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Proximal vs Distal

Posted

Can somebody please explain to me what these terms mean in plain English?

I cannot seem to grasp this.

Sure thing!!!

Proximal means closer to the point of attachment -- I remember this by thinking in terms of 'in the proximity of...' Meaning nearby.

Distal means the opposite of proximal- further away from the point of attachment. I remember this by thinking of 'distance'. If something is distant, it's farther away than being close enough to be considered 'in the proximity of' something.

Hopefully that makes sense for you!!! It might not, I have been doing schoolwork all day, so my mind is mush!!

First off, you must imagine the body in the anatomical position, standing, with arms at the sides and palms facing forward. Proximal and distal are relative to the point of origin (where the attachment is located on the body). Once you consider where the point of origin is, then proximal is closest to that point and distal is farther or more distant to the point of origin.

Thanks you guys.

So is the point of origin where it attaches to the trunk? I guess I am confused in closer or further from WHAT?

KelRN215, BSN, RN

Specializes in Pedi. Has 10 years experience.

stephanne said:
Thanks you guys.

So is the point of origin where it attaches to the trunk? I guess I am confused in closer or further from WHAT?

It depends on the context. For example, in my first job I worked in neurosurgery. We had a high number of patients with hydrocephalus who were VP shunt dependent. When these shunts failed, they had to undergo revisions. These revisions could be distal (revisions to the part of the shunt in the belly) or proximal (revisions to the part of the shunt in the head)- this is the proximal part because the shunt originates in the head.

psu_213, BSN, RN

Specializes in Emergency, Telemetry, Transplant. Has 6 years experience.

stephanne said:
Thanks you guys.

So is the point of origin where it attaches to the trunk? I guess I am confused in closer or further from WHAT?

Basically, yes.

An example...the wrist is distal to the elbow since the wrist is farther from the arm's point of attachment to the body. One of the bones that goes between the wrist and the elbow is the radius. The distal end of the radius would be the end farther from the attachment to the body...i.e. the end of the radius at the wrist.

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 6 years experience.

psu_213 said:
Basically, yes.

An example...the wrist is distal to the elbow since the wrist is farther from the arm's point of attachment to the body. One of the bones that goes between the wrist and the elbow is the radius. The distal end of the radius would be the end farther from the attatchement to the body...i.e. the end of the radius at the wrist.

Because proximal and distal both reference from where the limb attaches to the trunk, when describing something on that limb, you have to reference some other point. For example, the wrist is distal to the elbow and proximal to the metacarpal bones. Everything is distal to the glenohumeral joint and proximal to the distal phalanges.

If the body is an anatomical position, you could also potentially reference a spot on an arm or leg as "superior to" or "inferior to" as long as you specify what you are referencing from. Given that the body is rarely put in anatomical position, I would be much more inclined to use "proximal" and "distal" when referencing something on a limb.

Thanks everyone for the help!! I understand it now. I feel better haha

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

I used to tell my students - think in terms of the heart. Things closer to the heart are more 'proximal'.

Proximal is used with reference to the limbs. One structure is closer to the median plane or the root of the limb than another structure in the limb. Distal refers to limbs when a structure is further away from the median plane or the root of the limb than another structure in the limb. (Anatomy Coloring Book.)

A&P is a very tough subject that we need to know and not just memorize. One thing that has helped me greatly is YouTube! Go to you tube and type bullharrier (that's his name) Anatomic Terms and Anatomic Planes. He has a lot of other great videos as well. Another good professor to watch is Professor Fink. Good luck!!!

Quote
A&P is a very tough subject that we need to know and not just memorize. One thing that has helped me greatly is YouTube! Go to youtube and type bullharrier (that's his name) Anatomic Terms and Anatomic Planes. He has a lot of other great videos as well. Another good professor to watch is Professor Fink. Good luck!!!

Thanks for sharing this resource!!

poko, BSN, RN

Specializes in Community/ Home Health. Has 6 years experience.

I just came across this thread and wanted to thank everyone who took the time to explain these two terms. I was pretty confused as well but I am clear now!

BostonFNP, APRN

Specializes in Adult Internal Medicine. Has 10 years experience.

Proximal/distal is used for more than limbs, just so the OP is aware. :)

brillohead, ADN, RN

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty. Has 5 years experience.

For things that are not limb-oriented, the head is typically used as the point of reference.

For example, when talking about the esophagus, the "mouth end" is the proximal portion and the "stomach end" is the distal portion.

I did not know how to post a new thread, so I was hoping that you could answer some questions for me. I cannot seem to grasp the difference between proximal and distal. I know that distal is farthest away, and proximal is closet. I need some examples. What exactly is the main point of attachment they talk about? For the arm, would it be the shoulder, and for the leg would it be the hip. What is the elbow to the wrist or the shoulder? What is the fingers to the wrist or the elbow? Any help you can give me would be greatly appreciated. Thanks!

brillohead, ADN, RN

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty. Has 5 years experience.

ryan62568 said:
I did not know how to post a new thread, so I was hoping that you could answer some questions for me. I cannot seem to grasp the difference between proximal and distal. I know that distal is farthest away, and proximal is closet. I need some examples. What exactly is the main point of attachment they talk about? For the arm, would it be the shoulder, and for the leg would it be the hip. What is the elbow to the wrist or the shoulder? What is the fingers to the wrist or the elbow? Any help you can give me would be greatly appreciated. Thanks!

I'm not really sure how else to describe this to you... you have the main points.

Proximal is closest, distal is farther away. Point of attachment is where the limb attaches to the torso. Stick your left arm straight out to your side.

Is your elbow closer or farther away than your shoulder? It's farther away, so it is distal to the shoulder.

Is your wrist closer or farther away from your shoulder than your elbow? The wrist is farther away, so it is distal.

Is your palm closer or farther away than your fingertips? It is closer, so it is proximal.

The distal portion of your finger is the end that is the most distance away from your body/torso (in other words, the end with the fingernail). The proximal portion of your finger is closer to the palm.

The idea of proximal/distal is that by using the same wording/definition system, you can always know what portion of the body is being discussed regardless of the position of the body and the individual limbs.

For example, if the arm is held straight out to the side, the wrist end of the radius and ulna are farther away from your torso and the elbow is closer. But if you bend your elbow so your fingers can touch your shoulder, now the wrist end is closer to the torso than the elbow is. If there was a fracture of the radius "on the end closer to the torso" then the location of the fracture would be different based on whether the elbow is bent or if the arm is straight.

But by using proximal and distal using the point of attachment as the reference point, the placement/positioning of the arm has no bearing on which end is closer and which is farther away.

Another way to think of it is to mentally take a string and a thumbtack and affix one end of the string to the middle of the chest (ouch!). If you run the string along the body to the shoulder / elbow / wrist / finger and compare the measurements of each, no matter what position (up, down, left, right, bent, straight) the arm is placed in, the length of the string to the elbow is always going to be shorter than the length of the string to the wrist.

Take the same string (still attached to the chest...ouch!) and now run it down the leg instead.... the string length to the knee will always be shorter (proximal) compared to the string length to the ankle.

Another way to think of it -- you're going on vacation and you can either fly or drive. To get from the southern part of Texas to the southern part of Florida, the distance involved is much more if you drive up Texas, across the Gulf states, and then down Florida versus if you flew directly from the tip of Texas to the tip of Florida over the Gulf. But the actual distance between the two points never changed... just the way you looked at them.

Using distal/proximal is looking at the human body as if it were a continent you need to drive on, with hopping on a plane not being an option. If you have to drive from the heart to the wrist, it's going to be a farther distance than if you have to drive from the heart to the elbow.