There must be some kind of bad connection

A reader of my EMPractice LLSA review on paracentesis (still available, buy yours today!) wrote my editor with a question. Not, thankfully, on anything factual in my writeup, but rather on an issue of word usage.

This is picayune but a start. 2010 LLSA 4 paracentesis refers to a \"Z tract\" as a technique to avoid leakage. When I learned this years ago I thought it was Z track-as the pathway (track) left when the needle was removed. I thought using tract was just sloppy language. Checking Roberts for procedures I read Z tract-OK-solved. BUT then Roberts' Illustrative Guide calls it Z track. So, evidenced-based mavens which is it?!!!

Our editor referenced the original NEJM article on which my review was based. The NEJM uses the term “Z-tract.” But further Googling turned up varied usage, and "Z-track" was far more popular.

Is there a definitive answer?

Of course not. This is medicine, after all.

I favor "tract" because it feels more consistent with other biological tracts -- a 3D tunnel system like the GI tract.

I've always felt "track" was reserved for more linear or 2D systems, like a race track or tenure track.

This isn't the first time this question has come up.  But what I find puzzling is so many online dictionaries and language sites all state that "tract" can refer to organ systems -- but I've never heard the phrase "cardiovascular tract" or "musculoskeletal tract" -- it's always GI or reproductive tracts. Mostly, I suspect, because these are organ systems based around a single tubular structure.

Thus, it's my assertion that the Z shape we're making in paracentesis has more in common with a tracT than a tracK, and is more in keeping with the original definition of tract:

Tract: 1350–1400; (in senses referring to extent of space) < L tractus stretch (of space or time), a drawing out, equiv. to trac-, var. s.of trahere to draw + -tus suffix of v. action; Track: 1425–75; late ME trak (n.) < MF trac, perh. < ON trathk trodden spot; cf. Norw trakke to trample; akin to tread

Still, despite favoring the tracT side of this debate, I can't say it's completely unreasonable to call it a tracK and so I'm not planning on annoyingly correcting my colleagues who refer to it as such. The other big K-for-T switch in medicine, however -- vomicking for vomiting --  must be corrected at every opportunity.