough to attain closure. Perhaps Halsted’s most important contribution was the application and use of the scientific method to surgical questions. Halsted’s principles set the standards used today in surgical suturing and surgical stapling.
He also pioneered the development and surgical techniques for radical mastectomy as a treatment for breast cancer.
As a side effect of this studied in anesthesia and the use of cocaine for anesthesia, Halsted became addicted to this substance, a problem that followed him through the years. Without impairing his capacity as a researcher and a surgeon, Halsted eventually recovered. He died in Baltimore in 1922 as a complication to surgery.
Sources:
1. Dubay, A. D., & Franz, G. M. (2003). Acute Wound Healing: The Biology of Acute Wound Failure. Surg Clin NA, 83, 463-481.
2. Halsted, W. S. (1887). Circular Suture of the Intestine - An Experimental Study. Am J Med Sci, 436-461.
3. “William Stewart Halsted: his life and contributions to surgery” Osborne, P. Lancet Oncol 2007; 8: 256–65
4. “William Stewart Halsted: Surgical pioneer” Burress, P Endoc Today (2010), 8: (2) 22
5. “William Stewart Halsted (1852–1922) Neurological stamp” Haas, LF J Neurol Neurosurg Psych 2000;69:641
Original image courtesy of "Images from the History of Medicine" at www.nih.gov
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The term [nystagmus] is derived from the Greek word [νυσταγμένος], (nystagm?nos) meaning "sleepy" or "dizzy". It refers to the sensation of dizziness when you are just awakening from a deep sleep.
In medical terminology nystagmus refers to the rapid, usually lateral, movement of the eyes. This movement has a slower component that moves en eye to one side with a secondary rapid component that brings the eye to the starting point. Nystagmus eye movement is usually bilateral and can be unilateral in rare cases.
Nystagmus is a normal capability of the human visual system where the eyes move slightly to change the location of an image on the retina to avoid fatigue of the retinal components. In some individuals this movement is quite visible but it does not cause a problem and is called physiological or congenital nystagmus as shown in the video..
When nystagmus is pathological it can be the cause for vertigo, as the patient feels that the world is moving, when only the eyes are doing so. This can be caused by a pathology in the abducens nerve system.
Nystagmus can be triggered by using warm fluids in the external ear that will cause flow of the fluid in the semicircular canals of the inner ear. You can also see it if you turn a person around in a swiveling chair for a few turns and then stop and watch their eyes. You will see the rapid nystagmus movement of the eye. If you do this experiment, please be careful, as a person with nystagmus will have poor balance and they can fall with potential for injury.
Thanks to Lashkyrie for the use of her video on YouTube.
Note: The links to Google Translate include an icon that will allow you to hear the Greek or Latin pronunciation of the word.
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The midclavicular line is one of the surface reference lines used in surface anatomy of the thorax.
It is a parasagittal vertical plane that passes halfway through the body of the clavicle. The lateral portion of the clavicle is close to the highest point of the shoulder joint (the acromioclavicular joint), while the head (medial aspect) of the clavicle is found just lateral to the jugular notch of the sternum, a depression in the superior aspect of the sternal manubrium.
Although it was originally used as a thoracic reference point, the continuation of the midclavicular line into the abdomen is used today as a reference for laparoscopic procedures, to indicate the location where a trocar must be introduced into the abdomen. As an example, in a laparoscopic cholecystectomy, one of the four trocars (in this case a 5mm trocar) is introduced into the abdomen on the right midclavicular line four fingerbreadths inferior to the costal margin (the lower border of the ribs). This trocar is used to manipulate the gallbladder and is placed in the gallbladder infundibulum.
It is also one of the lines used to describe the abdominal regions.
Sources:
1. "Clinical Anatomy" Brantigan, OC 1963 McGraw Hill
2. "Tratado de Anatomia Humana" Testut et Latarjet 8th Ed. 1931 Salvat Editores, Spain
3. Davis, Gwilym G. "Applied Anatomy: The Construction of the Human Body Considered in Relation to Its Functions, Diseases, and Injuries"; Philadelphia: J.B. Lippincott Co., 1910
Image modified from the original Davis, 1910
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The transpyloric plane (also called the transpyloric line) is one of the surface reference lines used in surface anatomy. It is one of the lines used to describe the abdominal regions.
It is a horizontal or transverse plane located halfway between the jugular notch of the sternum, a depression in the superior aspect of the sternal manubrium, and the superior aspect of the symphysis pubis.
The transpyloric plane crosses the body of the first lumbar vertebra and approximates the course and location of the pancreas. The plane also transects the kidney horizontally in half at about the region of the renal hilum. This plane also passes through the origin of the superior mesenteric artery, the body of the gallbladder, and of course through the pylorus of the stomach, from whence the name of this plane arises.
To be precise, the pylorus will be found on or slightly above the transpyloric plane, and slightly to the right of the midline
Sources:
1. "Clinical Anatomy" Brantigan, OC 1963 McGraw Hill
2. "Tratado de Anatomia Humana" Testut et Latarjet 8th Ed. 1931 Salvat Editores, Spain
3. Davis, Gwilym G. "Applied Anatomy: The Construction of the Human Body Considered in Relation to Its Functions, Diseases, and Injuries"; Philadelphia: J.B. Lippincott Co., 1910
Image modified from the original Davis, 1910
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Brainstem. Anteroinferior view
The anatomical term crus cerebri is Latin. The term [crus] means "pillar" or "leg", and [cerebri] means "brain", thus it means the "pillars of the brain" or "the brain legs".
It refers to the anterior view of the midbrain or mesencephalon. There are two slightly divergent columns or pillars separated by the interpeduncular fossa, a space or region that contains in its superior aspect the mammillary bodies. These two columns are also known as the "cerebral peduncles".
The interpeduncular fossa is a dilated region of the subarachnoid space and as such it is a cistern called the "interpeduncular cistern". The oculomotor nerve (third cranial nerve) appears on the lateral aspect of the interpeduncular fossa.
The trochlear nerve (4th cranial nerve) wraps around the lateral aspect of each crura cerebri on its way towards the eye.
Image property of:CAA.Inc.
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A simple surface anatomy division of the abdomen is into four quadrants. A more detailed division of the abdomen is into nine abdominal regions.
The abdominal quadrants are formed by two planes. The first is the midsagittal or median plane. The second one is a transverse or horizontal plane that passes through the umbilicus. This creates four quadrants with specific content as follows:
Right Upper Quadrant (RUQ): This quadrant contains most of the liver, with the gallbladder, portal vein, the distal portion of the stomach, duodenum, head of the pancreas, part of the ascending colon, part of the transverse colon, the right flexure of the colon, and the right kidney and right adrenal gland
Left Upper Quadrant (LUQ): This quadrant contains the tip of the left lobe of the liver, most of the stomach, spleen, body and tail of the pancreas, part of the transverse colon and the left colic flexure, and the left kidney and left adrenal gland
Right Lower Quadrant (RLQ): This quadrant contains the cecum and ascending colon, vermiform appendix, right ovary, the ileocecal junction, right ureter, part of the small intestine, and the right half of the greater omentum
Left Lower Quadrant (LLQ): This quadrant contains the descending colon, sigmoid colon, left ovary, part of the small intestine, and the left half of the greater omentum
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Continuing on the topic of surface anatomy, the surface of the body has been divided into anatomical regions which are used to describe locations on the body.
The number of regions varies according to different authors and even the boundaries of these regions are sometimes not clearly delineated and will vary from author to author. Still, these regions are the basis of surface anatomy.
The human body as a whole can be divided into eight basic regions:
• Head
• Neck
• Torso (itself divided into abdomen and thorax)
• Superior extremities (not to be confused with “the leg”)
• Inferior extremities (not to be confused with “the arm)
The division of thorax and abdomen is not clearly evident, as the respiratory diaphragm, which is considered the boundary between them is curved. The abdomen is divided into nine abdominal regions and four abdominal quadrants.
Original image courtesy of Connexions (http://cnx.org) [CC-BY-3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons
