What Do Distal and Proximal Mean? «

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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

What Do Distal and Proximal Mean?

Distal means farthest away, and proximal means closest to. In the picture, the left side of the wound (represented as being closed with duct tape) is distal to the heart, and the right side is proximal to the heart.

by James Hubbard, M.D., M.P.H.

In medical terminology, distal and proximal, or distally and proximally, describe anatomical locations.

Proximal means closest to, and distal means farthest away.

With reference to a wound on an arm, distal to the wound would be past the wound toward the fingers. Proximal to the wound would be from the wound toward the shoulder.

On the leg, the toes are the most distal, the hip the most proximal.

The knee is proximal to the ankle; the elbow is proximal to the wrist. Get it?

With reference to blood vessels, distal would be furthest from the heart. Proximal closest.

If it’s not clear, please ask in the comments section below.

  • R3D3Y3K1K1

    These two terms are used to define the relevance and proximity of the wound and heart. For example proximal is always between the wound and heart while distal is going to be after the heart and wound

    • R3D3Y3K1K1

      To refine distal is on the furthest side of the wound from the heart while proximal is on the closer side of the wound to the heart

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        Thanks.

  • Jennifer

    When discussing cross clamping of the aorta for example above the aortic valve, but below the innominate artery, is the innominate artery proximal or distal to the clamp? Thank you

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Unless there’s something I don’t know about how a surgeon would orient that, I would think the innominate artery would be distal to the clamp.

  • Saberina

    on what basis are the proximal convoluted tubule and the distal convoluted tubule named so? i mean, both seem to be on the same position, so what is the reference point?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I assume it’s proximal distal to the junction with the artery, but that’s just a guess.

  • Jai

    Your foot is what to your hip

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Your foot is distal to your hip.

  • http://www.jakeshomeworkouts.com/ Jake Long

    This one has been confusing for me. But I think I get it. So is it always in relation to the heart, or the middle of the body?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Yes.

  • Christy Detrick

    does it mean going up toward the body is proximal, and going down is distal?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Yes.

  • susan

    if the point of attachment is the coxal(hip) how is the knee distal to the foot?
    If the point of attachment is the deltoid (shoulder) how is the anticubital(anterior of elbow) proximal the hand ?

  • kayon

    What is the correct directional term to describe the relative position of the hands to the arms

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      The hands are distal to the arms. The arms are proximal to the hands.

  • Evelyn

    Very often, in textbooks and other references, the muscles of the neck seem to get this definition ‘mixed up’…unless I am the one mixed up. I keep reading that the distal attachment of the anterior and middle scalenes (for example) is the First Rib, and the proximal at the transverse processes.
    My understanding is that it should be the other way around, is that because I view the head as an ‘appendage’? Can you help me clarify and come to a firm decision about this? Maybe these sources don’t consider the heart as the point of reference for the proximal/distal terms.
    Help?

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Evelyn, distal and proximal, of course have to have a reference point. Distal and proximal from what. I’m not sure what the standard reference point is in internal anatomy. Possibly the center of the body? A line from the mid sternum and spine is center and everything is distal to that? I’m not sure.

  • So

    I’m desperated I still don’t understand the difference between distal & proximal.Can someone help me?

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      So, distal is downstream, proximal is upstream. Disal is farthest away from the heart. Proximal is closest. For a wound on the forearm, the most distal part of your arm is your fingertip. The most proximal part of your arm is your shoulder.

      • Laura

        and when we talk about the intrument used in a surgery..do we use the patient or the surgeon as the reference point?

        • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

          I’m not sure when that is used, if we’re talking about some instrument the surgeon is using, I would guess you’d use the surgeon.

          • Bird

            Simple question. If a patient has a cut just below his elbow, is it distal to the elbow?

            Next, if a patient has a cut that is equally between his wrist and elbow, what is it? Proximal to his wrist or distal to his elbow?

          • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

            A cut below the elbow would be distal to the elbow. A cut equally between the elbow and wrist would be both distal to the elbow and proximal to the wrist. There’s no one or the other. Distal and proximal are determined by whatever body part is you use for a reference point.

          • Bird

            Thanks. I actually had a chance to use it at a car wreck yesterday to the 911 operator. I told them the man had a compound fx of the radius and ulna distal to the elbow. and it had an anterior protrusion. Any how, thanks.

          • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

            Bird. Good for you for stopping.