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.

  • 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.

  • Lorraine

    When speaking of distal and proximal, is it ever correct to say “The elbow is proximal from the wrist?” Or, are you only supposed to use the word ‘to’ and say “The wrist is distal to the elbow?”

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

      Lorraine, I guess either way could be used. I’ve always heard and read “to” used in that context, but as long as you get the point across it really doesn’t matter, in my opinion.

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

    Yes. The patient’s right hand is distal to his right wrist. Or the other way around, the wrist is proximal to the hand.

  • Jonothan C.

    I have been preparing for the EMT-Basic National Registry Exam and one of the topics that I have been studying is anatomy. When explaining the terms “distal” and “proximal” the test prep book that I am using (Kaplan) gives this example, “The patient’s right hand is proximal to the patient’s right wrist and distal to the patient’s right shoulder.” Part of this does not make sense to me. How is the right hand proximal to the right wrist? Shouldn’t it be distal since the hand is further away from the trunk than the wrist?

    • HairyGuy

      no. the hand is proximal to the right wrist while the elbow (not sure of its medical term) area is distal to the wrist. we are comparing two direct parts. we do not care about using the center of the body (trunk) as part of the comparison. regarding the quote, it basically says that the patient’s right hand is close to the wrist while it is far from the shoulder. that’s all.

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

        The right hand is distal to the right wrist. The right elbow is proximal to the right wrist.