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Doctors decide that a thumb is a finger and an elbow is an ulna

Jeremy Laurance
Thursday 28 August 1997 23:02 BST
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Doctors have renamed the parts of the body so that there is a global consensus on which bit belongs where.

The world's leading specialists in anatomy, meeting in Sao Paulo, Brazil, yesterday announced that they had reached agreement on the revised nomenclature which includes between one and two thousand new names.

The results are likely to mean early obsolescence for familiar terms such as Adam's apple (henceforth to be known as "the laryngeal prominence") and Achilles' tendon ("calcaneus tendon"). The fallopian tubes are to be known as "uterine tubes."

It will not, however, require re-writing of the song Dem Bones which was, anatomically, ahead of its time. The leg bone - both in the song and under the new nomenclature - connects the ankle to the knee (and not the hip, as many people think). The part between knee and hip the song correctly calls the thigh bone.

The new names run to 144 pages, plus an index of the same length, with each one given in Latin and English. The aim is to reduce confusion between doctors using different terminologies in different parts of the world. It took eight years for the terminology subcommittee of the International Federation of Associations of Anatomists to draw up the list.

According to the chairman of the committee, Professor Ian Whitmore, the growth of international travel and the expansion of information technology had driven the change. "We want to work for safety and congruence throughout the world. It is now very easy to send a patient's notes via e-mail to the other side of the globe. It is better if the notes mean the same when they get there."

The two bones in the forearm known as the radius and the ulna provide an example of the sort of difficulties than can arise. In some countries, the ulna is called the cubitus whereas in others, including the UK, the cubitus is the elbow.

Similarly, most English-speakers think of the hand as having a thumb and four digits with the "first finger" meaning the index finger. But the Latin terminology gives the hand five digits with the first being the thumb. "You can see the potential for confusion," said Professor Whitmore.

Latin has been chosen as the core language because it is stable politically uncontroversial, and has always been used to name body parts since Galen, the 4th-century Roman dissector, made the first attempt to classify them. Each part is also being given its English equivalent but countries will be encouraged to translate the core Latin term into their own language if they wish.

Many Latin terms have become part of the language. "Testicle" comes from the Latin testes meaning witness (to the sexual act - cf testament). "Vagina" means scabbard (sheath of the sword).

In recent years, doctors have increasingly dispensed with eponyms such as Achilles' tendon and Adam's apple because there is no rationale for them. An Achilles' tendon could be anywhere in the body but the new name, the calcaneus tendon, indicates that it is the tendon attached to the calcaneum, the bone of the heel. The "angle of Louis", the lump at the top of the breast bone named after the anatomist who discovered it, is to become the "manubrio sternal angle." The manubrium is the upper part of the breast bone (or sternum) between the collar bones .

"It is not that we don't like the names or the people, it is simply that most of the new terms are related to their function or position," Professor Whitmore said.

The approved list of names will be published early next year and anatomists hope it will be rapidly adopted. "We consulted widely so we are confident it will be accepted," Professor Whitmore said. The international federation comprises 60 associations representing more than nine out of 10 anatomists around the globe, he said.

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