Exploring the uncharted: Missing anatomical names in the Terminologia Anatomica.

Effective communication and precise navigation within the intricacies of the human body rely on robust anatomical terminology. Since its creation by the Federative Committee on Anatomical Terminology (FCAT), the Terminologia Anatomica (TA 1998) has consistently served as the benchmark in the field. However, the constant advancement of anatomical knowledge requires regular revisions, updates, and enhancements of anatomical nomenclature to accommodate the latest scientific discoveries. The recent adoption of the second edition of Terminologia Anatomica (TA 2019) by the International Federation of Associations of Anatomists (IFAA) has drawn attention to certain notable omissions. Despite over a century of dedicated work establishing standard anatomical terminology, specific widely recognized gross anatomical structures are still absent from the official listing in the Terminologia Anatomica. There is, however, a consensus that the inclusion of names for trivial or variably present structures should be avoided. Accordingly, this article focuses on a thoughtfully selected group of anatomical structures, which are so important that they are routinely discussed during anatomy courses, despite their exclusion from the official lists of anatomical terms. These basic structures hold fundamental importance for both anatomy education and clinical practice. Consequently, their appropriate nomenclature warrants consideration for inclusion in future editions of TA.

Osseous variations associated with physiological thinning of the glenoid articular cartilage: an osteological study with CT, MRI and arthroscopic correlations.

OBJECTIVE: To investigate the relationship between osseous variations of the glenoid fossa and thinning of the overlaying articular cartilage. MATERIALS AND METHODS: In total, 360 dry scapulae, comprising adult, children and fetal specimens, were observed for potential presence of osseous variants inside the glenoid fossa. Subsequently, the appearance of the observed variants was evaluated using CT and MRI (each 300 scans), and in-time arthroscopic findings (20 procedures). New terminology of the observed variants was proposed by an expert panel formed by orthopaedic surgeons, anatomists and radiologists. RESULTS: Tubercle of Assaky was observed in 140 (46.7%) adult scapulae, and an innominate osseous depression was identified in 27 (9.0%) adult scapulae. Upon radiological imaging, the tubercle of Assaky was found in 128 (42.7%) CTs and 118 (39.3%) MRIs, while the depression was identified in 12 (4.0%) CTs and 14 (4.7%) MRIs. Articular cartilage above the osseous variations appeared relatively thinner and in several young individuals was found completely absent. Moreover, the tubercle of Assaky featured an increasing prevalence with aging, while the osseous depression develops in the second decade. Macroscopic articular cartilage thinning was identified in 11 (55.0%) arthroscopies. Consequently, four new terms were invented to describe the presented findings. CONCLUSION: Physiological articular cartilage thinning occurs due to the presence of the intraglenoid tubercle or the glenoid fovea. In teenagers, the cartilage above the glenoid fovea may be naturally absent. Screening for these variations increases the diagnostic accuracy of glenoid defects. In addition, implementing the proposed terminological updates would optimize communication accuracy.

Description and nomenclature of organ subdivisions in the Terminologia Anatomica and in anatomical education: Comparison with cancer classifications.

Terminology is the basis for communication among medical professionals. For anatomists, their daily work is based on the Terminologia Anatomica (TA), while pathologists cite the Tumor Node Metastasis (TNM) classification when referring to the anatomical boundaries and regions of malignant tumors. Terminologia Anatomica and clinical-based classifications, including the TMN classification of tumors, use a world-wide standardized nomenclature, which has been revised regularly to incorporate new anatomical discoveries and clinically relevant structures. In medical education, students are familiarized with medical nomenclatures in anatomy textbooks and online learning platforms. Sometime, descriptions and illustrations in anatomy teaching materials put a different focus on the importance of anatomical subdivisions and their borders than is found in cancer classifications. This discrepancy contrasts with the efforts of medical societies to define and implement clinically relevant anatomical structures, including organ subdivisions and their boundaries, in daily clinical practice. Here, we illustrate this problem using the larynx and pancreas as examples. Anatomy education should coordinate teaching content with the requirements of the clinical disciplines.

Scapula revisited: new features identified and denoted by terms using consensus method of Delphi and taxonomy panel to be implemented in radiologic and surgical practice.

BACKGROUND: The scapular structures that have not yet been assigned anatomic terms generate a challenge in clinical diagnostics and surgical application, as well as in scientific observation. The aim of this study was to solve the lack in terminology concerning the scapula and the scapular region. METHODS: Observation and description of 29 structures were carried out on both dry scapulae and radiographs of the shoulder joint. In addition, several terms commonly encountered throughout the literature concerning the scapula were revised. A degree of consensus was reached by using the Delphi method surveying the opinions of 21 invited experts in the field. Taxonomy panels and etymology of anatomic terminology were considered in the generation of the proposed terms. RESULTS: The scapula was redefined as a lamina with projecting processes, and several landmarks demarcating certain newly defined topographic spaces were highlighted via 2 rounds of Delphi systematic voting and discussion. The overall level of the peer nominees' consensus was high. Few terms received a neutral opinion. CONCLUSIONS: This study communicates a proposal of 16 new terms defining grossly visible structures on the scapula that have not yet been described by officially recognized terms, including a call to unify 13 previously contributed terms that have not been codified and are often used interchangeably within different surgical and scientific fields. Incorporating these terms into the anatomic nomenclature would facilitate communication accuracy and eliminate ambiguity among clinicians, surgeons, and anatomists.

Mandibular canal vs. inferior alveolar canal: Evidence-based terminology analysis.

INTRODUCTION: The mandibular canal, as it was formerly named in Terminologia Anatomica (TA), has also been called the inferior alveolar (nerve) canal in many scientific publications. This study was conducted to investigate how these terms have been understood in different regions and different areas of expertise and to discuss the appropriate future application of the term "mandibular canal." METHODS: A literature search was conducted using PubMed, and articles using different terms for this structure were classified into two groups, inferior alveolar canal/inferior alveolar nerve canal (IAC/IANC) and the mandibular canal (MC). The 50 most recent articles in each group were included. Publication year, journal title, country of the first author, and affiliation of all authors were recorded in both groups for all 100 articles. RESULTS: There was a significant difference between the IAC/IANC and MC groups in the numbers of anatomy journals, other journals, and anatomy affiliations. Turkey published most frequently with a total of 15 articles, followed by Iran with 10 articles, and China/India/United States with seven each. When the six countries of the first author that had three or more publications in each group were compared, only Turkey appeared in both groups; otherwise, different countries were in the two groups. CONCLUSIONS: Based on the results of this analysis, and considering that the tentative new term "inferior alveolar foramen" is used in the latest TA, we suggest that the mandibular canal should be renamed the "inferior alveolar canal."

Mandibular canal versus inferior alveolar canal: A Delphi study.

The general principles of anatomical terminology indicate that the "mandibular canal" should be named the "inferior alveolar canal" as it accommodates the inferior alveolar neurovascular bundles. Therefore, we performed a Delphi study to evaluate the current understanding and use of the terminology in different geographical regions and areas of expertise and to determine the appropriate terminology for this bony canal. A Delphi panel was formed and questions sent and answered via email about: field of expertise (anatomy, oral surgery/oral and maxillofacial (OMF) surgery, oral radiology/OMF radiology, plastic surgery, ENT surgery, or dentistry with the exception of oral/OMF surgery and oral/OMF radiology), years of experience in the field of expertise, country currently working in, "what is the name of the bony canal that contains the inferior alveolar neurovascular bundle," and "what should the structure above be called, in general?" A total of 52 participants responded to the questionnaire. Half or more of the experts in anatomy, oral/OMF surgery, and ENT/plastic surgery considered "mandibular canal" to be the most appropriate name for this bony canal. In contrast, more than half of all experts in oral/OMF radiology and dentistry, that is, most fields of dentistry, considered "either mandibular canal or inferior alveolar canal" to be the appropriate name. The results of the Delphi study and general principles suggest that an alternative term for the "mandibular canal" should be "inferior alveolar canal."

Contribution to the anatomical nomenclature concerning lower limb anatomy.

PURPOSE: The aim of this article is to extend and revise the sections of Terminologia Anatomica (TA) dealing with the lower limb structures and to justify the use of newly proposed anatomical terms in clinical medicine, education, and research. METHODS: Anatomical terms were gathered during our educational experience from anatomical textbooks and journals and compared with the four previous editions of the official Latin anatomical nomenclature. RESULTS: The authors summarise 270 terms with their definitions and explanations for both constant and variable morphological structures (bones, joints, muscles, vessels, nerves and superficial structures) of the hip, thigh, knee, leg, ankle, and foot completed with several grammatical remarks and some general anatomical terms. CONCLUSION: The proposed terms should be discussed in wider anatomical community and potentially added to next edition of the TA.

Contribution to the anatomical nomenclature concerning upper limb anatomy.

PURPOSE: The aim of this article is to revise and extend the existing sections of Terminologia Anatomica dealing with the upper limb structures, which nomenclature belongs to its most neglected and not developing parts, and to justify the use of the proposed anatomical terms in the clinical practice, research, and education. METHODS: A sample collected from own educational and research experience was matched in the main anatomical textbooks as well as old and recent anatomical journals and compared with four versions of the official Latin anatomical nomenclatures. RESULTS: The authors summarize here 145 terms, completed with their definitions or explanations, concerning both constant and variable (inconstant) morphological structures (bones, joints, muscles, vessels, and nerves) of the pectoral girdle, arm, cubital region, forearm, wrist, and hand, completed with some grammar remarks and several general terms. CONCLUSION: After a broad discussion on this topic, the Terminologia Anatomica should be revised and extend with the listed terms (or their equivalents).

The Terminologia Anatomica matters: examples from didactic, scientific, and clinical practice.

The proper usage of the anatomical terminology is of paramount importance to all medical professionals. Although a multitude of studies have been devoted to issues associated with the use and application of the recent version of the anatomical terminology in both theoretical medicine and clinical practice, there are still many unresolved problems such as confusing terms, inconsistencies, and errors, including grammar and spelling mistakes. The aim of this article is to describe the current situation of the anatomical terminology and its usage in practice, as well as explain why it is so important to use precise, appropriate, and valid anatomical terms during the everyday communication among physicians from all medical branches. In this review, we discuss some confusing, obsolete, and erroneous terms that are still commonly used by many clinicians, and surgeons in particular, during the process of diagnosis and treatment. The use of these ambiguous, erroneous, and obsolete terms enhances the risk of miscommunication. We also provide some edifying examples from everyday clinical practice.

Clinical anatomy of the subserous layer: An amalgamation of gross and clinical anatomy.

The 1998 edition of Terminologia Anatomica introduced some currently used clinical anatomical terms for the pelvic connective tissue or subserous layer. These innovations persuaded the present author to consider a format in which the clinical anatomical terms could be reconciled with those of gross anatomy and incorporated into a single anatomical glossary without contradiction or ambiguity. Specific studies on the subserous layer were undertaken on 79 Japanese women who had undergone surgery for uterine cervical cancer, and on 26 female cadavers that were dissected, 17 being formalin-fixed and 9 fresh. The results were as follows: (a) the subserous layer could be segmentalized by surgical dissection in the perpendicular, horizontal and sagittal planes; (b) the segmentalized subserous layer corresponded to 12 cubes, or ligaments, of minimal dimension that enabled the pelvic organs to be extirpated; (c) each ligament had a three-dimensional (3D) structure comprising craniocaudal, mediolateral, and dorsoventral directions vis-á-vis the pelvic axis; (d) these 3D-structured ligaments were encoded morphologically in order of decreasing length; and (e) using these codes, all the surgical procedures for 19th century to present-day radical hysterectomy could be expressed symbolically. The establishment of clinical anatomical terms, represented symbolically through coding as demonstrated in this article, could provide common ground for amalgamating clinical anatomy with gross anatomy. Consequently, terms in clinical anatomy and gross anatomy could be reconciled and compiled into a single anatomical glossary.

Towards a Terminologia Anatomica Humana.

Unfortunately, the long-awaited revision of the official anatomical nomenclature, the Terminologia Anatomica 2 (TA2), which was issued in 2019 and after a referendum among the Member Societies officially approved by the General Assembly of the International Federation of Associations of Anatomists in 2020, is built on a new version of the Regular Anatomical Terminology (RAT) rules. This breaks with many traditional views of terminology. These changes in the Terminologia Anatomica of 1998 (TA98) met great resistance within many European Anatomical Societies and their members are not willing to use terms following the RAT rules. European anatomy teachers and scientists using traditional Latin in their teaching, textbooks and atlases will keep using the TA98. The German Anatomical Society (Anatomische Gesellschaft) recently announced the usage of the TA2023AG in curricular anatomical media such as textbooks and atlases, based on the TA98 and the Terminologia Neuroanatomica (TNA). We are preparing a more extensive improvement of the TA98, called Terminologia Anatomica Humana (TAH). This project is fully based on the noncontroversial terms of TA98, incorporating the recent digital version (2022) of the TNA from 2017. Further, it is completed with many new terms, including those in TA2, along with their definitions and relevant references, clinical terms, and correcting inconsistencies in the TA98. The TAH is still in process, but many chapters are already freely available at the IFAA Website in Fribourg ( https://ifaa.unifr.ch ) as is the digital version of the TNA.

Terminologia Anatomica in Latin-American countries: a systematic review.

Terminologia Anatomica (TA) is a unique collection of technical terms that allow communication in anatomy and medicine around the world. Considering this, we reviewed articles published by Latin American authors on Terminologia Anatomica and synthesized the main results found in this article. This study is a systematic review about Terminologia Anatomica that focuses on non-English-speaking countries in Latin America. The database used was Scopus via Elsevier. 207, and candidate articles were identified after applying the search strategy and with no restriction of year of publication. After the exclusion of articles whose authorship was not Latin American, 68 articles were filtered based on their titles and abstracts without the exclusion of any of them. These articles were fully evaluated resulting in 66 articles that met all the inclusion criteria of this review. We collected the following data: title of the article, year of publication, journal of publication, keywords of the study, country of origin, and aim of the article. Among the analyzed articles, 22 proposed changes to terms present in Terminologia Anatomica, 15 of them proposed the inclusion of terms for Terminologia Anatomica, and several articles sought to explain the existence of the existing terms. It is necessary to analyze the terms that are and their origins in the Latin America languages to evaluate their coherence and anatomical correspondence. A standard descriptor for Terminologia Anatomica was not obtained and it is a limitation since eventual articles may not have been obtained. As the study evaluates only articles that were published in journals indexed in Scopus, some articles published in non-indexed journals were not included.

Contributions to the development of an anatomical terminology in Spanish from South America.

The development of a standard anatomical language in Spanish dates back to the early stages of medicine, and its significance lies in the necessity for a common vocabulary to describe the structures of the human body. Anatomists and morphologists have been striving to achieve this goal since the late nineteenth century when the first Anatomical Nomenclature was created in Basel in 1895. Over the years, various versions of the International Anatomical Terminology have been published in Spanish, following the guidelines of the International Federation of Associations of Anatomists (IFAA). These versions have been produced in partnership with the Spanish Anatomical Society and have aimed to adjust the terms to the Spanish language and linguistic rules. The Ibero-Latin American Symposia on Anatomical, Histological, and Embryological Terminology (SILAT) have embraced the naming of morphological structures, keeping in mind the Latin and Greek roots, while respecting the translations accepted by the linguistic rules of the official languages. These symposia stick to the principles of universality, precision in structure description, and consistency in terminology. Despite more than a century of progress in anatomical terminology, there is a need for frequent revisions and adjustments to anatomical terms, particularly when translating them into various languages and because of the high number of international publications related to anatomy. A shared anatomical language is essential for the study and application of anatomy across various medical practices and in undergraduate education. Finally, the establishment of anatomical terminology in Spanish represents a long history of efforts to create a universal and precise language in this field. Despite advancements, the revision and adaptation of anatomical terms remain a continuous challenge to keep up with scientific progress and ensure effective communication in the field of anatomy.

The Epic of the Thalamus in Anatomical Language.

Understanding the origin of Greek and Latin words used as metaphors to label brain structures gives a unique window into how scientific and medical knowledge was produced, preserved, and transmitted through generations. The history of the term thalamus exemplifies the complex historical process that led to the current anatomical terminology. From its first mention by Galen of Pergamon in the 2nd century A.D. to its definitive and current use by Thomas Willis in 1664, the thalamus had an epical journey through 1500 years across Europe, the Middle East, and the North of Africa. The thalamus was confusingly described by Galen, in the Greek language, as a chamber to the brain ventricles. The term thalamus was transferred from Greek to Syriac through the translations of Galen's books done in Baghdad and also from Syriac to Arabic. Then, it was translated in Europe during the Middle Ages from the Arabic versions of Galen's books to Latin. Later, during the Early Renaissance, it was translated again to Latin directly from the Greek versions of Galen's books. Along this epical journey through languages, the term thalamus switched from referring to a hollow structure connected to brain ventricles to naming a solid structure at the rostral end of the brainstem. Finally, the thalamus was translated from Latin to modern languages, where it is used, until today, to name a nuclear complex of subcortical gray matter in the lateral walls of the third ventricle.

NOMENs land: The place of eponyms in the anatomy classroom.

The law of Non-Original Malappropriate Eponymous Nomenclature (NOMEN) states that no phenomenon is named after its discoverer. However, eponymous terms are rife in the anatomical and medical literature. In this viewpoint commentary, the authors discuss the history of anatomical eponyms, explain the additional cognitive load imposed by eponyms that can negatively impact student learning and explore the view that eponyms are "pale, male and stale" in the socially conscious 21st century. The authors probe two of the most common arguments used to keep eponyms in anatomy education: (1) clinicians use them because they are easy, and (2) eponyms remind us of anatomy's history. Educators, clinicians and students need to work together to progress this movement and bring a modern lens to this discussion. Based on the arguments presented in this commentary, the authors propose that eponyms should be removed from anatomy curricula, textbooks and have no place in the anatomy classroom.

New Terminologia Anatomica: cranium and extracranial bones of the head.

In 2019, the updated and extended version of Terminologia Anatomica was published by the Federative International Programme for Anatomical Terminology (FIPAT). This new edition uses more precise and adequate anatomical names compared to its predecessors. Nevertheless, numerous terms have been modified, which poses a challenge to those who prefer traditional anatomical names, i.e. medical students, teachers, clinicians and their instructors. Therefore, there is a need to popularise this new edition of terminology and explain these recent changes. The anatomy of the head, including the cranium, the extracranial bones of the head, the soft parts of the face and the encephalon, poses a particular challenge for medical students but also engenders enthusiasm in those of them who are astute learners. The new version of anatomical terminology concerning the human skull (FIPAT 2019) is presented and briefly discussed in this synopsis. The aim of this article is to present, popularise and explain these interesting modifications that have recently been endorsed by the FIPAT. Based on teaching experience at the Division of Anatomy/Department of Anatomy at Wroclaw Medical University, a brief description of the human skull is given here. This text can be useful to medical students, teachers, authors and researchers who might want to use the current version of anatomical terminology concerning the human skull.

New Terminologia Anatomica highlights the importance of clinical anatomy.

Although not all authors agree that Terminologia Anatomica merits special attention, any type of scientific terminology should be clear, exact, logical, coherent and worldwide accepted. A precise definition of every anatomical term is also crucial. New changes have recently been approved by the Federative International Programme for Anatomical Terminology as the previous version of terminology required minor revisions. This situation offers an opportunity to take a closer look at these new and interesting modifications. It turns out that selected traditional terms have been excluded from the list of official anatomical names. Furthermore, many changes have been introduced to modernise the Terminologia Anatomica. Nevertheless, the new version of anatomical terminology has both strengths and limitations, which warrants further refinement.

Bony canal and grooves of the middle meningeal artery: mythic structures in anatomy and neurosurgery?

BACKGROUND: It has been previously published that the frontal branch of the middle meningeal artery (MMA) is usually embedded in a bony canal (BC). Although the incidence of the BC was over 70%, this structure is currently omitted both in anatomical nomenclature and in most of the literature. We found the same gap pertaining to the grooves for the MMA on the skull base. The aims of our study were to assess the incidence and morphometry of the MMA BC and grooves on the skull base. MATERIALS AND METHODS: Computed tomography (CT) scans of 378 patients, 172 skull bases as well as 120 sphenoidal bones and 168 temporal bones, and 12 histological specimens from 3 men and 3 women and 3 different regions of the MMA course were assessed. RESULTS: Based on CT scans, the incidence of the BC was 85.44% and was significantly higher in females than in males. Most of the canals and grooves were bilateral. The mean canal length was 17.67 mm, the mean transverse diameter 1.33 mm, and the mean distance from the superior orbital fissure (dFOS) was 26.7 mm. In the skull bases, the BC incidence was 70.07%, the mean canal length 10.74 mm, and the mean dFOS was 19.16 mm. The groove for the MMA on the temporal and sphenoidal bones was present in 99.42% and 95.35%, respectively. Histological specimens confirmed the presence of the MMA and accompanying vein/s. CONCLUSIONS: Based on our results, we suggest the addition of the BC and grooves for the middle meningeal vessels to the upcoming version of the Terminologia Anatomica.

3D Exploration of the Brainstem in 50-Micron Resolution MRI.

The brainstem, a structure of vital importance in mammals, is currently becoming a principal focus in cognitive, affective, and clinical neuroscience. Midbrain, pontine and medullary structures serve as the conduit for signals between the forebrain and spinal cord, are the epicenter of cranial nerve-circuits and systems, and subserve such integrative functions as consciousness, emotional processing, pain, and motivation. In this study, we parcellated the nuclear masses and the principal fiber pathways that were visible in a high-resolution T2-weighted MRI dataset of 50-micron isotropic voxels of a postmortem human brainstem. Based on this analysis, we generated a detailed map of the human brainstem. To assess the validity of our maps, we compared our observations with histological maps of traditional human brainstem atlases. Given the unique capability of MRI-based morphometric analysis in generating and preserving the morphology of 3D objects from individual 2D sections, we reconstructed the motor, sensory and integrative neural systems of the brainstem and rendered them in 3D representations. We anticipate the utilization of these maps by the neuroimaging community for applications in basic neuroscience as well as in neurology, psychiatry, and neurosurgery, due to their versatile computational nature in 2D and 3D representations in a publicly available capacity.

Should Terminologia Anatomica be revised and extended? A critical literature review.

The first edition of the Terminologia Anatomica was published in 1998 by the Federative Committee for Anatomical Terminology, whereas the second edition was issued in 2011 by the Federative International Programme for Anatomical Terminologies. Since then many attempts have been made to revise and extend the official terminology as several inconsistencies have been noted. Moreover, numerous crucial terms were either omitted or deliberately excluded from the official terminology, like sulcus popliteus and diaphragma urogenitale, respectively. Furthermore, several synonyms are to be discarded. Notwithstanding the criticism, the use of the current version of terminology is strongly recommended. Although the Terminologia Anatomica is open to future expansion and revision, every change should be made after a thorough discussion of the historical context and scientific legitimacy of a given term. The anatomical nomenclature must be as simple as possible but also precise and coherent. It is generally accepted that hasty innovation ought not to be endorsed. Therefore, there is a need to take a closer look at these new proposals as they have been presented in numerous dispersed papers. This article provides an overview of these issues and concentrates on selected revisions and extensions that are didactically and clinically useful, thereby summarising the salient aspects of these new and compelling proposals.