Creating the HAPS Physiology Learning Outcomes: terminology, eponyms, inclusive language, core concepts, and skills.

Learning outcomes are an essential element in curriculum development because they describe what students should be able to do by the end of a course or program and they provide a roadmap for designing assessments. This article describes the development of competency-based learning outcomes for a one-semester undergraduate introductory human physiology course. Key elements in the development process included decisions about terminology, eponyms, use of the word "normal," and similar considerations for inclusivity. The outcomes are keyed to related physiology core concepts and to process skills that can be taught along with the content. The learning outcomes have been published under a Creative Commons license by the Human Anatomy and Physiology Society (HAPS) and are available free of charge on the HAPS website.NEW & NOTEWORTHY This article describes the development of competency-based learning outcomes for introductory undergraduate human physiology courses that were published and made available free of charge by the Human Anatomy and Physiology Society (HAPS). These learning outcomes can be edited and are keyed to physiology core concepts and to process skills that can be taught along with the content.

The retrocolic fascial system revisited for right hemicolectomy with complete mesocolic excision based on anatomical terminology: do we need the eponyms Toldt, Gerota, Fredet and Treitz?

AIM: Right hemicolectomy with complete mesocolic excision (CME) requires the removal of an intact mesocolic envelope. The study aimed to determine, on the basis of macroscopic and microscopic anatomical studies, the optimal surgical dissection planes for CME to preserve fascial integrity. Unequivocal anatomical nomenclature was applied to describe the retrocolic fascial system and compared to frequently used eponyms (Toldt, Gerota, Fredet, Treitz). METHOD: Stepwise macroscopic dissections, cross-section studies and histological analysis were performed on body donors to identify the components of the retrocolic fascial system. Based on these anatomical findings, the optimal surgical dissection planes for CME were validated in laparoscopic training courses on body donors and in robot-assisted surgical procedures in patients. RESULTS: The mesocolic tissue and lymphovascular pedicles were enveloped by the ventral and dorsal mesocolic leaf (mesocolic fascia). The mesocolic fascia was attached to the parietal peritoneal fascia ('fascia of Toldt') along the parieto-mesocolic interface, and further cranially to the pre-duodenopancreatic fascia along the mesocolic-duodenopancreatic interface ('space of Fredet'). Dorsally, the parietal peritoneal fascia was separated from the anterior renal fascia ('fascia of Gerota') by the parieto-renal interface. Dissection along this interface in front of the anterior renal fascia followed by incision of the parietal peritoneal fascia at the duodenal border and opening the mesocolic-duodenopancreatic interface yielded the best macroscopic appearance of specimens and was considered optimal for CME. CONCLUSION: The retrocolic fascial system as well as the surgical dissection planes for CME can be described by clearly defined anatomical terms rather than potentially confusing eponyms.

The seminal contributions of Benedict Stilling (1810-1879) to neuroanatomy.

Benedict Stilling (1810-1879), was a prolific, prominent, and ambitious anatomist, who performed works on the organization of the nervous system for many years. He made numerous observations on the anatomy of the nervous system in various animal species. Stilling contributed to the establishment of significant foundations in the anatomy of the spinal cord, brainstem, and cerebellum. Stilling paved the way for future researchers by describing the techniques he used in his diligent studies published in his published books. In his books, which include many drawings and cadaveric images, he revealed the relationships between the structures in the nervous system. He also made significant contributions to neuroanatomy terminology by coining terms in these books. At the same time, some nuclei in the anatomy of the nervous system were later named after him as an eponym by many researchers. Therefore, Stilling's neuroanatomical works, which are still important today, should be appreciated. This article aims to emphasize his pioneering work in neuroanatomy.

Eponyms of Upper Extremity Surgical Approaches: A Historical Perspective.

Numerous eponymous surgical approaches are used in the treatment of upper extremity pathology, especially in the trauma setting. Knowledge of anatomy and planes is critical to maximize visualization, achieve anatomic reduction, and avoid iatrogenic injury to critical neurovascular structures. Understanding the history of these commonly used eponymous upper extremity approaches (Kaplan, Kocher, Boyd, Thompson, and Henry) provides a humanistic perspective of each of these surgeons' narratives, which shaped their description of anatomic approaches that have forever changed the course of hand and upper extremity surgeries, providing greater means and possibilities to treat our patients.

Emil Zuckerkandl and his Dental Tubercle (Historical Note).

One of the eponyms most frequently cited in dental morphology texts, together with the Carabelli tubercle of the first permanent maxillary molars, is the Zuckerkandl tubercle of deciduous molars. However, references about Emil Zuckerkandl in the field of dental history and this particular entity are scarce. The reason this dental eponym was pushed "into the shadows" probably lies in the many other anatomical parts (including another tubercle, the pyramidal one of the thyroids), which took their names from this great anatomist.

Bell's Palsy and the Peril of Eponyms.

The seemingly mundane management of a Bell's palsy can have devastating consequences if the diagnosis of nonidiopathic cranial nerve palsy is not kept in perspective. The case of an elderly man mislabeled by a primary care physician as having a Bell's palsy illustrates how eye physicians can prevent an adverse outcome. Unilateral incomplete eyelid exposure and ipsilateral progressive pain were this patient's main problems for roughly 18 months during which time ophthalmologists managed his corneal exposure but failed to appreciate a parotid gland tumor. Eye physicians are in a unique position to recognized if a nonidiopathic cause of seventh cranial nerve palsy exists because they manage problems with corneal exposure. Replacing Bell's palsy with the term idiopathic facial nerve palsy may heighten awareness that other causes of seventh cranial nerve palsy must be considered, but recounting an adverse outcome may also be a valuable learning experience.

A History of Anatomical Eponyms of the Ulnar Nerve.

The ulnar nerve has a long and often misunderstood history with eponym usage. We describe the history of eponym usage in the anatomy of the ulnar nerve-who, when, what, where, and how. The relevant anatomy is investigated from proximal to distal, from the Arcade of Struthers to Osborne's band, to forearm ulnar nerve to median nerve connections, to Guyon's canal. We hope to provide a historical perspective of interest, resolve any controversies in semantic definitions, and create a comprehensive library of eponymous terms related to ulnar nerve anatomy.

Percivall Pott (1713-1788) on the curvature of the spine and the French contribution.

Physicians remember the name of the surgeon Percivall Pott (1713-1788) because of the eponym "Pott's disease", described as "paralysis in the lower limbs, which is often accompanied by curvature of the spine". Pott's writings on surgical subjects are far vaster. For example, he described the fracture-dislocation of the ankle, or Pott's fracture, and determined the cause of scrotum cancer in chimney sweeps. He attributed this disease to contact with tar that contaminated the clothing of workers, often very young children because they were small enough to fit into chimney conduits. His work led to the first law addressing the employment of children. After a brief account of Pott's life, this article presents the description of Pott's paraplegia, for which both Jean-Martin Charcot and Yvonne Sorrel-Dejerine paid him homage. The contribution of some of his predecessors and of French contemporaries is highlighted. Pott was also a pioneer in neurosurgery, describing the non-symptomatic interval between cranial trauma and coma and the indication for trepanation to remove a haematoma.

Jean-Alexandre Barré: Babinski's brilliant student.

Guillain-Barré Syndrome, (GBS), is a popular eponym that comes from a paper written in 1916 by Doctors. Guillain, Barré, and Strohl. Its spectrum has been enlarged considerably since the first description of it. Jean Alexandre Barré was a French neurologist, whose name is still widely associated with that of Georges Guillain, (1876-1961). He is also known for the leg manoeuvre. As Joseph Babinski's brilliant student, (1857-1932), we wanted to briefly retrace his biography in order to highlight some of the salient points within it and subjects that are topical for young neurologists today.

François-Amilcar Aran (1817-1861) and the recognition of spinal muscular atrophy.

Jean-Martin Charcot coined the term Duchenne-Aran atrophy. The inversion of names compared to standard practice shows the respect Charcot had for Guillaume Duchenne de Boulogne, who had encouraged him to study nervous disease. Using innovative localised electrification, Duchenne identified various types of muscular atrophy which he distinguished from paralysis. But it was François-Amilcar Aran who, published the observations that he had compiled and studied with Duchenne's help first in 1848 and again in 1850. The result was the seminal articles that led to the eponym "Aran-Duchenne hand". Focusing on the second half of the nineteenth century in Paris, this article will explore how knowledge evolved around the nosography of different types of muscular atrophy, starting with Duchenne and Aran and then with Charcot and his students, notably Albert Gombault, Joseph Babinski, Fulgence Raymond, and Jean-Baptiste Charcot. This historical overview is accompanied by a biographical account aimed at rescuing Aran from the sea of oblivion and covering the other subjects he wrote about, especially in neurology: including cerebral hydatid disease, skull base fractures and "cancer of the dura mater".

Gayet-Wernicke Syndrome: The eye surgeon in a French neurologic eponym.

Gayet-Wernicke syndrome is an eponym mainly used in France. In this article, we revisit Charles Gayet's (1833-1904) speciality and his patient example that gave rise to the eponym. Charles Gayet attributed the anatomical lesions to inflammation. However, they were mainly due to hemorrhage, as Wernicke's term "polioencéphalite supérieure aiguë hémorragique" (polio-encephalitis superior haemorrhagica) explicitly indicates. The pathology of Gayet's case did not involve the mamillary bodies, colliculi, or cerebellum. Gayet did not mention abnormal memory functions, which are also cardinal signs of Wernicke-Korsakoff's disease. We argue that the Gayet-Wernicke eponym is not merited and that the more common international term "Wernicke-Korsakoff syndrome" should be used in France as elsewhere in the world.

Arnold Kirkpatrick Henry (1886-1962) and his eponym (Master Knot of Henry): a narrative review.

PURPOSE: The aims of this review were to form a more precise description for Master Knot of Henry (MKH), and to modify classifications related to interconnections between flexor hallucis longus (FHL) and flexor digitorum longus (FDL) for showing all configurations in the literature. METHODS: A literature search was performed in main databases to obtain information related to anatomical definitions and variations of MKH. The search was carried out using the following keywords: "Master Knot of Henry", "Chiasma plantare", "Flexor hallucis longus" and "Flexor digitorum longus". Information extracted from the studies was: sample size, numerical values, classifications, variation types, incidence of types, anatomical definitions of MKH, year of publication, and type of study. RESULTS: This study proposes that MKH should be defined as the intersection territory where FDL crosses over FHL in the plantar foot. The postchiasmatic plantar area located at distal to MKH (the narrow space between MKH and the division of FDL) should be termed as the triangle of Henry. Moreover, the classification systems showing different configurations related to interconnections situated at Henry's triangle were updated as eight types to present all forms in the literature. CONCLUSION: Our definitions may assist in determining the precise anatomical boundaries of MKH, and thus facilitate the use of MKH as a surgical landmark. In addition, our modified classification systems covering all variations in the current literature may be helpful for surgeons and anatomists to understand formations of the triangle of Henry, and the long flexor tendons of the lesser toes.

[Persecution, expulsion and extermination of German-speaking neurologists during the NS era: attempt at an assessment]. / Verfolgung, Vertreibung und Vernichtung deutschsprachiger Neurologinnen und Neurologen während der NS-Zeit: Versuch einer Bewertung.

Some 90 years after the beginning of the Nazi regime, the German Neurological Society (DGN) commissioned an investigation into the extent to which persecution, expulsion and extermination during the "Third Reich" also affected neurologists. In total, the biographies of 61 mostly Jewish physicians and scientists, of whom more than 70% were members of the neurological association of the time, could be analyzed. Most of them emigrated, a few remained in Germany or Austria despite persecution, and nine died in the Holocaust or by suicide. The racistically motivated expulsion affected all age groups, especially those who were 30-60 years old in "middle" positions. In close connection with Nazi legislation, three waves of emigration can be distinguished (1933-1934, 1935-1937, 1938-1939) and the clearly preferred destination country was the USA (64.7%). Younger age, knowledge of a universal language, reliable family and academic connections as well as internationally recognized publications, could make it easier to start a career in the country of exile. It was not uncommon for those who were involved in neurological fields before emigration to turn to basic science or psychiatry afterwards. The general "brain-drain"/"brain gain" hypothesis must be expanded by analyses on the biographical microlevel in order to illustrate the difficulties emigrants encountered when trying to start a new career and to publicize a sometimes unsuccessful acculturation. Not a single neurologist returned to Germany and, as far as can be assessed, any compensation, if at all was low. The critical assessment of the racistically motivated persecution between 1933 and 1945 can today be an occasion for the DGN and its members to reflect on collegiality as a value as well as to become more aware of structurally related discrimination and injustice and to counteract it in a timely manner.

[Classification of systemic vasculitis: evolution from eponyms to modern criteria].

Systemic vasculitis is a manifold group of systemic autoimmune diseases characterized by the inflammation of the blood vessels. The first clinical cases of systemic vasculitis were described in the Middle Ages, and most of the currently recognised nosological forms were reported in the first half of the 20th century. The first attempt to create a united classification of vasculitis was performed by P. Zeek in 1952. In the following decades accumulation of the data on the etiology and pathogenesis of different vasculitis guided researchers from different countries in their attempts to improve classification. The main principles of classification were the size of the affected blood vessels, disease etiology and pathogenesis. In 1990 American College of Rheumatology (ACR) published classification criteria for seven forms of the systemic vasculitis, that gave a significant contribution to the conduction of large-scale studies in this field. However, the first international nomenclature of vasculitis was developed only in 1994 during the Consensus Conference in Chapel Hill. Revised and augmented version of this nomenclature was created in 2012 and is still valid. An important step in the development of the classification of vasculitis was a joint project of ACR and EULAR aimed to develop new diagnostic and classification criteria for vasculitis (DCVAS). The first result of this project are the new classification criteria for granulomatosis with polyangiitis, microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis published in 2022. In general, the evolution of the classification of vasculitis occurs under the influence of the progress in the understanding of their etiology and pathogenesis.

Preserving the eponym: Klinkenbergh technique for bronchial stump suturing.

The technique for bronchial stump suturing following lung resection which is currently applied in the Department of Thoracic Surgery at the University Hospitals Leuven, Belgium owes its name to the Dutch surgeon Dr. Klinkenbergh (1891-1985). A true pioneer of cardiothoracic surgery in Europe, Dr. Klinkenbergh dedicated himself to the surgical treatment of pulmonary tuberculosis. His work was praised by his peers for his precision and the reasoning behind every gesture. The Klinkenbergh technique consists in performing two running sutures which cross each other 'in the same manner as the laces of a shoe' to close the bronchus, limiting the occurrence of broncho-pleural fistulas. In our experience with more than 100 patients in the last 5 years (2016-2020) who underwent open pneumonectomy for benign or malignant disease, less than 2% developed post-operative broncho-pleural fistulas.

Commentary: The diagnostic label of Asperger's in historical perspective - a commentary on Kehinde et al. (2021).

Eponyms and diagnoses that originate from the era of National Socialism have been re-evaluated as a result of historical research which reveal the unethical research and treatment behind the diagnosis. This article presents the case of Asperger's as a distinct diagnostic category and reflects on historical research which has provided further nuance behind the origins of this diagnosis.

The extension, importance and function of eponymous terms in forensic medicine.

Forensic medicine is a multidisciplinary medical field that cooperates with a number of complementary medical disciplines and receives knowledge from many other non-medical disciplines. Cooperation with forensic toxicologists and forensic radiologists is routine in forensic practice, as well as with traffic engineers, forensic ballistics, forensic biomechanics, anthropologists, geneticists, and forensic entomologists is well established in expert practice and scientific research. Our work focuses on the connection of forensic medicine with linguistics. The essence of the article is the evaluation of the function, importance and use of eponymic terms in the field of forensic medicine. Total of 28 eponymous terms were searched and analysed in four Czech written textbooks of forensic medicine from different time periods (published in years 1937, 1976, 1999 and 2015/2016). The occurrence and extension of eponymous terms in field of forensic medicine is presented. The origin, the authorship, advantages or disadvantages of eponymous terms are discussed. Function of these terms in professional communication, in communication with police, in court, and with lay people is evaluated.

"Stat Rosa Pristina Nomine, Nomina Nuda Tenemus": The Many Syndromes, Diseases, and Anatomic Structures Bearing Jean-Martin Charcot's Name.

The sheer magnitude of Jean-Martin Charcot's contributions to neurology, pathology, psychiatry, and internal medicine has allowed for the common usage of eponyms bearing the master's name in recognition of his work. However, these are so numerous that confusion has naturally arisen concerning the exact nature of each eponym, allowing for different specialists to refer to completely different ailments or symptoms, while using the very same expression. Previous compilations of his eponyms were often incomplete. Therefore, the authors aimed to bring some clarification into the nature and origin of each known eponym with Charcot's name.

Abdominal Physical Signs and Medical Eponyms: Part I. Percussion, 1871-1900.

BACKGROUND: Percussion is derived from the Latin word to hear and to touch. Percussion of the abdomen is used to detect areas of tenderness, dullness within an area of tenderness suggestive of a mass, shifting dullness representing fluid or blood, splenic, hepatic and bladder enlargement, and free air in the peritoneum. Covered are abdominal signs of percussion attributed as medical eponyms from the time-period beginning in the mid-late nineteenth century. Described is historical information behind the sign, descriptions of the sign, and implication in modern clinical practice. DATA SOURCES: PubMed, Medline, online Internet word searches, textbooks, and references from other source text. PubMed was searched using the Medical Subject Heading (MeSH) of the name of the eponyms and text words associated with the sign. CONCLUSION: Percussion signs defined as medical eponyms were important discoveries adopted by physicians prior to the advent of radiographs and other imaging and diagnostic techniques. The signs perfected during this time-period provided important clinical cues as to the presence of air within the peritoneum or rupture of the spleen.

Abdominal Physical Signs and Medical Eponyms: Part II. Percussion and Auscultation, 1924-1980.

BACKGROUND: Percussion and auscultation are derived from the Latin words to touch and hear, respectively. Covered are abdominal percussion signs and ausculatory signs discovered from 1924 to 1980. Signs ascribed as medical eponyms pay homage to these physicians who provided new and unique insights into disease. DATA SOURCES: PubMed, Medline, online Internet word searches, textbooks, and references from other source text. PubMed was searched using the Medical Subject Heading (MeSH) of the name of the eponyms and text words associated with the sign. CONCLUSION: Many of these signs have been discarded because of modern imaging and diagnostic techniques. When combined with a high clinical suspicion, positive results using percussion combined with palpation is a useful bedside technique in detecting splenic enlargement. Thus, some of these maneuvers remain important bedside techniques that skilled practitioners should master, and along with a meaningful history, provide relevant information to diagnosis. It is through learning about these signs that we gain a sense of humility on the difficulty physicians faced prior to the advent of techniques that now allow us an easier way to visualize and diagnose the underlying disease processes.