Reviewing a science book for high-school honors courses

Essentials of Human Anatomy & Physiology
1995. 586 pages. ISBN: 0-697-22925-4 (paperback) or 0-697-16044-0 (hardback).
Wm. C. Brown Publishers, 2460 Kerper Boulevard, Dubuque, Iowa 52001.

A Good, Readable Textbook
Despite Occasional Defects

Ben E. Coutant

Essentials of Human Anatomy & Physiology is in fact an introductory college text, explicitly aimed at students who want to pursue careers in "health fields" and who have "minimal backgrounds in physical and biological sciences." (So says the preface, on page xiii.) It would certainly be appropriate in a high-school honors course for students who have a variety of career goals. Ideally, the students should be familiar with high-school biology and chemistry, but even students who lack those prerequisites will be able to use this book if they are willing to study and to master the basic biology and basic chemistry in the first few chapters.

The book integrates anatomy and physiology in twenty chapters. The text is well laid out, well written and quite readable, giving enough detail without becoming too dense. There are a few places where a desire for brevity overcomes the demand for clarity, or where additional illustrations would provide a more complete story, but -- as a whole -- this is a sound textbook.

The numerous charts do a good job of summarizing and supplementing the text, and most of the illustrations are very good. For instance, the diagram of mitosis, on page 63, shows three successive stages of the prophase, three stages of the anaphase, and two stages of the telophase. (This underscores the point, made in the text, that mitosis is a continuous process, though we divide it into discrete phases because this helps us to learn the events that the process entails.) In chapter 10, which covers the somatic and special senses, good diagrams of ocular anatomy help to explain how the diameter of the pupil is controlled and how the shape of the lens is regulated. Most introductory books do not include illustrations of these concepts, though the concepts are difficult to convey in text alone. (Lens accommodation can be especially troublesome, since it involves seemingly contradictory processes. When the ciliary muscle fibers contract, the lens thickens and becomes rounder because the suspensory ligaments have relaxed. When the ciliary muscle fibers relax, the ligaments become taut and the lens becomes thinner and flatter.) In the same chapter, a useful figure shows how impulses from discrete rods may converge and be transmitted toward the brain through a single nerve fiber, while impulses from discrete cones are transmitted through discrete fibers. This explains why visual acuity is lower in dim light than in normal daylight.

The text pages include numerous short, boxed asides as well as longer sidebars that are labeled "A Topic of Interest" or "Clinical Case Study" or "A Perspective in Science." Some of the sidebars discuss pathological conditions, helping students to see relations between normal physiology and diseased states. Others supplement the main text by giving additional information that will allow students to relate anatomical or physiological concepts to observations or problems that they may encounter personally. The topics include skin calluses, coronary artery disease, anabolic steroids, respiratory-distress syndrome in infants, carbon-monoxide poisoning, and heart murmurs (to mention just a few).

Later in the same chapter, the writers oversimplify some important physiology by implying that a neurotransmitter induces excitation or inhibition of a postsynaptic membrane by making the membrane more permeable or less permeable to sodium ions only. In fact, however, postsynaptic excitation or inhibition can also arise when neurotransmitters cause the opening or closing of membrane channels that are specific to other ions (such as potassium or chloride ions). The writers commit another error by classifying neurotransmitters themselves as excitatory or inhibitory. Actually, whether a neurotransmitter produces excitation or inhibition depends on what receptors and what ion channels are present; some neurotransmitters can be either excitatory or inhibitory, according to the combination of receptors and channels that occur at a particular synapse.

Another error is evident in chapter 8, where the writers say that muscle cramps are due to a lack of ATP. While a lack of ATP can produce rigor mortis, it is not implicated in muscle cramps; even when a muscle is in a fatigued state, its supply of ATP is not depleted. Cramps are sustained contractions resulting from a prolonged surge of action potentials, which are thought to be caused by nutrient deficiencies, dehydration, ion imbalances or neuronal derangements.

In chapter 7, "Skeletal System," the diagrammatic paintings of a skull are supplemented by photographs that show a real skull in several aspects. This is a helpful technique (because drawings and paintings do not always do justice to the actual structure of bones), and it could have been used advantageously in presenting other parts of the skeleton. For example, photographs might have clarified the structure of the femur; the femur is depicted only by a painting, on page 149, in which the condyles appear strangely protruded on the bone's anterior surface.

It would also be good to have some more graphs of physiological phenomena (so that students could become adept at interpreting graphical information) and more questions that require students to handle quantitative data and to get some practice in performing physiological calculations. Perhaps the next edition will include an appendix of quantitative problems.

Despite its occasional defects and omissions -- most of which seem to have arisen from the writers' attempts to keep their book from becoming too long -- Essentials of Human Anatomy & Physiology can be recommended for use in a high-school honors course for students who intend to follow diverse career paths.

The Fundamentals Are Lost
amid Gimmicks and Details

William T. Mosenthal

This book is literally colorful! Color-coding is one of today's textbook fads, and the almost gluttonous use of colored items in Essentials of Human Anatomy & Physiology leads to confusion and distraction. There are purple clinical notes, purple asides, brown charts, buff review questions, blue-striped "Topic of Interest" features and buff "Perspective in Science" articles, all interspersed with the main text and all working to distract anyone who is trying to read the text and maintain a train of thought. Were I a student struggling with the difficulties of studying human anatomy and physiology, I would be irritated by those incessant interruptions. A student will learn more easily if text is presented as a continuum, without a colored box of review questions on every page, shaking a warning finger while the student is attempting to follow a concept.

The black-and-white text, the heart of any book, is comprehensive in its scope and generally accurate. I have no argument with its overall veracity, though a few errors can be found. For instance, the "specialized capillaries" of the choroid plexuses do not arise from the pia mater (page 223); the trigeminal nerve does not "transmit impulses from the scalp behind the ears" (page 229); and the output of the cerebellum is not directed exclusively to the midbrain (page 228). The writers have neglected to mention that some 95% of the cerebellar output proceeds to the thalamus and the cortex!

My difficulties with this book arise not from inaccuracies but from the way it obfuscates basic concepts by submerging them in details and by failing to explain them adequately. Let the gory details come later. The writers of Essentials of Human Anatomy & Physiology expect too much of the beginner, and they fail to stimulate the reader by imparting understanding. For instance:

• In describing the structure and functions of the cell and its membrane, the writers present a congested explication of chemical function and microscopic structure, far beyond the grasp of students who have minimal scientific backgrounds. The students will struggle mightily to remember what "rough endoplasmic reticulum" signifies, where the globular proteins and glycolipids reside, what function is served by membrane cholesterol, and so forth -- but the students will not be impressed with the importance of the semipermeability of the cell membrane, which is crucial to homeostasis and, therefore, to life itself. In any introductory course, that concept must be emphasized over and over, so that students will recognize its paramount importance. I don't find such emphasis here. I find that detail is overdone, to the detriment of the students' ability to comprehend fundamental processes.

• The chapter about the lymphatic system and immunity suffers from similar faults. The central import of the antigen-antibody reaction is lost, hidden under the trappings of the complement system, the activation of T-cells, lymphokines, clones, B-cells, plasma cells, helper T-cells, killer T-cells et cetera.

• The important function of fever is never made clear. Hyperthermia is described on page 118, and the heat of inflammation is described in purely local terms on page 432, but nowhere is fever recognized as a beneficial, general accompaniment to the body's fight against infection. Students have to understand that fever is not something bad. It is a normal, life-saving response to infection, and it should not be "treated" with antipyretics unless it becomes excessive and pathological.

• The description of the production of energy from glucose, protein and fat is another extravaganza that will overwhelm uninitiated students. Give oxygen the respect that it deserves, but simplify the overall presentation. Then students may be able to understand the basics of anaerobic and aerobic energy-production, even if they don't learn the names of all the players.

  Bald, unexplained statements abound in this book, and students will have to accept and memorize these without understanding them. The statements will soon be forgotten or, at best, will congeal into a superficial, almost useless body of information which will neither stimulate the students nor inspire further study. For example:

• The description of the pH scale (page 37) gives no indication of how the concept of pH evolved, and the statement that "There is a tenfold difference in the hydrogen ion concentration between each [sic] whole number on the pH scale" is never explained. The writers present no real justification for memorizing pH facts, and no information about the narrow range of pH values that a human can tolerate. They should have put off this entire pH business until they were ready to discuss acid-base balance.

• In the description of the spinal cord (page 216): "[A] thickening in the spinal cord . . . gives off nerves to the arms." Yes, but why is there a thickening? The perfectly simple explanation is not given. Later on the same page, students read that the cord "consists of a core of gray matter surrounded by white matter," but there is no explanation of why white matter is white or gray matter is gray. On page 221: "Like motor fibers, sensory fibers [within the brain] cross over." Why not tell the students that no one knows why this crossing occurs? On page 223, in a purple aside about lumbar puncture, the writers say that the needle is inserted "between the third and fourth or between the fourth and fifth lumbar vertebrae." No reason for this is given. The writers should have reminded the students of a fact that was presented back on page 216: The spinal cord ends at the second lumbar.

Finally, I believe that there are several important omissions:

• As far as the nervous system is concerned, a short overview of the development of the human brain would be extremely helpful in explaining the presence of primitive "lower" centers and of "higher" centers that perform integration and control.

• A short discourse on the uniqueness of every strand of human DNA (and therefore of every human) would be useful, as would some explanation of heredity and the concept of dominant and recessive genes. The intimate details of protein formation are bountifully depicted in Essentials of Human Anatomy & Physiology, but the reader doesn't learn why his fingerprint is different from anyone else's, why his hair is or isn't red like his mother's, or indeed why all humans are discernibly unique.

• There is no statement about the volume of the secretions that are dumped into the gut. If the student were to learn that some seven liters enter the gut tube every day, while only one-tenth of a liter is excreted in the feces, he would appreciate the marvelous economy of a healthy gut, and he would better understand the problems inherent in diarrhea.

• Though each human is a discrete mass of modified seawater, the book never gives credit to the integument for its function of containing this "inland sea." Loss of skin leads to leaks, and to death if the leaks are severe enough!

• What is more human than the marvelous dexterity of the hand? -- and why does this textbook of human anatomy say nothing about it? There is not a word about the exquisite anatomy involving the intrinsic musculature, the tendon sheaths, or the opposable thumb, though this is anatomy of real significance!

The best part of Essentials of Human Anatomy & Physiology is the illustrative material. The pictures and charts are profuse and understandable, and they almost always are placed so that they work with the text.

In sum, this is a garishly colored, richly illustrated book which would be much improved if the writers and editors would take some advice:

• Provide a reader-friendly text, stripped of advanced scientific detail.

• Abolish the tactic of interrupting the text with asides, purple clinical notes, striped articles, and other distracting bits of auxiliary information. If such information is needed, put it into the main text or into an end-of-chapter addendum.

• Simplify the presentation of concepts, so that they really will be comprehensible to the intended audience. Basic concepts must be much more carefully explained, not just stated; and then they must be repeated over and over, in all the segments of the book where they are applicable.

As it stands now, Essentials of Human Anatomy & Physiology is not a textbook that I would recommend for the instruction of students who have minimal backgrounds in physical and biological sciences.

Ben E. Coutant is an assistant professor in the School of Natural and Health Sciences at Barry University (Miami Shores, Florida), where he teaches courses in physiology, anatomy, neuroanatomy and general biology.

William T. Mosenthal, a surgeon, is a professor of anatomy and surgery, emeritus, at the Dartmouth Medical School (Hanover, New Hampshire). He has given courses in anatomy, neuroanatomy and surgical principles at that institution, and he has taught introductory anatomy and physiology at a nearby community college. He is the author of A Textbook of Neuroanatomy with Atlas and Dissection Guide, issued in 1995 by the Parthenon Publishing Company (Pearl River, New York).

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