Over the centuries, anatomists developed a standard nomenclature, or method of naming anatomical structures. Terms such as "up" or "down" obviously have no meaning unless the orientation of the body is clear. When a body is lying on it's back, the thorax and abdomen are at the same level. The upright sense of up and down is lost. Further, because anatomical studies and particularly embryological studies were often carried out in animals, the development of the nomenclature relative to comparative anatomy had an enormous impact on the development of human anatomical nomenclature. There were obvious difficulties in relating terms from quadrupeds (animals that walk on four legs) who have abdominal and thoracic regions at the same level as opposed to human bipeds in whom an upward and downward orientation might seem more obvious.
In order to standardize nomenclature, anatomical terms relate to the standard anatomical position. When the human body is in the standard anatomical position it is upright, erect on two legs, facing frontward, with the arms at the sides each rotated so that the palms of the hands turn forward.
In the standard anatomical position, superior means toward the head or the cranial end of the body.
The term inferior means toward the feet or the caudal end of the body.
The frontal surface of the body is the anterior or ventral surface of the body. Accordingly, the terms "anteriorly" and "ventrally" specify a position closer to—or toward—the frontal surface of the body. The back surface of the body is the posterior or dorsal surface and the terms "posteriorly" and "dorsally" specify a position closer to—or toward—the posterior surface of the body.
The terms superficial and deep relate to the distance from the exterior surface of the body. Cavities such as the thoracic cavity have internal and external regions that correspond to deep and superficial relationships in the midsagittal plane.
The bones of the skull are fused by sutures that form important anatomical landmarks. Sutures are joints that run jaggedly along the interface between the bones. At birth, the sutures are soft, broad, and cartilaginous. The sutures eventually fuse and become rigid and ossified near the end of puberty or early in adulthood.
The sagittal suture unties the parietal bones of the skull along the midline of the body. The suture is used as an anatomical landmark in anatomical nomenclature to establish what are termed sagittal planes of the body. The primary sagittal plane is the sagittal plane that runs through the length of the sagittal suture. Planes that are parallel to the sagittal plane, but that are offset from the midsagittal plane are termed parasagittal planes. Sagittal planes run anteriorly and posteriorly, are always at right angles to the coronal planes. The medial plane or midsagittal plane divides the body vertically into superficially symmetrical right and left halves.
The medial plane also establishes a centerline axis for the body. The terms medial and lateral relate positions relative to the medial axis. If a structure is medial to another structure, the medial structure is closer to the medial or center axis. If a structure is lateral to another structure, the lateral structure is farther way from the medial axis. For example, the lungs are lateral to the heart.
The coronal suture unites the frontal bone with the parietal bones. In anatomical nomenclature, the primary coronal plane designates the plane that runs through the length of the coronal suture. The primary coronal plane is also termed the frontal plane because it divides the body into frontal and back halves.
Planes that divide the body into superior and inferior portions, and that are at right angles to both the sagittal and coronal planes are termed transverse planes. Anatomical planes that are not parallel to sagittal, coronal, or transverse planes are termed oblique planes.
The body is also divided into several regional areas. The most superior area is the cephalic region that includes the head. The thoracic region is commonly known as the chest region. Although the celiac region more specifically refers to the center of the abdominal region, celiac is sometimes used to designate a wider area of abdominal structures. At the inferior end of the abdominal region lies the pelvic region or pelvis. The posterior or dorsal side of the body has its own special regions, named for the underlying vertebrae. From superior to inferior along the midline of the dorsal surface lie the cervical, thoracic, lumbar and sacral regions. The buttocks is the most prominent feature of the gluteal region.
The term upper limbs or upper extremities refers to the arms. The term lower limbs or lower extremities refers to the legs.
The proximal end of an extremity is at the junction of the extremity (i.e., arm or leg) with the trunk of the body. The distal end of an extremity is the point on the extremity farthest away from the trunk (e.g., fingers and toes). Accordingly, if a structure is proximate to another structure it is closer to the trunk (e.g., the elbow is proximate to the wrist). If a structure is distal to another, it is farther from the trunk (e.g., the fingers are distal to the wrist).
Structures may also be described as being medial or lateral to the midline axis of each extremity. Within the upper limbs, the terms radial and ulnar may be used synonymous with lateral and medial. In the lower extremities, the terms fibular and tibial may be used as synonyms for lateral and medial.
Rotations of the extremities may de described as medial rotations (toward the midline) or lateral rotations (away from the midline).
Many structural relationships are described by combined anatomical terms (e.g. the eyes are anterio-medial to the ears).
There are also terms of movement that are standardized by anatomical nomenclature. Starting from the anatomical position, abduction indicates the movement of an arm or leg away from the midline or midsagittal plane. Adduction indicates movement of an extremity toward the midline.
The opening of the hands into the anatomical position is supination of the hands. Rotation so the dorsal side of the hands face forward is termed pronation.
The term flexion means movement toward the flexor or anterior surface. In contrast, extension may be generally regarded as movement toward the extensor or posterior surface. Flexion occurs when the arm brings the hand from the anatomical position toward the shoulder (a curl) or when the arm is raised over the head from the anatomical position. Extension returns the upper arm and or lower to the anatomical position. Because of the embryological rotation of the lower limbs that rotates the primitive dorsal side to the adult form ventral side, flexion occurs as the thigh is raised anteriorly and superiorly toward the anterior portion of the pelvis. Extension occurs when the thigh is returned to anatomical position. Specifically, due to the embryological rotation, flexion of the lower leg occurs as the foot is raised toward the back of the thigh and extension of the lower leg occurs with the kicking motion that returns the lower leg to anatomical position.
The term palmar surface (palm side) is applied to the flexion side of the hand. The term plantar surface is applied to the bottom sole of the foot. From the anatomical position, extension occurs when the toes are curled back and the foot arches upward and flexion occurs as the foot is returned to anatomical position.
Rolling motions of the foot are described as inversion (rolling with the big toe initially lifting upward) and eversion (rolling with the big toe initially moving downward).
Gray, Henry. Gray's Anatomy. Philadelphia: Running Press, 1999.
Marieb, Elaine Nicpon. Human Anatomy & Physiology. 5th Edition. San Francisco: Benjamin/Cummings, 2000.
Netter, Frank H., and Sharon Colacino. Atlas of Human Anatomy. Yardley, PA: Icon Learning Systems, 2003.
K. Lee Lerner Larry Blaser