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Doody's Review ServiceReviewer: Robert M. Klein, PhD (University of Kansas Medical Center)
Description: This is the 11th edition of a classic textbook that has facilitated mastery of the difficult subject of embryology for generations of health professions students. This book combines succinct text with beautifully drawn illustrations that explain normal development and aberrations of development that lead to congenital dysmorphologies. This edition includes improved illustrations, updated explanations of genetic and molecular regulation of developmental events, improved clinical problems, and a very effective companion web site. The supplemental learning resources are excellent and easily navigable. The Simbryo animations are excellent, as is the test system which allows learners to choose review or test modes for some very well-written USMLE-style questions. The book is available electronically on the web through "the Point" which facilitates learner-centered activities, especially for those involved in electronic curricula. The answers to the problems can be obtained online with a click of the mouse.
Purpose: As stated in the preface, the purpose is to provide "a concise, but thorough description of embryology and its clinical significance, an awareness of which is essential in the diagnosis and prevention of birth defects." The objective to provide a succinct embryology text is very much on target as there is diminished time and emphasis on the important discipline of human embryology in current undergraduate medical curricula at the same time that our understanding of developmental biology and the genetic regulation of development is expanding exponentially. This book clearly meets the goal of being a concise, but thorough presentation of key embryology topics.
Audience: It is written specifically for health professions students studying medical embryology and human developmental biology for the first time. It also is a valuable resource for clinicians who need a resource for rapid review and update of human embryology for their medical practice in obstetrics, pediatrics, and/or maternal-fetal medicine.
Features: This book provides a written description of general embryology followed by a systems-based approach to development and an appendix section. The author first discusses old and new frontiers in embryology and does an excellent job of succinctly summarizing molecular regulation and signaling. While this information is not sufficient for an undergraduate medical student, it is a remarkably good five-page summary of signaling pathways which is augmented by appropriate molecular developmental biology in the systems-based chapters. The remaining chapters in the general embryology section follow a traditional, chronological developmental sequence: gametogenesis, week one through three, week three through eight, and the third month through birth. Dr. Sadler thankfully includes parturition, although it could be expanded beyond the one page. The last chapter of this section provides an abbreviated but appropriate discussion of birth defects, including state-of-the-art in utero treatments for congenital anomalies and other fetal medical problems. The second major section of the book follows an organ/body, systems/regional approach in the following order: skeletal system, muscular system, body cavities, cardiovascular system, respiratory system, digestive system, urogenital system, head and neck, central nervous system, ear, eye, and integumentary system. In each chapter, Dr. Sadler effectively integrates clinical correlates and molecular and genetic regulation specific to the system, a concise summary of developmental events, and problems to solve. Dr. Sadler has always included extensive scanning electron micrographs which help students to understand the morphological changes that occur during development. Unfortunately, in my experience, students ignore this section and faculty members often delete those images from their presentations. Perhaps use of color and coloration, Ted Turner movie style, would help. Some of the scanning electron micrographs are difficult to discern, even for an experienced embryology instructor. The third part of the book contains answers to the problems found in each chapter, an excellent glossary of key terms, and an index. The book has only a few minor shortcomings. The abbreviated text sometimes leaves students flipping back and forth between sections. For example, the discussion of the pericardioperitoneal canals, pleuropericardial folds, and the pleuropericardial membrane is not clear and the relationship of figures in chapter 11 (i.e. figures 11.7 and 11.8) and chapter 13 (Figure 13.6) and the structures therein are confusing. In fact, figure 11.8 is mislabeled. The label "pericardioperitoneal" is incomplete. There are misspellings, for example, on page 9, "diffusible" not "diffusable." That misspelling appears again in the USMLE-style questions. While references are rarely used by students, the total absence of citations is inappropriate. References are a means of connecting current generations of medical students with the medical literature — old and new. They are also a means of providing credit for the primary literature that is the basis of the book.
Assessment: This is a classic book that has been updated regularly. This edition provides an excellent update of genetic and molecular regulation of human embryonic development. Dr. Sadler and the publisher have changed with the times, adding a CD in previous editions and now providing an online resource with the complete text including figures, animations, and a question bank that can be easily accessed. There are several human embryology textbooks from which students and faculty can choose. Drs. Keith Moore and T.V.N. Persaud publish two: The Developing Human: Clinically Oriented Embryology, 8th edition (Elsevier, 2008), and Before We Are Born: Essentials of Embryology and Birth Defects, 7th edition (Elsevier, 2008). The Developing Human is the more comprehensive text and Before We are Born is the more concise text. Dr. Bruce Carlson's Human Embryology and Developmental Biology, 4th edition (Elsevier, 2009) as the title indicates, combines embryology and developmental biology. The most comprehensive and up-to-date book is Dr. Gary Schoenwolf and colleagues' revision of Larsen's Human Embryology, 4th edition (Elsevier, 2008). That outstanding reference would make an excellent course text as long as the required readings are focused on the shorter/concise sections which will suffice for most undergraduate health professions students. All of these books have been updated to include more clinical correlations, more genetic and molecular regulation information, and online supplemental materials. Ultimately, the choice of textbook is based upon the style of the course or module leader and the time allotted for embryology. Dr. Sadler kept the original goals of Langman's Medical Embryology in mind when preparing this 11th edition. He has carefully updated this excellent book with an awareness that the new generation of students may prefer online activities and the ability to access content electronically.