The Last Best Story in Teaching Anatomy & Physiology | Episode 37

01:17 | Feedback in Online Tests
08:17 | The Anatomical Compass
14:47 | Sponsored by AAA
15:12 | Reserve hematopoiesis
18:09 | Sponsored by HAPS
18:54 | Featured: Last Best Story in Adult Neurogenesis & ANS Pathways
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Scientific theories are tested every time someone makes an observation or conducts an experiment, so it is misleading to think of science as an edifice, built on foundations. Rather, scientific knowledge is more like a web. The difference couldn’t be more crucial. A tall edifice can collapse – if the foundations upon which it was built turn out to be shaky. But a web can be torn in several parts without causing the collapse of the whole. The damaged threads can be patiently replaced and re-connected with the rest – and the whole web can become stronger, and more intricate. (Massimo Pigliucci)

1 | Feedback in Online tests

7 minutes
In Episode 36, Adam Rich called in regarding how we can provide feedback to students taking online tests. I responded that I encourage students to get the correct response from their study buddies—or from me. After the episode aired, Krista Rompolski pointed out that this could be a challenge in very large courses. What do y'all think? Tell us. Really.

• Big Year in Anatomy & Physiology Teaching with The A&P Professor | Episode 36
  • Spaced Retrieval Practice | Episode 1
  • Test Debriefing Boosts Student Learning | Episode 11
  • Test Frequency in the A&P Course | Episode 33
  • Long Term Learning | Five Strategies for Teaching A&P
  • Testing as Teaching
• Here's a tool I use for repeated feedback (saves a LOT of time):
  • Sign up for TextExpander. Recall your best words. Instantly, repeatedly.
• We want your feedback!
  • 1-833-LION-DEN or 1-833-546-6336
  • podcast@theAPprofessor.org
  • @theAPprofessor (Facebook, Twitter, Instagram, Pinterest, and beyond)

2 | The Anatomical Compass

6.5 minutes
Although you and I are comfortable in orienting ourselves to anatomical directions when looking at diagrams, photographs, and specimens in anatomy, our beginning student often are not. The simple process of adding an "anatomical rosette" reflecting the anatomical directions in each encountered diagram can  help students develop the skill of understanding anatomical perspective.

• Anatomical Rosettes Help Student Orient Themselves

 

3 | Sponsored by AAA

0.5 minutes
The searchable transcript for this episode, as well as the captioned audiogram of this episode, are sponsored by The American Association of Anatomists (AAA) at anatomy.org. Their big meeting is in April at the Experimental Biology (EB) meeting in Orlando FL. Check it out!

• Searchable transcript
• Captioned audiogram 

 

4 | Reserve Hematopoiesis

3 minutes
Hematopoietic stem cells  (HSCs) may have a "back-up system" that helps out after damage to the working population. These "reserve" HSCs (rHSCs) may step up when the primed HSCs (pHSCs) cannot keep up with the demand for hematopoiesis.

• Scientists have identified a bone marrow backup system (summary article) my-ap.us/2BmcoE0
• N-Cadherin-Expressing Bone and Marrow Stromal Progenitor Cells Maintain Reserve Hematopoietic Stem Cells
  (report by Zhao, et al. in Cell Reports) my-ap.us/2Bk7vLN

 

5 | Sponsored by HAPS

0.5 minutes
The Human Anatomy & Physiology Society (HAPS) is a sponsor of this podcast. Did you know there's a one-day regional HAPS conference in March? Check it out. You can help appreciate their support by clicking the link below and checking out the many resources and benefits found there.

Anatomy & Physiology Society 

theAPprofessor.org/haps

 

6 | Featured: Last Best Story in Adult Neurogenesis & ANS Pathways

12 minutes
The "last best story" is what I tell my students I'm providing to them. That approach emphasizes the evolving nature of scientific understanding. In this episode, I mention two stories that are evolving right now.

• Storytelling is the Heart of Teaching A&P | Episode 12 (where I introduce the idea of teaching as storytelling)
• Adult neurogenesis in the brain
  • Running Concept Lists Help Students Make Connections | Episode 8 (where I first discuss this story)
    • The Discovery of the Neuron (outlines the origin of central dogmas about neuroscience, including Ramón y Cajal's role)
    • Neurogenesis in the adult human hippocampus (paper that established the idea that adult brain neurogenesis does occur)
    • Human hippocampal neurogenesis drops sharply in children to undetectable levels in adults (paper that challenges the idea of adult brain neurogenesis)
    • New Study Questions Confidence in Neurogenesis in the Adult Brain (article that summarizes the recent controversy)
  • Are Learning Styles Real? Why or Why Not? | Episode 14 (where I bring up newer research on adult neurogenesis)
    • New Evidence Suggests Aging Brains Continue to Make New Neurons (article by Francis Collins on the new paper)
    • Human Hippocampal Neurogenesis Persists throughout Aging (new research paper in Cell)
  • The last best story in adult neurogenesis?
    • A New Look at Neurogenesis in Humans (blog post by Neuroskeptic, summarizing new perspectives) my-ap.us/2TDxTXU
    • Recalibrating the Relevance of Adult Neurogenesis (article by Jason S. Snyder in Trends in Neurosciences) my-ap.us/2TEb5r4
• Are sacral autonomic pathways sympathetic or parasympathetic?
  • Sacral Efferent Pathways are Sympathetic, Not Parasympathetic (summary from The A&P Professor blog) my-ap.us/2TJMHnS
    • The sacral autonomic outflow is sympathetic (I. Espinosa-Medina, O., et al., of J.-F. Brunet lab's in Science the proposed change; includes an updated version of the classic diagram of sympathetic and parasympathetic pathways) my-ap.us/2fNdcF3
    • Neural circuitry gets rewired (Adameyko, I. in Science comments on the report cited above, stating that "This finding provokes a serious shift in textbook knowledge, and, as with any fundamental discovery, it brings important practical implications..." and goes on to mention of a few of the implications (e.g., how to treat bladder dysfunction) my-ap.us/2gg9O8P
    • The Autonomic Nervous System. Part I. (John Newport Langley's classic "primary source" that codified the modern concept of the ANS.) my-ap.us/2fYHt3M
  • The sacral autonomic outflow is parasympathetic: Langley got it right (John P. Horn's commentary in Clinical Autonomic Research; the last best story?) my-ap.us/2TCvwF5

If the hyperlinks here are not active, go to TAPPradio.org to find the episode page.

• More details at the episode page.
• Transcript available at the script page.
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Transcript and captions for this episodeare supported by theAmerican Association of Anatomists.anatomy.org


The Human Anatomy & Physiology Societyalso provides support for this podcast.
theAPprofessor.org/haps

(Clicking on sponsor links helps let them know you appreciatetheir support of this podcast!)

Click here to listen to this episode—or access the detailed notes and transcript.

Big Year in Anatomy & Physiology Teaching with The A&P Professor | Episode 36

0:42 | Adam Rich Asks About Student Feedback
10:32 | New Type of Vessel in Bones
14:17 | Big Ideas: Content Updates & Applications
20:15 | Big Ideas: This Podcast
20:45 | Big Ideas: Featured Ideas of the Year
29:45 | Big Ideas: Wrapping Up the Year

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"Do what you can, with what you have, where you are."  (Theodore Roosevelt)

1 | Adam Rich Calls In

10 minutes
Kevin responds to a call from Adam Rich of SUNY Brockport regarding giving students feedback/corrected responses in online tests.

• Spaced Retrieval Practice | Episode 1
• Test Debriefing Boosts Student Learning | Episode 11
• Test Frequency in the A&P Course | Episode 33
• Long Term Learning | Five Strategies for Teaching A&P
• Testing as Teaching

 

 

2 | New Type of Vessel in Bones

3.5 minutes
Scientists have discovered a system of small vessels that cross every part of a bone's cortical layers to supply most of the bone's blood—over 80% of the arterial supply and 59% of venous drainage. The proposed name is trans-cortical vessels (TCVs).

• We’ve discovered a new type of blood vessel in our bones (brief article summarizing the discovery) my-ap.us/2B6tHce
• A network of trans-cortical capillaries as mainstay for blood circulation in long bones (full research article) my-ap.us/2B6ttSq
  • Video (gif) showing a virtual trip through a TCV my-ap.us/2B6XX6H

 

 

3 | Big Year: Content Updates & Applications

6 minutes
The first of several segments in a "debriefing" of the first year of this podcast.
This year brought many content updates and brief teaching snippets, from using green pens for grading to the role of platelets in immunity. Too many to mention, but Kevin gives his best shot at listing some of those that seem to be most memorable.
 

 

4 | Big Year: Evolution of This Podcast

9.5 minutes
What are show notes and how do they differ from the episode page? How best to listen and share? What's the episode list (theAPprofessor.org/podlist)? Preview episodes! And a word about our sponsors:

The Human Anatomy & Physiology Society (HAPS) is a sponsor of this podcast. Did you know there's a one-day regional HAPS conference in March? Check it out. You can help appreciate their support by clicking the link below and checking out the many resources and benefits found there.

Anatomy & Physiology Society 

theAPprofessor.org/haps

The searchable transcript for this episode, as well as the captioned audiogram of this episode, are sponsored by The American Association of Anatomists (AAA) at anatomy.org

• Searchable transcript
• Captioned audiogram 

 

5 | Big Year: The Big Ideas of the Past Year

 11 minutes
Each full episode usually has a "featured topic." This segment reviews some of the major topics and themes that emerged during the first year of the podcast.  From caring-empathy-compassion to integrity to storytelling, and from testing-as-teaching to elephant skin to learning science, a lot was covered! And what about those guest interviews--the Learning Scientists, media expert Barbara Waxer, anatomy educator Aaron Fried, and artist-professor Paul Krieger? And let's not forget those "lucky numbers"!
 

5 | Big Year: Wrapping Up

2 minutes
What do you want me to cover? I have some ideas, of course. But I want to hear  your ideas, too!
1-833-LION-DEN
1-833-546-6336
podcast@theAPprofessor.org
@theAPprofessor (Facebook, Twitter, Instagram, Pinterest, and beyond)

If the hyperlinks here are not active, go to TAPPradio.org to find the episode page.

• More details at the episode page.
• Transcript available at the script page.
• Listen to any episode on your Alexa device.
• Join The A&P Professor social network:
  • Blog
  • Twitter @theAPprofessor
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Amazon referrals help defray podcasting expenses.
Transcript and captions for this episode are supported by the American Association of Anatomists.anatomy.org


The Human Anatomy & Physiology Societyalso provides support for this podcast. theAPprofessor.org/haps

(Clicking on sponsor links helps let them know you appreciatetheir support of this podcast!)

Click here to listen to this episode—or access the detailed notes and transcript.

Episode 35 Intro | TAPP Radio Preview

Host Kevin Patton previews the content of the upcoming full episode, which focuses on the big ideas (essential concepts) of the A&P course.
 

There's more... a few content updates... plus some word dissections, a toast to Elaine Marieb, and a recommendation from The A&P Professor Book Club.
If you cannot see or activate the audio player click here and scroll down to the Preview section.

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Topics
.5 minute

• News about how smell relates to stress
• News about how oxytocin works
• Cholesterol testing for cardiac risk - are changes coming?
• Big ideas - the essential concepts of A&P

•  

Word Dissections
9.5 minutes

• Dissection
  • Section
• Concept
• Gradient
• Apolipoprotein B (ApoB)

Elaine Marieb
1.5 minute

• A toast to the late Elaine Marieb
• Elaine Marieb obituary my-ap.us/MariebObit

Book Club
3.5 minutes

• The Core Concepts of Physiology: A New Paradigm for Teaching Physiology
  • by Joel Michael , William Cliff, Jenny McFarland, Harold Modell, Ann Wright
• Book details:
  • Published on behalf of APS The American Physiological Society by Springer
  • APS members: my-ap.us/CoreConceptsBook
  • Bookstore: amzn.to/2GJd2Rb
• 15 core concepts of physiology
  • Explanations and applications of a concept-based approach to the physiology course
  • Concepts:
    • Evolution
    • Homeostasis
    • Causality
    • Energy
    • Structure/function
    • Cell theory
    • Levels of organization
    • Cell–cell communication
    • Cell membrane
    • Flow down gradients
    • Genes to proteins
    • Interdependence
    • Mass balance
    • Physics/chemistry
    • Scientific reasoning

If the hyperlinks here are not active, go to TAPPradio.org to find the episode page.

• More details at the episode page.
• Transcript available at the script page.
• Listen to any episode on your Alexa device.
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Transcript and captions for this episode are supported by the 

American Association of Anatomists.anatomy.org

The Human Anatomy & Physiology Society 

also provides support for this podcast.theAPprofessor.org/haps

(Clicking on sponsor links helps let them know you appreciate their support of this podcast!)

Click here to listen to this episode—or access the detailed notes and transcript.

EVEN MORE Tricks for Retention & Success in Online Courses | TAPP Episode 23

Medical mitochondria (4 min)
Syllabuses: I need your help (1 min)
Review of first two parts of this series (3 min)
Featured: EVEN MORE Tricks for Retention & Success in Online Courses (18.5 min)

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(0:42) New research proposes using mitochondria isolated from healthy tissue in a patient's body to treat ischemic heart muscle and perhaps other dysfunctional tissues or organs.

• Dying Organs Restored to Life in Novel Experiments (New York Times article)

(4:44) Syllabuses, syllabi. Whatever. It's almost time to think about tweaking our course documents for the fall semester. I'll cover that in an upcoming episode, so I need you to send your contributions now!

• Please share your syllabus ideas, questions, or comments at:
  • 1-833-LION-DEN or 1-833-546-6336
  • podcast@theAPprofessor.org

 

(5:55) It's too long for one episode, so it's a series of three episodes: 21, 22 (previous episodes), and 23 (this episode).
If you're not teaching online now, you will be someday! Most of these tips apply to face-to-face courses, anyway.
In  the previous two episodes, Kevin suggested:

• It's all about connections.
• Cultivate a friendly, informal, and supportive "online teaching persona"
• Express empathy, don't just have empathy.
• Use customer-service skills when communicating with students
• Use our own pain points and frustrations to tap into how our students might feel
• How we can literally make our online course a face to face course
• How to use faces, voices, and scheduled course announcements to enhance the connections necessary to retain students and promote student success.

 (8:47) Online courses are notorious for high dropout rates and high failure rates, compared to traditional face-to-face classes. Kevin continues to share even more strategies he has found to work in creating and nurturing the kinds of connections that help retain students and support their success in the course.
This episode focuses on:

• Why reaching out to individual students who may be at risk is important--and how to do that.
• Why feedback to students is important in nurturing connections.
• Some final thoughts.

If you experience a repeated section starting about about timestamp 21:36, it's not your imagination. Probably. A pre-release version had such a hiccup and it may have been downloaded into your app. If so, you can simply re-download in the app. Or enjoy twice the fun by leaving the repeat in there!
If the hyperlinks here are not active, go to TAPPradio.org to find the episode page.

• More details at the episode page.
• Transcript available at the script page.
• Listen to any episode on your Alexa device.
• Join The A&P Professor social network:
  • Blog
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Amazon referrals help defray podcasting expenses.

Click here to listen to this episode—or access the detailed notes and transcript.

Concept Maps Help Students Find Their Way| TAPP Radio 5

Use concept mapping for student learning and assessment.
Blood doping is a perennial news topic that helps apply central concepts of A&P.

If you cannot see the audio player click here.

(0:48) Blood doping stories related to the 2018 Winter Olympics (or in any context) are effective in helping student students apply and integrate diverse concepts in anatomy and physiology

• Olympic athletes are cheating more often than you think (article concerning current issues in doping)
• Doping topics from The A&P Professor blog (various concepts that apply doping in A&P courses)
• World Doping Agency | WADA (website with various resources, including their official prohibited list)
• Blood Sport: Alex Rodriguez, Biogenesis, and the Quest to End Baseball’s Steroid Era (book)
• Tainted Blood: The Untold Story of the 1984 Olympic Blood Doping Scandal (book)
• Doping, Performance-Enhancing Drugs, and Hormones in Sport: Mechanisms of Action and Methods of Detection | Emerging Issues in Analytical Chemistry (A great acquisition suggestion for your institution’s library)

(6:32) The featured topic is concept mapping and its uses in helps students learn and helping instructors assess learning and diagnose misconceptions and other learning concerns.

• Small Teaching: Everyday Lessons from the Science of Learning
• Teaching Nursing Using Concept Maps
• Deep Active Learning: Toward Greater Depth in University Education
• Topics in concept mapping for students from The A&P Student blog
• Concept Maps | A How-To for A&P Students (link to this from your course website or syllabus)

Click here to listen to this episode—or access the detailed notes and transcript.

Testing as a Teaching Strategy | Students Learn From Tests | TAPP Radio 2

A new episode of The A&P Professor podcast (TAPP Radio) is here!

Testing is not just for assessment—tests can be a primary way to learn.
What's in the new blood pressure guidelines?
Going to the annual HAPS conference?

I encourage all anatomy and/or physiology instructors to attend the 2018 Annual Conference of the Human Anatomy and Physiology in Columbus OH. (0:50)

• HAPS 2018 Annual Conference

I summarize a few key points from the new 2017 guidelines on hypertension and their impact on how we talk about blood pressure in our A&P course. (3:45)

• Got High Blood Pressure Covered? The 2017 Hypertension Guidelines.
  • What we need to know for teaching A&P.
  • Link to the full report. And many more related links.
  • Free slide to use in your course.
  • Brief video interview of report authors, giving pithy highlights.

A previous topic, spaced retrieval practice (Episode 1), is the basis for a new discussion of Kevin's experience using online tests to provide students with regular and required spaced retrieval practice. (10:17)

• Testing as a Learning Tool
• Testing as Teaching
• Testing as a Learning Tool | Update
• Online Seminar: Testing as Teaching

More details at the episode page.
Transcript available at the script page.

If the hyperlinks above are not active, go to TAPPradio.org to find the episode page.

Check out the detailed notes and transcript of this episode!

Platelets vs. Bacteria

Platelets as potent scavengers of bacteria? Really?

Something like 750 billion tiny cell fragments called platelets circulate in the human blood stream. When an injury to a blood vessel occurs, they stick to the exposed collagen in groups—forming platelet plug. And trigger additional reactions that eventually result in a blood clot.

But did you know that they have other helpful jobs, too? Like rounding up bacteria and feeding them up to immune cells, which devour them to make us safe.

This innate immune function of platelets has recently been outlined by researchers, as the information below summarizes.

Read through the quick points below to get an overview of some immune functions of platelets. Then read the full articles if you want to know more about these discoveries—including some great diagrams, micrographs, and videos.

[A short item on this topic also appears in today's edition of my daily Nuzzel newsletter of curated headlines for A&P professors.]

Quick points about platelets as bacterial scavengers

• At sites of vessel injury/inflammation, platelets that contact intact collagen stick together—but platelets that do not contact collagen are motile.


• Motile platelets change shape from a "fried egg" to a polarized "half moon" to better navigate the shearing forces of blood flow.


• They can even navigate "upstream" against the flow of blood.


• Platelets can use mechanical force to pull particles—including bacteria—from surrounding substrates.


• Platelets collect and bundle bacteria, which facilitates neutrophil activation and subsequent phagocytosis. 

Migration pattern of motile platelet (left). Platelets collecting bacteria into bundles.

What can we use from this in teaching undergraduate A&P?

• Yeah, okay we don't have time to go into all the ins and outs of platelets in a typical A&P course, but we can mention that platelets are now known to have immune functions.


• Consider circling back to this mention later, when (if) you cover innate immune mechanisms a bit later in the course.


• Consider calling attention to the sensory functions needed for platelets to analyze their microenvironment within the bloodstream.


• Consider pointing out the specialized structure and function of the platelet's plasma membrane.


• Integrins (integral membrane proteins) have a role in detecting particles for adhesion, binding to them, and sorting them.


• Invaginations of the plasma membrane facilitate bundling of bacteria.


• The shape changes needed for migration and handling of bacteria require actin-myosin reactions to power them. As in muscle fibers, these contractions are triggered by influx of extracellular calcium. In case you want to circle back to that.


• Perhaps we should make a stronger point in reminding students that although they are "cell fragments" without a nucleus, they're more than just bags of hemostatic chemicals.


• All these opportunities to "circle back" to previously studied concepts helps students make connections in their developing conceptual framework. And help them form a better understanding of the "big picture."

Want to know more?

Platelets, On Your Marks, Get Set, Migrate!

• Bambach S, Lämmermann T. Cell. 2017 vol: 171 (6) pp: 1256-1258
• Introduction to the Gaertner, et. al., paper below—giving background and overview to enhance understanding of the new discoveries. Great diagram, too! Click "Supplemental information" in the article to access video clips. 
• my-ap.us/2EbU6Eu

Migrating Platelets Are Mechano-scavengers that Collect and Bundle Bacteria.

• Gaertner F et. al. Cell. 2017 vol: 171 (6) pp: 1368-1382.e23
• Journal article describing the scavenger role of platelets. Includes a few very nice, simple diagrams—and some cool micrographs and data graphs. These can also be downloaded as PowerPoint slides. Click "Supplemental information" in the article to access video clips. 
• my-ap.us/2F5iM2U

Platelets Mediate Host Defense against Staphylococcus aureus through Direct Bactericidal Activity and by Enhancing Macrophage Activities.

• Ali R et. al. Journal of immunology. 2017 vol: 198 (1) pp: 344-351
• Journal article that supports the concept that platelets can kill MRSA bacteria and enhance their phagocytosis by macrophages.
• my-ap.us/2EaO5be

[NOTE: If you can't access the full text of any resource, ask your school's reference librarian for help. If they can't provide direct access, they'll probably know how to get a copy of the resource for you. Quickly.]

Sketch: パタゴニア

Photos: LMU

Got High Blood Pressure Covered? The 2017 Hypertension Guidelines.

With the new guidelines for high blood pressure popping up all over the news recently, we may wonder what we need to know when this comes up in our A&P classrooms. And we know it will—students love, love, love to connect what they are learning in A&P with what they are experiencing in their lives. 

It turns out that although the new 2017 Guideline For the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults is focused on how physicians should make diagnoses and manage patient care, the definitions of exactly what constitutes high blood pressure (hypertension or HTN) are important learning points in the undergrad A&P course.

I'll outline the main things for us A&P professors to know here, but do check out the resources I've linked below to deepen your understanding of current thinking regarding approaches to blood pressure (BP) health.

First, there are revised guidelines as to what constitutes high blood pressure or HTN:

• Normal BP: Less than 120/80 mm Hg;
• Elevated BP: Systolic between 120-129 and diastolic less than 80;
• Stage 1 HTN: Systolic between 130-139 or diastolic between 80-89;
• Stage 2 HTN: Systolic at least 140 or diastolic at least 90 mm Hg;
• Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

Regardless of the precise cutoffs listed above, in an interview discussing the new guidelines, the main author states that, "120/80 is normal, the same as we had before" the new guidelines. So I think we're safe in using 120/80 as an example of BP when discussing the normal science, even though technically it could be designated as "elevated." Not that we can't use an elevated variable measurement as an example when discussing the physiology of anything. The fact that even the main author of the guidelines uses 120/80 as the starting point of discussion makes me feel more confident in using it as the starting point of my course discussions, too.

The main thing to note in the categories above is that the cutoffs for HTN categories have been lowered. This puts many more people in an HTN category that were not there before. The main goal is for those folks to have conversations with their physicians to evaluate their risk for complications and develop a personalized prevention and care plan.

Note also that the category of prehypertension has been eliminated.

The new guidelines also recommend prescribing medication for Stage 1 HTN if the patient already had a cardiovascular event—or is at a high risk for such an event. They also recognize that many patients will need more than one medication to manage BP and that combining meds into one pill is likely to help folks take them consistently.

There are a lot of other recommendations, so reviewing the Executive Summary or similar resource (see below) may be a good idea.

What can we use from this in teaching undergraduate A&P?

• If you discuss hypertension, or use case studies in teaching, you need to update the cutoff BPs you are using.
• A BP of 120/80 is still considered the starting point for discussing blood pressure.
• Consider discussing the impact of the changes in the new guidelines for ordinary people.
• Discuss why such diagnosis, prevention, and treatment recommendations often change over time. Consider discussion other recent clinical updates.
• Consider discussing specific changes suggested in the new guidelines.
• Consider having students explore the Executive Summary and/or other documents and write their own summary or interpretation of key points. Perhaps they can create their own chart or concept map.

Need some free teaching materials?

SLIDE SET: High Blood Pressure

• Kevin Patton. Lion Den Slide Collection. 18 Nov 2017
• Small slide deck that includes an animated version of the BP Category chart pictured above. Part of the Lion Den Slide Collection (requires free registration to download). You can also download a static PNG image file of the chart in the slide collection set.
• my-ap.us/2ivoql5

VIDEO: AHA 2017 | New High Blood Pressure Guidelines

• America Heart Association. 13 Nov 2017.
• Free video (viewable in the player above) features a chat with the main author of the new guidelines and summarizes the main points. Very practical and easy to understand.
• youtu.be/rvYL-7ergDs

SLIDE SET: 2017 Guideline For the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults

• American College of Cardiology. 13 Nov 2017
• Free set of almost 100 PowerPoint slides to use in teaching. And it has a decided focus on clinical applications, rather than the basic science. These are way, way beyond the coverage desirable in an undergrad A&P course. But some slides may be useful to you.
• my-ap.us/2itMBjY

Want to know more?

New blood pressure guidelines put half of U.S. adults in unhealthy range

• A. Cunningham Science News. 13 Nov 2017 
• Plain-English article summarizing the first major update since 2003 aims to spur heart-healthy lifestyle changes. Has a useful graph and links to other articles and resources.
• my-ap.us/2itVnOR

New Multisociety Hypertension Guideline Is Released

• Allan S. Brett, MD reviewing Whelton PK et al. J Am Coll Cardiol 2017 Nov 13. NEJM Journal Watch Nov 2017.
• Brief review of the larger report (listed below), summarize key take-away points.
• my-ap.us/2iumCc1

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary
A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

• PK Whelton et al. Hypertension, Dec 2017, Volume 70, Issue 6.  DOI: 10.1161/HYP.0000000000000066
• Free PDF of the Executive Summary of the larger report. I recommend reading this first, then decide if you need to read the whole report.
• my-ap.us/2iuzvCT

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults
A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

• PK Whelton et al. Hypertension. Dec 2017, Volume 70, Issue 6.  DOI: 10.1161/HYP.0000000000000065
• Free PDF of the entire report. It's huge, so make a whole pot of tea before starting it.
• my-ap.us/2irTUZj

Potential U.S. Population Impact of the 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline

• Paul Muntner et al. Journal of the American College of Cardiology. November 2017. DOI: 10.1016/j.jacc.2017.10.073
• Free abstract briefly outlines the impact of the new HTN guidelines.
• my-ap.us/2iu8BLi

Photo: Bill Branson/NCI
Chart: Kevin Patton

What About That Negative Blood?

Every once in a while, I get an A&P student who expresses the concept of a negative Rh blood type as "having negative blood"—along with the connotation that having this blood type has a negative health impact.

We do not ordinarily think about red blood cell types such as A, B, AB, O, Rh+/-, or others, as being "bad for you" or even "good for you" healthwise. We most often think of them simply as different "flavors" of RBCs present in the human population.

Oh yeah, there are specific situations in which have a particular blood type can have significant health consequences. If you need an organ or tissue transplant—especially a blood donation—having the same RBC type as the available donor supply is "good for you." The lack thereof, then, is "bad for you" to at least some degree. Just like being tall can be bad for you when going through a low doorway.

Likewise, we all know there are health risks associated with a Rh- mother carrying an Rh+ fetus—especially the situation is not identified or if precautions are not taken.  But it's not like the Rh- type itself has a direct health impact on the person with that type.

However, such a view may be a bit more complex than it first seems.  Research continues to confirm that having a particular RBC type may affect your risk for certain health conditions.

For example, a little over a year ago, research published in the journal Neurology found that adults with type AB blood were at an increased risk of cognitive impairment compared to type O.  Of course, much more work needs to be done to establish a potential mechanism for this phenomenon. But it does give some evidence that the idea of certain blood types having health consequences may be true.

Other studies have suggested these links:

• Type O may be linked to depression, anxiety, low (female) fertility


• Type O and/or A may be linked to attention-deficit disorder (ADD) in children


• Type B may be linked to a lower risk of ADD in children


• Type A may be linked to obsessive-compulsive disorder and stomach cancer


• Type A, B, and AB may be linked to heart disease and abnormal blood clotting

What can we use from this in teaching undergraduate A&P?

• Another interesting aside to throw into an exploration of blood types to "liven up" the conversation a bit to motivate students.


• Consider using a diagram of the actual ABO markers to show what's involved at the cellular level—and their similarity to each other.


• One may want to mention that blood types may become a factor health professionals may look at when assessing health risks in patients


• A classroom discussion on possible mechanisms of a blood-type—health risk could be interesting and useful. This could lead to some great insights about methods of scientific discovery. For example, what's the difference between correlation and cause? How confident should we be in one study?


• Consider leading the discussion toward exactly what you want your students to know about blood types and health (e.g., blood donors and recipients, erythroblastosis fetalis, etc.)

Want to know more?

Blood Type Matters for Brain Health

• A. Anderson and V. Stern. Scientific American MIND January 1, 2015
• Brief article explains discovery that people with AB blood type are at higher risk for age-related cognitive decline. Also lists some of the other blood-type links I mentioned above.
• my-ap.us/1KohroF

ABO blood type, factor VIII, and incident cognitive impairment in the REGARDS cohort

• K. S. Alexander, et al. Neurology September 30, 2014 vol. 83 no. 14 1271-1276 
• doi:http://dx.doi.org/ 10.1212/WNL.0000000000000844
• Original research article about the discovery about AB blood type and brain health.
• my-ap.us/1Koiq8j

Type O blood may be a fertility barrier

• New Scientist. 10:15 26 October 2010
• Brief article in plain English.
• my-ap.us/1KolWzn

Yes, your blood group DOES affect your health

• J. Naish Daily Mail 22 February 2011
• Brief article includes some interesting historical facts.
• my-ap.us/1Kompl7

Your Blood Type May Boost Your Heart Risk, Study Finds

• S. Reinberg HealthDay Aug. 14, 2012
• Brief article on link between blood type and heart disease
• my-ap.us/1KomIfW

Blood photo: M. Osuchowicz

Diagram: InvictaHOG

Virtual Cardiology Lab

Looking for a supplemental hands-on activity with cardiology in your course?

Try the FREE online interactive Cardiology Virtual Lab from the Howard Hughes Medical Institute.

It covers these concepts:

• Symptoms of a selection of heart diseases, to serve as examples of what kinds of things can go wrong with the heart. 
• How are symptoms detected and why?
• Tools and techniques used for diagnosis. 
• What can the different techniques detect and how do they work?
• Principles of pedigree analysis.

What can we use from this in teaching undergraduate A&P?

• Link to this virtual lab activity from your online syllabus, course web page, or LMS (or in an email  or tweet to students)
• If you want to give course points for the lab, consider an online quiz or lab report submitted through your learning management system (LMS) or emailed to you.
• Gives students a "real life" clinical lab application for the concepts they are learning in A&P.
• Provides a cardiology lab option for online/hybrid courses or wet labs that don't have funding for cardiology experiments.
• Helps integrate principles of genetics with cardiology, so it can be used in your genetics unit.

Want to know more?

Cardiology Virtual Lab

• BioInteractive. Howard Hughes Medical Institute. Accessed 16 Sep 2014.
• This virtual lab will familiarize you with heritable diseases of the heart. Learn about the diagnostic tools used to examine and diagnose patients.
• my-ap.us/1qKWiK7

BioInteractive Virtual Labs

• BioInteractive. Howard Hughes Medical Institute. Accessed 16 Sep 2014.
• List of all the FREE virtual labs offered by HHMI's BioInteractive project.
• my-ap.us/1wAX92q

Cardiovascular Topics

• Kevin Patton. The A&P Professor. Various dates.
• List of previous blog posts on cardiovascular topics
• my-ap.us/1uEGngu

A Brain-Lymphatic Connection

Existing dogma in neuroscience states that the brain does not possess the classical lymphatic drainage system found in other parts of body. However, a recent letter in the journal Nature reports the discovery of lymphatic vessels lining the dural sinuses in mice. These were shown to drain immune cells and cerebrospinal fluid (CSF) into the deep cervical lymph nodes.

Although more work is yet to be done in humans, this discovery will cause neuroscientists to revisit a number of concepts related to CSF and lymphatic drainage, as well as immune functions in the brain.

For example, do these new data truly challenge the notion of immune privilege in the nervous tissue of the central nervous system—or do they apply to the brain as an organ and allow for lymphatic drainage of tissues outside the nervous tissue of the brain?

What can we use from this in teaching undergraduate A&P?

• When discussing CSF drainage, consider mentioning the possibility that filtration of CSF directly into dural sinuses may be augmented by the newly discovered lymphatic drainage.


• If you discuss the dogma of the "immune privilege" of the brain, consider mentioning this possible challenge to the concept. This may trigger a great discussion of whether these newly discovered lymphatic vessels are truly "in the brain."


• If you discuss disorders involving altered immunity, such as multiple sclerosis, consider mentioning this discovery.


• Bringing up this new information may be useful in discussions related to the process of science—how existing concepts are sometimes challenged by new information, for example. Perhaps a discussion of the need for more investigation would stimulate students to think about what future steps can be taken to map out a possible lymphatic network in or around the brain.

Current concept of lymphatic drainage (left) compared to updated version to reflect new data (right).

Want to know more?

Brain Drain | The brain contains lymphatic vessels similar to those found elsewhere in the body, a mouse study shows.

• Ashley P. Taylor, The Scientist, June 1, 2015 (online)
• Plain-English article summarizing the study and its significance.
• my-ap.us/1IezLLF

Structural and functional features of central nervous system lymphatic vessels,

• A. Louveau et al., Nature, June 1, 2015.doi:10.1038/nature14432, 
• The original research article. Includes images and video.
• my-ap.us/1KNFPy6

Missing link found between brain, immune system; major disease implications

• University of Virginia Health System, Science Daily, June 1, 2015
• Illustrated press release describing the research.
• my-ap.us/1HQys2J

Images: DBCLS (top)
Univ Va Health System (bottom)

Shepherd's Apps for Teaching Physiology

Here are some computer-based activities that help students learn specific concepts of physiology produced by veteran professor Pete Shepherd.  Dr. Shepherd has been developing over the course of many years based on his extensive teaching experience.

A while back, I told you about the Life Science Teaching Resource Community and its archive of free teaching and learning resources.  Here's an example of a collection of resources from that archive that your students can use to "play around with" physiological conditions to see what changes occur in the body as a result.  All of them can either be used in the classroom/lab setting or can be used individually by students for self-learning.

Included in the collection are these apps, most of which are available on multiple platforms:

Capillary Pressure, which illustrates the vascular control of capillary hydrostatic pressure.

Alveolar Gas, which lets you study some of the physiological factors that affect the composition of alveolar and expired gases. Such factors include dead space, tidal volume, the frequency of breathing, and the rates of oxygen consumption and carbon dioxide production. A worksheet is included.

Blood Oxygen, which enables the user to change variables like the PO2, hemoglobin concentration, and hemoglobin's affinity for oxygen and calculate the concentrations of oxygen in the form of oxyhemoglobin and dissolved oxygen. Simulations include anemia, polycythemia, comparing the effects of oxygen inhalation in a pulmonary "patient" with a normal person, carbon monoxide poisoning, hyperbaria, etc., as well as the concepts of the Fick Principle and the arteriovenous oxygen difference.

Pulse Pressure, which simulates the arterial pressure pulse. The user explores factors like heart rate, stroke volume, arterial compliance, and arterial resistance and see how they affect the arterial pulse pressure.

Sat Curves, which allows the user to demonstrate the effects of pH, PCO2, DPG, and temperature on the oxyhemoglobin dissociation curve. Two graphs are displayed so that one can serve as a control and compared with the other. Cursors on both graphs can be manipulated to obtain exact readings of oxyhemoglobin saturation as specified PO2s.


If you want to check out these amazing resources, please access them in the Life Science Teaching Resource Community at

my-ap.us/1qD4uHU

Image credit: Shepherd

Biological Pacemaker Using Gene Therapy

Researchers recently induced ordinary cardiac muscle fibers into becoming functioning pacemaker cells by injecting a therapeutic gene.

Working with pigs, a common model for human cardiovascular research, researchers first destroyed the natural pacemaker cells in each subject's heart and installed an electronic pacemaker. They then inserted a gene for transcription factor TBX18 into cardiac muscle tissue using an adenovirus.  Using adenovirous vectors for inserting genes is a common strategy in gene therapy.

Within a couple of days, ordinary myocardial fibers had developed the structure and function of pacemaker cells.  In about 5 days, the electronic pacemakers were no longer needed.

However, this biological pacemaking peaked at about 8 days, then eventually disappeared.  This may occur because the virus-infected cells are probably destroyed by the body's immune defenses.  So researchers are thinking that perhaps, at the very least, this could eventually lead to a temporary treatment for certain arrythmias in humans.

What can we use from this in teaching undergraduate A&P?  

• This is an interesting bit of news that helps illustrate the frontiers of human biomedical sciences.
• This story provides a good case to provoke a discussion of the nature of gene therapy.  
• Why did the effect last only 8 or so day?  
• What does this tell us about transcription factor TBX18?  
• What benefit might this treatment have if developed for humans?
• This may add interest to an discussion of the function of the electrical system of the heart in general, and artificial pacemakers in particular.
• The case also provides a scenario in which the body attacks and destroys virus-infected cells.

FREE image you can use in your course

Want to know more?

Next Generation: Biological Pacemakers

• R Williams, The Scientist (the-scientist.com) July 16, 2014
• Plain-English article summarizing the discovery.  Includes quotes from the researchers.
• my-ap.us/1ruocYu

Biological pacemaker created by minimally invasive somatic reprogramming in pigs with complete heart block

• Y-F. Hu et al., Science Translational Medicine, 6:245ra94, 2014. DOI:10.1126/scitranslmed.3008681
• Original research report.
• my-ap.us/1nfErcA

FREE image you can use in your course

Photo credit: vfdbsn

Blood viscosity

Blood viscosity is a concept that is important in understanding blood flow.  It is, after all, one of the factors that affects peripheral resistance to blood flow.

One major factor influencing blood viscosity is hematocrit.  You may be interested in using the analogy of ketchup outlined a few months ago in my article for students Blood viscosity and peripheral resistance at theAPstudent.org

Recently, researchers also looked at the viscosity of the blood plasma alone (without the formed elements).  They found that blood plasma has unique characteristics of flow found only in non-Newtonian fluids, becoming less viscous with increasing pressure.  Again, just like ketchup. Plasma, unlike plain water, exhibits both viscous and elastic behaviors.

Researchers found in recent experiments that this characteristic of plasma may promote swirling where blood vessels diameters change—both at the beginning and end of a narrowed segment.  Thus, this could have an effect on formation of clots at stenoses or where a stent has been placed.

So, as you may have suspected all along, blood is not only thicker than water—it's weirder than water.

Want to know more?

• Blood viscosity and peripheral resistance
• Kevin Patton
• The A&P Student 12 September 2012
• [Analogy of ketchup flow for students.  Includes video.]
• my-ap.us/XuR596

• Blood Is Thicker Than Water – And Blood Plasma Is, Too
• Science Daily Feb. 18, 2013
• [Brief, plain-language article outlining the recent research.]
• my-ap.us/YpGhas

• Rheology of human blood plasma: Viscoelastic versus Newtonian behavior.
• M. Brust, et al.
• Phys. Rev. Lett, 110, 078305 (2013) DOI: 10.1103/PhysRevLett.110.078305
• [Original journal article.  See photos from the experiments below.]
• my-ap.us/15HVkle

Recording from one of the "drop-experiments": If blood plasma is placed between two plates and then they pulled apart, high-speed cameras show in conjunction with high-resolution microscope objectives that strands and droplets form. This demonstrates that plasma is elastic and viscous and does not behave like water.

Photo: Christof Schaefer, Phys. Rev. Lett. 110, 2013, 078305th Copyright (2013) by the American Physical Society

Plasma turbulence affects the blood. In one experiment, the researchers had plasma flow through a microfluidic constriction as in vasoconstriction. They showed turbulence at the end of the contraction, but also - as seen here in the pictures - sticking to its beginning. This turbulence is caused by the viscoelastic properties of blood plasma.

Photo: Mathias chest, Phys. Rev. Lett. 110, 2013, 078305th Copyright (2013) by the American Physical Society

Free book on heart function!

Besides free advice, The A&P Professor is also a big fan of free resources and references.  And here's a set of free resources that will help give you a new perspective on cardiovascular function, particularly the factors that affect cardiac output.

I was recently contacted by Doug Anderson, a relative of the late cardiac surgeon, educator, and inventor Robert M. Anderson.  Doug told me about their family's efforts to make Dr. Anderson's contributions to understanding cardiovascular function widely available to the educational community.

Besides a FREE downloadable textbook outlining an approach to understanding cardiovascular function that is different than what you might be used to, there is also a FREE video that summarizes Anderson's concepts.

The video features Anderson himself walking the viewer through the operation of an elegant pump that he designed and built for teaching purposes. For a deeper understanding of the fluid dynamics behind cardiac function, you should consider watching the video.

By the way, this textbook has a  Creative Commons license that allows you to use all or part of it FREE in your course!

Anderson with his circulation model 

If you are looking for a FREE "medical school lesson" on the factors that influence blood flow, then check out these resources:

Want to know more?



Free textbook

Gross Physiology of the Cardiovascular System
Robert M. Anderson
PDF (printable) my-ap.us/zGtqOa 
Kindle and ePub formats coming soon!

Free video

The Determinants of Cardiac Output
University of Arizona Health Sciences Center with Robert M. Anderson et. al.
Video my-ap.us/xT5dx9
Illustrated transcript my-ap.us/ywWcgL

Free website

Gross Physiology of the Cardiovascular System
Includes additional resources
cardiac-output.info

Anderson's approach is a bit different than what many of us are used to.  Tell me what you think!