Book Reviews 215
the new part of the atlas on sectional anatomy. Dr.
Carlos Machado has skillfully and accurately modified
some of Dr. Netter’s cross sections and added some of
his own in similar artistic style to that of the original
author/artist. A series of 11 cross sections, meticulously
keyed to specific vertebral levels are complemented
by coronal sections at the anterior axillary and midaxil-
lary lines.
Additional Netter illustrations have been incorpo-
rated in the following areas: (1) arterial variations and
collateral supply of liver and gallbladder, (2) flexor
tendons, arteries, and nerves at the wrist, and (3)
lumbrical muscles and bursae. These illustrations, as
well as all others in the atlas, are complemented by
clearly spaced and an appropriate number of leader
lines that, unlike some atlases, so often mislead the
reader by virtue of their overabundance. Nomencla-
ture is revised to the more common anglicized form
and medically oft-used eponyms are included in re-
spect for long-standing habits.
In the best tradition of scientific/educational litera-
ture, a current list of references is included in the
second edition. An example of outstanding merit, in
this reviewer’s opinion, is the reference to updated
current illustrations of perineal fascias, so brilliantly
based on the modern clinical imaging techniques
employed by Stormont et al. (Clin. Anat. 1944:7:115).
This work should certainly put an end to the confu-
sion, uncertainty, or inadequately presented illustra-
tions/discussion that have previously characterized
this region of the body.
Serious students of human anatomy, regardless of
level of interest or need, will most certainly rejoice at
the level of accuracy and scholarship that has guided
this second edition of an Atlas of Human Anatomy to its
present state. Both congratulations and rewards are
sure to follow!
Charles E. Blevins
Cave Creek, Arizona
McMinn’s Color Atlas of Human Anatomy,
4th edition, by P.H. Abrahams, R.T. Hutchings,
and S.C. Marks, Jr. 352 pp., London: Mosby, 1998.
$63.00 (soft cover $45.00).
Except perhaps for Bassett’s Stereoscopic Atlas of
Anatomy (1963, color film mounted in reels), McMinn’s
Color Atlas of Human Anatomy was, to my knowledge,
the first bound atlas that presented anatomy through
realistic color photographs of cadaver specimens. The
first edition (1977) apparently revealed the potential of
this approach, and several atlases have since followed
in its wake.
The objective of the first edition was to bridge the
gap, for the student in the dissecting room, between
textbook descriptions and the reality of the body. The
unique aspect of this approach was that it displayed
preserved, dissected specimens in their natural size. In
many of the specimens, cavities and spaces were
injected with color contrast media. Particularly impres-
sive were the corrosion casts prepared by D.H. Tomp-
sett, using special methods that he had developed for
the Royal College of Surgeons of England. The
specimens and casts were, and still are, housed in the
Anatomy Museum of the College (along with the
specimens that John and William Hunter collected in
the eighteenth century) and remain in active use in
courses taught by the college for preparing candidates
for examinations equivalent to those of surgical boards.
More than 20 years ago, I gained firsthand experience
with these specimens as a visiting professor at the
college. Therefore, I welcomed the publication of
McMinn’s Atlas; it has provided access to a unique and
valuable anatomical resource for students worldwide.
Photographs of these specimens still form the core
of the fourth edition. Some, however, have been
replaced and—although the total number of pages is
still more or less the same—the contents of the Atlas
have been expanded by the addition of new dissec-
tions, clinical imaging (radiology as well as endoscopy),
surface anatomy, explanatory sketches, and notes per-
taining to anatomy and clinical medicine. The Atlas is
now published in both hard and soft cover, the latter
with a substantially smaller page size. Of the original
authors, only R.T. Hutchings remains; he has been
responsible for photography throughout. Drs. Abra-
hams and Marks have clinical backgrounds in medi-
cine and dentistry, respectively, as well as being
teachers of anatomy.
The stated objectives of the authors are to empha-
size clinical anatomy and make the Atlas more user-
friendly. They succeed in these intentions to varying
degrees. Many of the clinical images are well paired
with the anatomy specimens and effectively demon-
strate applied anatomy (e.g., dissection of the nasolac-
rimal duct paired with a macrodacryocystogram, p. 55;
surface anatomy of the forearm paired with a super-
216 Book Reviews
ficial dissection, p. 122). In some cases, however, the
clinical images are hard to relate to the anatomy, e.g.,
laparoscopic view of inguinal hernia, p. 194; a similar
view of the gall bladder paired with a specimen
showing the stomach and greater omentum, p. 197;
endoscopic view of the glottis paired with radiological
(MR) and anatomical sagittal sections of the larynx, p.
50, and they are likely to disorient and frustrate the
student.
A similar problem arises in relation to some of the
clinical notes that appear ‘‘pasted on’’ the pages among
the images. Whereas comments about ulnar nerve
compression behind the medial epicondyle, or about
breast cancer, are well paired with appropriate anatomi-
cal specimens, I could not see the reason for the
clinical notes pasted on a number of other pages. A
note about cavernous sinus thrombosis (p. 51) for
example, occurs on a page where none of the images or
labels actually show the sinus. Furthermore, the clini-
cal notes often include information that seems prema-
ture or too complex for students of anatomy. For
instance, associated with a neck dissection showing
the carotid arteries, there is a clinical note about
carotid artery bruits: ‘‘Extra sounds (extra to what?)
heard through the stethoscope. . . . Early detection of
narrowing of this essential artery is often accomplished
by color Doppler ultrasound.’’ (What is that and to what
purpose should the student track it down at this stage?)
Since the key requirement for learning is the
establishment of logical relationships or linkages, unan-
chored clinical images and notes may encourage memo-
rization of these vignettes by a novice student, rather
than promoting the facility for anatomical reasoning.
Indeed, one wonders whether an atlas is the appropri-
ate place for clinical vignettes. After all, understanding
of the structural organization of the human body is, in
itself, the most clinically relevant knowledge a course
of study in anatomy can promote, and a well-organized
atlas—even without clinical vignettes—is an appropri-
ate tool for gaining such an understanding through
dissection.
McMinn’s Atlas offers many resources that could
support such an endeavor. It is organized according to
the major parts of the body from head to toe. Although
the specimens do not illustrate comprehensively suc-
cessive stages in dissecting a particular body part, they
are logically organized and many page pairs tell an
instructive story through their composition. Superim-
posed on this framework is a classification of the pages
by color icons, which suggest the relevance of the page
to medicine, physical therapy, and ATLS and ACLS
courses (the latter acronyms are not explained). The
icons are intended to support user-friendliness, as are
the simple line drawings of many of the dissected
specimens. Structures are labeled with numbers in
both the photographs and the sketches; the number
sequence is determined by an alphabetized list of the
terms, rather than by an ordered sequence of struc-
tures in the image. Since a page may contain three or
four such lists of terms, labeling each list with the same
letter as the corresponding image would facilitate
navigation through a busy page.
A feature that runs counter to the authors’ intention
of enhancing user-friendliness is a tendency to overla-
bel the images. This is manifest in two ways. First, the
images of surface anatomy often bear labels not only
for the visible and palpable features, but also for some
deep structures that are not accessible by palpation.
For example, the vocal folds are indicated on the skin
of the neck (p. 36). Likewise, on page 28, the ‘‘parotid
duct emerging from the gland’’ is labeled on the face of
a living subject. (Paradoxically, the duct is not shown
in the companion image of a cadaver specimen.) An
anatomical note pertaining to the surface anatomy
image gives the landmarks for the duct, but the
number identifying the first landmark, the tragus, is
some distance above and in front of the actual tragus.
The numbers on the skin that are meant to indicate
the course of the duct are off the line described in the
note. But apart from the labeling errors, the rationale
for adding such information to the surface anatomy
image remains unclear; it does not provide the basis for
either dissection or the physical exam.
The second manifestation of overlabeling relates to
the sheer denseness of the information. An image of
the infratemporal fossa (⬃2” ⫻ 3” in the softcover
edition) contains 44 numbers crowded in its central
area. In larger images, structures are labeled that
cannot be seen properly and are peripheral to the main
points that can be learned from the image. Judicious
attention to labeling and the pairing and sequencing of
the images would have greatly improved the user-
friendliness and educational value of many of the
excellent images that are presented. The newly added
dissections are of good quality and are worthy compan-
ions to many of the specimens that have been retained
in the Atlas through its successive editions.
In summary, the authors have set themselves ambi-
tious objectives by focusing the Atlas on clinical
anatomy. The challenge of organizing the large volume

of information they include is considerable. A more
deliberate focus on providing support for a structured
course of study that explores the body through dissec-
tion may, in fact, have promoted the authors’ objec-
tives more effectively and lessened the risk of fragment-
ing and crowding the material. A return to the
objectives of the first edition, therefore, may encour-
age students more effectively to make use of the
excellent anatomy that can be gleaned from the rich
resources on which the Atlas is based.
Cornelius Rosse
University of Washington
Seattle, Washington
Color Atlas of Anatomy, 4th edition, by Johannes W.
Rohen, Chihiro Yokochi, and Elke Lütjen-Drecoll, with the
collaboration of Lynn J. Romrell. 486 pp., Stuttgart:
Schattauer/Baltimore: Williams & Wilkins, 1998.
$62.00.
Although I had been aware of the Rohen-Yokochi
Color Atlas of Anatomy since its first publication in 1983,
I had not examined it thoroughly until I was invited to
review the fourth edition. Had I paid this much
attention to the Atlas when its earlier editions ap-
peared, I would have incorporated it into my teaching
a long time ago and would have urged it on my
students as a primary and preferred resource to guide
them in their dissection and assist them in visualizing
anatomy. The Atlas is an outstanding scholarly, educa-
tional, and artistic achievement, deserving not only of
professional recognition and praise but widespread use
by anatomy students and teachers alike. For the
remainder of this review, I provide justification for
these extravagant remarks and try, hard as it is, to point
out some minor shortcomings to which the authors
might pay attention when they prepare the next
edition.
The overall content and organization of the Atlas,
and of its nine chapters, are designed to support the
learning of anatomy through cadaver dissection. Ow-
ing to the comprehensiveness and quality of its im-
ages, however, the Atlas also can serve as a valuable
substitute for dissection when cadavers are not avail-
Book Reviews 217
able, or when dissection is beyond the scope of an
educational program.
This is a photographic atlas of dissected cadaver
specimens. Its educational value is assured by several
notable features, which include: the uniformly high
quality and the comprehensiveness of the dissected
specimens, the sequence in which these dissections
are assembled in each chapter, the radiological images
and schematic sketches that accompany the dissec-
tions, the strategic layout of the individual and facing
pages, the attention paid to accuracy and selectiveness
of labeling, and—not least of all—the sheer pleasure
the book imparts through the beauty of its images and
the overall professionalism of the entire presentation.
The dissections were prepared in the Department
of Anatomy, University of Erlangen-Nürnberg, Erlan-
gen, Germany, and the Department of Anatomy,
Kanagawa Dental College, Yokosuka, Japan. The pre-
served specimens are of a surprisingly even quality,
displaying varying shades of a light ochre to a deep-
bronze palette, with bone and connective tissues
retaining an ivory to pearly white color. The contrast in
the specimens is excellent; even the finest branches of
the nerves and arteries (meticulously dissected) are
readily discernible and stand up to the scrutiny of a
magnifying lens (as may be verified on dissections of
the cranial nerves, for example). Vessels are enhanced
in many specimens by the injection of colored contrast
medium. Color is also applied to the surface of various
structures, using admirable restraint and excellent
judgement (e.g., posterior roots of lumbar nerves, p.
216; lymph vessels of posterior body wall, p. 312).
Applying the color to the specimen rather than to the
photograph (as is usually done in atlases), enhances
the three-dimensional quality of the specimens. The
same purpose is achieved by placing black paper tags
beneath fine branches of nerves, rendering them
identifiable even on large specimens (e.g., medial
branches of posterior rami in a dissection of the entire
back, p. 213). The imaginative use of colored probes
inserted into openings, passages, and spaces likewise
enhances appreciation of their three-dimensional rela-
tionships as they are depicted on the two-dimensional
page.
As in most atlases, the first part of each chapter
dealing with a body part begins with the relevant
bones. In this atlas, however, the systemic approach is
carried through to other organ systems. The second
part of each chapter focuses on relationships and takes
a regional approach; it proceeds, like a dissection, from