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 Human anatomy and physiology for high-school students

Editor's Introduction -- The company that publishes Structure & Function of the Body claims that this textbook can be used in a one-semester course for students who already have completed a high-school course in general biology. One of our reviewers finds that Structure & Function of the Body "can provide solid grounding for students who may study human anatomy and physiology during their college work." Our second reviewer says that Structure & Function of the Body "does a creditable job with the what, the where and the when, but it often fails to give proper explanations of the why and (especially) the how."
from The Textbook Letter, July-August 1994

Reviewing a high-school book in human biology

Structure & Function of the Body
1992. 492 pages. ISBN: 0-8016-6403-9. Mosby - Year Book, Inc.,
11830 Westline Industrial Drive, St. Louis, Missouri 63146.

An Excellent Introduction
to a Complicated Subject

Stephanie A. Young

Structure & Function of the Body -- a book that was originally published in 1960 and has been revised every four years since then -- does a generally excellent job of presenting a complicated subject to the novice.

Before discussing the book's strengths and weaknesses, I should point out some of the limitations of this review and some of my own biases. I am a practicing pathologist, and I teach medical students, but I have had no experience in teaching at the high-school level. I took an anatomy-and-physiology course 25 years ago, but the textbook that I remember using then had much less material than Mosby's book does. To cover the material in Structure & Function of the Body during a one-semester high-school course would be a very ambitious undertaking.

When I began working on this review, I had seen no earlier edition of Structure & Function of the Body, and I had no competing text that might serve for making comparisons, so I borrowed a copy of a book that is used by a local private high school: Gerard Tortora's Introduction to the Human Body, issued by HarperCollins College Publishers. In comparison with that text, Mosby's is less detailed and is more accessible to a high-school audience.

The writers of Structure & Function of the Body seem to be aware of the difficulty in memorizing lots of anatomical detail, and they have tried to provide interesting commentary along with their factual information. Sometimes, however, their comments create problems, as in their discussion of the structure of nerves. On page 133 the text says that axons in the peripheral nervous system are sheathed in a myelin-containing neurilemma (formed by the Schwann cells), that the myelin plays a part in the regeneration of damaged axons, and that the potential for regeneration is therefore greater in the peripheral nervous system than in the brain and the spinal cord, where axons "have no neurilemma." But the text on the next page introduces the oligodendroglia and says that "they produce the fatty myelin sheath that envelops nerve fibers located in the brain and spinal cord." The apparent discrepancy is never explained. (In the HarperCollins book, on the other hand, the student finds a clear -- albeit long and detailed -- discussion of this issue.)

One of the strengths of Mosby's book is the clarity of its illustrations and of the captions and call-outs that go with them. The relevant information is all there, the presentation is usually as straightforward as possible, and the illustrations invite the student to learn.

There are a few exceptions, however, and two of these occur in the chapter about nerves. Page 151 has an illustration that purports to show the circulation of cerebrospinal fluid. This is a notably difficult concept to depict graphically, and Mosby's attempt fails. On the next page, a painting of the underside of the brain has call-outs designating the olfactory tract, the optic chiasm and the mammillary body, but these structures are never defined in the text.

Here are some more observations that I made as I looked through Mosby's book:

Chapter 2, "Cells and Tissues," is well written and well illustrated. The only serious fault that I find is that the genetics section needs to be expanded and clarified. The student who relies on Mosby's treatment of genetics will be hard pressed to answer the monumental question that appears in the chapter review: "What is a gene?" (The HarperCollins book has a genetics section that is superior to Mosby's in both depth and clarity.) In revising their genetics section, Mosby's writers should be sure to correct the factual error on page 27: A human zygote gets 23 chromosomes, not "23 pairs of chromosomes," from each parent.

Generally, the photomicrographs seen in chapter 2 are good and are used effectively, but the one on page 33 could be better: It supposedly shows lung alveoli, where "[a]bsorption of oxygen into the blood" occurs, but the capillaries are nowhere in sight. A better photomicrograph, at the same magnification, would solve this problem.

Chapter 4, "The Integumentary System and Body Membranes," includes a good, illustrated description of the structure of the skin, and the correlation between structure and function is emphasized. Chapter 5, "The Skeletal System," is lucid and to the point, with a fine illustration of the various types of diarthrotic joint. Chapter 6, "The Muscular System," opens with a discussion of how muscles work, and then -- perhaps necessarily -- becomes a series of figures that show musculature and list the muscles' names. Welcome, students, to the world of anatomy.

Chapter 7, "The Nervous System," has some shortcomings, as I have noted above, but the chapter as a whole is effective and is appropriate for high-school students. Where it is weak, the classroom teacher can introduce supplementary material derived from the HarperCollins text from another text that has a strong chapter on neurology.

Chapter 11, "The Circulatory System," is a good discussion of a difficult topic, and it includes an interesting, illustrated explanation of EKGs. Chapter 12, "The Lymphatic System and Immunity," is thorough and makes good use of both photomicrographs and scanning electron micrographs. I was not impressed, however, by the sidebar about AIDS (page 261). It is nothing in comparison with the excellent, three-page presentation in the HarperCollins text. If students are to get a proper lesson about AIDS, the teacher will have to look beyond Structure & Function of the Body for information.

Chapter 13, "The Respiratory System," is sound and includes a good sidebar on infant respiratory distress syndrome (page 281). In chapter 16, "The Urinary System," I was particularly impressed by the diagram of the nephron unit, the text and illustration that describe the formation of urine, and the discussions of the artificial kidney, hemodialysis and peritoneal dialysis.

While the sidebar about AIDS is weak, most of the sidebars in Structure & Function of the Body are commendable. They help to keep the book interesting by discussing important topics clearly. The topics range from in-vitro fertilization to endocrine abnormalities to the Heimlich maneuver.

As a whole, Structure & Function of the Body is an excellent introductory text, and it can provide solid grounding for students who may study human anatomy and physiology during their college work.

A Book That Skimps
on the Why and How

Ben E. Coutant

A textbook of human anatomy and physiology should contain the essentials: what, where, when, why and how. Mosby's Structure & Function of the Body does a creditable job with the what, the where and the when, but it often fails to give proper explanations of the why and (especially) the how. These are certainly the most difficult aspects to explore in an introductory text, but they are also the most important and interesting ones. Unless sufficient time is spent on them, it is very hard to capture and maintain the student's attention.

While Structure & Function of the Body provides an extensive overview of its subject, there are significant omissions in its coverage of cellular physiology. As a result, students will have difficulty in achieving an understanding of how the body really works and can accomplish its many tasks.

Studying biology requires a commitment to learning about cells and cellular functions, as a requisite for understanding the workings of an entire organism. Even an introductory text should attempt to give readers an idea of how individual cells within a tissue or an organ system contribute to the functioning of that tissue or system, so students can see connections between events at the cellular level and effects at the higher levels of organization.

In Structure & Function of the Body, cell biology is presented in chapter 2, "Cells and Tissues," but the chapter is weak. The writers, in their attempt to simplify matters, have omitted so much that the chapter fails to equip the reader for comprehending material that will appear later in the book. For example: Because chapter 2 gives so little space to chemistry, the student is ill-prepared to understand why the breaking down of carbohydrates, proteins and fats requires an array of different enzymes -- a point that the student will encounter in chapter 14, "The Digestive System." A brief overview of chemistry and biochemistry is given in Appendix A, at the back of the book. That material might better have been put into the book's text, before the discussion of cells and tissues.

A Surprising Defect

In the opening chapter, the discussion of homeostasis (on page 12) contains a major flaw -- surprising because Structure & Function of the Body is now in its ninth edition. Homeostasis, the maintaining of a relatively constant internal environment, is the central concept of physiology, and students can't understand homeostasis unless they know about the chief mechanism of homeostatic control: the negative feedback loop. Mosby's writers cite the system used to maintain homeostasis of the concentration of carbon dioxide in the blood, yet their description of that system fails to tell what processes are involved in sensing the carbon-dioxide concentration and keeping it within a "normal" range. Further, the accompanying diagram is titled "Negative Feedback Loop" but fails to show any feedback path.

A number of other, less serious problems are apparent, some of them involving the order in which topics are presented. For instance, the chapter on muscles comes before the chapter about the nervous system. When students read that muscles respond to stimuli, it is not at all clear that the stimuli are electrical and, under normal circumstances, are delivered by nerves.

There are also occasional silly statements, such as the one on page 313, in the chapter about the digestive system: "Salivary amylase usually has little time to do its work because so many of us swallow our food so fast." This appears to be merely a snide remark, not a scientific statement. It disregards the fact that amylase, protected within a bolus of food, can continue to work (for a short time) even after the bolus has entered the acidic environment of the stomach.

In the same chapter, on page 305, the writers state: "After food has been in the stomach for about 3 hours, chyme passes through the pyloric sphincter into the first part of the small intestine." This erroneously implies that no food leaves the stomach until some three hours have elapsed. In fact, though, the stomach normally empties gradually, over a period of two to three hours after food has been swallowed. The error is minor, but it can produce a misunderstanding of the digestive process.

The chapter about digestion also suffers from inadequate coverage of absorption, the major digestive process. The text fails to present a clear picture of how molecules can move across the intestinal epithelial layer, whether by active transport or by passive mechanisms.

In the chapter called "Nutrition and Metabolism," page 321 offers the statement that "For some reason, energy released from food molecules cannot be used directly for doing cellular work." This entirely misses a key point: One major result of metabolic processes is the conversion of energy into forms that can easily be used -- or, alternatively, can be stored -- by the organism.

Readable Writing

In terms of its overall structure, the book is well designed. The text is readable and appears to be appropriate for an audience of high-school students, though the writers sometimes use analogies that aren't the most appropriate. For example, on page 148 they compare the spinal-cord reflex arcs to a telephone switchboard. This could lead to incorrect perceptions, since reflex arcs involve synapses that do not change readily. The connections within a switchboard, on the other hand, change continually to create alternative pathways for signals to follow.

Each chapter begins with a short outline and a list of objectives, and each chapter ends with an "outline summary," a new-word list, a short-answer test, and a set of review questions. The book would be better if each outline summary were replaced by a plainly written textual summary that would synthesize the information presented in the chapter and would state the functions of the relevant organ systems.

The figures and tables generally seem clear and informative, and they generally support the text very well. In some instances, however, a figure is at odds with the text. One such instance is seen in chapter 13, "The Respiratory System": The text is correct in stating that bicarbonate is the predominant form of carbon dioxide in the venous blood, but figure 13-13 implies that carbaminohemoglobin is the predominant form.

An introductory textbook should not overload students with more information than they can synthesize and remember, but neither should it give them so little information that it keeps them from making logical connections. Structure & Function of the Body tends to err in the latter direction, at least in its presentation of physiology.


Stephanie A. Young is a physician, a staff pathologist at Cook County Hospital (in Chicago), and an assistant professor of pathology at Rush Medical College (in Chicago).

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 and general biology.

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