Eduard Pernkopf

Who is Eduard Pernkopf and why should we care?

Eduard Pernkopf was a Nazi. That is the short of it. He also created an anatomical atlas that has become a notorious source of ethical debate since at least the 1990s.

So, who was Eduard Pernkopf?

Pernkopf was an Austrian medical doctor. During World War 1, he served as a military physician for Austria.  After the war, he returned to the University of Vienna and became an Anatomy Instructor for the medical school. By 1928 he was a full professor and by 1933 he was the director of the anatomical institute. Also in 1933, Pernkopf pledged his allegiance to the Nazi party, later becoming a member of the Sturmabteilung, Hitler’s pre-war Stormtroopers.

In 1933, he also started work on his anatomical atlases. Four artists rendered watercolor portraits of his dissections, Pernkopf set out to create the most realistic representations of cadaveric dissections ever available with the caveat that the color be as realistic as possible. Two volumes ended up being published, one in 1937 and one in 1941. By 1941, all four of the artists joined active military or paramilitary service for Germany.

So, why is this atlas so controversial?

In 1938, Pernkopf became Dean of the medical college at the University of Vienna. He immediately expelled all non-Aryan professors; at Vienna, that meant over 75% of the faculty, several of whom would end up dying in concentration camps across occupied German territory. As Dean, Pernkopf enacted a strict racial hygiene approach to medicine. Across occupied Germany, medical schools were teaching that there were inferior anatomical characteristics of non-Aryans like Jews, Gypsies, Romani, and Poles, and homosexuals.

As a footnote to history, no one was forcing these scientists to go along with ideas like racial hygiene. In fact, it seems like the scientists were the driving force behind these ideas. Spurred on by eugenicists in the U.S., Nazi scientists were pushing hard for eugenics in Germany. This lead to forced sterilization, anti-miscegenation and anti-immigrant laws, and euthanasia. These were the three basic prongs of the Nazi Volksgesundheit, or Public Health. By 1934, forced sterilization turned to euthanasia of people deemed mentally feeble. Early euthanasia programs turned to Holocaust as Germans placed non-Aryans in concentration, work, and prison camps.

As you can imagine, a lot of dead bodies meant a steady supply of cadavers for teaching and research at the 31 German or German occupied medical schools in Europe. There is evidence that while Pernkopf was dean, the University of Vienna medical school accepted 1,377 executed prisoners. It was customary that the medical schools would have embalming centers at the execution sites so that cadaveric materials could stay as fresh as possible.

There is questionable imagery within the atlases; images of emaciated cadavers in poor condition. There is also Nazi imagery in the signatures of the artists.

So, we have a bunch of Nazis who were very racist and who used very questionable sources for dissection to make their controversial anatomical atlas.

But, Vienna was bombed by allied forces in 1945. The university sustained heavy damage and the records containing the information about where the bodies used for the atlas came from were destroyed.

Did he use executed prisoners or not? And what should we do about the book?

Come find out and discuss the answers to these questions at the workshop Pernkopf, NAZIs, and MVCC at the 2018 HAPS Conference in Columbus.


This post was written by Aaron Fried, Assistant Professor of Anatomy and Physiology at Mohawk Valley Community College. Thanks to my colleagues and willing editors: Shannon Crocker, Eileen Bush, Don Kelly, Bill Perrotti, Emeritis, and the late Sam Drogo.

 

Study Abroad: Human Anatomy in Poland

Student-interactive activities at the Public Higher Medical Professional School in Opole.
Student-interactive activities at the Public Higher Medical Professional School in Opole.

Two years of planning, many discussions, and revisions of the program’s agenda and it finally happened!

On May 29, 2017, a wonderful group of CCBC (Community College of Baltimore County) biology students and faculty left for an exciting 10-day adventure, dubbed Human Anatomy in Poland.  The human anatomy and education parts of the program included a visit to the Anatomy Museum at the Jagiellonian University Medical College in Krakow (the oldest university in Poland), the Criminal and Forensic Medicine Museum at the Wrocław Medical University, the unforgettable experience of visiting and attending a workshop at the world-famous Plastinarium in Guben, and student-interactive activities at the Public Higher Medical Professional School in Opole.

Workshop at the Plastinarium in Guben, Germany.
Workshop at the Plastinarium in Guben, Germany.

This anatomy focused experience was intermingled with touring the cities of Wroclaw, Opole, Krakow and Warsaw. The participants learned about Polish history, culture, and architecture by visiting many sites registered on the UNESCO World Cultural and Natural Heritage List, including the Centennial Hall in Wroclaw, the Old Town in Krakow, the Nazi German concentration camp Auschwitz-Birkenau, the Salt Mine in Wieliczka, and the Historic Centre in Warsaw.

Description of the study abroad program would not be complete without adding that the participants were enthralled with Polish food, enjoying all varieties of pierogi (commonly confused with “pierogis”). Some are even still experiencing “lody (ice cream) withdrawal”. I was asked on multiple occasions throughout the study abroad by the participants whether the program will be repeated; I share this enthusiasm and hope it isn’t the last of its kind!

It was a fantastic trip!
It was a fantastic trip!

Ewa Gorski is a biology professor at the Community College of Baltimore County in Maryland where she has been teaching human anatomy & physiology and physiological pathology courses for about twenty years. The majority of her students are preparing for careers in nursing and mortuary science. Ewa has been HAPS member since 2002.

Gail Jenkins Learning and Mentoring Award

Gail Jenkins was a dynamic teacher and long-time HAPS member.  Gail loved teaching. Most of all, she loved to make difficult concepts in anatomy and physiology easily comprehensible to her students.  To accomplish this, she employed the “Keep is simple, Sweetie” (KISS) approach.  When facing a difficult concept, she’d urge her students to “KISS” it by using everyday analogies or tools to visualize and simplify the subject.  Her students loved this approach.

In Gail’s honor and to keep her memory at HAPS alive, Wiley Publishing, in partnership with HAPS, has established the Gail Jenkins Teaching and Mentoring Award. This prestigious award recognizes a HAPS member who:

  • Uses engaging learning activities to help students comprehend difficult concepts and,
  • Is willing to mentor other instructors in this approach.  

The award includes a $1000 cash award and waiver of the 2018 Annual Conference registration fee. Award recipients will present a workshop during the workshop sessions at the annual conference.

To qualify for the award, applicants must be HAPS members engaged in teaching anatomy and physiology, must provide an explanation of how engaging learning activities are incorporated into their classes, must provide an abstract of a workshop to be presented at the 2018 conference, and must provide a letter of recommendation from a colleague with direct knowledge of the applicant’s teaching and student interaction.  Applicants who can demonstrate a spirit of sharing this approach and mentoring their colleagues will be given preference. 

HAPS expresses its thanks to Wiley Publishing for support in the establishment and continuation of this award.
HAPS expresses its thanks to Wiley Publishing for support in the establishment and continuation of this award.

Applications can be found on the HAPS website.  The application deadline is December 1st.

Don Kelly
HAPS Grants and Scholarships Committee

Looking for Community College A & P Instructors Who Wish to Engage in Research on Student Attrition

First, a few questions:

  1.  How many of these abbreviations do you know?
  • SoTL
  • DBER
  • IUSE
  • CAPER
  1.  Where do most students in the USA take entry-level anatomy and physiology?

The answer the first question will be at the end, but it’s the second question that is important now.  Answer: Community Colleges!

Community Colleges are where thousands of instructors are teaching tens of thousands of students lessons in anatomy and physiology every day of the academic year.  Students in these courses often have high hopes – they hope to change their lives by gaining the qualifications to enter allied health professions such as nursing, surgical technology, and emergency medicine.  But as most of us know, many students do not complete the two-semester A & P sequence, and others complete the course but do not have high enough grades to continue in the program.  The course needs to be difficult; it’s a difficult topic. But too many students are failing.

I recently gave a SoTL (Science of Teaching and Learning) workshop at a community college that had an attrition rate of well over 50% in A & P.  The instructors in the program all talked about students being academically ill prepared for the rigors of an A & P course.  Other students, they said, were just too busy with work, kids, and “life” to devote the time required to succeed.  “Stress” was a common theme; stress caused by financial problems, family problems, and in many cases academic struggles.  In the workshop we talked about different strategies that “might help” students who struggle.  We can never “save” all our students, but we can improve the present situation.  We can help a few students succeed in A & P who otherwise might fail.

During the next month, a group of HAPS members will develop a National Science Foundation (NSF) ISUE (Improving STEM Undergraduate Education) grant targeting the attrition problem in community colleges.  If funded, we will work with instructors at community colleges who wish to try out a new teaching practice and conduct a small research project on its effectiveness (i.e., Discipline Based Education Research, or “DBER”).  We have to start out small, but if successful we will expand the program to include larger numbers of instructors and community colleges.  (And of course, NSF grants are hard to get – but you’ll never get one if you don’t apply!)

Are you teaching at a community college?  Are you interested in such a project?  If so, read about our project (CAPER) in the text below, which will also be posted on the HAPS List serve later today.    

And now the answer to the first question:

  • SoTL: Science of Teaching and Learning
  • DBER: Discipline Based Education Research
  • IUSE: Improving STEM Undergraduate Education
  • CAPER: College Anatomy and Physiology Education Research

(CAPER is the name of our HAPS/NSF research project!  So a bonus point if you got that one.)

College Anatomy and Physiology Educational Researchers (CAPER) – We want you!

One topic guaranteed to start up chatter on the HAPS Discussion Board is attrition – the disturbingly high number of students failing and withdrawing from our A & P courses, especially at 2- year colleges.  The HAPS Attrition Task Force has spent the past 18 months gathering data to document the problem.  The causes are complex, and the solutions equally so, but as HAPS members we posit that how we teach matters.   Unfortunately, while many of our members teach at 2-year schools, very little data that we use to inform our practices has actually been gathered at these institutions.  We are submitting an NSF grant application to help address this deficiency, and we need participants.  We are looking for 6 to 8 instructors at large enrolment community colleges serving diverse student populations who are willing to act as partners and participants in this grant. We want people who love teaching, love their students, and want to develop methods to help their students succeed – especially those who struggle.

Our goal is to identify specific classroom interventions that will reduce attrition in diverse student populations.  These interventions will target two important components of student success: conceptual understanding of physiology and psychological distress. Educators involved in this project will work together to develop, implement, and evaluate the impact of curriculum and pedagogy designed to influence one or both of these determinants.  We know full well that we cannot “save” all students, but we know that implementing some simple methods into our regular teaching practice can make a big difference our students’ chance of success.

Here is our preliminary plan, but we are interested in working with grant participants to fine-tune the methods.

What Do I Have To Do?

  1. July to December 2018:  Complete a 1-credit HAPS –I course (Title:  Introduction to Educational Research Methods) that covers basic principles of instructional design and assessment, and the mechanics of carrying out classroom research projects. The course includes online sessions as well as an in-person meeting at a regional HAPS conference in the Fall, and your tuition and travel will be covered by the grant.  We know that many of you are also teaching during this period, so will be asking to commit no more than 3 hours per week for this endeavor during the Fall semester. By the end of the course (probably in early December) you will have a plan for an intervention that you would like to try out, and evaluate, in your course.
  2. While completing the course, you will work with one of the course instructors to refine your classroom research project focusing on your specific student population.  Each participant will test the impact of an intervention on student performance (attrition) and stress levels using tools such as validated student surveys, instructor reports, and/or student interviews.  We will provide you with a list of interventions and research tools to choose from, but participants are also welcome to come up with their own.  For instance, one participant might look at how student stress and performance is impacted by two-stage cooperative quizzes, in which students complete a quiz both individually and in groups (cooperative quiz).  Another participant might decide to investigate if his or her students feel less psychological distress, and/or perform better, if they spend 3-5 minutes at the beginning of each group activity discussing their everyday lives. A third might examine the impact of instituting active learning activities, such as those that will be published in an upcoming Special Issue of the HAPS Educator, the inquiry activities on the HAPS website (HAPS Archive of Guided Learning Activities), or the many teaching tips on the HAPS website (A & P Teaching Tips).  We will also help you get Institutional Research Board (IRB) approval for your project. Note that interventions will be realistic and achievable – we are looking for small-scale interventions, not changing an entire course.
  3. January-May 2019: Carry out, analyse, and write up your classroom research project, with the support of the instructional team.  We hope that all participants can present their findings at the 2019 Annual HAPS conference at the end of May, and we also would encourage participants to submit their findings to the HAPS Educator.
  4. We will also ask each participant to participate in informal entry and exit interviews, in which your will discuss your perspectives on teaching and educational research with an interviewer.

Why?  What’s in it for me?

First of all, the educational community needs your input, and data from your students, to inform our practices.  Second, it will be FUN.  Educational scholarship has the potential to revitalize your teaching, and make your job more interesting, challenging, and satisfying.  Third, we will help support your travel to two HAPS meetings (one regional and one national), and there will be a stipend for completion of the manuscript describing your work.   

Sounds Interesting….What’s the Catch?

First, all participants will need to talk to their administrators. They must know what you are doing (research on teaching and student retention), support you in your efforts, help secure IRB / Human Subjects approval for you to conduct your project with students, and work with us to collect data on attrition.

Second, the project will work best if we have teams of two or three anatomy and physiology instructors from one community college, city, or region.  It isn’t an absolute requirement, but apply with a colleague from your own or neighbouring colleges if you can.  It’s even better if your school in involved in a program such as Community College Biology Instructor Network to Support Inquiry into Teaching and Educational Scholarship, or the SEPAL project.  

And third, please remember that this is a grant proposal, and there is no guarantee that the grant will be funded.  We can only accept 6 to 8 participants for the first year, but, if funded, we would run a second group of 6 to 8 participants in the second year.  

Still interested or have questions?  Email the project lead, Murray Jensen, at msjensen@umn.com.  Please include as much of this information as possible:

  • Names of instructor(s):
  • Name of your school:
  • Number of students enrolled in your anatomy and physiology program each year:
  • A rough estimate of your attrition rate (that is, the percentage of your class that receives a D or an F or withdraws before completion:
  • School involvement in national programs:
  • Name and title of your administrator who will support you in this project:

We need to have the list of participants finalized by November 21, so let us know if you are interested ASAP!   

Teaching Backwards: From Motion to Muscles

Have you taught those boring muscles lately? And those dreaded origins and insertions?

Bored student going through the motions of learning muscle origins and insertions...
Does this look familiar?

And when students get to the exam they are frazzled and sad? Why do we do the same things over and over and wonder why students don’t recall what we teach them? Muscles are one of the most dynamic tissues of the body so let’s teach them dynamically!

Working in healthcare for the past decade has taught me that patient “buy in” usually leads to better outcomes. Interestingly enough, students are the same way. So why not let them pick some of the muscles they have to learn? They can choose based on personal or occupational interest. For example, if your group is interested in occupational therapy, focus on muscles that are involved in activities of daily living. Are they mostly nursing students? Include muscles commonly strained by nurses in their daily practice from poor lifting mechanics or improper conditioning. This could incentivize strengthening to prevent future injuries. Student buy in may develop into personal investment, which enhances their compliance and advances their outcomes. Follow this formula, and see what happens!

Formula 1:  Buy in > Personal Investment > Compliance > Improving Outcomes

It is also important to think about the breadth of material to cover. It’s not essential that  students learn every specific muscle and attachment, and an operational method may enhance recall. Consider the following four step process starting with motion and ending with the muscle. First, focus on the motion desired. Second identify the plane of motion and axis of rotation. Third, isolate the line of action. Fourth, label the primary movers. A possible fifth addition could be offering an everyday example.

Formula 2:   Motion Desired > Plane of Motion/Axis of Rotation > Line of Action > Primary Mover

Are your students having difficulty identifying the plane of motion and axis of rotation? Try this!
Are your students having difficulty identifying the plane of motion and axis of rotation? Try this!

If students have difficulty identifying the plane of motion and axis of rotation, have them poke a pencil through the middle of a large index card. Then place the index card in the plane of motion desired. If the body part contacts the card while going through the full range of motion, they’re in the wrong plane. The axis of rotation will automatically be perpendicular to the plane of motion for easy identification.

Next, they overlay a piece of string to identify a logical line of action across the joint.

String can help students identify the logical line of action across a joint.
String can help students identify the logical line of action across a joint. 

Using this method, students can isolate the muscles in that region responsible for the action. As a bonus, they can suggest an example of how that muscle is used in everyday life.

 

If you have the students pick a few of their own muscles too, be sure they are able to complete the process despite the muscle’s obscurity. I have always included a few interesting muscles for their action, shape or function. For example, the gluteus medius not only performs hip abduction, but also executes hip internal rotation due to its line of action. The temporalis not only functions in mandibular elevation but also retraction. The piriformis, besides being a cute pennant shaped muscle, is the only gluteal muscle with a sole proximal attachment on the sacrum. If you have some high level students, dare them to discover how the gluteus maximus can perform knee extension! How else could a patient with an above knee amputation negotiate stairs in a reciprocal fashion? And if that’s not fun enough, challenge them to identify the motion that occurs if one muscle attachment is fixated and the other is not. For instance, if the distal end of the Biceps Brachii is fixated, by placing the hand under a table, then the trunk will flex forward (unfixed).  Try it with other muscles too! Muscles are dynamic and should be taught that way. Because in the end, we want our students to look like this!

This student is having her "AHA!" moment!
This student is having her “AHA!” moment!

John Zubek is a Doctor of Physical Therapy and is an Assistant Professor of  Physiology at Michigan State University. 

How does Physical Activity Exert Beneficial Effects on Atherosclerosis and Coronary Artery Disease?

This post describes an update seminar delivered by Harold Laughlin, Professor at the University of Missouri at the 2017 HAPS Annual Conference in Salt Lake City.


Update Seminar VII was given by Harold Laughlin.  In this talk, the benefits of exercise on cardiovascular health were clearly documented.  I’m sure we’ve all heard the sobering stats before.  Cardiovascular disease, largely due to atherosclerosis, is the leading cause of death in the USA, accounting for ~ 1/3rd of all deaths.  As our President-Elect Ron Gerrits announced, we were all left feeling very inspired to getting fit for the HAPS conference Fun Run next year!  

For those interested in a great review article on the regulation of coronary blood flow during exercise, Harold mentioned the Physiology Review article by Duncker and Bache (2008).   In particular, here is list of some of the things we know so far regarding coronary blood flow during exercise:

  • During exercise, heart rate and myocardial contraction increase to meet the increased oxygen demands of the body and heart itself.
  • In order to meet increased metabolic demand, coronary blood flow increases (~5 fold) and there is also a small increase in oxygen extraction.
  • An increase in heart rate, will increase the relative time spent in systole, which affects (impedes) coronary blood flow.
  • There are many factors which regulate coronary vessel dilation (neurohormones, endothelial factors, and myocardial factors)
  • During exercise, coronary vasodilation appears to be induced by many factors including: exercise-induced ischemia, shear stress, increased arterial pressure, tangential wall stress, higher levels of endogenous NO, and β-adrenergic activity.
  • Exercise training results in coronary microvascular adaptations including: the formation of new capillaries, increased arteriolar diameters, increased adrenergic receptor responsiveness, and increased endothelium-dependent vasodilation (as a result of increased expression of endothelial NO synthase (eNOS), increased NO production, and increased Kv (potassium voltage) channel activity).

In his talk, Harold brought up some current data from his experiments with swine vasculature (Simmons et al., 2012).  He noted that healthy individuals typically have good vasomotor tone, and express low levels of the inflammatory markers and adhesion molecules (e.g. E-selectin and vascular cell adhesion molecule-1, VCAM-1) that are associated with atherosclerosis.  It has been previously found that endothelial cells located at bifurcations and other points of turbulence, are more at risk for developing atherosclerotic plaques than straight conduit arteries (Davies et al. 2010).  Laughlin et al. (2012) decided to investigate the straight conduit arteries and veins in six different regions of the swine to determine whether there were any differences in susceptibility to the development of atherosclerosis.  Overall, they found conduit arteries expressed higher levels of both pro- and anti-atherogenic markers than veins.  Also as one might expect, vessels of healthy individuals that lack atherosclerosis, are the most responsive to exercise.

In this talk, the improvements in vasculature as a result of exercise training were specifically addressed (Green et al. 2017).  The exercise-induced effects on vasculature is actually remarkable.  It is estimated that physical activity increases longevity, and reduces the risk of cardiovascular mortality by 42-44%.  The positive effect of exercise is noted to have dose-dependent curve and exercise training has been found to be on par with contemporary drug interventions (Green et al. 2017).  Exercise induces structural and functional adaptations in the vascular walls that reduce the risk of atherosclerotic plaque formation.  In addition increased capillary density and formation of additional collateral circulation is observed, as exercise induces the release of VEGF (Vascular Endothelial Growth Factor) (Green et. al. 2017).  Also, exercise was found to increase endothelial progenitor cell (EPC) activity which contributes to the growth of new vessels as well as repair.

It is important to note that exercise training increases cardiac output and oxygen uptake, without increasing mean arterial pressure.  This is because as cardiac output increases, peripheral vasodilation occurs (reducing afterload).  Exercise training improves vasodilation capabilities through structural changes.  During exercise, the increased systolic pressure stimulates vascular endothelial and smooth muscle cells to grow and align in response to stress, allowing for greater vasodilation.  In addition, vessel wall stretching induces vasodilation through increased eNOS activity (which produces the vasodilator NO) and activation of Kv channels (which causes smooth muscle cells to hyperpolarize and relax).  In addition, increased blood flow, has been found to increase both acetylcholine and prostacyclin levels which have been shown to induce vasodilation.  Conversely, low levels of shear stress, has been found to increase expression of adhesion molecules (ICAM-1 and VCAM-1) and reduce levels of the endogenous vasodilator NO (Green et al. 2017).

Thankfully for those of us looking to improve vasodilatory function in our conduit arteries and increase our capillary density, improvements through exercise can be seen in as little as 1-4 weeks of exercise and of course continue with longer training sessions.  So with that in mind, I’ll be sure to grab my running shoes and sign my kids up for sports, as fewer than 30% of females and 50% of males get the recommended 60 minutes 5-7 days/ week of exercise!  Yikes-arama!  Time to unplug and play…

A big thank you to Harold Laughlin for a highly motivating talk!


Post from Dr. Zoë Soon, School of Health and Exercise Sciences, University of British Columbia Okanagan, BC, Canada


Davies, P.F., Civelek, M., Fang, Y., Guerraty, M.A. Passerini, A.G. (2010). Endothelial heterogeneity associated with regional athero-susceptiblity and adaptation to disturbed blood flow in vivo. Semin. Thromb. Hemost. 36, 265-275.

Duncker, D.J. and Bache, R.J. (2008). Regulation of coronary blood flow during exercise. Physiol. Rev. 88, 1009-1086.

Green, D.J., Hopman, M.T.E., Padilla, J., Laughlin, M.H., Thijssen, D.H.J. (2017). Vascular adaptation to exercise in humans: role of hemodynamic stimuli. Phsiol. Rev. 97, 495-528.

Simmons, G.H., Padilla, J., and Laughlin, M.H. (2012). Heterogeneity of endothelial cell phenotype within and amongst conduit vessels of the swine vasculature. Exp. Physiol. 97(9), 1074-1082.

Join HAPS– for the conversations!

The HAPS Discussion group (also known as HAPS-L and before that as “the listserv”) is the place where the most interesting conversations in A&P are happening.  This discussion group has hundreds of members, is very active, and has often features amazingly high level conversations among leaders in the field.  This group was started in 1998 as an email listserv, and some still call it that, but it is a modern discussion group with email preferences and a web archive.  The HAPS discussion group is open to all current HAPS members and is one of the most valuable perks of membership.

This week, one discussion revolved around the most accurate classification of bone types. In this discussion, Mark Nielsen (University of Utah Anatomy Professor and winner of the 2017 HAPS-Theime Excellence in Teaching Award) shared multiple illuminating contributions to the conversation. Check out the excerpt below…and then imagine having content like THIS delivered to your email box on a regular basis.

WOW, there is a lot of interesting discussion going on here, this is one of the nice things about the HAPS listserve. It is always great to share and discuss. While I agree with many of the sage comments about classification and “does it really matter because the bones do not care or know where they fit in the scheme of things”, it is still important to recognize that there is correct and incorrect within a classification scheme. Following is the bases of the classification scheme:

Long bone = what is the one characteristic shared by long bones that none of the other bone types have, one thing and one thing only, a medullary cavity, and yes all the phalanges, even the small distal phalanges have a medullary cavity, as does the clavicle. The following bones have a medullary cavity:

  • clavicle
  • humerus
  • radius
  • ulna
  • metacarpals
  • proximal phalanges of hand
  • middle phalanges of hand
  • distal phalanges of hand
  • femur
  • tibia
  • fibula
  • metatarsals
  • proximal phalanges of foot
  • middle phalanges of foot
  • distal phalanges of foot

I believe someone stated that long bones are characterized because they have a diaphysis with proximal and distal epiphyses. This is not true. Many long bones only have epiphyses at one end and not the other. This is the case for many of the phalanges. Again, the characteristic that defines a long bone is the presence of a medullary cavity. Besides, many bones have epiphyses – for example, short bones and irregular bones have epiphyses.

Short bones = are characterized by a core of spongy bone with an outer covering of compact bone. They typically have a length, width, and depth that are approximately of equal dimensions. The carpal and tarsal bones are placed in this category.

Flat bones = the true flat bones of the body all reside in the skull, but the ribs are also often considered to fall in this category because their bone structure is similar to the flat bones of the skull. These are bones that are characterized by external and internal tables (laminae) of compact bone sandwiching dense trabecular diploe, the diploic spaces of the trabecular bone being filled with hemopoetic red marrow in the living subject. This would include the parietal bones, frontal bone, squamous portion of the occipital bone and temporal bone, sutural or wormian bones that are ossification centers that never fused with the fore mentioned bones.

Most of the remaining bones did not fit into one of these three categories. Like the short bones and flat bones all the remaining bones had an outer covering of compact bone and an internal core of spongy bone and no medullary cavity, but they were not short and they were not flat. This led to the next category that became the catch all:

Irregular bones = a variety of bone shapes consisting of an outer covering of compact bone and a central core of spongy bone, with some bone surfaces that are so flat and thin that they lack spongey bone completely e.g., the scapula, ethmoid. Most of the other bones fall in this category – vertebrae, the bones of the facial skeleton and inferior cranial vault bones, hyoid, malleus, incus, stapes, and the scapula and os coxae.

The final category is the sesamoid bones = these are bones that form within tendons. In human anatomy they are similar in bony structure to short bones but have a unique classification as sesamoid bones because of their location within tendons. In some other vertebrates they are very long slender bones within tendons.

One other recognized category is a pneumatized bone. These are bones that contain air spaces within their cores and can overlap with other categories. For example, the frontal bone is both a flat bone and a pneumatized bone. The ethmoid bone, sphenoid bone, and petromastoid part of the temporal bone are both irregular bones and pneumatized bones.

So there is a logic to classification and it is not a random thing that we can bend to our whims. We now have the choice to ignore it or teach it correctly.

So if you’re a HAPS member, by all means, join this discussion group. And if you’re not a member, JOIN HAPS so you can join the discussion group. (Then adjust your email settings, because most HAPSters have experienced the infamous “blown up email box” that results from some of the more rigorous conversations! Thankfully, executive director Peter English wrote a blog post with instructions for doing just that.)