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, also known as "Halsted's Rules of Surgery", 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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- Written by: Efrain A. Miranda, Ph.D.
Sinus rhythm electrocardiogram
A contraction, from the Greek [συστολή] (systolí) meaning “contraction”, also [συστελλει] (systellei) meaning “to shrink, to shorten, or to draw together”.
It refers to the contraction of the heart. If you analyze a normal heartbeat (sinus rhythm), there are two systoles: an atrial systole, followed by a short interval, followed by the ventricular systole. The term systole is usually used in reference to the ventricular systole.
Systole is part of the normal rhythm of the heart and was first recognized and named by Herophilus of Alexandria (325-255BC), most probably trough animal vivisection. Herophilus was accused of animal vivisection and the dissection of human cadavers. Because of this, some call Herophilus "The Father of Anatomy".
Galen of Pergamon (129AD - 200AD) used the term [συστελλεσθαι] meaning “contracted”.
The word in English was first used in the 16th century and was originally written as “sistole”, with an "i" instead of the accepted use today with a "y". The modern pronunciation in English follows the Greek pronunciation by ending the word in a long “e” as in “to be”.
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
3. "Dorlands's Illustrated Medical Dictionary" 26th Ed. W.B. Saunders 1994
4. "Greek anatomist Herophilus: the father of anatomy" Si-Yang, N. Anat Cell Biol. 2010; 43(4): 280–283
Note: Google Translate includes an icon that will allow you to hear the pronunciation of the word
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- Written by: Efrain A. Miranda, Ph.D.
Sinus rhythm electrocardiogram
Sinus Rhythm (SR), also known as Normal Sinus Rhythm (NSR) is the term used to denote normal cardiac activity. A normal beating heart is in sinus rhythm.
In the normal beating of the heart the left and right atria contract almost simultaneously, followed by the contraction of the left and right ventricles. These atrial and ventricular contractions are separated by a lag time of 1/10th of a second which allows the atria to relax (atrial diastole) while the ventricles contract (ventricular systole). The addition of the normal action of the four heart valves (tricuspid, mitral, aortic, and pulmonary) allows the heart to work as a blood pump and circulate blood within the heart and through the body and lungs.
NSR is coordinated by a complex set of structures. The first part is the conduction system, composed of heart muscle cells (cardiomyocytes) which are characterized by automaticity. It is important to state here something that is known, but many times ignored: The conduction system is not composed of nerves... it is formed by specialized cardiac muscle cells! The description of this cardiomyocyte-based system can be read in a separate article here.
The second component is the cardiac autonomic nervous system (CANS), which acts as a moderator (accelerating or slowing) the cardiomyocyte-based conduction system. The CANS has two components, an extrinsic component formed by nerves and ganglia outside the heart, and an intrinsic component of nerves and ganglia that forms a complex network within the superficial aspect of the heart muscle and fat surrounding the heart. These are the cardiac ganglionated plexuses, and their dysfunction can cause abnormal heart rhythm.
Both these systems, the conduction system, and the CANS form a complex cardiac rhythm control system. For more information click here.
When these two components and their thousands of cardiac muscle cells, ganglia, and nerves are working property, the heart is in sinus rhythm, and beats between 60 to a 100 times per minute.
Personal note: The term Normal Sinus Rhythm (NSR) is redundant. By definition, if the heart is in SR, it is normal. On the other hand, the term Abnormal Sinus Rhythm is also not correct… if the heartbeat is abnormal, the heart is not in SR! (Dr. Miranda)
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Histology image of cardiac muscle*
[UPDATED] Cardiac muscle is one of the three types of muscle found in the human body. It is found exclusively in the heart, where it forms the main component of its middle layer, the myocardium.
[Myo]=combining form for "muscle"; [-card-]=heart; and [-ium]=layer or membrane. The myocardium is the muscle layer of the heart.
Cardiac muscle has distinct striations and intercalated discs (see accompanying image). The cardiac muscle acts as a functional syncytium.
The key characteristic of cardiac muscle is automatism or automaticity, its capacity to contract rhythmically in the absence of an external electrical stimulus. The other two types of muscle (smooth and skeletal) lack this characteristic.
The term [cardiomyocyte] can be used to describe each of these cells as the word is composed of [Card(i)o=combining form for "heart"; [myo]=combining form for "muscle"; and the suffix [-cyte]= cell. A cardiomyocyte is a cardiac muscle cell.
The conduction system of the heart is made exclusively of cardiomyocytes, and is part of a more complex rhythm control system of the heart.
Image modified from the original on YouTube from the British Heart Foundation.
* Original histology image by S, Girod and A. Becker, courtesy of Wikipedia.
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- Written by: Efrain A. Miranda, Ph.D.
Anterior view of the heart*
[UPDATED] These two root terms mean "heart".
The first one, [-card(i)-] arises from the Greek [καρδιά] pronounced kardiá, and can be seen in medical words such as: cardiac, echocardiogram, cineangiocardiogram, cardioplegia, myocardial infarction, etc.
The second one [-cord(i)-] arises from the Latin [cor] or [cordis] and can be seen in words such as: precordial pain, cordial, commotio cordis, etc.
As a point of interest, the original Greek spelling of [kardium] was used by Nobel prize winner Dr. Willem Einthoven (1860 - 1927) when he invented the electrocardiograph and the electrocardiogram. The German term is [elektrokardiogramm] and the German abbreviation for the procedure is EKG. Since we use the term in English, [electrocardiogram] we use the abbreviation ECG. Both are correct, although if you are speaking English, ECG should be used.
* Image property of:CAA.Inc.. Artist:Victoria G. Ratcliffe
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Vine tendril. Image courtesy of Jon Sullivan
The term [pampiniform] comes from the Latin term [pampinus] meaning "a vine tendril". It refers to a twisted, curved structure as seen in the accompanying image. The second portion of the word also comes from Latin, [forma] means "shape" or "in the shape of".
Pampiniform then means "in or with the shape of a vine tendril"
Although mostly associated with the pampiniform plexuses found in both the testicular veins in the spermatic cord and the ovarian veins found within the infundibulopelvic ligament, the term is also used to denote the coiled aspect of the organ of Rosenmuller, also known as the pampiniform body or paraovarium.
The pampiniform body is a non-functional embryological remnant of the development of the female reproductive system. It is composed of a blind longitudinal duct and 10-15 transverse smaller ducts. It is located in the mesosalpinx, an extension of the broad ligament related to the uterine tube (Fallopian tube).
Thanks to David Van Tol for suggesting this article!
Image courtesy of Jon Sullivan, Public domain, via Wikimedia Commons https://jonsullivan.com/
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Brachial plexus
UPDATED: The term [plexus] comes from the Latin term [plectere] meaning " to twine, or to braid". In anatomy, the term [plexus] refers to a group of structures that are intertwined or form a meshwork. The plural form is [plexuses], although the Latin plural form [plexi] is also correct. Gabrielle Fallopius used the term to denote "a tangle of nerves"
There are many plexuses described in the human body. Most are formed by nerves, but there are many that are lymphatic or vascular. The best known are the plexuses of nerves formed by the ventral rami of the spinal nerves. These are the cervical plexus, the brachial plexus, the lumbar plexus, and the sacral plexus. The image depicts the brachial plexus. For a larger version, click on the image, and for further information on the cervical and brachial plexuses, click here.
Images and links courtesy of:www.bartleby.com