SIST EN 15521:2008
Health informatics - Categorical structure for terminologies of human anatomy
Health informatics - Categorical structure for terminologies of human anatomy
To define the characteristics required to synthetically describe the organisation and content of human anatomy within a terminological system. The proposed European Standard is primarily intended for use with computer-based applications such as clinical electronic health records, decision support and for various bio-medical research purposes. It does not include categorical structures that may be necessary for the description of development anatomy.
Medizinische Informatik - Kategoriale Struktur für Terminologien der Anatomie des Menschen
1.1 Hauptzweck
Diese Europäische Norm legt die erforderlichen Merkmale für die synthetische Beschreibung von Aufbau und Inhalt der Anatomie des Menschen innerhalb eines Terminologiesystems fest. Sie ist vorrangig für die Verwendung innerhalb computergestützter Anwendungen, wie z. B. klinische elektronische Gesundheitsakten, Entscheidungsunterstützung, sowie für verschiedene biomedizinische Zwecke vorgesehen.
Die Europäische Norm dient folgenden Zwecken:
vereinfachter Aufbau neuer Terminologiesysteme in geregelter Form zur Erhöhung ihrer Kohärenz und Ausdruckskraft;
vereinfachte Pflege der Anatomie des Menschen innerhalb von Terminologiesystemen;
erhöhte Konsistenz und Kohärenz vorhandener Terminologiesysteme;
Ermöglichung systematischer Querverweise zwischen Elementen der Anatomie des Menschen in unterschiedlichen Terminologiesystemtypen;
vereinfachte Konvergenz der Anatomie des Menschen innerhalb von Terminologiesystemen;
Verdeutlichung der im Bereich der Anatomie des Menschen bestehenden Überlappungen mit unterschiedlichen Terminologiesystemen verschiedener Gesundheitsfachgebiete;
Bereitstellung von Verhandlungsgrundlagen für die jeweiligen Entwickler in Hinblick auf die Integration verschiedener Terminologiesysteme in Informationssysteme;
Ermöglichung der systematischen Bewertung der Anatomie des Menschen innerhalb von Terminologiesystemen.
1.2 Zielgruppen
Die Europäische Norm an sich ist nicht für die Verwendung durch einzelne Klinikärzte oder Krankenhausverwaltungen geeignet oder vorgesehen.
Die Zielgruppen dieser Europäischen Norm sind Folgende:
Entwickler spezialisierter, genormter, kategorialer Strukturen für die Terminologie im Gesundheitswesen;
Entwickler von Terminologiesystemen für das Gesundheitswesen, einschließlich Klassifikationen und Kodiersystemen;
Dienstanbieter für Terminologiesysteme und Entwickler von Software mit Verarbeitung natürlicher Sprache;
Informatique de santé - Structure catégorielle des terminologies d'anatomie humaine
1.1 Objectif principal
La présente Norme européenne définit les caractéristiques requises pour décrire de façon synthétique l’organisation et le contenu de l’anatomie humaine au sein d’un système terminologique. Elle est prévue principalement pour une utilisation avec des applications informatiques telles que les dossiers de santé électroniques cliniques, l’aide à la décision et les différents objectifs de la recherche biomédicale.
La présente Norme européenne servira :
à faciliter l’élaboration de nouveaux systèmes terminologiques avec une régularité qui augmentera leur cohérence et leur expressivité ;
à faciliter la maintenance de l’anatomie humaine au sein des systèmes terminologiques ;
à augmenter l’homogénéité et la cohérence des systèmes terminologiques existants ;
à permettre de systématiser les références croisées entre les éléments d’anatomie humaine des différents types de systèmes terminologiques ;
à faciliter la convergence de l’anatomie humaine au sein des systèmes terminologiques ;
à expliciter le chevauchement de l’anatomie humaine entre les systèmes terminologiques des différents domaines de la santé ;
à fournir des éléments de négociation sur l’intégration de différents systèmes terminologiques dans des systèmes d'information aux développeurs respectifs ;
à permettre de systématiser l’évaluation de l’anatomie humaine au sein des systèmes terminologiques.
1.2 Groupes cible
La présente Norme européenne en elle-même n’est pas adaptée ni destinée à être utilisée individuellement par des cliniciens ou des administrateurs d’hôpitaux.
Les groupes cible de la présente norme européenne sont :
les créateurs des structures catégorielles des terminologies de santé spécialisées et normalisées ;
les développeurs de systèmes terminologiques de santé y compris les classifications et les systèmes de codage ;
Zdravstvena informatika - Kategorijska struktura terminologij človeške anatomije
General Information
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Standards Content (Sample)
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.Health informatics - Categorical structure for terminologies of human anatomyInformatique de santé - Structure catégorielle des terminologies d'anatomie humaineMedizinische Informatik - Kategoriale Struktur für Terminologien der Anatomie des MenschenTa slovenski standard je istoveten z:EN 15521:2007SIST EN 15521:2008en35.240.80Uporabniške rešitve IT v zdravstveni tehnikiIT applications in health care technologyICS:SLOVENSKI
STANDARDSIST EN 15521:200801-februar-2008
EUROPEAN STANDARDNORME EUROPÉENNEEUROPÄISCHE NORMEN 15521November 2007ICS 35.240.80 English VersionHealth informatics - Categorial structure for terminologies ofhuman anatomyInformatique de santé - Structure catégorielle desterminologies d'anatomie humaineMedizinische Informatik - Kategoriale Struktur fürTerminologien der Anatomie des MenschenThis European Standard was approved by CEN on 7 October 2007.CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this EuropeanStandard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such nationalstandards may be obtained on application to the CEN Management Centre or to any CEN member.This European Standard exists in three official versions (English, French, German). A version in any other language made by translationunder the responsibility of a CEN member into its own language and notified to the CEN Management Centre has the same status as theofficial versions.CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland,France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal,Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and United Kingdom.EUROPEAN COMMITTEE FOR STANDARDIZATIONCOMITÉ EUROPÉEN DE NORMALISATIONEUROPÄISCHES KOMITEE FÜR NORMUNGManagement Centre: rue de Stassart, 36
B-1050 Brussels© 2007 CENAll rights of exploitation in any form and by any means reservedworldwide for CEN national Members.Ref. No. EN 15521:2007: E
EN 15521:2007 (E) 2 Contents Page Foreword.3 Introduction.4 1 Scope.5 1.1 Main purpose.5 1.2 Target groups.5 1.3 Topics outside the scope.6 2 Normative references.6 3 Terms and definitions.6 4 Categorial structure for terminologies of human anatomy description.7 4.1 Principles.7 4.2 Anatomical categories (3.7).8 4.3 Precise goal of the categorial structure (3.8).10 4.4 List of anatomical relations (3.8).11 4.5 List of minimal anatomical domain constraints (3.9).13 5 Conformance.13 Annex A (informative)
A reference ontology for biomedical informatics: the Foundational Model of Anatomy.14 A.1 General.14 A.2 Principles, Ontological Framework and Implementation of the FMA.14 A.3 Extensions of the FMA beyond human macroscopic anatomy.15 A.4 Relations in the FMA and their influence on other ontologies.16 A.5 Querying the FMA.16 A.6 Evaluation of the FMA.17 A.7 Uses and Selected Applications of the FMA.17 A.7.1 Research in ontologies, informatics and computer science.17 A.7.2 Research in biomedical imaging.18 A.7.3 Design of information systems.18 A.7.4 Clinical Informatics.18 A.7.5 Education.18 A.7.6 Sources of Anatomical Information.19 Bibliography.20
EN 15521:2007 (E) 3 Foreword This document (EN 15521:2007) has been prepared by Technical Committee CEN/TC 251 “Health informatics”, the secretariat of which is held by NEN. This European Standard shall be given the status of a national standard, either by publication of an identical text or by endorsement, at the latest by May 2008, and conflicting national standards shall be withdrawn at the latest by May 2008. According to the CEN/CENELEC Internal Regulations, the national standards organizations of the following countries are bound to implement this European Standard : Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and United Kingdom.
EN 15521:2007 (E) 4 Introduction This European standard specifies a categorial structure for terminologies of human anatomy. Computer-based processing and the interchange of medical or clinical information requires various kinds of terminological systems to represent that information, such as controlled vocabularies, classifications, nomenclatures, terminologies and thesauri, with or without coding schemes. The specific terminological issues in the field of health informatics are: large number of different terminological systems are available in different clinical specialties; large overlap among the subject fields involved; large number of codes and rubrics, typically in the order of magnitude of 10 000 to 100 000 entries, in commonly used terminological systems; increasing need for re-use of coded data in different health-care contexts; poly-semia across different clinical specialties and sometimes within them. The integration of computer-based medical records and administrative information systems in Electronic Health Records (EHR) require rationalization in the field, and a uniform way to represent the meaning of medical concepts to ensure that the receiver EHR of a message will catch the meaning introduced by the sender EHR and not only the string of characters embedded in it.
It is not possible to impose a rigid uniform standardized natural language clinical terminology on healthcare professional providers. Nevertheless standards need to be provided for guiding the development of terminologies in the different sub domains of healthcare to allow semantic interoperability between them. To this end a domain specific semantic representation
has been developed (EN 12264) and applied in a series of specific initiatives including European Pre standards (ENV), European Standards (EN) and international ISO standards on various subject fields to describe a set of categorial structures in partially overlapping subject fields: Human anatomy is central to medical terminology ( surgical procedures, carcinoma staging, annotation of radiological findings, disease, clinical laboratory and so forth ) and also to many scientific and bio-informatics study beyond the scope of clinical medicine . In the US the University of Washington has developed in the public domain an anatomical terminology for EHR named the Digital Anatomist Foundational Model of
Anatomy (FMA for short), a reference ontology for biomedical informatics. Adequate field testing in several countries, revision and integration have provided the comprehensive basis for this European standard.
EN 15521:2007 (E) 5
1 Scope 1.1 Main purpose This European standard defines the characteristics required to synthetically describe the organisation and content of human anatomy within a terminological system. It is intended primarily for use with computer-based applications such as clinical electronic health records, decision support and for various bio-medical research purposes.
This European standard will serve to facilitate the construction of new terminological systems in a regular form which will increase their coherence and expressiveness; facilitate maintenance of human anatomy within terminological systems; increase consistency and coherence of existing terminological system; allow systematic cross-references between items of human anatomy in different types of terminological systems; facilitate convergence among human anatomy within terminological systems; make explicit the overlap for human anatomy between different health care domains terminological systems; provide elements for negotiation about integration of different terminological systems into information systems between the respective developers; enable the systematic evaluation of human anatomy within terminological systems. 1.2 Target groups The European standard itself is not suitable or intended for use by, individual clinicians or hospital administrators.
The target groups for this European standard are: designers of specialised standard healthcare terminological categorial structures; developers of healthcare terminological systems including classifications and coding systems; producers of services for terminological systems and designers of software including natural language processing; information modellers, knowledge engineers, and standards developers building models for
health information management systems; developers of information systems that require an explicit representation of healthcare terminological systems; developers of marked-up standards for representation of healthcare documents.
EN 15521:2007 (E) 6 1.3 Topics outside the scope This European Standard does not include categorial structure that may be necessary for the description of developmental anatomy during the human life cycle, which includes prenatal development, post-natal growth and aging. This European Standard has been developed for use as an integrated part of computer-based applications and for the electronic healthcare record. It would be of limited value for manual use.
It is not the purpose of this European Standard to standardise the end user classification of human anatomy terminology or to conflict with the concept systems embedded in national practice and languages. 2 Normative references The following referenced documents are indispensable for the application of this document. For dated references, only the edition cited applies. For undated references, the latest edition of the referenced document (including any amendments) applies. Not applicable. 3 Terms and definitions For the purposes of this document, the following terms and definitions apply. 3.1 Human anatomy biological science that concerns the discovery, analysis and representation of the structural organisation of the human body NOTE Human anatomy thus defined encompasses the material objects from the granularity level of the whole human body to that of cell parts, portions of body substances, and non-material entities such as surfaces, spaces, lines and points, that form the phenotypic organisation of the human body. Although encompassed by the definition of anatomical structure (4.2.9), biological macromolecules do not come under the purview of the science human anatomy. 3.2 anatomical entity entity that constitutes the structural organisation of a human body 3.3 spatial dimension number of dimensions of the entity in space EXAMPLE 1 Entities with spatial dimension of value 3 are organs, cells and body cavity. EXAMPLE 2 Entities with spatial dimension of value 2: the plane of the esophagogastric junction and the surface of the parietal part of the head. EXAMPLE 3 Entities with spatial dimension of value 1: pectinate line, linea aspera and superior nuchal line. EXAMPLE 4 Entities with spatial dimension of value 0: the apex of petrous part of temporal bone, apex of the orbit and the apex of the sacrum. 3.4
three-dimensional shape shape of an anatomical entity of spatial dimension with value 3 EXAMPLE Hollow cylinder.
EN 15521:2007 (E) 7 3.5 terminology
set of designations belonging to one special language
[ISO 1087-1:2000] 3.6 anatomical term
verbal designation of an anatomical entity (3.2) 3.7 anatomical category type of anatomical entity shared by all the individual instances in existence in the present, past and future
EXAMPLE The anatomical category liver is instantiated by this liver and all individual livers in existence in the present, past and future. NOTE 1 Anatomical categories may be more or less general. Where one anatomical category is subsumed by another, the is_a relation is asserted to obtain a hierarchy between the more specific or subsumed category and the more general or subsuming anatomical category. NOTE 2 Each anatomical entity instantiates some anatomical category. 3.8 anatomical relation
relation between two or more anatomical categories derived from corresponding relations between instances of the respective categories EXAMPLE A is;;;a B defined to obtain when every entity in category A is at the same time an entity in category B.
B has;;;part_ A defined to obtain when every entity in category B has some entity in category A as part. Other examples of anatomical relations manifesting this every-some structure are: contained_in adjacent_to, attached_to NOTE The definition is adapted from the representation of types of characteristics in EN 12264 and authorised by an anatomical domain constraint (3.9). 3.9 anatomical domain constraint rule prescribing the set of representations of anatomical relations (3.8) that are valid to specialise an anatomical category (3.7) in a certain domain NOTE The definition is adapted from domain constraint in EN 12264. 3.10
anatomical categorial structure
minimal set of anatomical domain constraints (3.9) for representing anatomical entities (3.2) in a precise domain to achieve a precise goal
NOTE The definition is adapted from the categorial structure in EN 12264. 4 Categorial structure for terminologies of human anatomy description 4.1 Principles
The categorial structures for terminologies of human anatomy are in conformity with the categorial structure as prescribed by clause 4 of EN 12264:2005.
EN 15521:2007 (E) 8 To describe an anatomical categorial structure (3.10), the following information shall be provided: a) anatomical categories (3.7) that organise the anatomical entities (3.2) and the anatomical relations (3.8)dividing their representation in the domain;
b) precise goal of the anatomical categorial structure (3.10); c) list of the representations of anatomical relations (3.8) autorised by anatomical domain constraints (3.9); d) list of minimal anatomical domain constraints (3.9) required by the goal of the anatomical categorial structure (3.10). 4.2 Anatomical categories (3.7) 4.2.1 Physical anatomical entity anatomical entity that has a spatial dimension (3.3) EXAMPLE Organ ,surface, apex of the orbit. 4.2.2 Immaterial physical anatomical entity physical anatomical entity that has no mass EXAMPLE Anatomical space, anatomical surface (diaphragmatic surface of left ventricle). 4.2.3 Anatomical space immaterial physical anatomical entity which has a spatial dimension (3.3) of value 3 EXAMPLE Thoracic cavity. 4.2.4 Anatomical surface immaterial physical anatomical entity which has a spatial dimension (3.3) of value 2
EXAMPLE Diaphragmatic surface of heart. 4.2.5 Anatomical line immaterial physical anatomical entity which has a spatial dimension (3.3) of value 1
EXAMPLE Inferior margin of liver. 4.2.6 Anatomical point immaterial physical anatomical entity which has a spatial dimension (3.3) of value 0
EXAMPLE Apex of this heart. 4.2.7 Material physical anatomical entity physical anatomical entity that has a mass EXAMPLE Liver, cell nucleus, portion of blood. 4.2.8 Body substance material physical anatomical entity that has no inherent shape (3.4)
EN 15521:2007 (E) 9 EXAMPLE Portion of blood, portion of cytosol. 4.2.9 Anatomical structure material physical anatomical entity that has an inherent shape (3.4) and is generated by a coordinated expression of the organism’s own structural genes EXAMPLE Thorax ,tibia, hepatocyte. NOTE Post surgical anatomy (e.g surgically created stomas, stumps, vascular and intestinal anastomoses) is not an anatomical structure . When useful it shall be defined in the categorical structure needing it: e.g for surgical procedures. 4.2.10 Cell anatomical structure that consists of cytoplasm surrounded by a plasma membrane EXAMPLE Leucocyte, hepatocyte. 4.2.11 Organ anatomical structure that consists of a maximal collection of cardinal organ parts so connected to one another that together they constitute a self-contained unit of macroscopic anatomy, morphologically distinct from other such units EXAMPLE Heart , tibia, urinary bladder. 4.2.12 Cardinal organ part anatomical structure that consists of two or more portions of tissue, spatially related to one another in patterns determined by coordinated gene expression; together with other contiguous cardinal organ parts it constitutes an organ EXAMPLE
Upper lobe of right lung, shaft of humerus, left ventricle, head of pancreas. 4.2.13 Portion of tissue anatomical structure that consists of a directly connected collection of similarly specialised cells and intercellular matrix, aggregated according to genetically determined spatial relationships EXAMPLE Portion of smooth muscle, portion of endothelium. 4.2.14 Cardinal body part
anatomical structure that has as its parts the most complete set of diverse subclasses of organ and cardinal organ parts spatially associated with either the skull, a segment of the vertebral column or a complete set of bones of the appendicular skeleton; it is partially surrounded by skin and forms a distinct morphological subdivision of the body; together all cardinal body parts constitute the body EXAMPLE Head, neck, trunk, upper limb.
4.2.15 Body region sub volume of a cardinal body part (4.2.14) demarcated by at least one fiat boundary EXAMPLE Epigastrium, femoral triangle. 4.2.16 Organ systems anatomical structure that consists of organs predominantly of the same anatomical category, which are interconnected by zones of continuity
EN 15521:2007 (E) 10 EXAMPLE Alimentary system, musculoskeletal system.
NOTE 1 Each musculo-skeletal system is comprised of instances of the classes muscle (organ), bone (organ), joint, and ligament (organ), which together form an interconnected anatomical structure.
NOTE 2 Subdivisions of a musculoskeletal system are its skeletal system and articular system, which consist of collections of bones and joints, respectively; the joints interconnecting the bones and vice versa. NOTE 3 Several of the commonly known systems of the body satisfy this criterion but the endocrine and immune systems do not. Therefore, they are Body systems but not Organ systems. The rationale for subdividing the body into systems is usually claimed to be function. Organ systems have organs as their direct and connected parts. There are many other systems in the body that are not constituted by organs. Some are anatomical structures, others are not. 4.2.17 Anatomical cluster anatomical structure that consists of a heterogeneous set of organ parts grouped together in a predetermined manner, but which do not constitute the whole or a subdivision of either a body part or an organ system EXAMPLE Joint, adnexa of the uterus, root of the lung, renal pedicle, back.
NOTE Such clusters can be composed of cells (e.g., splenic cord consists of erythrocytes, reticular cells, lymphocytes, monocytes, and plasma cells), cardinal organ parts (e.g., tendon sheath consists of the fused tendons of several muscles), as well as of organs (e.g., lacrimal apparatus consists of a lacrimal gland, lacrimal sac, and nasolacrimal duct, each of which is an organ).
4.2.18 Anatomical set material anatomical entity that consists of the maximum number of discontinuous members of the same class EXAMPLE Set of cranial nerves, ventral branches of aorta, set of mammary arteries, thoracic viscera, dental arcade. NOTE 1 Anatomical sets have members, rather than parts (e.g., each instance of oculomotor nerve is a member of some instance of set of cranial nerves).
NOTE 2 Membership in an anatomical set is often regarded as a kind of part relation. In anatomy, the distinction between part and membership relations is that there is direct continuity of a part with its respective whole, whereas no direct continuity exits exist between members of an anatomical set. NOTE 3 In an anatomical set the meaning of set is different from the meaning of a set in mathematics.
4.2.19 Anatomical junction
anatomical structure in which two or more anatomical structures are in physical continuity with one another or intermingle their component parts EXAMPLE Suture, commissure of the mitral valve, gastroesophageal junction, synapse.
4.3 Precise goal of the categorial structure (3.10) The goal of each anatomical terminology used in the terminology systems of healthcare and biomedical science shall be defined by the users, situations and applications for which the categorial structure is intended and a statement on the limits of use. EXAMPLE Controlled vocabulary production for clinicians or comparison with another terminological system for coding centres.
EN 15521:2007 (E) 11 4.4 List of anatomical relations (3.8) 4.4.1 has_part anatomical relation (3.8) which holds between each anatomical entity (3.2) of one to three dimensions in category A and some anatomical entity of the same dimension in category B such that if A has_part B, there is a complement C which together with B accounts for the whole (100%) of A EXAMPLE Stomach has_part fundus. Together with body and pyloric antrum fundus accounts for the whole (100%) of Stomach. NOTE
a semantic link has in most cases an inverse, i.e. another semantic link with the opposite direction at the instance level; has_part has an inverse part_of which is commonly used. 4.4.2 A contained_in B
anatomical relation (3.8) that holds between each anatomical entity (3.2) in category A contained in some anatomical entity (3.2) in category B. The former is a body substance or an anatomical structure; the latter is an anatomical space
EXAMPLE Urinary bladder contained_in pelvic cavity.
NOTE 1 Contained_in does not imply part_of. Although cavity of urinary bladder is part_of urinary bladder, urine part_of urinary bladder is an invalid assertion. NOTE 2
Imposing such a restricted meaning on the contained_in relation may seem pedantic, because it implies that an assertion such as brain contained_in skull needs to be replaced by two related statements: brain contained_in cranial cavity, cranial cavity part
of skull. The purpose of such specificity at the level of terminological representation is to assure that the role of container is constrained to anatomical structures which have anatomical space as one of their part. This constraint will prevent a reasoner from returning results such as right lobe of liver contained_in liver.
4.4.3 A adjacent_to B
anatomical relation (3.8) which holds between each anatomical entity (3.2)in category A is adjacent to some entity in category B. Two anatomical entities of the same dimension are adjacent when they are spatially proximate, share no boundary or parts, and are separated by no further anatomical entities of the same dimension
EXAMPLE 1 Spleen adjacent_to stomach EXAMPLE 2 Kidney adjacent_to quadratus lumborum EXAMPLE 3 Medial surface of spleen adjacent_to posterior surface of stomach Posterior surface of kidney adjacent_to anterior surface of quadratus lumborum. NOTE 1 The relation of adjacency must be asserted at different levels of granularity according to context: Examples of various levels of granularity include organism, organ system, organ, organ part, maximal portion of tissue, cell and subcellular organelle. NOTE 2 Adjacent_to may be qualified with the aid of qualitative anatomical coordinates such as anterior_to, posterior_to, superior_to, inferior_to, medial_to, lateral_to depending upon the value of the trajectory relationship with the body in the standard anatomical position.
NOTE 3 Adjacency is adirectional and therefore symmetrical; its qualifiers such as anterior and posterior are directional and therefore antisymmetric.
4.4.4 A continuous_with B
anatomical relation (3.8) that holds between each anatomical entity (3.2) in category A and some entity in category B when there is no bona fide boundary (real physical discontinuity) between the related entities and their parts
EN 15521:2007 (E) 12 EXAMPLES Arterial trunk continuous_with branch of arterial trunk.
Thoracic part of oesophagus continuous_with abdominal part of oesophagus.
NOTE 1 Continuous_with like adjacent_to, can be qualified: thoracic part of oesophagus Continuous_with superiorly, cervical part of oesophagus ; thoracic part of Oesophagus continuous_with inferiorly abdominal part of oesophagus.
NOTE 2 Qualification here is different from the case of anterior, posterior, etc. qualifications of adjacency (4.4.3.). In this case the qualification pertains to the parts of the entities related.
In the case of adjacency the qualification is of the relation itself.
4.4.5 A attached_to B anatomical relation (3.8) which holds between each anatomical entity (3.2) in category A and some entity in category B when some of the parts of the entity in category A
are intermingled with
some entity in category B across a portion of their maximal boundary which the related entities share EXAMPLE
Each patellar ligament is attached_to the patella at a narrow area along the lower margin of the latter and also to the tuberosity of the tibia. All these anatomical structures have their own real boundaries, but at its proximal and distal ends the patellar ligament comes in intimate contact with circumscribed areas of each bone, where extensions of its collagen fiber bundles (so called ‘Sharpey’s fibers’) penetrate the bone and intermingle with each bone’s own collagen fibers network. The ligament may be separated from the bone only by severing Sharpey’s fibers.
The circumference of the tympanic membrane is attached_to bones of the skull forming the external auditory meatus.
The visceral pleura is attached_to the lung proper intermingling its loose connective tissue on its non-serous surface with the fibrous stroma of the lung.
The brachialis muscle is attached_to the humerus.
NOTE A maximal boundary of entity A is the sum of the tangential boundaries of all parts of entity A. A maximal boundary completely demarcates entity A from its neighbourhood. 4.4.6 has_dimension
anatomical relation (3.8) that relates an anatomical entity to the number of its spatial dimension (3.3)
EXAMPLE Wall of stomach has_dimension 3. 4.4.7 has_shape
anatomical relation (3.8) that relates an anatomical entity to its three dimensional shape (3.4)
EXAMPLE Oesophagus has_shape hollow cylinder. 4.4.8 has_boundary
anatomical relation (3.8) which relates categories of anatomical entities of one to three dimensions to categories of immaterial physical anatomical entities of one dimension lower, called bounding anatomical entities. Such bounding entities delimit anatomical entities of one, two or three dimensions from one another. A
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