Evaluating relation terms and comparison in Terminologia Anatomica: a study on supreme

The terms of relationship and comparison, which consist of 44 elements grouped as general terms in Terminologia Anatomica, describe the location of anatomical structures and facilitate communication between health professionals and students. During a review in Terminologia Anatomica, the term 'supreme' was found in various structures. However, it is not part of the general terms, which could create confusion when describing and comparing anatomical structures. For this reason, this study aimed to analyze the relevance of supreme and its possible relationship with the superior term. A review of Terminologia Anatomica was conducted to identify structures designated by the adjective "supreme" or its Latin equivalent, suprema. The term was then categorized based on anatomical context. An etymological analysis of supreme and superior revealed that both terms stem from the Latin root super, meaning above or over. However, over time, each term evolved with distinct meanings. In Terminologia Anatomica, 'superior' is used as a comparative adjective for a higher position relative to another structure. 'Supreme' is a superlative adjective that indicates the highest level and the designation of structures in a principal position relative to others. Due to inconsistent usage, we suggest including 'supreme' in Terminologia Anatomica and unifying its application. Specifically, it should be limited to structures where terms such as superior, middle, and inferior are applied and when describing structures that occupy a principal position relative to others. In this sense, we suggest changing the supreme, superior and inferior nuchal lines to superior, middle and inferior nuchal lines, respectively.