Say It. Take It Apart. Learn It.

How we rebuilt the terminology tools in Anatomy & Physiology, 12th Edition.

An A&P course is partly a language course.

Okay, it's a huge language course.

Our students encounter hundreds of unfamiliar terms, many of them long, difficult to pronounce, and constructed from word parts they've never seen before. And we're asking students to learn all that new language while simultaneously learning some pretty challenging concepts.

That's why Anatomy & Physiology has long provided terminology-learning tools that you may not find—or may not find in the same depth—in other A&P textbooks.

For our new 12th Edition, we decided those tools deserved a major tune-up.

And that's how Frank got himself into trouble.

A word list with a job

At the beginning of each chapter, we provide a chapter word list.

It's comprehensive. The list gathers all the boldface terms from the chapter narrative, along with an occasional italicized term when we think it's useful to include it.

That gives students one convenient place to preview the important language of the chapter.

But these aren't intended simply as "vocabulary words that might be on the test."

I've previously explained the idea in Word Lists Help Students Build Their Mental Lexicons.

One useful way to prepare for reading an A&P chapter is to scan its terminology before digging into the narrative. That gives the reader a chance to start becoming familiar with the words before trying to understand the concepts they represent.

Learning research gives us good reason to think about new vocabulary this way. Becoming familiar with a word involves developing connections among how the word is written, how it sounds, and what it means.

That's one reason I don't want students meeting carbaminohemoglobin cold in the middle of an already complicated explanation of blood-gas transport.

Give the poor student a fighting chance.

Say it

Our chapter word lists include a simple phonetic pronunciation guide for each term, along with an embedded hint instructing the reader how to use it.

The comprehensive Glossary does, too.

That lets students practice saying a term before encountering it within a sentence that's already asking them to understand some new anatomical or physiological idea.

Yes, I actually encourage students to say the terms aloud.

I've been beating that drum for years—in Word Lists Help Students Build Their Mental Lexicons, in The A&P Professor podcast Episode 20, Reading A&P Terms Out Loud Helps Reading Comprehension, and again in Episode 145, A Tongue Twister's Guide to Mastering Anatomy Pronunciation.

There is learning science behind my nagging.

Research on what's called the production effect has repeatedly found that saying words aloud can improve later memory for them compared with simply reading them silently. One leading explanation is that producing the word makes its memory more distinctive.

Does that mean saying carbaminohemoglobin three times will suddenly make you understand blood-gas transport?

Nope.

But the term can begin to "sound right" in the learner's mental lexicon. When it later appears in a sentence, the reader has one less completely unfamiliar thing to wrestle with while trying to understand the actual A&P.

That can be especially helpful for readers who aren't yet very comfortable predicting the pronunciation of unfamiliar English words.

Which, when you think about English pronunciation, could be just about anybody.

Why not put the pronunciation right in the sentence?

Some textbooks put pronunciation guides immediately after a term the first time it appears in the narrative.

There's an obvious advantage to that: the pronunciation is sitting right there when the reader needs it.

But we chose a different approach.

A beginning A&P learner is already trying to hold unfamiliar structures, processes, relationships, and vocabulary in mind while making sense of a sentence. Dropping a phonetic pronunciation guide into the middle adds another piece to process—and interrupts the flow of an explanation that may already be challenging.

We'd rather give students the pronunciation before they read.

And if they need it again, it's waiting in the chapter word list or Glossary.

I should be clear that I don't know of research directly comparing our approach with inline pronunciation guides in A&P textbooks. That's our application of what we know about reading, vocabulary learning, memory, cognitive load, and our experience watching beginning A&P students wrestle with unfamiliar terminology.

Take it apart

Pronunciation is only part of the job.

Most A&P instructors I know are constantly taking terms apart for their students.

Hyper- means above.

Hypo- means below.

Cardi- refers to the heart.

-itis means inflammation.

We do this almost without thinking.

Why?

Because once students start recognizing commonly used roots, prefixes, and suffixes, an intimidating scientific term becomes a lot less intimidating.

Our chapter word lists support that approach by showing useful word parts and their basic translations. Students can skim them while previewing a chapter.

Our Glossary provides those same kinds of clues when students look up terms later.

I've discussed this strategy before in Word Parts Help Students Master the Language of Science and Handy Supplement Helps Students Master the Lingo of A&P.

Word parts can act as little mnemonic clues. They may help students remember the spelling and meaning of a term.

More importantly, each familiar word part becomes another tool students can carry forward. When they encounter a term they've never seen before, they can often begin taking it apart and making an educated guess about what it means.

That's a skill they'll keep using in later courses and eventually in clinical settings.

And isn't that exactly what we A&P professors already do?

We point out word parts during lectures and discussions. We explain them in handouts and assignments. We keep reminding students that this bit means one thing and that bit means another.

The difference is that our chapter word lists give students a complete, consistent resource that's always handy.

Research on morphological learning—learning to recognize and use meaningful word parts—supports its usefulness in building vocabulary. A 2023 study with college learners, for example, found that explicit morphological training improved receptive academic vocabulary learning. The National Library of Medicine likewise teaches medical terminology by having learners identify prefixes, roots, suffixes, and other components and use them to work out meanings of unfamiliar medical terms.

Anatomy-specific research has also found benefits from explicitly teaching Latin and Greek etymologies alongside anatomical terminology

No, learning a pile of Greek and Latin roots isn't a magic shortcut to mastering A&P. Research with undergraduate A&P students has found only a weak relationship between their existing knowledge of Greek and Latin roots and overall course performance.

That's fine.

We're not trying to turn the chapter word lists into a Latin course.

We're giving students another tool for figuring things out.

Names change, too

Another part of our terminology cleanup involved continuing a transition we've been making for years: moving farther away from eponyms as our preferred anatomical terms.

An eponym names something after a person. Islets of Langerhans, haversian canal, and fallopian tube are familiar examples.

Eponyms remain deeply embedded in clinical language, and our students are going to encounter many of them. So we don't pretend they don't exist.

But international efforts to standardize anatomical terminology have long favored standardized descriptive terminology rather than eponyms as the preferred names for structures. Clinical usage has not always moved at the same speed.

So our general approach is practical: teach students the currently preferred descriptive terminology while helping them recognize important alternate terms they'll still hear and read elsewhere.

I've written about some of this before in What's Up with Eponyms in A&P? Part 1 and What's Up with Eponyms in A&P? Part 2.

And yes, at the end of Part 2 I promised a Part 3.

In 2018.

I really ought to get back to that.

Especially because A&P faculty still have some pretty lively disagreements over what we should do with eponyms. We had a few of those discussions within the Patton Team, too.

Or what passes for lively disagreement among us.

More about that another time.

Then Frank got the job

All of this sounds fairly straightforward until you realize how many terms we're talking about.

And how many pieces each entry has.

Which term should be preferred?

Which alternate terms should remain?

Is the pronunciation accurate?

Is it consistent with similar terms elsewhere in the book?

Are the syllables and word parts divided appropriately?

Are their translations useful to a beginning learner?

Does the formatting make the entry easier to understand?

Now multiply that by an entire A&P textbook.

Then remember that our revision team included four authors, at least three editors, and a collection of reviewers, copyeditors, proofreaders, compositors, and others.

Having all of us independently "fix" terminology seemed like an excellent recipe for making it less consistent.

Clearly, we needed one person to wrangle the whole thing.

Author Frank Bell, our in-house terminology guru, seemed like the obvious choice.

I vaguely recall that Frank was absent from the weekly Patton Team meeting when his name came up as the perfect person for the job.

Pure coincidence, I'm sure.

When the news reached him, Frank didn't hesitate.

Much.

A global terminology cleanup

Frank took on a global review of the terminology resources for the entire book.

And it turned out to be a much bigger job than any of us anticipated.

Besides reviewing the terminology itself against current usage and authoritative sources, he went through the pronunciation guides, word parts, translations, and formatting.

Occasionally, Frank would come back to me with a question such as, "Why did you do it this way?"

That's always a fun question for an author who has been revising a textbook for decades.

Sometimes I could explain the original thinking.

Sometimes the answer was probably some variation of, "Well, I'm sure there was a reason."

With that background, Frank could decide whether the original approach still made sense—or whether he had found a better one.

Once Frank completed his review, the other authors incorporated his terminology changes throughout the chapters and other elements being revised.

Then editors checked us.

Then copyeditors checked us.

Then proofreaders checked us.

And, as always, despite all that checking, I'm sure somebody will eventually find something we missed. That's what happens in a project containing thousands upon thousands of tiny details.

But this is by far the most systematic and consistent terminology review we've ever done.

And there's the Glossary

As I mentioned in the first post of this series, The A&P Textbook You May Have Overlooked, we've moved our large Glossary from the back of the printed textbook to the Evolve Student Resources.

That helped us make the physical book noticeably shorter without taking this resource away from students.

The Glossary is more comprehensive than the chapter word lists. It includes all the boldface and italicized terms from the text narrative, plus some additional terms that students encounter only in figures or tables.

And it reinforces the same learning tools students encounter in the chapter word lists.

How do I say this term?

What useful word parts can I recognize?

What do those parts mean?

So a student can preview terminology in the chapter word list, encounter it while learning the chapter's A&P, and return to it later in the Glossary.

Same language. Same system. Same tools.

Our best terminology tools yet

When Frank finally emerged from beneath the mountain of terminology, the 12th Edition had the most carefully reviewed and internally consistent collection of A&P terms, simple pronunciations, and useful word-part translations we've ever produced.

Having looked at the terminology resources available in the other A&P textbooks we examined, I suppose I could claim that ours is the best A&P terminology collection in the universe.

I'm not going to claim that.

But I think I could.

What I will claim is that we worked very hard to make these resources accurate, consistent, easy to use, and genuinely useful to beginning A&P learners.

Terminology isn't something we add around the edges of an A&P course.

It's the language students need to learn the course.

So we think it's worth getting the words right.

If you'd like to explore these terminology resources yourself, request a free instructor review copy of the new 12th Edition of Anatomy & Physiology.

The Ovary Is Not a Conveyor Belt

Rethinking how we tell one of the trickiest stories in reproductive A&P.

In my previous post, Why We Flipped the Reproductive Story, I explained why we reorganized three chapters in the new 12th Edition of Anatomy & Physiology.

But reorganizing chapters was only the beginning.

Once we started taking apart our traditional reproductive story and putting it back together, we found ourselves looking much more closely at some familiar explanations and illustrations.

One of the biggest examples was the ovary.

The ovary is harder than it looks

The basic story seems straightforward enough.

Ovarian follicles develop. An oocyte is released at ovulation. The remaining follicular tissue becomes a corpus luteum. If pregnancy does not occur, the corpus luteum degenerates. Meanwhile, hormonal changes help regulate the whole process.

Simple, right?

Well, not really.

The more closely we looked at how introductory A&P textbooks—including our own previous editions—portray this story, the more we wrestled with a basic problem:

How do we make ovarian structure and function simple enough for a beginning learner without making it so simple that we teach something misleading?

That's always a challenge in A&P.

We aren't trying to prepare our students to become reproductive biologists during one chapter of an introductory course. But we don't want the simplified story they learn now to become something they'll have to unlearn later, either.

A cycle isn't a straight line

One particular problem is the cyclical nature of ovarian function.

Textbook illustrations necessarily arrange developmental stages in some kind of sequence so students can follow them. That's useful. But a sequence laid out from left to right can begin to look like a conveyor belt.

One follicle progresses to the next stage, then the next, then ovulation happens, and then comes the corpus luteum.

Except an ovary doesn't really work like a factory assembly line.

Follicles at different stages can be present at the same time. Most do not proceed all the way through the sequence. And the whole process operates within recurring ovarian and menstrual cycles regulated by changing physiological conditions.

So one of our goals was to preserve a clear developmental sequence while making the cyclical nature of ovarian function easier to see.

That's harder than simply drawing a circle instead of a line.

Simple, but not too simple

We spent a lot of time discussing what a beginning A&P student actually needs to know about ovarian follicles.

How many developmental stages do we name?

Which structural changes really matter for understanding function?

How much histological detail helps the story, and when does added detail start obscuring it?

What terminology best prepares students for what they'll encounter in later courses?

And how closely can an introductory illustration resemble actual ovarian structure while still functioning as an explanatory diagram?

Those questions generated considerably more discussion than you might expect from looking at the finished pages.

Yeah. We can talk about follicles for a surprisingly long time.

Our goal was not to include everything that's currently known. Our goal was to identify the structural and functional ideas that give beginning students a sturdy conceptual framework.

Then they can keep building on it.

Some terminology changed, too

Rethinking the story also meant looking carefully at the words we use to tell it.

For example, the new edition introduces vesicular ovarian follicle in place of the older term graafian follicle in our chapter-opening vocabulary. That change also aligns with our ongoing quest to deemphasize the use of eponyms.

We've also made terms such as oocyte, menstrual cycle, and menstrual phase more visible in the reproductive story.

These aren't simply vocabulary swaps.

Terminology affects how students organize concepts in their minds. If we're asking them to understand ovarian function as part of recurring reproductive cycles and as part of changes across the life span, the vocabulary should support that framework.

Menopause belongs in the larger story

We also took a fresh look at our coverage of menopause.

In Chapter 46, we now introduce perimenopause and postmenopause and describe what happens during each stage. These terms are becoming increasingly familiar to patients and are showing up more often in conversations with their healthcare providers. We think our health professions students should begin building that framework in A&P.

Menopause, after all, isn't simply the point when menstrual cycles stop. It belongs to a broader physiological story involving changing ovarian function, reproductive hormones, and effects that extend beyond the genital system.

So we refined the discussion in Chapter 46: Reproduction and coordinated it with the broader life-cycle coverage in Chapter 47: Growth, Development, & Aging.

That's another advantage of our new organization.

Chapter 46 can establish the reproductive physiology—including perimenopause, menopause, and postmenopause. Chapter 47 can then revisit those changes within the larger context of aging.

Same concept. Different perspective.

You may recognize a familiar theme here: students build stronger conceptual frameworks when important ideas show up again in meaningful new contexts.

Textbook illustrations are arguments

I've often said that an illustration in an A&P textbook isn't merely decoration.

It's part of the narrative.

In some ways, every anatomical illustration makes an argument about what students should notice, what they should connect, and what they should remember.

That became especially obvious as we worked on the ovary.

We wanted our revised presentation to say, visually as well as verbally:

This is a dynamic organ. These processes are cyclical. The stages are related, but they are not simply beads moving along a string.

And, as always, this is the beginning of the story—not the last word on ovarian biology.

Take a look

When you receive your review copy of the new 12th Edition, spend a few minutes with Chapters 45 and 46 and compare our new ovarian story with the one you remember from earlier editions—or with the way you currently explain it to your students.

I'd be interested to know whether you think we've found the right balance between clarity, accuracy, and just enough detail.

If you haven't already requested a free instructor review copy of the new edition, click here and do that now.

Why We Flipped the Reproductive Story

Rethinking the traditional male-first organization of A&P.

In my earlier post, The A&P Textbook You May Have Overlooked, I mentioned that in our revised 12th Edition of Anatomy & Physiology, we turned our story of the human reproductive systems inside out, upside down, and flipped around.

Here's what I meant.

In the 11th Edition of Anatomy & Physiology, our organization probably looked very familiar:

Chapter 45: Male Reproductive System
Chapter 46: Female Reproductive System
Chapter 47: Growth, Development, & Aging

That's also the traditional organization in many A&P textbooks and curriculum documents. The currently posted HAPS A&P Learning Outcomes, for example, list male reproductive anatomy before female reproductive anatomy, followed by spermatogenesis before oogenesis. Of course, the HAPS Learning Outcomes are not intended to prescribe a teaching sequence.

The same male-first convention remains in the other major A&P textbooks we examined. Current examples from Saladin, Tortora, and OpenStax all begin their reproductive-system coverage with the male system before moving to the female system.

So why did we decide to change it?

We didn’t simply reverse the old chapters. We changed the way the reproductive story is organized.

The old story made sense

We had a legitimate pedagogical reason for our traditional organization.

We regarded the typical male genital system as the structurally simpler of the two systems. Starting there allowed students to establish some basic structural principles before moving to the more complex typical female system.

And because the story then moved toward fertilization, gestation, and birth, having the female system immediately precede that content also seemed logical.

I still think those are reasonable arguments.

But we eventually had to ask ourselves how much of our reasoning came from pedagogy and how much came from that very powerful force in education:

That's the way we've always done it.

We were also hearing concerns from professors, students, and others that routinely starting with the male system can carry an unintended message. It can suggest that male anatomy is the starting point or standard, with female anatomy following as a variation on that story.

That certainly wasn't the message we intended.

But intent isn't the only thing that matters in telling a story.

We weren't the only ones thinking about this

Once we began looking into the issue, we found that scholars had been raising related concerns for decades.

In 1992, Susan Lawrence and Kae Bendixen examined 31 anatomy textbooks used by U.S. medical students from 1890 through 1989. They found that illustrations, vocabulary, and syntax commonly presented male anatomy as the norm or standard against which female anatomy was compared.

Susan Morgan and colleagues later examined contemporary anatomy textbooks. They likewise found problems with equal representation of female and male anatomy. Interestingly, their research with medical students suggested that many students did not recognize some of these issues themselves.

Then, in 2021, Katherine Ray King, Linda Fuselier, and Harshini Sirvisetty analyzed four widely adopted undergraduate nursing A&P textbooks. They specifically described a "male-first" perspective in which males occupy the central position and female and nonbinary identities become the "other."

Elizabeth Whitaker and Raffaella Baccolini looked at a different setting—Italian middle-school science resources—but found the same ordering convention. All the books they examined followed a male-first sequence when presenting reproductive topics.

These studies don't all examine the same learners, the same kinds of textbooks, or the same issue in exactly the same way. So I don't want to stretch their findings beyond what they actually show.

But they did reassure us that we hadn't rocketed off to an entirely new planet by questioning the traditional sequence.

There really is something worth thinking about here.

Just flipping the chapters wasn't enough

The obvious solution would be easy:

Chapter 45: Female Reproductive System
Chapter 46: Male Reproductive System

Done!

Except we didn't like that solution very much.

It would still make one system the starting point and the other the follow-up. It wouldn't really rethink the story. It would simply reverse it.

We wanted to organize these topics around something other than male versus female.

And we had another important consideration.

As I've explained previously [Chunking Chapters—By The Numbers], we've deliberately divided our A&P story into relatively small chapters. In our comparisons, our chapters average about half the size of those in many other undergraduate A&P textbooks.

We think that kind of chunking makes a huge body of unfamiliar information more manageable for beginning learners.

So we wanted to keep three relatively small chapters. We didn't want to solve one problem by creating one or two monster chapters on reproduction.

Yeah, it took us a while to figure this out.

The Patton Team discussed and debated the reorganization for several years. A change this large unravels all kinds of other things in a textbook—figures, tables, review questions, online resources, cross-references, and much more. And the limited amount of time between editions is a very real factor in deciding whether a major change can actually be accomplished.

We also weren't yet sure where our A&P colleagues and students wanted this story to go.

Eventually, two familiar ideas came together and gave us our solution.

Structure first, then function

When we've divided larger chapters into smaller chunks in previous editions, one approach that has often worked well is a structure/function split.

We aren't alone in finding that sequence useful. Even within the larger chapters of other A&P textbooks, it's common to establish important anatomical structures before moving more deeply into the physiological processes involving them. You can see versions of that pattern throughout A&P—for example, respiratory anatomy before pulmonary ventilation, or kidney anatomy and histology before renal physiology.

Of course, anatomy and physiology ultimately belong together. Many of us quite rightly say that we integrate structure and function in our teaching.

But to integrate things, students first need some things to integrate.

At some point, a beginning learner needs a reasonably clear picture of the structures involved and a reasonably clear picture of the processes involving those structures. Then the connections between them can become richer and more useful.

That familiar structure/function approach gave us one part of our solution.

The other part came from terminology.

Genital or reproductive?

We had been noticing increasing use of genital system, especially when the emphasis is on anatomy.

And that term has a solid anatomical pedigree.

Terminologia Anatomica, the international standard for human anatomical terminology, calls its Chapter 9 Genital Systems. It lists the Female Genital System first, followed by the Male Genital System. It also recognizes female reproductive system and male reproductive system as synonymous terminology.

Now, Terminologia Anatomica is a terminology standard, not an A&P curriculum guide. Its ordering doesn't tell us how to teach.

But the terminology helped us see an elegant way forward.

We didn't want to abandon reproductive system, either. That's the familiar term that our students will continue to encounter in courses, learning outcomes, clinical settings, and other textbooks.

So we explain that the terms can be used interchangeably. But in our own narrative, we tend to use genital when we're emphasizing the structures and their basic functional anatomy. We tend to use reproductive when we're emphasizing the physiological processes involved in producing offspring.

And there it was.

Instead of dividing our chapters into male and female, we could divide them largely into structure and reproductive function.

And within each part of the story, we could use a female-first sequence.

It’s not just a claim: the new chapter actually begins the anatomical story with the typical female system.

The goal wasn't to declare female anatomy the new "default." The more important change was getting rid of sex as the dividing line between the chapters.

Act 1: Genital Systems

Our new Chapter 45: Genital Systems establishes the structures and their basic functional anatomy.

And yes, we flip the traditional sequence. We begin with the typical female genital system.

Here's the first half of the program:

Chapter 45: Genital Systems—Typical Female Genital System

• Overview of the Genital Systems

• Overview of the Typical Female Genital System

• Ovaries

• Uterine Tubes

• Uterus

• Vagina

• Vulva

• Breasts

Within those sections, students explore location, structure, microscopic anatomy where appropriate, and basic functions.

Then we move to:

Chapter 45: Genital Systems—Typical Male Genital System

• Overview of the Typical Male Genital System

• Testes

• Epididymis

• Vas Deferens

• Ejaculatory Ducts

• Urethra

• Accessory Genital Glands

• Supporting Structures

• Composition and Course of Seminal Fluid

• Differentiation and Development of Genital Organs

Notice that we haven't simply reversed two chapter titles.

We've brought the anatomy of both genital systems together into one chapter.

That lets students encounter them as related variations on the same basic biological story. It also makes their similarities, differences, and developmental relationships easier to connect.

Act 2: Reproduction

Once students know the structures and their basic functions, Chapter 46: Reproduction moves more deeply into reproductive physiology.

Again, we begin with female functions.

Here's that program:

Chapter 46: Reproduction

• Overview of Reproductive Physiology

• Female Reproductive Physiology

• Female Reproductive Cycles

  • Recurring Cycles

  • Control of Female Reproductive Cycles

  • Importance of Female Reproductive Cycles

  • Menarche and Menopause

• Male Reproductive Physiology

  • Hormonal Regulation

  • Male Fertility

• Sex Cell Production and Fertilization

  • Production of Sex Cells

  • Fertilization

  • Infertility

I really like the way this story now unfolds.

We first explore female reproductive physiology and its recurring cycles. Then we explore male reproductive physiology.

Finally, those two threads come together as we explore sex-cell production, fertilization, and infertility.

Instead of telling two mostly separate stories called Male and Female, we are telling one reproductive story involving both systems.

Act 3: The whole life cycle

After fertilization, the story flows naturally into Chapter 47: Growth, Development, & Aging.

Here's the program:

Chapter 47: Growth, Development, & Aging

• Prenatal Period

  • Cleavage and Implantation

  • Placenta

  • Periods of Development

  • Stem Cells

  • Formation of Primary Germ Layers

  • Histogenesis and Organogenesis

• Birth

  • Stages of Labor

  • Multiple Births

• Postnatal Period

  • Growth, Development, and Aging

  • Infancy

  • Childhood

  • Adolescence and Adulthood

  • Older Adulthood

• Aging

  • Mechanisms of Aging

  • Effects of Aging

• Causes of Death

So our three-chapter story now has a pretty simple logic:

Chapter 45: What are the genital structures, and what do they do?

Chapter 46: How do the two systems function in reproduction?

Chapter 47: How do offspring develop, grow, and age?

To us, that turned out to be a cleaner and more logical story than the one we started with.

It preserves our short-chapter approach. It uses a familiar structure/function progression. It keeps all the traditional reproductive content that A&P instructors expect. And it no longer requires maleness to be the automatic starting point for telling the story.

But do I have to reorganize my course?

Nope.

We believe this new organization responds to perspectives we're increasingly hearing from our colleagues and students while retaining the familiar content expected in an undergraduate A&P course.

If you're moving from our 11th Edition to the 12th Edition of Anatomy & Physiology, I think you'll find it relatively straightforward to rearrange your course content to follow the new sequence.

But you don't have to.

All the familiar content is still there.

You may decide that your own course works best with topics in another sequence. There's nothing wrong with students encountering material in one order during class and another order in their textbook. Seeing relationships from more than one direction may even help students develop a more flexible conceptual framework.

The same is true if you're moving to our book from another A&P textbook.

We didn't reorganize these chapters to tell you how you must teach reproduction.

We reorganized them because, after several years of thinking, researching, discussing, arguing, rearranging, and rearranging again, this is the clearest and most coherent way we found to tell the story.

There's more to the reproductive story

Reorganizing three chapters wasn't the only thing we changed.

We also took a fresh look at some of the most challenging reproductive concepts to explain and illustrate clearly for beginning A&P students.

One of the biggest examples is the ovary. How do we portray ovarian follicles simply enough for a beginning learner, realistically enough to avoid teaching something that isn't really there, and dynamically enough to convey that ovarian function is cyclical?

Yeah. We spent some time on that one.

I'll show you what we came up with in my next post.

If you haven't already requested a free instructor review copy of the new edition, click here and do that now.

The Human Microbiome Belongs in A&P

Why this essential story shouldn’t be left entirely to other biology courses.

In my previous post, The Human Microbiome Was There All Along, I briefly outlined the story of how we developed the new Chapter 49: Human Microbiome for the 12th Editon of Anatomy & Physiology. But the more important story, I think, is WHY we added this chapter. 

Is your microbiome missing?

Conversations with my colleagues tell me that a lot of A&P faculty haven't given much thought to teaching their students about the human microbiome. 

In the A&P textbooks and curriculum documents we examined, microbiome coverage was often limited, scattered, or absent. That absence can easily be interpreted as a signal that the topic belongs somewhere other than the undergraduate A&P course. That makes perfect sense, right?

Other courses?

Some of our students may encounter the human microbiome in introductory biology, microbiology, pathophysiology, nutrition, or another course. That’s great. Important concepts should not appear once and then disappear.

We already revisit basic concepts from chemistry, cell biology, genetics, homeostasis, and other foundational areas in several courses. Each encounter lets students add new connections and consider the concept in a different context. Over time, those connections can become stronger and more complex, making the knowledge easier to retrieve and apply.

The A&P course brings its own perspective to the microbiome. Our task is to help students connect microbial communities with body structures, physiological functions, homeostatic mechanisms, health, and disease. Another biology course may approach the same concept from a different direction—and that is exactly as it should be. The courses complement one another rather than compete for ownership of the concept.

Big-picture thinking

The microbiome is also a wonderfully integrative A&P concept. Its connections across body systems help students develop the big-picture, whole-body thinking we want them to build.

That fits naturally with a long-standing theme of our textbook. Every chapter ends with a Big Picture section that asks students to step back from the details and see how structures and functions connect across the whole body. The microbiome practically demands that kind of thinking.

The microbiome also has known—and still-emerging—clinical applications that many of our health professions students are likely to encounter. Giving students a basic framework now helps prepare them to understand and apply those connections when they encounter them later in their education and careers.

Adding the microbiome doesn't have to mean adding much

We know that A&P evolves, and when there's something new that has proven its importance to our understanding of A&P, somebody has to take a step in that direction. 

Adding the human microbiome to A&P does not mean carving out a week of lectures or piling another large block of content onto an already crowded course. Our textbook's coverage is more substantial than it was in earlier editions—and more substantial than what we found in the other A&P textbooks we examined—but it is still concise.

Brief mentions throughout the book help students connect the microbiome with the structures and functions they are already studying. For many courses, assigning the short Chapter 49 as reading, rather than devoting an entire lecture to it, may be entirely sufficient.

The goal is not to turn A&P into a microbiology course. It is to give students enough of a framework to understand that microbial communities are part of the human biological story. Later—or earlier—encounters in introductory biology, microbiology, pathophysiology, nutrition, and other courses can add new layers. And as the clinical importance of the microbiome continues to develop, that framework gives students something sturdy on which to build.

Our textbook has been nudging instructors toward the microbiome with small steps starting in the early 1990s, culminating in the big step I've been describing here—a whole new microbiome chapter. You can wait if you want to, but I think my students are better prepared knowing the basics of the microbiome than if I'd never mentioned it in my course. They'll be applying it in their later courses and clinical settings, and I want to get my students ready by giving them a small, easy-to-grasp introduction in their A&P course. Maybe you already do that, too.

We don’t have to teach students everything currently known about the human microbiome. We do need to give them enough of the story to recognize its connections with human structure and function—and enough of a framework to keep learning as they encounter the microbiome again.

That’s why we believe the human microbiome belongs in A&P.

Doesn't hurt to take a look!

I strongly suggest that you take a look at the new Chapter 49: Human Microbiome.

If you haven't already requested a free instructor review copy of the new edition, click here and do that now. Then you'll receive it as soon as it becomes available on or about September 15, 2026

The Human Microbiome Was There All Along

How decades of scattered coverage became a new chapter in Anatomy & Physiology.

As I mentioned in my previous post, the new 12th Edition of Anatomy & Physiology has a new chapter devoted entirely to the human microbiome. I also mentioned that we'd been covering the human microbiome for decades—but in small pieces placed strategically throughout the textbook. 

Our explanation of essential concepts related to the human microbiome goes back at least to our 1993 edition, when we talked about the roles of microorganisms living on the surfaces of our skin, intestines, and other membranes—each in the chapter where it naturally belonged. We didn't call the concept the "human microbiome" because that term was not in common use back then.

Google Ngram Viewer Showing Book Usage of "Human Microbiome"

(click here if the chart is not visible)

The chart above suggests that use of the term “human microbiome” in published books rose sharply after 2012. 

Something else happened during those years. In 2007, the National Institutes of Health (NIH) launched the Human Microbiome Project. Its researchers began the ambitious task of characterizing the microbial communities associated with different regions of the healthy human body. A coordinated collection of major findings appeared in 2012, helping push the human microbiome into the scientific spotlight.

In our 2013 edition, we introduced the term as our discussion of the microbiome concept evolved and expanded to reflect its growing importance in anatomy and physiology (and its clinical applications).

The 2016 edition of Anatomy & Physiology saw the introduction of our Connect It! (formerly A&P Connect) library of online "special interest" articles, including one about the human microbiome. 

As I've previously explained, many of these articles are intended to help students draw together core concepts that play roles in many different regions and processes of human biology. Because this approach helps our readers gradually build their conceptual frameworks, that microbiome article remains in our Connect It! library. Of course, we revised it to reflect the addition of our new Human Microbiome chapter.

After much research and discussion among the Patton Team of authors and editors, we recognized that the human microbiome deserves its own chapter. We saw how well giving homeostasis its own chapter worked for student understanding and we wanted to give similar emphasis and coherence to the increasingly important microbiome concept. 

In 2022, the final year shown in the Google Ngram chart, with use of the term still climbing, we began our work for this new edition.

Behind the scenes: how did we do it?

It sounds simple. And it may even sound easy. But it wasn't, of course. Such things never are, right?

First, we asked for a volunteer from among our author team to be the designated wrangler of this new chapter. Author Terry Thompson stepped up and is largely responsible for what you see in the new chapter. 

But hey, we're the Patton Team, so we all pitched in to help Terry. Anything you don't like in the new chapter? That's probably because we talked Terry out of something that we shouldn't have. We went back and forth on the new chapter for several years. Despite its brief length and straightforward storyline, there was a lot of research, debate, and hard work that went into producing the version you see.

As alluded to earlier, Terry scanned the entire previous edition to assess our existing microbiome content. Then, using her new research on current scientific thinking, she developed a storyline that we wanted to tell our readers. 

From Patton (2027) Anatomy & Physiology 12e. Elsevier. Contents p. xxxv

Our goal was to give your students the basic concepts they need to build and expand their conceptual frameworks, improve their understanding of A&P, and prepare for later clinical courses and health careers.

Terry wove the previously scattered microbiome content into the new chapter, leaving brief mentions in its previous locations to help students map out where the microbiome applies in their studies. For example, the human microbiome is still mentioned when discussing the skin, the gut, the respiratory tract, and other body regions.

She moved content about what microorganisms are and their roles in the body from Chapter 2's Mechanisms of Disease section and adapted it to the new Chapter 49 on the microbiome. Throughout the process, she added current content based on what microbiome experts are telling us—and what we believe our students really ought to know about.

This is a good spot to give a shout-out to HAPS member Brian Elliott at Saint Louis University, who has been introducing his A&P students to the microbiome concept. He graciously gave us feedback that helped guide us in developing our new chapter. When I participated in the HAPS Book Club discussions of the book, I Contain Multitudes: The Microbes Within Us and a Grander View of Life, I gained greater insight into how microbiome concepts intersect with the mainstream A&P curriculum. Thanks, bookclub friends!

Where to put the new chapter?

One issue that we really wrestled with was this: "Where do we put this new chapter in the book?" 

There are good arguments for putting it among the very earliest chapters. Microbial communities occupy many body sites, and the microbiome influences structures and functions throughout the body. We decided against that for at least two reasons. 

One reason is practical. It's not a small thing to renumber all the subsequent chapters and each of their numbered figures, boxes, and tables—not only in the book itself, but also in all the many, many supporting resources organized by the numbering in the textbook's table of contents. 

The other reason is pedagogical. We didn't want to overwhelm the beginning A&P learner, whose head is already spinning with all those anatomical, chemical, cellular, and metabolic terms by adding another new introductory topic with its own hard-to-pronounce terminology. So we mention it broadly, starting early in the book, but we put the microbiome chapter at the very end.

We could not find an ideal location later in the book, either. It really "goes with" nearly every chapter, so it wasn't clear to us where the "best" placement might be.

Setting all that aside, putting the new chapter at the end of the book gives both readers and instructors some real agency in deciding when they want to dive a bit more deeply into the human microbiome. Early on, we suggest that readers "peek ahead" to the last chapter. They have the option to do that, or to wait. 

Instructors likewise have the option to assign it early or late in the course—or at any point in between. 

Placing it at the end makes it easier to assign the chapter wherever it fits best—or to use only selected parts—without disrupting the book’s traditional sequence.

There's much more to this story.

I think this blog post is getting to be longer than the new chapter is! But now you know part of the story behind our new Chapter 49: Human Microbiome.

In my next post, I’ll get to the most important part of this story by explaining why we believe the human microbiome belongs in A&P—even when students may also encounter it in introductory biology, microbiology, pathophysiology, or other courses.

I strongly suggest that you take a look at the new chapter.

If you haven't already requested a free instructor review copy of the new edition, click here and do that now.

The A&P Textbook You May Have Overlooked

A new edition of my popular two-semester A&P textbook is coming—and I’d like to show you what makes it different. Who knows? Perhaps it’ll be a better fit for your students.

It's Anatomy & Physiology 12th edition by Patton, Bell, Thompson, and Williamson. Published by Elsevier, it's scheduled for release on or about September 15, 2026. If you're an A&P instructor and would like a free examination copy to explore as soon as it becomes available, click this link:

Reserve a Review Copy

I know that you are wondering: What ARE the big upgrades to the new Anatomy & Physiology 12th edition? Too many to describe in one blog post, that's for sure. So I'll simply list a few here and then follow up with a series of additional posts with more details about the revisions, why we made them, and how they will help your students learn A&P.

One thing we did was add a new chapter! But wait, these A&P textbooks are already too big, right? Right. So we also made this edition 40 pages shorter. 

The new chapter is titled Human Microbiome and draws together existing coverage of this increasingly important A&P concept from previous editions. It then updates and expands microbiome coverage into a concise, accessible, illustrated narrative of its important role in human structure and function. To our knowledge, this textbook was the first major two-semester undergrad A&P textbook to offer a distinct Homeostasis chapter. Now we believe it's the first to offer a Human Microbiome chapter.

Throughout the book, we made our explanations and layout more concise and either removed bits of content not needed for an essential understanding of A&P or moved it to our online resources. For example, our large, comprehensive Glossary—a student favorite—has now been moved to the online Evolve Student Resources. That alone has reduced the amount of pain caused by carrying a huge A&P textbook around!

We turned the story of the human reproductive systems inside out, upside down, and flipped around. Our flipped narrative puts the female system first. I think that's another notable "first" among major textbooks. But there's a lot more. We upended and improved the traditional coverage of the genital organs and reproductive functions—which I'll explain in a subsequent post. 

We've added to our already groundbreaking coverage of fascia, added some cool videos from the Complete Anatomy suite of resources, replaced the content of all of our Career Choices sidebars with new stories about current health professionals, improved our representation of variations of the human body, and a whole lot more!

The whole "Patton Team" of authors, editors, and designers has been working long hours over many months to update, upgrade, and upend our story of human anatomy and physiology. Our previous revisions have made the narrative clearer while incorporating the latest scientific thinking about the topics we cover. This revision steps that work up a couple of notches—so much so that we took extra time to get it right.

The Patton Team met virtually nearly every week to discuss and debate every aspect of this revision. I think the extensive research, lively discussions, coworking, and great care we took have made this a truly remarkable revision.

Since inviting my awesome coauthors to the Anatomy & Physiology project, I've been meaning to introduce them in this blog. So I'm taking this opportunity.

You may already know Frank Bell, Terry Thompson, and Peggie Williamson from their years of active participation in the Human Anatomy & Physiology Society (HAPS). Terry Thompson is a President Emeritus of HAPS. All three have earned several relevant degrees, including the Master of Science in Human Anatomy & Physiology Instruction (HAPI), in which I served as their faculty mentor. Frank Bell and Peggie Williamson currently serve on the faculty of the HAPI program. 

Besides having worked with them in these capacities, I have enjoyed their contributions to previous editions of this and other textbook revision projects. Working on this revision—and observing their keen awareness of how our students read and learn A&P—has solidified my view that they are exactly the right A&P educators for this team.

Be sure to subscribe to the Patton Anatomy & Physiology blog to stay up to date on upcoming posts introducing specific revisions in our new edition!

Active Concept Maps Help Students Make Connections

 

We all know that concept maps help students learn anatomy and physiology in at least two ways.

One way is when we use concept maps to teach principles in a visual manner that clearly shows relationships among several ideas. Students thus clearly see how to organize their thoughts about connected ideas as they construct their own conceptual frameworks as they learn.

Another way concept maps help students learn is when they build their own concept maps from what they already know about anatomy and physiology. Concept-map-making can thus be a powerful study tool. However, students without prior experience with concept maps often have a difficult time getting started. A few good examples of concept maps that relate to the ideas they are learning in your course are all they need to get a good start in making their own.

Starting with this edition of Patton Anatomy & Physiology we are providing Active Concept Maps in the Student Resources in Evolve. 

Each Active Concept Map is an animated video of a concept map presented in a similar style to the concept maps used throughout the text of Patton Anatomy & Physiology. However, these concept maps are "active" in the sense that they build from a single block as the narrator walks the viewer through each related concept that appears as the concept map branches and grows.

The block-by-block guided walk-through of a major concept will help students understand what they have read and heard in class more deeply. It will also model for students how they can build their own concept maps for other sets of related ideas that they encounter in your course.

Perhaps most importantly, the Active Concept Maps will provide a template for how to think in a "connected" way about the major concepts of the anatomy and physiology course. For many of our challenged students, this is an especially important skill they must develop to succeed.

Here's a brief video walk-through that shows where to find Active Concept Maps in Evolve and how they work:

Tips and Shortcuts for Surviving and Succeeding in A&P

A feature of Patton Anatomy & Physiology that is often overlooked by faculty, but loved by beginning anatomy and physiology students is called 

Tips and Shortcuts for Surviving and Succeeding in A&P.

As soon as an A&P student unwraps and opens their new textbook, they flip over that endpaper and find this one-page guide on how to get started on the path to success. That one page is loaded with great study tips and how-to-read-a-textbook guidance organized in an intuitive, graphic manner. 

From metacognition to tackling new terminology to retrieval practice, this guide uses simple language to quickly outline the key strategies needed to succeed in A&P.

This guide also give faculty a place to quickly send students asking for study advice. And it gives faculty a place to find quick and easy tips for them to share in class or in a syllabus or course website.

Embedded throughout each chapter are brief Hints that remind students to use these strategies just at the moment they need them. Read more about these Hints at Embedded Hints Improve Reading Comprehension.

Patton Anatomy & Physiology is a textbook that is truly focused on helping students succeed!

Netter 3D Anatomy—Now Better Than Ever!

We've been offering Netter 3D Anatomy as a supplement to Patton Anatomy & Physiology at no added cost through the past few editions. Faculty and students alike have enjoyed the adventures they've undertaken as they explore the various regions of the human body using three-dimensional, dissectible images. That won't change in the new 11the edition. Or will it?!

The availability of Netter 3D Anatomy will still be there. And it will continue to be offered at no added cost to students. But it will be better in several ways. 

You probably already know the name of Frank Netter, the brilliant and widely respected anatomy and medical illustrator.  Dubbed "the Michelangelo of medicine" by the Saturday Evening Post, Netter revolutionized how anatomy is learned and taught through visual depictions. His work is realistic, yet clear and uncluttered.  And it is beautiful.

Netter 3D Anatomy adapts Netter's vast library of anatomical art to a gamification environment to make the study of Netter's "virtual" anatomy highly engaging.  The environment does this by melding 3D versions of anatomical structures with the ability to manipulate them in real time—thus adding the fourth dimension of time.  

Netter 3D Anatomy uses advanced gaming technology and interactive 3D anatomy models to learn, review, and teach anatomy. That's still true, but many improvements have been made to the ease-of-access and functionality of the platform. 

Students using Patton Anatomy & Physiology will no longer have to create a separate account and login through a separate system. It'll all be contained within the Evolve Student Resources that students already use—and have logged into—for all their other textbook tools and resources. As instructors, we know how important a single-login system can be for our students.

Students and instructors will find that the ease of use of Netter 3D Anatomy has improved tremendously. We worked closely with the developer, wearing our teacher hats, then wearing our student hats, to make sure that any obstacles to easy use are eliminated. And we're very happy with the results!

Because each user is "in control" as they zoom, twist, pull apart, unwrap, peel away, and pan, this program also adds the kinesthetic dimension characteristic of the best "virtual reality" experiences. Users can add or remove labels at will. This multimodal approach implements principles of brain-based learning a a way that gives the user the enjoyment of playing an exploratory game.

Professors can also use this tool in the classroom or lab to demonstrate anatomical relationships in a way that 2D illustrations, plastic models, and even dissection specimens cannot.  For example, layers of the GI wall can be easily peeled away to demonstrate each coat.  The skull bones can be pulled apart—then put back together—to help students quickly learn this tricky part of the skeleton. 

Something new in Patton Anatomy & Physiology is that we've added guided explorations to the Netter 3D Anatomy platform. These are developed in key areas with our own students in mind. They walk users through a specific set of concepts. This not only guides learning, it also gives students practice in using the platform so that they can be more confident about striking out on their own to explore other areas of the body.

The really cool thing about using Netter 3D Anatomy as a teaching tool is that each student can recreate—and extend—this experience on their own during individual or group time! This is a perfect tool to use in remote learning. If you suddenly have to shift to fully remote, you students will already have an interactive tool they can use independently!

Oh—did I mention?—Netter 3D Anatomy is provided at no additional cost to students!

Enough of me jabbering away about it—why not have your Elsevier Educational Solutions Consultant give you a free, personalized demonstration.

The Lymphatic System Deserves Its Own Chapter

 A social media thread I ran across recently laments that the lymphatic system is an undervalued and undertaught topic in the anatomy and physiology curriculum. That puzzles me.

Admittedly, I don't bring up the lymphatic system a lot in my day-to-day conversations. Not even in chats with other A&P enthusiasts. But it does come up sometimes in conversations about teaching or learning A&P. And when it does, I think the usual reaction involves some variety of love for the lymphatic system. So I'm puzzled.

In our Patton Anatomy & Physiology textbook, the lymphatic system certainly gets the love and attention it deserves. In fact, we feel that it deserves its own chapter! Unlike most A&P textbooks, Patton Anatomy & Physiology has a separate Lymphatic System chapter that follows Blood, Heart, Blood Vessels, and Circulation of Blood chapters and precedes the chapters Innate Immunity, Adaptive Immunity, and Stress.

That placement of the chapter puts it in exactly that spot in the story where we want it. That is, our story of the lymphatic system picks up the story of circulation begun in the Circulation of Blood chapter by explaining where the excess fluid left out of venous return goes. It goes back to the bloodstream via an elegant lymphatic drainage system. 

But wait! There's more! That fluid being returned to the bloodstream from the tissues is filtered in the lymph nodes before joining the blood supply. Which then allows us to introduce the concept of immunity and the lymphatic system's key role as a partner in the immune system. 

The next chapters Innate Immunity and Adaptive Immunity then pick up that part of the story after the Lymphatic System chapter. Then, after all those parts of the story set the final pieces needed, the Stress chapter integrates diverse concepts learned in previous chapters into a big picture of how our body deals with the world.

Although that social media thread lamenting that the lymphatic system is undervalued and undertaught puzzles me on one level, I wholeheartedly agree that the lymphatic system deserves any love we do give it. In the eleventh edition of Patton Anatomy & Physiology, available November 2021, we've added a bit more love by adding a brief description of the emerging concept of the glymphatic system. And, in our usual style, we generally refined and clarified our story of the amazing lymphatic system.

Check out the heavily illustrated story of the lymphatic system in Patton Anatomy & Physiology. I think you'll agree that we really do show this system some love.

Diverse Representation in Anatomy & Physiology

From the earliest days of my involvement with the Anatomy & Physiology textbook, I've strived to ensure that the representation of people in the illustration program, the chapter narratives, the examples and cases presented, reflects the diversity of humanity. 

My publisher has fully supported my (rather expensive) requests for creating new artwork and shooting new photographs. They have also supported my chapter revisions and have helped me find and revise passages that need improvement.

Why is this important? 

Our students—my readers and users of the textbook—must see themselves and their lived experiences reflected in this textbook and other learning materials. If they cannot, then it's difficult for them to see themselves fully accepted as part of the humanity that we explore in the anatomy and physiology course. This perceived lack of acceptance is a very real barrier to learning. When they cannot easily see themselves as part of the world of A&P, then it's also a barrier for students as they pursue their career path. 

Diverse representation in Anatomy & Physiology is also important because students must develop an understanding, acceptance, and appreciation of the normal variation and diversity among the human population if they are to be successful as healthcare and athletic professionals. 

The seventh edition of Anatomy & Physiology marked the moment when diverse and inclusive representation became a goal of every revision cycle. In the tenth edition, we were able to significantly diversify our photo collection and anatomical illustrations. 

For example, in the tenth edition, we were among the first to use Black female subjects for the key illustrations of human musculature—overturning centuries of white males serving that role.

Diversity and inclusion has been a primary goal of the upcoming eleventh edition of Anatomy & Physiology, as well. As we review our page proofs and make our final tweaks, we continue our strong effort to make our textbook one of the most inclusive science textbooks on the market.

However, as much as we have made admirable progress and maintained our lead in this area, we still have a long way to go. It's a daunting task. And the path is not always clear. The resources are not always available. Our awareness is still expanding. Nonetheless, I think you'll be pleased with the new edition when it is published later this year. 

And I hope you'll join us in pointing out where we've made good progress and where we still need to improve. We're in this together.

Stress Deserves Its Own Chapter

One of the advantages of organizing anatomy and physiology concepts into short, modular chapters is that it gives us more flexibility in teaching. It also permits us to focus on important topics that are often buried within a large chapter that covers many subtopics.  Taking this advantage, Anatomy & Physiology puts the clinically important concepts of stress into a single, independent chapter.

The concepts of stress interconnect with concepts of neuroscience, endocrinology, immunology, and many others—covered in diverse chapters of a textbook and diverse modules of an A&P course. Putting the core concepts of stress into its own independent chapter means that the instructor has more flexibility in where they place in their own course structure—into their own unique telling of the story of the human body.

Our book was the first A&P textbook to have an independent stress chapter. Since its introduction, we've been keeping the content up to date and relevant to student learning—and to the clinical applications of stress they'll be making in their professional courses and careers. 

More recently, we enlisted the advice of the late Dr. Bruce McEwen, an icon of the modern concepts of human stress and it's real-life implications. Contributing author Dr. Peggie Williamson and I used Bruce's advice and his generous stack of resources to give our stress chapter a major refresh and update. You will find that the engaging story-of-stress approach remains, but with the more recent parts of that story reflected with greater clarity and relevance.

We need not let the concepts of stress be stressors themselves in our teaching and learning. Using the stress chapter in Anatomy & Physiology—a reader favorite—can help us all better understand the pivotal role stress can have in wellness and disease.