part 5 page 12 chapter 1 orientation of the human body this actually this table that i'm viewing right here is preceded by this little topic heading here called the language of anatomy and one of the things that comes to mind is that we were told as medical students at the university of texas that the um number of new words we would be imbibing that are not found in webster's collegiate dictionary are about twenty five thousand in number over the course of four years twenty five thousand is a large number of new words on average that we learn it takes 5000 new words in a language to become fluent in that language so it's sort of the equivalent of becoming fluent in five different languages and in the case of the sciences we're possibly learning more than just five but uh so we need to begin here with uh vocabulary and actually there are some idiomatic expressions that i need to apprise you of so let's look here at orientation and direction what does superior mean we're a two-legged animal not a fish and not a four-legged animal the dorsal fin of a shark is its most superior feature that sticks out of the water and that's its back basically whereas our back is a posterior feature not a superior feature it's our head or cranium which is superior in the human body so i need you to sort of come to that realization and this represents direction upward so the superior or cranial direction then we have um the fish has a caudal fin which is its tail which is a posterior feature but for us it's inferior because our feet which would be the caudal direction or our tail as it were here is in a downward position okay so we have superior and inferior and uh we're going to be learning planes and planes will divide that into uh parts we'll take a look at that but for now superior inferior cranial caudal we also have something which is ventral which is the equivalent of anterior ventral is a reference to the stomach or the belly as it were right so if you were a dog or a cat that would be an inferior feature for us it's not inferior we belly up to the bar it's an anterior feature okay so it's this direction here ventral okay dorsal again is something that has to do with our back okay on a four-legged animal or a fish that's the superior aspect but on a two-legged animal like us whose position is erect then we have a posterior feature going on it's this way is dorsal then we have the uh concept of medial which is somewhere in between it's in between ventral and dorsal or it could be in between left and right lateral or it could be uh any number of in betweens but so medial now in this case because we have bilateral symmetry at the mid-sagittal line medial is going to be anywhere near the mid-sagittal line so i would say to you for instance that the um if we're looking at the front of the body here this would be a sternum and i would say that the sternum is medial between the left and the right shoulders okay so this is the sternum is a medial feature the nose is a medial feature the umbilicus is a medial feature right so the trachea of the neck is a medial feature shoulders are lateral features ears are lateral features here in anatomical position notice the position of the hands the palms are forward okay actually this over here represents anatomical position we're standing erect on two feet the hands are down at the sides and the palms are facing forward the most lateral aspect of the human body are the thumbs and of course we have a term for thumb that's not the word thumb it's the word pollux okay we'll come to that in a moment already then so um we have our superior and our inferior aspects we have our ventral and dorsal aspects we have our medial aspects which are along the midsagittal line in between the lateral aspects which are as far away as possible from the midsagittal line okay so lateral is away from medial left or right then we have this term called intermediate so let's consider that and um we need to think about intermediate though most often in terms of proximal and distal so i'll come to intermediate in a second okay i'll come back here let's look at proximal proximal means close in most cases it means close to the beginning of something so our arms and legs were formed by limb buds they budded away from the torso so the this aspect at the shoulder is going to be proximal and then the hand as you can see here with regard to distal distal is the furthest developmental aspect of that limb bud so the hand is going to be distal the shoulder will be proximal it's the very beginning same thing with the hip is the beginning most proximal the foot is the most distal okay then you can use the term intermediate you could say the elbow is intermediate between the shoulder and the hand the knee is intermediate intermediate between the hip and the foot here's the knee okay the other thing that i'd like you to pay attention to is that when we use the term proximal and distal we could also be describing a pathway so the pathway of the normal pathway of food is through the mouth the esophagus on down to the stomach into the small and large intestines that's the normal pathway and we're not considering things like um emesis or vomiting we're considering the normal pathway and so if the normal pathway is a mouth esophagus stomach small intestine then you could say that the esophagus is intermediate between mouth and stomach the stomach is intermediate between the esophagus and the small intestine right so the mouth is proximal to the stomach the stomach is distal distal to the mouth the esophagus is intermediate between the two so i'd like you to have that sense of ability to discuss those things if there's a if there's an injury on the body that's um between the elbow and the wrist you would say that there's an injury on the body intermediate between the elbow and the wrist and the injury might be two inches distal to the elbow and a number of inches proximal to the wrist so you will identify more specifically to the attending physician who's listening to your um uh nurses notes or or whatever notes it is that you're writing on behalf of the patient okay so proximal and distal then we have superficial and deep the skin is uh superficial to the underlying muscles the muscles are deep to the skin deep to the muscles are the bones and the muscles are intermediate between bones and skin okay so superficial and deep okay you discuss sometimes how deep the wound is if there is a wound in your patient right how deep is that wound the wound is a certain number of millimeters or centimeters deep um if it's a superficial wound that means it's not going so deep okay and then we have specific nomenclature in which we're going to be actually describing parts of the body so the frontal here is a reference to this portion of the anatomy of the forehead is the frontal aspect of the facial anatomy orbital is something to do with the eye the eye lives in the orbit nasal is referencing the nose oral the the mouth mental is a reference to the chin cervical as a reference to the neck etc you can go through all of these areas and you can find things the shoulder is interesting it's acromial the anterior elbow is um antecubital and you should find an anti-cubital vein to take blood from uh the knee is patellar the thigh is referenced as femoral the leg is uh referenced here remember the leg is not a is not a thigh this is not a leg here this is the leg this is a thigh so we have very marketplace rules going on uh most times we don't make the swirl curl aspect but the front of the leg is has curled the back of the leg of searle you might not come across that the great toe it turns out has a name it's holics whereas the large first finger is going to be the pollux also fingers and toes are one through five one two three four five the fifth finger is digity minimi okay we'll pick up uh in the next section