Eponyms

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Achilles Tendon

 

Other Known Aliases – Calcaneal tendon

Definition – The tendon attaching the gastrocnemius, plantaris, and soleus muscle to the calcaneus.

Achilles-tendon.jpg

Clinical Significance – The Achilles tendon is the thickest tendon in the body and rupturing this structure takes a tremendous amount of force.  Powerful plantarflexion while jumping is the most common mechanism and most commonly occurs in inflammed or chronically stressed tendons.

History – I am a bit of a mythology geek and I love this eponym.  The Achilles tendon was named after the famous Greek warrior, Achilles, who was the hero of the Trojan War for killing Prince Hector, son of King Priam of Troy.  This is a major part of Homer’s Illiad. 

I digress…..

The reason for this eponym is that Achilles’ mother is Thetis, an immortal sea nymph, who could not bear to see her child injured or killed.  To remedy this, she dipped him in the River Styx to make him invulnerable.  Since he was mortal, she couldn’t just drop him in, so she held him by the heel.  The spot on his heel that was held by Thetis was unprotected and ultimately would be his “Achilles Heel” (get it) when an arrow shot by Paris, brother of Hector, pierced this spot and killed him.

Image result for achilles river styxThetis dipping Achilles in the River Styx by Thomas Banks 02.jpg

Image result for achilles arrow to the ankle

 

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

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Lisfranc Injury

 

Other Known Aliases – Tarsometatarsal fracture/dislocation

Definition – Fracture/dislocation of the articulation of the tarsal bones with the metatarsals of the foot.

Clinical Significance – The Lisfranc joint of the foot is where the first three metatarsals articulate with the three cuneiforms and the fourth and fifth metatarsals articulate with the cuboid. The Lisfranc ligament attaches the medial cuneiform to the 2nd metatarsal bone on the the plantar surface of the foot.  This is a very serious injury of the foot and sometimes may simple present as a bad sprain.  This injury is most common seen with direct crush injuries and indirect load onto a plantar flexed foot.

Image result for lisfranc jointRelated imageImage result for lisfranc ligament

History – This injury was first described by Jacques Lisfranc de St. Martin (1790-1847), a French surgeon who served in Napoleon’s army in 1813.  He noted this injury pattern in Calvary soldiers who fell from their horse and caught their foot in the stirrup. 

 

Image result for jacques lisfranc

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. Welck MJ, Zinchenko R, Rudge B. Lisfranc injuries. Injury. 2015; 46(4):536-41. [pubmed]
  6. Chaney DM. The Lisfranc joint. Clinics in Podiatric Medicine and Surgery. 2010; 27(4):547-60. [pubmed]

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Aviator’s Astragalus

 

Other Known Aliases – None

Definition – Any fracture dislocation of the talus.

Clinical Significance – None.  This is an antiquated term for talar injuries

History – First coined in 1919 by Henry Graeme Anderson, who was a consulting surgeon for the Royal Flying Corps during World War I.  He described 18 cases of fracture and dislocation of the talus in pilots between 1914-1919.  During the early history of flight, planes did not reach lethal speeds and when they crashed, the rudder bar (which was controlled by the pilot’s feet) would get driven up into the instep of the foot just anterior to the calcaneous.

Image result for plane rudder bar world war one

Image result for talus fracture mechanism

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. Anderson HG.  The Medical and Surgical Aspects of Aviation.  The Henry Frowde Oxford University Press.  London, 1919
  6. Coltart WD.  Aviator’s Astragalus.  Journal of Bone and Joint Surgery. 1952;34(4):545-566.
  7. Lee P.  Musculoskeletal Colloquialisms: How Did We Come Up with These Names?.  Radiographics.  2004;24(4):1009-1027.

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Argyll Robertson Pupils

 

Other Known Aliases – Prostitute’s Pupil

Definition – Small, bilateral pupils with an absence of miotic reaction to light, both direct and consensual, with preservation of miotic reaction to near stimulus.  In other words, they accommodate, but do not react light (light-near dissociation).

Clinical Significance – Classically associated with tabes dorsalis of neurosyphylis, but can also be seen in diabetic neuropathy.  Rare now due to the widespread of antibiotics and treating early syphilis infections

History – Named after Douglas Moray Cooper Lamb Argyll Robertson (1837-1909), who was a Scottish surgeon and ophthalmologist and one of the first to specialize in the eye.  He published his findings of several case reports in two articles in the “Edinburgh Medical Journal” in 1869.  Previous to this however, he was also the first to discover and use the extract of the Calabar bean (otherwise known as physostigmine) for treatment of various eye disorders.

“Dougie”, as his friends called him****

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. Robertson DA. On an interesting series of eye symptoms in a case of spinal disease, with remarks on the action of belladonna on the iris. Edinb Med J. 1869;14:696–708.
  6. Robertson DA. Four cases of spinal myosis with remarks on the action of light on the pupil. Edinb Med J. 1869;15:487–493
  7. Robertson, D. A.:  On the Calabar Bean as a New Agent in Ophthalmic Medicine.  Edinb Med J. 1863;93:815-820.

****I have no source for this but he looks like a Dougie….plus with a name like Douglas Moray Cooper Lamb Argyll Robertson, you have to have a nickname, right?

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Kussmaul Breathing

 

Other Known Aliases – None

Definition – Form of hyperpnea (hyperventilation) characterized by a rhythmic, labored, and deep respiration pattern

 

Clinical Significance – Compensatory mechanism of profound metabolic acidosis, classically associated with diabetic ketoacidosis

History – Named after Adolph Kussmaul (1822-1902), a German physician, who noticed it in patients with severe diabetes mellitus and first published the finding in 1874.  Dr. Kussmaul was a prolific physician in the late 1880’s and this is just one of many eponymous distinctions that bears his name.  I am sure his name will come again in this series.

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. A. Kussmaul: Zur Lehre vom Diabetes mellitus. Über eine eigenthümliche Todesart bei Diabetischen, über Acetonämie, Glycerin-Behandlung des Diabetes und Einspritzungen von Diastase in’s Blut bei dieser Krankheit., Deutsches Archiv für klinische Medicin, Leipzig, 1874, 14: 1-46.
  6. Young P, Finn BC, Bruetman JE, Buzzi A, Zylberman M. [The outstanding achievements of Adolf Kussmaul]. Revista medica de Chile. 2012; 140(4):538-44. [pubmed]

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Varess Needle

 

Other Known Aliases – None

Definition – 12-15cm long, 2 cannula instrument used for insuflating the abdominal cavity before laparoscopic port placement.  The outer cannula has a beveled needle for dissecting through the abdominal wall.  The spring-loaded inner stylet resides within the outer cannula and has a dull tip to prevent injury to abdominal viscera.  Due to this spring-loaded mechanism, the inner stylet retracts into the outer cannula while it moves through the abdominal planes and advances past the sharp, cutting tip of the outer cannula once through the peritoneum.

Image result for veress needleImage result for veress needle

Clinical Significance – Using the Varess needle is the oldest and most traditional techniques for obtaining laparoscopic access

History – Named after János Vares (1903-1979), a Hungarian internist, who used iatrogenic pneumothoraces to treat tuberculosis patients.  He created this spring loaded needle in 1932 and published his results in 1936 (in a Hungarian journal), which was subsequently translated and published in German for wider audience in 1938.  Raoul Palmer (1904-1985), a French gynecologist, began using the Varess needle for laparoscopic surgery in 1947.

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. Vares J. Neues instrument zur ausfuhrung von brust-oder bauchpunktionen und pneumothoraxbehandlung. Deut Med Wochenschr. 1938;64:1480-1481.
  6. Palmer R. Instrumentation et technique de la coelioscopie gynécologique. Gynecologie et obstetrique. 1947; 46(4):420-31. [pubmed]

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Glisson’s Capsule

 

Other Known Aliases – None

Definition – Outer capsule of connective fibrous tissue, surrounding the liver, the intrahepatic branches of the portal vein, hepatic arteries, and bile duct

Clinical Significance – The is a structure that must be dissected while operating on the liver.  In trauma, you can have subcapsular hematomas from hemorrhage that are contained by Glisson’s capsule.

History – Named after Francis Glisson (1597-1667), who was an English physician, anatomist, and pathologist.  His work on the liver in the late 1600s produced the foremost textbook on the digestive system, The Anatomia Hepatis, where he first described the covering of the liver in detail.

 

 

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. Haubrich WS. Glisson of Glisson’s capsule of the liver. Gastroenterology. 2001; 120(6):1362. [pubmed]