Adding excerpt from: http://docs.opengeospatial.org/is/12-063r5/12-063r5.html#35

```
Axis direction indicates the positive increment along an axis. The handedness 
of a 2- or 3-dimensional coordinate system may be derived from the directions.

Requirement: the following constraints shall apply:

i.        For geodetic CRSs having an ellipsoidal 2-D coordinate system, the 
two-dimensional ellipsoidal coordinate system axes are geodetic latitude, 
positive northwards, and geodetic longitude, positive eastwards. Axis direction 
shall be ‘north’ and ‘east’ respectively.
ii.        For geodetic CRSs having an ellipsoidal 3-D coordinate system, the 
three-dimensional ellipsoidal coordinate system axes are geodetic latitude, 
positive northwards, geodetic longitude, positive eastwards, and ellipsoidal 
height, positive upwards. Axis direction shall be ‘north’, ‘east’ and ‘up’ 
respectively.
iii.       For geodetic CRSs having a geocentric Cartesian coordinate system, 
in WKT strings the axis directions shall be ‘geocentricX’, ‘geocentricY’ and 
‘geocentricZ’ respectively. The first axis of the earth-centred 3D Cartesian 
coordinate system lies in the equatorial plane such that a vector pointing in 
the positive direction passes through the intersection of the equator and the 
prime meridian. The second axis is in the equatorial plane such that a vector 
pointing in the positive direction passes through the intersection of the 
equator and the meridian of 90°E. The third axis is perpendicular to the first 
two such that it completes a right-handed coordinate system; it is 
approximately parallel to the earth’s rotation axis, positive towards the north 
pole.
 iv.      For projected CRSs, except for coordinate systems centred on a pole, 
the axis direction shall be ‘north’ or ‘south’ and ‘east’ or ‘west’.

    For coordinate systems centred on a pole the direction for both axes will 
be ‘south’ (for the north pole case) or ‘north’ (for the south pole case); the 
axes direction shall be supplemented with a <meridian> description. This is the 
value of the meridian that the axis follows from the pole. The prime meridian 
from which the meridian value is reckoned is given through the <prime meridian> 
object; if no <prime meridian> object is in the WKT string then the IRM or 
Greenwich meridian shall be assumed.
v.       For vertical CRSs, the axis direction shall be ‘up’ or ‘down’.
vi.       For temporal CRSs, the axis direction shall be ‘future’ or ‘past’.
vii.      In engineering CRSs the horizontal directions are only approximate, 
the set of directions indicating whether the coordinate system is left-handed 
or right-handed. (In the 2D case, the handedness is when viewed from above the 
plane of the system). For engineering CRSs with polar coordinate systems the 
direction of the rotational axis shall be ‘clockwise’ or ‘counterClockwise’. 
The specified direction from which the rotation is measured shall be given 
through the supplementary object <bearing>; the bearing value shall be given in 
the unit defined through <axis unit>.

See 6.5 for comment on case sensitivity.

NOTE        The requirements in 7.5.4, iv) for projected CRSs with a coordinate 
system centred on a pole and in 7.5.4, vi) for engineering CRSs with a polar 
coordinate system require the enumeration for <axis direction> in 7.5.1 to be 
an extended version of the codelist given in ISO 19111:2007, 9.4.
```

I think this adds clarity for some of the concerns raised by @JonathanGregory. 
Thoughts?

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