Concepts which are frequently misunderstood by students during medical scribe certification

Elbow’s location on the body in comparison to the hand:

While referencing relative positions of parts on the limbs, the terms proximal and distal describe the location in reference to the body’s center. Distal refers to farther away from the center of the body. For example, the thumb is distal to the wrist, and the hand is distal to the shoulder. The proximal position is closer to the point of attachment or to the trunk of the body1. To answer the question, the elbow is proximal to the hand2. The proximal position is opposite to the distal position.

Location of Knee on the body:

It’s important to keep straight anterior versus posterior and ventral versus dorsal. Anterior position refers to the front (frontal plane) of the body. In anatomical terminology, the terms ventral or anterior mean “in front of” (trunk of the body). However, when we consider the brain’s parts, the ventral ones are underside (i.e., side nearer to the trunk). To answer the question, the kneecap is located on the anterior side of the leg.

While talking about human anatomy, the posterior position means that the structure is situated near the body’s back or dorsum (dorsal). For example, the shoulder blades are located on the posterior side of the body3.

Catheterization laboratory:

Cardiac catheterization is one of the most commonly performed cardiac procedures. The procedure is performed for the diagnosis and treatment of cardiac conditions and for the:

The cardiac catheterization procedure is mostly performed in a cardiac catheterization lab. Fluoroscopy guides and positions catheters in the proper position4.

Patients who resuscitate out-of-hospital due to cardiac arrest caused by ventricular fibrillation or ventricular tachycardia, with no clinical signs of a heart attack must be taken straight to the cardiac catheterization lab or admitted to ICU for further evaluation. If the patient is promptly sent to the cardiac catheterization lab to reverse the blocked artery, it results in improved neurological outcomes and survival5.

Systolic and diastolic blood pressure:

The pressure created by blood pushing against the artery walls is called blood pressure. Arteries carry oxygenated blood away from the heart to other parts of the body to supply oxygen. Throughout the day it is normal to have fluctuating blood pressure because it rises and falls. Generally, a sphygmomanometer is used to measure blood pressure and shows results in two numbers. These numbers indicate the blood pressure6.

For instance, if the measurement reads 115 systolic and 75 diastolic, it is written as “115/75 mmHg”.

The normal blood pressure level is, however, less than 120/80 mmHg6.

Body positioning for an X-ray exam:

X-rays are high-energy electromagnetic radiation that passes through most objects, including the human body. In the medical field, X-rays are used to generate images of the body structures and are used for diagnostic purposes like X-ray radiography, mammography, CT (computed tomography), fluoroscopy, etc. It is also used for treatment like radiation therapy in cancer treatment.

Determine the body position for an X-ray exam the patient’s condition, suspected disease, and the targeted body part. The X-ray tech, also known as the radiologic technologist, uses standardized positions for taking an X-ray7. Superior or cephalic position refers to the direction of the body towards the head. While inferior or caudal position refers to the direction of the body away from the head. The proximal position describes the proximity while the distal position points away from the source. The medial position refers to the body’s center while the lateral position directs away from the center8.

The medial side of the leg:

Medial refers to the median plane the body’s midline which splits the body into two halves, head-to-toe, the left, and right. Medial position refers to a position that is nearer to the middle of the body. The medial position is towards the midline of the body. For example, the medial side of the leg is toward the midline (or inside of the leg) where the tibia is located)9,10. If there is a disorder in the medial position of the leg it would mean that the internal part of the leg is affected.

Resources:

  1. https://medlineplus.gov/ency/article/002287.htm
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545723/
  3. https://training.seer.cancer.gov/anatomy/body/terminology.html
  4. https://www.ncbi.nlm.nih.gov/books/NBK531461/
  5. https://clinicaltrials.gov/ct2/show/NCT03119571
  6. https://www.cdc.gov/bloodpressure/about.htm
  7. https://www.nibib.nih.gov/science-education/science-topics/x-rays
  8. https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/body-positioning-x-ray-studies
  9. https://opentextbc.ca/biology/chapter/19-1-types-of-skeletal-systems/
  10. https://www.machinedesign.com/markets/medical/article/21834827/the-difference-between-medial-and-lateral-proximal-and-distal-and-superior-and-inferior-biomechanics

Last reviewed and updated by on 2020-09-27

Caitlin Goodwin, DNP, RN, CNM, is a Board Certified Nurse-Midwife, Registered Nurse, and freelance writer. She has over twelve years of experience in nursing practice.