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

Georg Eduard Von Rindfleisch

Georg Eduard Von Rindfleisch
(1836 – 1908)

German pathologist and histologist of Bavarian nobility ancestry. Rindfleisch studied medicine in Würzburg, Berlin, and Heidelberg, earning his MD in 1859 with the thesis “De Vasorum Genesi” (on the generation of vessels) under the tutelage of Rudolf Virchow (1821 - 1902). He then continued as a assistant to Virchow in a newly founded institute in Berlin. He then moved to Breslau in 1861 as an assistant to Rudolf Heidenhain (1834–1897), becoming a professor of pathological anatomy. In 1865 he became full professor in Bonn and in 1874 in Würzburg, where a new pathological institute was built according to his design (completed in 1878), where he worked until his retirement in 1906.

He was the first to describe the inflammatory background of multiple sclerosis in 1863, when he noted that demyelinated lesions have in their center small vessels that are surrounded by a leukocyte inflammatory infiltrate.

After extensive investigations, he suspected an infectious origin of tuberculosis - even before Robert Koch's detection of the tuberculosis bacillus in 1892. Rindfleisch 's special achievement is the description of the morphologically conspicuous macrophages in typhoid inflammation. His distinction between myocardial infarction and myocarditis in 1890 is also of lasting importance.

Associated eponyms

"Rindfleisch's folds": Usually a single semilunar fold of the serous surface of the pericardium around the origin of the aorta. Also known as the plica semilunaris aortæ.

"Rindfleisch's cells": Historical (and obsolete) name for eosinophilic leukocytes.

Personal note: G. Rindfleisch’s book “Traité D' Histologie Pathologique” 2nd edition (1873) is now part of my library. This book was translated from German to French by Dr. Frédéric Gross (1844-1927) , Associate Professor of the Medicine Faculty in Nancy, France. The book is dedicated to Dr. Theodore Billroth (1829-1894), an important surgeon whose pioneering work on subtotal gastrectomies paved the way for today’s robotic bariatric surgery. Dr. Miranda.

Sources:
1. "Stedmans Medical Eponyms" Forbis, P.; Bartolucci, SL; 1998 Williams and Wilkins
2. "Rindfleisch, Georg Eduard von (bayerischer Adel?)" Deutsche Biographie
3. "The pathology of multiple sclerosis and its evolution" Lassmann H. (1999)  Philos Trans R Soc Lond B Biol Sci. 354 (1390): 1635–40.
4. “Traité D' Histologie Pathologique” G.E.
Rindfleisch 2nd Ed (1873) Ballieres et Fils. Paris, Translated by F Gross


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Diagnosis / Prognosis

These two terms are related by the Greek root term [-gnos-] which means "knowledge".

The first word [diagnosis] has the prefix [dia-] meaning "apart" or "to take apart". [Diagnosis] then means "to discern", or in a more detailed explanation, it is "knowledge by taking apart", identifying a pathology by looking at all its components.

The second word [prognosis] has the prefix [pro-] meaning "forward". Prognosis is then "forward knowledge", an statement of outcome of the course of a pathology.

Words suggested by:Sara Mueller


Coronary arteries

Coronary Arteries
Click for a larger image

The term [coronary] comes from the Latin root [corona] meaning "crown", therefore [coronary] is used to denote a structure that surrounds another as a crown or a garland. In the heart, the coronary arteries and their branches form a crown that surrounds the heart at the level of the atrioventricular sulcus. There are two coronary arteries, the right coronary artery (RCA), and the left coronary artery (*). Both these coronary arteries are the only branches that arise from the ascending aorta.

The right coronary artery passes from the anterior to the posterior surface of the heart, ending in a terminal branch, the posterior descending artery, or PDA. The left coronary artery, sometimes called the "left main", gives origin to two branches: the circumflex artery (CFX) and the left anterior descending artery (LAD). Each one of these arteries gives origin to several named branches. 

There can be interesting anatomical variations in the coronary arteries of the heart. Heart and coronary artery anatomy is one of the topics developed and delivered by CAA, Inc.

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


Ventricle

Heart model - LAO cranial view
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The Latin word [ventriculus] means "little sac" or "little belly" and arises from the Latin term [venter] meaning "belly" or "abdomen". Originally the term [ventricle] was used to denote the stomach. This use of the word has changed and now the term [ventricle] denotes a "sac" or "cavity", as in the "ventricles of the brain". The term [ventricular] means "pertaining or related to a ventricle".

In the case of the heart, the ventricles represent the two inferior chambers of the heart. (see image, items "C=right ventricle" and "D=left ventricle"). The anatomy of the right and left ventricles is quite different. The left ventricle has a thicker lateral muscular wall, almost three times thicker than the lateral wall of the right ventricle.

Image property of:CAA.Inc.Photographer:D.M. Klein


Perineum

Perineum, inferior view
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The term [perineum] has two definitions:

1. It is the area of the trunk inferior to the pelvic diaphragm. As such, the perineum contains the ischioanal fossa, the urogenital diaphragm, and the superficial genitalia.

2. It is the area of the body between the upper thighs containing the external openings of urethra, vagina, and anus. This area is delimited (see image) by the symphysis pubis, ischial tuberosities, and coccyx.

The perineum, as described in the second definition, is formed by two large triangular regions. The anterior region (in purple) is called the urogenital triangle, and the posterior region (in yellow) is called the anal triangle. 

There is another definition in use that is wrong! Please understand that I post it here as an example only. "The perineum is the area that is found between the scrotum (or vagina) anteriorly and the anus posteriorly". This is NOT the definition of perineum, it is the definition or location of the perineal body, the center of the pelvic floor where 17 named muscles attach of cross. The muscles are:

  • Iliococcygeus (2)
  • Pubococcygeus (2)
  • Superficial transverse perineal (2)
  • Deep transverse perineal (2)
  • Puborectalis (2)
  • Bulbospongiosus (2)
  • Pubovaginalis (2)
  • Sphincter urethae (1)

Image property of: CAA.Inc.. Artist: D.M. Klein.
Word suggested and edited by:Dr. Sanford S. Osher, MTD Contributor


Pelvic diaphragm

 

Pelvic diaphragm, superior view
Click for a larger image

The pelvic diaphragm is one of the four diaphragms in the human body (do you know the other three?) and it represents the lower boundary of the abdominopelvic cavity. This thin and  transversely oriented structure is formed from anterior to posterior by the puboccygeus, the iliococcygeus, and the coccygeus muscles.

The first two anterior muscles overlap, the pubococcygeus muscle being superior to the iliococcygeus muscle. Both of them attach laterally to a thickening of the obturator internus fascia that covers the obturator internus muscle. This thickening is known as the arcus tendineus levator ani (ATLA in the image). Because of the relation of the medial fibers of the puboccygeus muscle to the anal canal (puborectalis muscle), and what happens when these muscles contract, these two anterior muscles are known by one common name, the "levator ani" muscle. Click on the picture for a larger image.

The posterior component of the pelvic diaphragm is the coccygeus muscle, which is found lying on the internal aspect of the sacrospinous ligament.

Image property of: CAA.Inc. Artist: D.M. Klein
Word suggested and edited by:Dr. Sanford S. Osher, MTD Contributor 


Gynecology

A man-midwife and a 'modesty blanket' c.1681
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The root word [-gyne-] is Greek, from [gynaik] meaning "woman" or "female". The suffix [-ology] is also Greek,  derived from [logos] meaning "study of". [Gynecology] is then "study of a woman or a female". The term refers to the medical specialty that studies and treats the female reproductive system. A separate specialty, obstetrics, deals with the care of the pregnant patient and delivery of the fetus.

Originally, both specialties were the domain of midwives. It was not until the 1600's that male physicians were allowed to treat gynecological problems and attend  births. As the image shows, man-widwifes in Europe were allowed access to the patient only with the use of a "modesty blanket". This is plate XV from the 1681 book "Korte en Bondige Van Der Voortteeling en Kinderbaren" by Samuel Janson.

As an interesting side note in history, the first male physician to work as a man-midwife was Dr. Wertt from Hamburg. Dr Wertt decided to disguise himself as a woman to attend patients. When he was discovered, the punishment was "swift and salutary": He was burned at the stake.

Source:
"The Story of Surgery" by H. Graham, 1939
Word suggested and edited by: Dr. Sanford S. Osher, MTD Contributor