Terminologia Anatomica and its practical usage: pitfalls and how to avoid them

In 2016, the Federative International Programme for Anatomical Terminology tentatively approved the updated and extended version of anatomical terminology that replaced the previous version of Terminologia Anatomica (1998). This modern version has already appeared in new editions of leading anatomical atlases and textbooks, including Netter's Atlas of Human Anatomy, even though it was originally available only as a draft and the final version is different. We believe that updated and extended versions of anatomical terminology are important and they can be a powerful tool in communication between anatomists and other specialists around the world. In general, the new version uses more precise and adequate anatomical terms and many segments, including the part dealing with the nervous system, which is also known as the Terminologia Neuroanatomica, have been considerably improved. Nevertheless, some segments have not been extended or modernised, while other parts have been modified considerably, thereby posing a challenge to those who prefer the traditional version of Latin terminology because a number of official names for bones, muscles, organs and blood vessels have been changed. Whilst most of these changes seem to be inspired by a long anatomical tradition and thus cannot come as a surprise to anyone in the field, other modifications are characterised by terminological innovativeness. Selected new and unexpected changes that might cause confusion among those who prefer traditional anatomical terms and definitions are discussed here.

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.

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.

Elevated leukocyte count as a harbinger of systemic inflammation, disease progression, and poor prognosis: a review

Total leukocyte count increases significantly in response to infection, trauma, inflammation, and certain diseases. Factors affecting leukocyte count in healthy adults include sex, hormonal milieu, genetic inheritance, stress level, diet, nutrition, and lifestyle (e.g. tobacco-induced inflammatory changes, chronic psychological stress, etc.). To date, numerous studies have reported that high but normal leukocyte counts at baseline predict increased cardiovascular and noncardiovascular mortality in older adults. Recent findings suggest that elevated leukocyte count within the normal range, but especially neutrophil and monocyte counts, may be a harbinger of increased systemic inflammation and subclinical disease. Moreover, elderly people who tend to have high but normal leukocyte counts are at greater risk of cancer, cardiovascular disease, type 2 diabetes, some other age-related conditions, and they also have increased all-cause mortality. These results indicate that strong and reliable inflammatory markers, such as leukocyte count, may reflect the rate of ageing and therefore can predict long-term survival in the elderly. Remarkably, leukocyte count correlates positively with genuine markers of systemic inflammation like C-reactive protein and interleukin 6. Interestingly, some authors conclude that leukocyte counts have a stronger prognostic ability with regard to total and cardiovascular mortality than total cholesterol or low-density lipoproteins. The fact that these inflammatory markers are clinically useful predictors of long-term survival in the elderly is quite remarkable as these blood parameters are included in routine medical check-ups. Therefore, they can be used as simple and reliable morphological indicators of chronic systemic inflammation, disease progression, and poor prognosis, especially among individuals who are likely to develop age-related conditions. Nevertheless, the pathomechanism that links elevated but normal leukocyte counts to increased mortality remains poorly understood. This review summarises the most important findings on the links between leukocyte count, chronic systemic inflammation, and health outcomes in older adults. (Folia Morphol 2018; 77, 2: 171-178).