Publications of Ann C. Zumwalt

%% Journal Articles   
   Author = {Zumwalt, AC},
   Title = {The effect of endurance exercise on the morphology of muscle
             attachment sites},
   Journal = {Journal of Experimental Biology},
   Volume = {209},
   Pages = {444-454},
   Year = {2006},
   Month = {February},
   Keywords = {muscle attachment sites • entheses • exercise
             effects • morphology},
   Abstract = {The morphology of muscle attachment sites, or entheses, has
             long been assumed to directly reflect in vivo muscle
             activity. The purpose of this study is to examine whether
             variations in muscle activity that are within normal
             physiological limits are reflected in variations in external
             attachment site morphology. This study tests the hypothesis
             that increased muscle activity (magnitude, number and
             frequency of loading cycles) results in the hypertrophy of
             muscle attachment sites. The attachment sites of six limb
             muscles and one muscle of mastication (control) in mature
             female sheep were measured and compared in exercised
             (weighted treadmill running for one hour/day for 90 days)
             and sedentary control animals. Attachment site surface
             morphology was assessed by quantifying the size (3D surface
             area) and complexity (fractal dimension parallel and
             perpendicular to soft tissue attachment) of the surfaces.
             Results of this study demonstrate no effect of the exercise
             treatment used in this experiment on any measure of enthesis
             morphology. Potential explanations for the lack of exercise
             response include the mature age of the animals,
             inappropriate stimulus type for inducing morphological
             change, or failure to surpass a hypothetical threshold of
             load for inducing morphological change. However, further
             tests demonstrate no relationship between muscle size and
             either attachment site size or complexity in sedentary
             control animals as well. The results of this study indicate
             that the attachment site morphological parameters measured
             in this study do not reflect muscle size or activity. In
             spite of decades of assumption otherwise, there appears to
             be no direct causal relationship between muscle size or
             activity and attachment site morphology, and reconstructions
             of behavior based on these features should be viewed with
   Key = {fds44402}

   Author = {A.C. Zumwalt and Marks, L.M. and Halperin, E.C.},
   Title = {Integration of Gross Anatomy into a Clinical Oncology
   Journal = {Academic Medicine},
   Year = {2006},
   Abstract = {The amount of time devoted to teaching gross anatomy to
             medical students is declining. This topic remains critically
             important for some medical students, especially those
             seeking training in anatomy-laden specialties. We describe
             here a course currently being offered in the Department of
             Radiation Oncology in the Duke University School of Medicine
             which expands anatomy education into the medical school
             clinical years. The audience for this course consists of
             medical students rotating in Radiation Oncology (n=2-4 per
             month) and the residents (n=9) and clinical faculty (n=17)
             in the Department of Radiation Oncology. Anatomists and
             Radiation Oncology residents together present monthly case
             conferences and cadaver-based demonstrations about the
             relationships between a tumor’s anatomical location and
             its symptoms, patterns of spread and treatment
             considerations. Anonymous surveys were distributed to course
             participants to assess the success of the course. Survey
             results indicate that the participants find the course to be
             interesting, relevant and of high quality. This course is
             therefore favored by students, residents and faculty as a
             way to supplement gross anatomy education during training
             for a specialty in which anatomy knowledge is
   Key = {fds49858}

   Author = {Zumwalt AC and Hamrick MW and Schmitt D},
   Title = {A force platform for measuring the ground reaction forces in
             small animal locomotion},
   Journal = {Journal of Biomechanics},
   Year = {2005},
   Month = {Winter},
   url = {},
   Keywords = {force plate • mouse • rodent • kinetic
   Abstract = {The importance of kinetic force plate studies of locomotion
             in small animals has grown recently with the increasing use
             of rodent models for studies of musculoskeletal diseases.
             However, the force plates for use with animals much smaller
             than a cat are difficult to design and use. Here we present
             data on a commercially available small force plate that
             accurately collects whole-body and, in a modified form,
             single-limb ground reaction forces in mice. The method used
             here is convenient, inexpensive, and readily adaptable for
             use with a variety of small species.},
   Key = {fds44401}

   Author = {Zumwalt, AC},
   Title = {A new method for quantifying the complexity of muscle
             attachment sites},
   Journal = {The Anatomical Record, Part B: The New Anatomist},
   Volume = {286B},
   Pages = {21-28},
   Year = {2005},
   Month = {September},
   url = {},
   Keywords = {muscle attachment sites • entheses • fractal
             analysis • morphological complexity},
   Abstract = {Muscle attachment site morphology may have valuable use for
             reconstructing activity patterns in individuals from
             historic populations or extinct species. The skeletal
             locations where muscles and tendons attach are
             morphologically very complex, and variations in this
             morphology may reflect stresses experienced by these
             attachment sites as a result of muscular contractions.
             However, existing methods for assessing attachment site
             complexity are qualitative and subjective. This paper
             describes a new method for quantifying attachment site
             complexity in which attachment sites are scanned with a 3D
             laser scanner and the morphological complexities of their
             surfaces are quantified using fractal analysis. The method
             described here documents the complexity at specific
             transects along six limb attachment sites in adult female
             sheep (Ovis aries), and variations in complexity within
             attachment sites are explored. Overall trends indicate that
             most of the attachment sites examined here are more complex
             at their peripheries than at their centers, indicating that
             these sites experience more varied loads at the peripheries
             of the tendon attachments. Exceptions to this trend are
             noted and all functional implications are discussed. This
             method provides the first opportunity to explore variations
             in morphological complexity within attachment sites.
             Assuming a relationship between tensile strains and bony
             morphology exists, this method provides a new tool to
             explore the strain environments of muscle attachment
   Key = {fds44400}

   Author = {Richstmeier JT and Zumwalt AC and Carlson, EJ Epstein CJ and Reeves, RH},
   Title = {Craniofacial phenotypes in segmentally trisomic mouse models
             for Down syndrome},
   Journal = {American Journal of Medical Genetics},
   Volume = {107},
   Number = {4},
   Pages = {317-324},
   Year = {2001},
   Key = {fds29673}

%% Papers Presented/Symposia/Abstracts   
   Author = {A.C. Zumwalt},
   Title = {Beyond the first year: Focused anatomy instruction during
             the clinical years of medical school},
   Year = {2006},
   Month = {July},
   Key = {fds49859}

   Author = {A.C. Zumwalt},
   Title = {Three specialized anatomy courses for advanced medical
             students: the impact of focused anatomy instruction},
   Year = {2006},
   Month = {April},
   Key = {fds49860}

   Author = {A.C. Zumwalt},
   Title = {Development of a New Clinical Anatomy Course: Issues,
             Inspirations and Ideas},
   Series = {American Association of Clinical Anatomists
   Year = {2005},
   Month = {July},
   Key = {fds44488}

   Author = {Zumwalt, AC},
   Title = {Endurance exercise does not affect the morphology of muscle
             attachment sites in adult female sheep (Ovis
   Series = {Experimental Biology Annual Meeting Supplement},
   Year = {2005},
   Month = {April},
   Key = {fds44403}

   Author = {Zumwalt AC and Schmitt D and McCormick J and Hamrick
   Title = {Locomotor biomechanics and muscle-bone interactions in
             myostatin-deficient mice},
   Series = {Experimental Biology Annual Meeting Supplement},
   Year = {2005},
   Month = {April},
   Key = {fds29670}

   Author = {Zumwalt AC},
   Title = {A new method to quantify the 3D morphology of bone surfaces,
             with application to muscle enthesis rugosity},
   Series = {Society for Integrative and Comparative Biology Annual
             Meeting Supplement},
   Year = {2004},
   Key = {fds29671}

   Author = {Zumwalt AC and Lieberman DE and Ruff CB},
   Title = {Too good to be true? Testing the relationship between muscle
             function and attachment site morphology},
   Series = {Society for Integrative and Comparative Biology Annual
             Meeting Supplement},
   Year = {2003},
   Key = {fds29672}

   Author = {Zumwalt, AC and Ruff, CB and Lieberman, DE},
   Title = {The influence of exercise on muscle insertion scars in
   Series = {American Journal of Physical Anthropology Supplement
   Year = {2001},
   Key = {fds29674}

   Author = {Zumwalt, AC and Ruff, CB and Wilczak, CA},
   Title = {Primate muscle insertions: What does size tell
   Series = {American Journal of Physical Anthropology Supplement
   Year = {2000},
   Key = {fds29675}