Eponyms

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Pemberton Sign

Other Known Aliases – none

Definition – Raising of the patient’s arms over their head (until the arms touch their face) causes flushing and congestion of head and neck due to venous congestion and thoracic inlet obstruction.

Clinical Significance – this is a simple physical examination maneuver to diagnose a patient with superior vena cava syndrome and pressure on the thoracic inlet. A positive sign is flushing and cyanosis of the head and neck with possible respiratory distress with prolonged holding and is associated with mediastinal masses, goiters, and mediastinal lymphadenopathy.

History – Named after Hugh Spear Pemberton (1890-1956), who was an English physician and recieved his medical doctorate from the University of Liverpool in 1913. He would subsequently serve as a physician in the Royal Medical Corp during World War I and returned to Liverpool at the David Lewis Northern Hospital where he would spend his entire career. He founded one of the first diabetic clinics there in 1922 and made a name for himself in he area of endocrinology and receiving Fellowship in the Royal College of Physicians in 1941. It was in 1946 that he published a very short letter to the Lancet describing his eponymous maneuver.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Pemberton HS. SIGN OF SUBMERGED GOITRE The Lancet. 1946; 248(6423):509 [link]
  7. De Filippis EA, Sabet A, Sun MRM, Garber JR. Pemberton’s Sign: Explained Nearly 70 Years Later . 2014; 99(6):1949-1954 [link]

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Heinz Bodies

Other Known Aliases – Heinz-Ehrlich bodies, Ehrlich Inner Body

Definition – Deep purple small irregular bodies in red cells stained with crystal violet which represents denatured hemoglobin due to oxidative damage.

Clinical Significance – Seen in conditions with high oxidative stress such as G6PD deficiency, alpha thalassemia, NADPH deficiency, chronic liver disease, and asplenia.

History – Named after Robert Heinz (1865-1924), a German physician and pharmcologist who recieved his medical doctorate from the University of Breslau in 1888. He would work in the university chemical laboratory in Jena and Munich throughout his career studying pathology, inflammation, degeneration, and regeneration of blood. It was during this time, specifically in 1890, that he published a study on the blood of guinea pigs treated with acetylphenylhydrazine to intoduce oxidative inflammation and identified his eponymous cellular structure. Of note, Paul Ehrlich (1854-1915) is also regionally credited with identifying this structure but did not formally publish his findings.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. R. Heinz. Morphologische Veränderungen des roten Blutkörperchens durch Gifte. [Virchows] Archiv für pathologische Anatomie und Physiologie und für klinische Medizin, Berlin, 1890, 122: 112-116

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von Willebrand Disease

Other Known Aliases – hereditary pseudohemophilia

Definition – Autosomal dominant, hereditary clotting disorder arising from a deficiency in the quantity and/or quality of von Willebrand factor (vWF), which is a protein required for platelet adhesion and involved in primary hemostasis.  The genetic defect responsible for vWF production the vWF gene located on the short arm of chromosome 12 (12p13.2)

Clinical Significance – This is the most common type of hereditary blood-clotting disorder in humans, with 3 main hereditary types and multiple subtypes.  Type 1 is the most common and often asymptomatic, Type 2 can have mild to moderate symptoms, Type 3 is the most severe and can manifest with hemarthosis and internal bleeding.

History – Named after Erik Adolf von Willebrand (1870-1949), a Finnish physician who received his medical doctorate from the University of Helsinki 1896, and who took a special interest in hematology and coagulation.  In 1924, a 5yo girl was brought to him due to a bleeding disorder and he successfully performed a family history map on the girl’s 66 living family members and discovered the autosomal dominant pattern.  He published his findings in 1926 in Swedish calling it “pseudo-hemophilia”, but it wasn’t until 1931 (when it was translated into German) did it gain any traction in the medical community.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Von Willebrand EA. Hereditary pseudohaemophilia. Haemophilia. 1999; 5(3):223-31. [translation of original paper] [pubmed]
  7. Leebeek FW, Eikenboom JC. Von Willebrand’s Disease. NEJM. 2016; 375(21):2067-2080. [pubmed]
  8. Nilsson IM. Commentary to Erik von Willebrand’s original paper from 1926 ‘Hereditär pseudohemofili’. Haemophilia. 1999; 5(3):220-1. [pubmed]

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Sampson’s Artery

Other Known Aliases – artery of the round ligament of the uterus

Definition – branch of the inferior epigastric artery that runs under and supplies the round ligament of the uterus

Clinical Significance – this artery constitutes an anastomosis of the uterine and ovarian artery and is generally considered an physiologically insignificant artery dissected during hysterectomies. However, if accidentally severed or damaged, can lead to hemoperitoneum and need for re-operation.

History – Named after John Albertson Sampson (1873-1946), an American gynecologist who received his medical doctorate from Johns Hopkins University in 1899. He would spend the majority of his career at the Albany Hospital in New York and was a pioneer in the research of endometriosis, first introducing and coining the term for this condition in 1921. He would also be the first to describe the implantation areas of endometriosis as “chocolate cysts”. It was during his time at Johns Hopkins that he took a keen interest in oncology and extensively studied the lymphatic drainage and vascular supply of the pelvis, where he was later credited with his eponymous artery of the round ligament of the uterus.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Sampson J.A. Perforating hemorrhagic (chocolate) cysts of the ovary. Am J Obstet Gynecol. 1921;2:526–528. [Google Scholar]
  7. Sampson J.A. Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol. 1927;14:422–469. [PMC free article] [PubMed] [Google Scholar]
  8. Wong JW. Sampson’s Artery Revisited RMGO. 2017; 2:1-2. [link]

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McRoberts Manuever

Other Known Aliases – none

Definition – forced hyperflexion of the hips with applied suprapubic pressure during vaginal delivery

Clinical Significance – this is the primary maneuver to attempt to help relieve a shoulder dystocia during vaginal deliveries. Due to the hypermobilty of sacroilliac joint during pregnancy, this allows for rotation of the pelvis and facilitates releasing the stuck shoulder. It has been shown to have a success of close to 90%.

History – Named after William McRoberts, Jr. (1914-2006), an American obstetrician who recieved his medical doctorate from the University of Pittsburgh in 1940. He would go on to have a modest career in obstetrics culminating in Professor and Chief of Obstetrics at the University of Texas Medical School and Hermann Memorial Hospital in Dallas, TX. It was here where he his reputation as a teacher flourished and where he taught his eponymous maneuver for shoulder dystocia for over 40 years. As a testament to his teaching and a gift on retirement in 1982, two of his residents published an article naming this maneuver after their teacher and mentor.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Gonik B, Stringer CA, Held B. An alternate maneuver for management of shoulder dystocia. Am J Obstet Gynecol. 1983; 145(7):882-4. [pubmed]

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Zavanelli Manuever

Other Known Aliases – cephalic replacement, Gunn-Zavenelli-O’Leary Manuever

Definition – replacement of the fetal head back into the uterus followed by immediate cesarean delivery

Clinical Significance – this is a controversial, last resort maneuver to a shoulder dystocia and involves rotating the head back to an occiput anterior position, flexing the head , and pushing it as far cephalad as possible. The other hand can be used depress the perineum to relieve pressure on the umbilical cord. Although rarely used, single case reports do show a high rate of success.

History – Named after William Zavanelli (1926- ), an American obstetrician from California who received his medical doctorate from College of Osteopathic Physicians and Surgeons in Los Angeles in 1957. He would go on to have a modest career until 1978 when he performed his eponymous maneuver followed by a successful cesarean delivery. His partner wanted to publish the results immediately, but Zavanelli wanted to wait to see if there were any developmental issues with the child. After seven years, the case report was published. Of note, this manuever was performed 2 years prior by Gunn and his case report was published later in 1985 refuting the eponymous naming.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Sandberg EC. The Zavanelli maneuver: a potentially revolutionary method for the resolution of shoulder dystocia. Am J Obstet Gynecol. 1985;152(4):479-84 [link]
  7. O’Leary J, Gunn D. Cephalic replacement for shoulder dystocia. Am J Obstet Gynecol. 1985; 153(5):592-3. [pubmed]

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Purkinje Fibers

Other Known Aliases – subendocardial branches

Definition – specialized conducting fibers composed of electrically excitable cells located just beneath the subendocardium in the inner ventricular walls of the heart

Clinical Significance – these cells actually conduct cardiac action potentials faster and more effeciently than any other cells in the heart and are responsible for the synchronized contractions of the ventricles during depolarization. They also have intrinsic pacemaking ability at 20-40 bpm to act as a back-up pacing system.

History – Named after Jan Evangelista Purkinje (1787-1869), a Czech anatomist and experimental physiologist who received his medical doctorate from Charles University in Prague in 1818. He would be appointed Professor of Physiology in Breslau in 1823 and did revolutionary work on vision. He would later create the world’s first Department of Physiology at the University of Breslau in Prussia in 1839 and the world’s second official physiology lab in 1842. During his career of physiologic discovery and research, he discovered large neurons with branching dendrites in the cerebellum (Purkinje cells), describe the change in brightness of red and blue colors as light intensity decreases (Purkinje shift), and the eye’s reduced sensitivity to dim red light compared to dim blue light (Purkinje effect). He also was the first scientist to present work on the cellular theory of biology, the first to use the term “protoplasm” to describe the fluid in cells, and the first to report on the individuality of fingerprints. But it was in 1839 when he described his eponymous fibers of the heart. He was one of the best known scientists of his era and was so famous, people would address letters to him and simply put “Purkinje, Europe”.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Cavero I, Guillon JM, Holzgrefe HH. Reminiscing about Jan Evangelista Purkinje: a pioneer of modern experimental physiology. Adv Physiol Educ. 2017; 41(4):528-538. [pubmed]

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Bundle of His

Other Known Aliases – atrioventricular bundle

Definition – collection of electrical conduction cells of the heart that transmit impulses from the AV node to the ventricles

Clinical Significance – this bundle of cells is responsible for communication contraction impulses from the atria to the ventricles. Any damage to this area can result in varying degrees of heart block and conduction abnormalities

History – Named after Wilhelm His Jr. (1863-1934), a Swiss-born cardiologist and anatomist who received his medical doctorate from the University of Leipzig in 1889. The son of the equally famous Basel anatomist Wilhelm His Sr., he would become professor extraordinaire at his alma mater 6 year after graduating. He also went on to be physician-in-chief at the Friedrichstadt Hospital in Dresden, chair of internal medicine in Berlin, and advisory internist for several armies during World War I. He would describe his eponymous bundle as an assistant professor in 1893.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. His Jr, W. Die Tätigkeit des embryonalen Herzens und deren Bedeutung für die Lehre von der Hezbewegung beim Menschen. Arbeiten aus der medidizinischen Klinik zu Leipzig, 1893: 23.

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Beck’s Triad

Other Known Aliases – none

Definition – classic physical examination findings associated with critical cardiac tamponade

Clinical Significance – although not seen in every patient with cardiac tamponade, it is a common question on boards and certification examinations. These include: 1) hypotension, 2) JVD, and 3) muffled/distant heart sounds.

History – Named after Claude Schaeffer Beck (1894-1971), an American cardiac surgeon who recieved his medical doctorate from Harvard University in 1921. He would attend surgical residency at Case Western University, where he would spend his entire career. He developed a novel re-circulation technique for cardiac ischemia called the Beck Procedure, where pectoral muscle was implanted in the pericardium, and later placing a vein graft between the aorta to the coronary sinus. He also pioneered the first successful use of a defibrillator in 1947 to restore ROSC in a 14yo patient he was operating on for a congenital heart defect. His eponymous triad was first described in 1935 in an article entitled “Two cardiac compression triads” in the Journal of the American Medical Association.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Beck CS. Two Cardiac Compression Triads. JAMA. 1935;104(9):714-716. [link]
  7. Theruvath P, Ikonomidis JS. Historical perspectives of The American Association for Thoracic Surgery: Claude S. Beck (1894-1971). JTCVS. 2015;149(3):655-660. [link]

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Austin Flint Murmur

Other Known Aliases – none

Definition – low-pitched, rumbling, mid-to-late diastolic murmur heard best at the apex

Clinical Significance – this murmur is associated with severe aortic regurgitation and is due to two distinct mechanisms. First, the aortic jet flow impinging on the mitral valve causing vibrations from premature closing and second, turbulence of two columns of blood from the left atrium to left ventricle and aorta to left ventricle.

History – Named after Austin Flint I (1812-1886), an American physician who received his medical doctorate from Harvard University in 1833. He would practice in Boston, Buffalo (where he would help found the Buffalo Medical College, and New York City, where he was professor of medicine at the famed Bellevue Hospital. A proponent of European diagnostic methods (as he was mentored by James Jackson at Harvard, who was a follower of Laënnec), he advocated and popularized the use of the binaural stethoscope in physical diagnosis. He was a prolific writer and researcher with his Treatise on the Principles and Practice of Medicine considered as a classic medical text. He is also recognized as having coined the term “broncho-vesicular breathing” in lung auscultation. He would publish the first detailed description his eponymous murmur in 1862 in the American Journal of Medicine Sciences in an article entitled “On cardiac murmurs”.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Flint A. On cardiac murmurs. American Journal of Medical Science. 1862;7;29-54 [link]
  7. The Mitral Valve. Austin Flint. http://www.themitralvalve.org/mitralvalve/austin-flint