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Scheme of lymphatic trunks of the upper limb. PLP plexus lymphaticus palmaris, TA truncus anterior, TL truncus lateralis, TM truncus medialis, VB vena basilica, and VC vena cephalica
Source publication
PurposeThe 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. MethodsA sample collected...
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Introduction The linguistic factor may have delayed the universal adoption of the International Anatomical Terminology (IAT), which was widespread in Latin and in English only. Independent translations are possible, but they are not devoid of methodological difficulties.
Objective To estimate the usage of the translated version of the Terminologia...
Citations
... This mistranslated and inaccurate "medial collateral" term persisted throughout the 20th and 21st century and was incorporated as the official term for the artery in the first edition of the Terminologia Anatomica in 1998. 48 Although the latest edition of the Terminologia Anatomica in 2019 replaced "medial collateral artery" with "middle collateral artery," this nomenclature issue continues to stay relevant because recent papers since then continue to publish the misleading "medial collateral" name. 17,44e46 Clarifying the name of the MCA is important for surgical reconstruction and medical education. ...
... Although no prior study has thoroughly examined the nomenclature issue, some sources have also commented that the "medial collateral" name is inappropriate. Though the authors' reasoning wasn't provided, Kachlik et al 48 noted that the Terminologia Anatomica's use of the term "medial collateral artery" in 1998 appeared incorrect and recommended the term "middle collateral artery" instead. Similarly, after describing the MCA's posterolateral position in the 2017 Atlas of Upper Extremity Trauma: A Clinical Perspective, Eglseder commented that the name "medial collateral artery" was "erroneous" and preferred the use of its original name, the "middle collateral artery." ...
Purpose
Current literature interchangeably uses the terms “middle” and “medial” for the middle collateral artery (MCA). However, the term “medial” implies that the artery is positioned on the medial aspect of the arm, which may lead to misunderstandings in medical education or interdisciplinary communication. Our purpose is to provide anatomic and historical support for the use of the original “middle collateral artery” terminology.
Methods
We reviewed a 300-year history of anatomy texts to elucidate the origin of the MCA nomenclature. In three cadaveric specimens, the MCA was dissected following latex infusion and its vascular contribution to three pedicled flaps was demonstrated. In three additional specimens, the arms were imaged with computed tomography and three-dimensional reconstruction following barium sulfate infusion.
Results
The term “middle” collateral artery predates the term “medial” collateral artery by 80 years. The origin of the term “medial” collateral artery is likely a mistranslation of the predecessor Latin term, “arteria collateralis media.” Our cadaveric dissections and computed tomography imaging confirmed that the MCA’s course is on the posterolateral side of the arm between the anterolateral-positioned radial collateral artery and the medial-positioned superior ulnar collateral artery.
Conclusion
The term “medial” collateral artery is an anatomic misnomer. “Middle” collateral artery, its original name, accurately reflects its posterolateral position in the arm between the radial collateral artery and superior ulnar collateral artery. We recommend that authors use the term “middle” collateral artery based on its anatomical position and recommend discontinuation of the term “medial” collateral artery in the scientific literature.
Clinical Relevance
Given the MCA’s surgical significance in reconstructive flaps, nonanatomic labeling of the MCA as “medial” may lead to misunderstandings in medical education and surgical site identification. Replacing a misnomer with an anatomically accurate name would improve professional communication and teaching.
... Nevertheless, many authors argue that certain sections of both TA 1998 and TA 2019 lack the necessary level of detail and precision (Kachlik et al. 2008(Kachlik et al. , 2010(Kachlik et al. , 2016(Kachlik et al. , 2017(Kachlik et al. , 2018(Kachlik et al. , 2021Musil et al. 2019). Most notably, the sections dedicated to the paranasal sinuses and vasculature are considered insufficiently comprehensive (Chmielewski 2023). ...
Since its inception, the International Anatomical Terminology has been an indispensable and widely embraced resource for authors, anatomists, researchers, and medical professionals, ensuring standardized anatomical terminology across various disciplines. Nonetheless, it is widely acknowledged that periodic updates and enhancements are necessary to incorporate the latest scientific knowledge and advancements in imaging techniques. The current version of Terminologia Anatomica includes a section dedicated to the paranasal sinuses, encompassing ethmoidal cells and three sinuses: frontal, sphenoidal, and maxillary. However, the anatomical lexicon pertaining to the paranasal sinuses is more extensive. In clinical practice, multiple terms related to clinically significant structures are commonly employed. This article focuses on the clinical terminology associated with the paranasal sinuses, proposing significant extensions to the existing Terminologia Anatomica. These extensions aim to enrich the anatomical nomenclature and facilitate a harmonious convergence between the language of clinicians and the anatomical lexicon. Further endeavors should bridge the gap in anatomical nomenclature and improve communication between anatomists, researchers, and clinicians, thereby enhancing diagnostic accuracy and improving interdisciplinary research collaboration.
... Again, the following parts are discussed in a partonomic hierarchy: 1. Cor: following the TA2, (a) the importance of an attitudinal appropriate description was emphasized (Anderson and Loukas 2009); (b) we reordered terms so that the atrioventricular valves are considered in the context of a 'valvar complex' (Complexus valvaris cordis); (c) the section on fibrous skeleton of heart (Skeleton fibrosum cordis) has been extended according to recent studies (Mori et al. 2016;Saremi et al. 2017); and (d) the conducting system of the heart (Systema conducens cordis) is listed separately, to which the internodal tracts were added (James 1963(James , 2001Seo et al. 2022). 2. Systema arteriosum commune following TA98 with some additions from the literature (Kachlik et al. 2015(Kachlik et al. , 2017. The intrarenal arteries have also been added. ...
... Sections on the portocaval anastomoses (Anastomoses portocavales) and the cavocaval anastomoses (Anastomoses cavocavales) have been added as well as the intrarenal veins. 6. Vasa lymphatica following TA98 with superficial and deep trunks for the limbs added (Kachlik et al. 2017. ...
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.
... In a final step, the arm was maximally abducted and externally rotated and the relationship between axillary arch and neurovascular bundle was documented.SPSS Statistics 29.0 (IBM, New York, USA) was used for descriptive statistics, statistical tests and statistical visualization. GraphPad Prism 9 (GraphPad Software Inc.) and Photoshop Elements 2020 were used for the creation of figures.Anatomical terms were used according to the official Terminologia Anatomica (TA) and publications byKachlik et al. (FIPAT, 2019;Kachlik et al., 2017;Kachlík et al., 2020). ...
Connective or muscular tissue crossing the axilla is named axillary arch (of Langer). It is known to complicate axillary surgery and to compress nerves and vessels transiting from the axilla to the arm. Our study aims at systematically researching the frequency, insertions, tissue composition and dimension of axillary arches in a large cohort of individuals with regard to gender and bilaterality. In addition, it aims at evaluating the ability of axillary arches to cause compression of the axillary neurovascular bundle. Four hundred axillae from 200 unembalmed and previously unharmed cadavers were investigated by careful anatomical dissection. Identified axillary arches were examined for tissue composition and insertion. Length, width and thickness were measured. The relation of the axillary arch and the neurovascular axillary bundle was recorded after passive arm movements. Twenty‐seven axillae of 18 cadavers featured axillary arches. Macroscopically, 15 solely comprised muscular tissue, six connective tissue and six both. Their average length was 79.56 mm, width 7.44 mm and thickness 2.30 mm. One to three distinct insertions were observed. After passive abduction and external rotation of the arm, 17 arches (63%) touched the neurovascular axillary bundle. According to our results, 9% of the Central European population feature an axillary arch. Approximately 50% of it bilaterally. A total of 40.74% of the arches have a thickness of 3 mm or more and 63% bear the potential of touching or compressing the neuromuscular axillary bundle upon arm movement.
... Although the proposals for hundreds of new terms are appreciated (Kachlik et al., 2008(Kachlik et al., , 2010(Kachlik et al., , 2015(Kachlik et al., , 2017a(Kachlik et al., , 2017b(Kachlik et al., , 2018Musil et al., 2018Musil et al., , 2019, their adherence to the principles and rules established by the IFAA is of utmost importance (Chmielewski, 2020(Chmielewski, , 2021(Chmielewski, , 2022Neumann et al., 2020). Nevertheless, the omission of names for gross anatomical structures, particularly those that are didactically and clinically important, necessitates their incorporation into future editions of TA, ensuring both consistency and comprehensiveness (Chmielewski & Strzelec, 2020). ...
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.
... Concerning the terminology, neural connections used to be called "anastomoses" according to their external similarity to the vascular interconnections, but this term is inappropriate as they are solid structures (unlike hollow vessels) and make no existing real connection "ana-stoma" (via-mouth). In the anatomical nomenclature (Terminologia Anatomica TA 1998 and Terminologia Neuroanatomica TNA 2017) concerning the upper limb, only the terms "Communicating branch with ulnar nerve (R. communicans cum nervo ulnari in TA; R. communicans ulnaris in TNA)," previously known as a Martin-Gruber anastomosis, sub-ordered under the median nerve, and "Communicating branch with ulnar nerve (R. communicans ulnaris in TA)," sub-ordered under the superficial branch of the radial nerve, are listed (FCAT, 1998;FIPAT, 2017;Kachlik et al., 2017). ...
Introduction:
The superficial branch of the radial nerve (SBRN) and the lateral antebrachial cutaneous nerve (LACN) are sensory nerves coursing within the forearm in a close relationship. This high degree of overlap and eventual communication between the nerves is of great surgical importance. The aim of our study is to identify the communication pattern and overlap of the nerves, to localize the position of this communication in relation to a bony landmark, and to specify the most common communication patterns.
Materials:
and methods: One hundred and two adult formalin-fixed cadaveric forearms from 51 cadavers of Central European origin were meticulously dissected. The SBRN, as well as the LACN, were identified. The morphometric parameters concerning these nerves, as well as their branches and connections, were measured with a digital caliper.
Results:
We have described the primary (PCB) and secondary communications (SCB) between the SBRN and the LACN and their overlap patterns. One hundred and nine PCBs were found in 75 (73.53%) forearms of 44 (86.27%) cadavers and fourteen SCBs in eleven hands (10.78%) of eight cadavers (15.69%). Anatomical and surgical classifications were created. Anatomically, the PCBs were classified in three different ways concerning: (1) the role of the branch of the SBRN within the connection; (2) the position of the communicating branch to the SBRN; and (3) the position of the LACN branch involved in the communication to the cephalic vein (CV). The mean length and width of the PCBs were 17.12mm (ranged from 2.33-82.96mm) and 0.73mm (ranged from 0.14-2.01mm), respectively. The PCB was located proximally to the styloid process of the radius at an average distance of 29.91mm (ranged from 4.15-97.61mm). Surgical classification is based on the localization of the PCBs to a triangular zone of the SBRN branching. The most frequent branch of the SBRN involved in the communication was the third (66.97%). Due to the frequency and position of the PCB with the third branch of the SBRN, the danger zone was predicted. According to the overlap between the SBRN and the LACN, we have divided 102 forearms into four types: (1) no overlap; (2) present overlap; (3) pseudo-overlap; and (4) both present and pseudo-overlap. Type 4 was the most common.
Conclusion:
The patterns of communicating branch arrangements appeared to be not just a rare phenomenon or variation, but rather a common situation highlighting clinical importance. Due to the close relationship and connection of these nerves, there is a high probability of simultaneous lesion.
... Since its publication in 1998 [4], the Terminologia Anatomica (TA 1998) has been the golden standard in anatomical terminology and has dominated the field, even though several minor mistakes, inaccuracies, discrepancies, multiplication of terms, synonyms and missing terms were noted [5][6][7][8][9][10]. Nevertheless, TA 1998 was accepted unanimously by all the member societies of the International Federation of Associations of Anatomists (IFAA), and the use of TA 1998 is highly recommended in education, clinical practice and scientific research [2,5]. ...
... Anatomical and medical terminology is subject to scrutiny and revision [1][2][3][4][5][6][7][8][9][10]19]. The second edition of the Terminologia Anatomica [11] was recently published, in which multiple traditional terms were significantly changed. ...
... Human anatomy is one of the oldest scientific disciplines and the first medical field, in which terminology plays a crucial role [1][2][3]. If correctly used, anatomical terminology can be a powerful tool of communication and a guide through the intricacies of the human anatomy [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. It should be remembered that it is also a base for scientific and medical terminology. ...
In science and medicine, terminology is a precise system of terms that are generally accepted in a given discipline. In anatomy, it is important to distinguish between terminology and nomenclature, which is an officially accepted set of terms arranged according to certain rules and principles. The Terminologia Anatomica (1998) has been the golden standard in the field of terminology, even though it contains minor errors, inaccuracies, discrepancies, multiplication of terms, inconvenient terms as well as synonyms and identical names for different structures. All of these problems need to be solved in the future, which is a key challenge in the field. Another major challenge is to create a clear, precise, logical, flawless and worldwide accepted list of anatomical terms that would cover all the names that are used in education and clinical practice. Many researchers and clinicians assert that this task is still ahead of us. The aim of this article is to explain why the longstanding tradition of medical terminology should be respected and why major and rapid changes should never be endorsed. Anatomical terminology, if correctly used, is a basic tool of communication both within and outside the field. It is also a guide through the intricacies of the human anatomy.
... The most frequently described variations are the accessory head of the FPL muscle (one of the variants of Gantzer's muscle) [2,5,6,15] and the Linburg-Comstock variation [7,10,11,19]. According to Asgharet al., the prevalence of the Gantzer's muscle concerning only the accessory head of FPL is 48% out of the total 65%. ...
Purpose
Knowledge of the unusual arrangement of the flexor pollicis longus (FPL) muscle is important as the variable tendon may be a rare cause of carpal tunnel syndrome.
Methods
During a routine dissection at the Department of Anatomy, an unusual formation of the FPL muscle was observed in a formalin embalmed Central European cadaver.
Results
This report presents a variation of the FPL muscle, where the muscle split and formed a separate accessory head inserting into the first lumbrical muscle. Moreover, a tendinous interconnection was present between the FPL muscle tendon and the tendon of the aberrant muscle head.
Conclusion
The cases described by previous literature, concerning the Linburg–Comstock variation or the accessory head of the first lumbrical muscle originating from the FPL muscle, are closest to the present case. Such variation has a clinical significance ranging from the functional limitation of the thumb and index finger movement to the potential median nerve compression.
... Currently the SPM is not codified by any official term in the Terminologia Anatomica, neither in TA nor TA2 (FIPAT, 2019). The shortage in terminology regarding the upper limb had been addressed and discussed in the literature (Al-Redouan and Kachlik et al., 2017). This study calls for incorporating the SPM into the Terminologia Anatomica. ...
Background:
The subclavius muscle runs underneath the clavicle. However, there have been a few reports of a duplicated subclavius muscle which is commonly referred to as subclavius posticus muscle due to its orientation being posterior to the proper subclavius muscle. Its occurrence seems to potentially create a narrowing interval at the superior thoracic aperture as it crosses over the brachial plexus. It might also have functional influence on the shoulder girdle.
Purpose:
To provide comprehensive gross anatomy description of the variant "subclavius posticus muscle" and to investigate its reported clinical implications with emphasis on its involvement in causing brachial plexus compression.
Basic procedures:
A scoping review with meta-analysis of the gross anatomy of the subclavius posticus muscle was conducted along with investigating its correlation to the thoracic outlet syndrome. Forty-seven articles were pooled through two rounds of the selection process. The relevant information was extracted and meta-analyzed.
Main findings:
The scoping review and meta-analysis of the 47 articles revealed a total prevalence of 11/2069 (4.9%); 10/1369 (5.1%) in cadaveric studies, and 1/700 (5.0%) in MRI studies. The subclavius posticus muscle is a short triangular muscle with an average length of 12cm and an average width of 1cm. It originates from the sternal end of the first rib in most cases with reported variants of one case originating from the costoclavicular ligament and one case where it was fused with the proper subclavius muscle. Its insertion is more variable: on the superior border of the scapula with variable length in 71.35%, on the coracoid process of the scapula in 25.42%, and on the clavicle in 0.90%. The subclavian nerve seems to be the dominant nerve supply with a 57.6% prevalence, while 25.8% are innervated by the suprascapular nerve. Other reported nerves were the nerve to the myolohyoid (4.5%), accessory phrenic nerve (4.5%), and a direct branch from the brachial plexus (2.0%). The blood supply was reported (only once) to be from the suprascapular artery. However, the venous drainage was not established at all.
Principal conclusions:
The subclavius posticus muscle is a variant muscle occurring with a reported overall prevalence of 4.9%. It can compress the brachial plexus as it runs across at the space of the superior thoracic aperture with exquisite contact, and this can lead to a neurogenic thoracic outlet syndrome. It also can be involved in the vascular thoracic outlet syndrome. Lastly, it is important not to omit its potential influence in shoulder joint instability to some extent.
... Normality was double checked for using Shapiro-Wilk test and normality plots. Comparisons between groups were done using analysis of variance (ANOVA) with multiple comparisons Bonferroni post hoc test in normally distributed quantitative variables while the non-parametric Kruskal-Wallis test and Mann-Whitney test were used for non-normally distributed quantitative variables (7). Correlations between quantitative variables were done using Spearman correlation coefficient. ...
