Why do we break one of the first rules of anatomy when describing the components of the heart?

Abstract

A rule of human anatomy is that all structures within the body should be described relative to the so-called "anatomical position." Along with those describing structures such as the skull and liver, those accounting for the components of the heart consistently break this rule, describing the organ as if removed from the body and positioned on its apex, the so-called "Valentine position." Although potentially appropriate to some animal species, this approach produces problems when used in human anatomy, even if the right and left ventricles are only viewed in truly right-sided and left-sided positions when assessed in the Valentine fashion. The names of the ventricles, of course, are never going to change. This is not necessarily the case with other cardiac components. Consider the artery that extends between the ventricles on their diaphragmatic surface. Blockage produces inferior myocardial infarction, which is to be expected, since the vessel is located in inferior and interventricular position. It is incorrect to describe the artery as being posterior and descending. Such infelicities are now the more obvious with the advent of techniques that, in clinical cardiology, show the components of the heart as it lies within the chest. In this review, we have assessed the frequency of use of the Valentine approach in popular textbooks used by students of human anatomy. We show that, using the conduction tissues as a model, this system also being incorrectly described in the majority of the textbooks, the situation can be improved by use of attitudinally appropriate description. Clin. Anat. 32:585-596, 2019.

Myocardial bridges: A meta‐analysis

“…In this study the authors have used attitudinally appropriate cardiac nomenclature as previously been described (De Almeida, Spicer, & Anderson, 2019; Loukas, Aly, Tubbs, & Anderson, 2016).…”

The ox atrioventricular conduction axis compared to human in relation to the original investigation of sunao tawara

“…Unlike the human heart, however, the bovine heart lies within the thorax in “Valentine” fashion. For the purpose of this investigation, nonetheless, we will position the bovine heart so as to describe its components in the attitudinally appropriate fashion for man (De Almeida et al, ). In this way, we are better able to facilitate comparisons between the cardiac anatomy of the two species.…”

Three‐dimensional visualization of the bovine cardiac conduction system and surrounding structures compared to the arrangements in the human heart

“…So as to permit direct comparisons with the human heart, we orientated the bovine images so as to match the attitudinally appropriate terminology for human anatomy (Anderson & Loukas, 2009;Cosío et al, 1999;De Almeida et al, 2019;McAlpine, 1975;Mori et al, 2019b;Walmsley, 1958). Thus, cranial, caudal, ventral, and dorsal structures in the ox are described as being superior, inferior, anterior, and posterior, respectively.…”