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

"Clinical Anatomy Associates, Inc., and the contributors of "Medical Terminology Daily" wish to thank all individuals who donate their bodies and tissues for the advancement of education and research”.

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Aortic arch

The aortic arch is a segment of the aorta that arches from the midline towards posterior and to the left. It presents with three branches. From proximal to distal they are the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. There are several anatomical variations of the branches of the aortic arch.

There is no clear anatomical landmark to denote the ending of the ascending aorta and the beginning of the aortic arch, as there is no clear anatomical landmark to denote the ending of the aortic arch and the beginning of the descending aorta. Anatomists use as a reference a horizontal plane that passes through the angle of Louis. Since this plane also separates the inferior from the superior mediastinum, the aortic arch is found in the superior mediastium, while the ascending and descending aorta are found in the inferior mediastinum.

Aortic arch and branches

Heart - Anterior view  Click on the image for a larger version.

The aortic arch has anatomical relations with the bifurcation of the trachea, the pulmonary trunk and its bifurcation, and the left brachiocephalic vein. In its inferior surface, the aortic arch in the adult has the embryological remnant of the ductus arteriousus, called the ligamentum arteriosum.

The term "aortic arch" was coined and first used by Lorenz Heister (1683 1785) 

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

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This is a medical root term that originates from the Greek and means "vessel", as in a "container". The term is commonly misunderstood to mean "artery". The original meanings of the term in early Greek and Roman medicine where multiple. It was Lorenz Heister (1683-1758) who first used the term in its modern meaning. Applications of this root term include:

Angiology: Study of vessels
Angioma: Vessel tumor or mass, usually referred to a malformation of knotted vessels. The plural form is "angiomata"
Angioplasty: Reshaping of a vessel
Angiitis: Inflammation of a vessel. Note the double "i" in the word. This is the correct form of the term. "Angitis" is not correct!
Angiogenesis: Creation or generation of vessels
Neoangiogenesis: The prefix [neo-] means [new], therefore the term means "creation or generation of new vessels"
Cholangiogram: The prefix [chol-] means "bile", while the suffix [-ogram] means "examination of". A [cholangiogram] is the "examination of a bile vessel"
Cineangiogram: The prefix [cine-] means "movement", although we use it to mean "movie", while the suffix [-ogram] means "examination of". A [cineangiogram] is the "examination of a vessel in movement"

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This is a medical root term that originates from the Greek "arthron" which means "joint". The term is used in many medical words. Applications of this root term include:

• Arthrotomy: Opening of a joint
Arthritis: Inflammation (or infection) of a joint
Arthrology: Study of a joint
Arthrodesis: Fixation of a joint
Arthropathy: A disease affecting a joint
Arthroplasty: Reshaping of a joint
Arthroscopy: Visualizing inside a joint with a scope

As a side note: What is the plural form for arthritis? Hover your cursor over the word "arthritis" to see the answer

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Charles H. McBurney, MD

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.

Charles H. McBurney, MD (1845- 1913). British surgeon and anatomist, Dr. McBurney studied at Harvard University, and received his MD from the Colombia University in New York. At the forefront of the aseptic technique revolution, Dr. MacBurney, following Halsted's example, required the use of surgical gloves and strict aseptic technique in his operating room, considered the "first modern operating room in America"

His studies focused on appendicitis, and demonstrated a point of maximum tenderness at a point "exactly between an inch and a half and two inches from the anterior spinous process of the ileum on a straight line drawn between that process and the umbilicus". This point has become known as the eponymic "McBurney's point". There is a discrepancy between the original description of this point by McBurney and some medical publications. Continuing his research on the surgical approach to the inflamed vermiform appendix, in 1894 Dr. MacBurney presented an approach that used a small incision for appendectomy. This incision is know today as "McBurney's incision."

1. "Charles Heber McBurney (1845 – 1913)" Yale,SH and Musana, KA Clin Med Res. 2005 August; 3(3): 187–189.
2. "Charles McBurney (1845–1913)—point, sign, and incision"  JAMA 1966;197:1098–1099
3. "The first modern operating room in America"  Clemons BJ AORN J. 2000 Jan;71(1):164-8, 170

Original imagecourtesy of National Institutes of Health.
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Cardiac apex

The word [apex] is Latin and means "the top". It refers to the highest point in a mountain or in a pyramid; the point furthest from the base. The plural form is [apices].  There are several anatomical apices in the human body.

The cardiac apex (also known by the Latin term apex cordis) is a misunderstood term. It refers to the "top" of the heart, but this is clear only when you place the heart in such a way that the apex is actually pointing "up" (see image). In this position the heart is like a pyramid and the base will be the surface opposite the apex. The anatomical location of the apex of the heart is posterior to the left 5th intercostal space in adults, just medial to the left midclavicular line.

Click on the image for a larger picture.

Human heart - Cardiac apex
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The prefix [endo-] is of Greek origin and means "inner or within". There are many uses of the term as follows:

Endocardium: the root term [card] means "heart" and the suffix    [-ium] refers to a "layer or membrane" - Inner layer of the heart
Endocrine: the suffix [-crine] means "secretion", the word meaning "inner secretion". Refers to a gland that deposits its secretions within the bloodstream. The products of endocrine glands are known generically as "hormones"
Endometrium: the root term [-metr-] is Greek, meaning "uterus" . The word endometrium means "inner layer of the uterus"
Endoscope: the term [-scope] refers to an instrument used for viewing. There is a consensus that a viewing instrument that enters through a natural body cavity will be called an "endoscope" (see image). All others will adopt the name of the cavity that is being viewed, as a laparoscope, a thoracoscope, an arthroscope, etc.

Original image courtesy of  Wikipedia.

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