Anatomy for Clinical Terminology

Abstract

Anatomical notions provide the foundations for much clinical terminology. However, clinicians’ concerns are notoriously practical. The goal in clinical terminology is not to represent anatomy for its own sake, but rather to facilitate faithful communication by clinicians about what they have heard, seen thought and done in their care of patients. The focus of clinical anatomy is therefore the interaction between the locus of disease and partonomy - that diseases of parts are, with specific exceptions, diseases of the whole. Clinical anatomy must also accommodate the clinical/functional view as well as the structural view basic to classic anatomy. One means of doing so in current ontology formalisms is through a hierarchy of relations. There are a number of problems where there is no consensus on solutions. Of particular importance are the relations of tissues and substances to structures and representation of characteristics collective effects of entities such as cells, One approach to this issue is discussed here. Finally, there is currently no expressively adequate and computationally tractable means for expressing abnormal and variant anatomy. All resources are explicitly about ”normative anatomy”. In dealing with all of these problems it is essential to separate issues of ”terminology” - i.e. the labeling of entities from their formal definitions and relations. Clinicians frequently use terms that anatomist now consider obsolete or deprecated. However, a distinction should be drawn between the mere renaming of an entity - however well motivated - and more fundamental revision as to its structure or function.