Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community, medical students, and the medical industry. 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

Self-portrait, Henry Vandyke Carter, MD (Public Domain)
Self-portrait, Henry Vandyke Carter, MD (Public Domain)

Henry Vandyke Carter, MD
(1831 – 1897)

English physician, surgeon, medical artist, and a pioneer in leprosy and mycetoma studies.  HV Carter was born in Yorkshire in 1831. He was the son of Henry Barlow Carter, a well-known artist and it is possible that he honed his natural talents with his father. His mother picked his middle name after a famous painter, Anthony Van Dyck. This is probably why his name is sometimes shown as Henry Van Dyke Carter, although the most common presentation of his middle name is Vandyke.

Having problems to finance his medical studies, HV Carter trained as an apothecary and later as an anatomical demonstrator at St. George’s Hospital in London, where he met Henry Gray (1872-1861), who was at the time the anatomical lecturer. Having seen the quality of HV Carter’s drawings, Henry Gray teamed with him to produce one of the most popular and longer-lived anatomy books in history: “Gray’s Anatomy”, which was first published in late 1857.  The book itself, about which many papers have been written, was immediately accepted and praised because of the clarity of the text as well as the incredible drawings of Henry Vandyke Carter.

While working on the book’s drawings, HV Carter continued his studies and received his MD in 1856.

In spite of initially being offered a co-authorship of the book, Dr. Carter was relegated to the position of illustrator by Henry Gray and never saw the royalties that the book could have generated for him. For all his work and dedication, Dr. Carter only received a one-time payment of 150 pounds. Dr.  Carter never worked again with Gray, who died of smallpox only a few years later.

Frustrated, Dr. Carter took the exams for the India Medical Service.  In 1858 he joined as an Assistant Surgeon and later became a professor of anatomy and physiology. Even later he served as a Civil Surgeon. During his tenure with the India Medical Service he attained the ranks of Surgeon, Surgeon-Major, Surgeon-Lieutenant-Colonel, and Brigade-Surgeon.

Dr. Carter dedicated the rest of his life to the study of leprosy, and other ailments typical of India at that time. He held several important offices, including that of Dean of the Medical School of the University of Bombay. In 1890, after his retirement, he was appointed Honorary Physician to the Queen.

Dr. Henry Vandyke Carter died of tuberculosis in 1897.

Personal note: Had history been different, this famous book would have been called “Gray and Carter’s Anatomy” and Dr. Carter never gone to India. His legacy is still seen in the images of the thousands of copies of “Gray’s Anatomy” throughout the world and the many reproductions of his work available on the Internet. We are proud to use some of his images in this blog. The image accompanying this article is a self-portrait of Dr. Carter. Click on the image for a larger depiction. Dr. Miranda

1. “Obituary: Henry Vandyke Carter” Br Med J (1897);1:1256-7
2. “The Anatomist: A True Story of ‘Gray’s Anatomy” Hayes W. (2007) USA: Ballantine
3. “A Glimpse of Our Past: Henry Gray’s Anatomy” Pearce, JMS. J Clin Anat (2009) 22:291–295
4. “Henry Gray and Henry Vandyke Carter: Creators of a famous textbook” Roberts S. J Med Biogr (2000) 8:206–212.
5. “Henry Vandyke Carter and his meritorious works in India” Tappa, DM et al. Indian J Dermatol Venereol Leprol (2011) 77:101-3

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The term [aphasia] has Greek origins and means "without speech". This pathology was first described by Paul Broca who called it "aphemia".

Aphasia is a total and complete loss of speech. Lesser presentations of this condition should be called [dysphasias) from the prefix [dys-] meaning "abnormal", and  [phasia], meaning "speech".

Aphasia is the lack of spoken  speech due to cerebral cortex damage in the dominant brain hemisphere, usually the left side in right-handed individuals. There are two main areas of the brain involved in speech: Broca's and Wernicke's. Broca's area is responsible for speech expression (the spoken and written word). Damage to this area causes expressive or motor aphasia (or dysphasia).

Wernicke's area is responsible for the comprehension of speech, the understanding of language. Damage to this area causes receptive orsensory aphasia (or dysphasia). Broca's and Wernicke's areas are connected by an intrahemispheric tract known as the arcuate fasciculus (see image).

Broca and Wernicke's areas in the dominant brain hemisphere

Broca and Wernicke's areas in the dominant brain hemisphere

Complete loss of all communication abilities is called global aphasia. Other dysphasia pathologies are:

• Agraphia / dysgraphia: Incapacity / difficulty in writing
• Anomia / dysnomia: Incapacity / difficulty in naming objects
• Aphrasia / dysphrasia: Incapacity / difficulty forming phrases or sentences. The patient can communicate with single words, but cannot form sentences.

Image under copyleft agreement courtesy of The Brain from Top to Bottom
Thanks to  Margaret P. Tschimperle for suggesting this word. 

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The scaphoid is one of the proximal carpal bones that form the wrist. The name arises from the Greek [scaphe], meaning "boat"; and [-oid], meaning "similar to". The scaphoid bone roughly resembles a rowboat. It is also known as the navicular bone (from the Latin [navis] meaning "boat"), and os naviculare manus.

Proximally, the scaphoid bone articulates with the radius. Distally, the scaphoid articulates with the trapezium and trapezoid bones. On its medial  aspect, the scaphoid bone has two articular surfaces for the lunate and the hamate bones. The scaphoid bone also has very strong ligamentous connections with the lunate bone by way of the scapholunate interosseous ligament

The accompanying image shows the anterior (volar) surface of the wrist. Click on the image for a larger picture.

Image modified from the original: "3D Human Anatomy: Regional Edition DVD-ROM." Courtesy of Primal Pictures

Scaphoid bone - anterior (volar) view of the wrist


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Cardiac muscle

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 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, called automatism or automaticity.

Cardiac muscle (Dr. S. Girod, A. Becker)
Original image by S. Girod and A. Becker, courtesy of Wikipedia. Click on the image for a larger version.
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Medial / lateral

The terms [medial] and [lateral] are opposing anatomical relationship terms that indicate the location of a structure or structures in relation to the midline or median plane. The accompanying image depicts the median plane.

The term "midline" is a bit of a misnomer, as this is a plane and not a line, although if you look at the median plane from the anterior or posterior aspect of an individual in the anatomical position, you would have a line, ergo, midline! Look at this article on the anatomical position to see an explanation and image of this concept.

The term [medial] means "closer to the midline". An example of the use of this term is: "the head of the clavicle is medial to the shoulder joint", that is, the head of the clavicle is closer to the midline than the shoulder joint.

The term [lateral] means "further from the midline". An example of the use of this term is: "the wrist joint is lateral to the elbow joint", that is, the wrist joint is further away from the midline than the elbow joint.

Click on the image for a visual explanation of the concepts of "medial" and "lateral".


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

Medial / Lateral
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The term [inion] is Greek and originally referred to the posterior aspect of the neck, as mentioned in the Iliad.

The term fell in disuse for hundreds of years, until it was resurrected by Peter Paul Broca (1824-1880) as a craniometric point. The inion is the midline protuberance in the posteroinferior aspect of the external surface of the occipital bone. Today, in most anatomy texts the inion is referred to as the "external occipital protuberance"

The inion is found at the intersection of three bony lines that are easily palpable, the bilaterally situated superior nuchal line, and the median nuchal line (see accompanying image). There is a corresponding internal occipital protuberance in the internal aspect of the occipital bone.

Original image courtesy of Bartleby.com. Click on the image for a larger version. 

External view of the occipital bone. (www.bartleby.com)
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The word [sesamoid] means "similar to a sesame". First used by Galen c.180AD, he describes small ovoid bones that are "similar to a sesame seed", referencing the seed of the plant sesamum indicum, the oil of which was used as a laxative at that time. 

Sesamoid bones are found in the tendons of some muscles and are mostly inconstant. Largey and Bonnet proposed a classification for these bones as: accessory, capsuloligamentous, intratendineous, and mixed.

Of special interest to this article are the sesamoid bones found within the two tendons of the flexor hallucis brevis muscle in the base of the foot (see accompanying X-ray image). These bones, especially the medial sesamoid bone, was attributed religious, mystical, and magical powers since ancient times. This is due to the fact that this small bone is highly resistant to natural decomposition. A Hebrew medical text dated 210 BC, attributed to Ushaia presented a small bone he called "luz" as the "depository of the soul". Many other authors, including Vesalius (who called it Albadaran), believed that upon resurrection, the whole body could reform from this "seed" bone.

This belief was later reinforced by religious texts into the early Renaissance which stated that this bone was indestructible and its presence was enough to guarantee resurrection for believers. 

1. "Les os se?samo?¨des de l’hallux : du mythe a` la fonction" Largely,A; Bonnel, BE Med Chir Pied 2008 24: 28–38
2. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
3. "De Humani Corporis Fabrica" Vesalius, Andrea. 1543 Oporinus
Thanks to the first year medical students at the University of Cincinnati who inspired this article. Dr. Miranda

Foot X-ray

Original image courtesy of
Wesley Norman, Ph.D.

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