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NERVOUS SYSTEM AND SPECIAL SENSES

Table of content

NERVOUS SYSTEM AND SPECIAL SENSES..................................................................................1

AIMS:........................................................................................................................................2

OBJECTIVES:..............................................................................................................................2

MODULE OUTCOMES:...............................................................................................................2

PRE-REQUISITES:.......................................................................................................................2

TRANSFERABLE SKILLS:.............................................................................................................2

MODULE FORMAT....................................................................................................................2

MODULE STRUCTURE:..............................................................................................................2

COURSE CONTENT....................................................................................................................2

LECTURES:.............................................................................................................................2

PRACTICAL:...........................................................................................................................2

TUTORIALS:...........................................................................................................................2

PROBLEM BASED LEARNING (PBL):.......................................................................................2

CLINICAL PRESENTATION:.....................................................................................................2

ASSESSMENT:............................................................................................................................2

INSTRUCTORS INFORMATION:..................................................................................................2

Detailed content: lecture..........................................................................................................2

Practical....................................................................................................................................2

Tutorial.....................................................................................................................................2

Self Direct Learning..................................................................................................................2

Clinical presentation:................................................................................................................2

PBL case in neurology module.................................................................................................2

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Chief and coordinator: Dr. Hussein MalibaryEmail: [email protected]

Coordinator: Dr. Maha Hegazi E mail: [email protected]

Module length SingleSemester SixYear ThreeTimetabled hours 46L/ 9T/ 11P/ 2 CL/1 PBL.Student self study 6 SDL

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mailto:[email protected]

mailto:[email protected]

Undergraduate Program Learning Outcomes

CodeLearning Outcomes

KnowledgeBy the end of the program the graduate will be able to:

A1 Describe normal human development across the life-span and how these affect normal structure and function.

A2 Describe normal structure and function of the major systems and how they interrelate.

A3 Describe the molecular, biochemical and cellular basis essential for maintaining homoestasis.

A4 Demonstrate knowledge of the basic medical sciences that explain causes and mechanisms of disease.

A5 Describe the alterations in structure and function of major body systems as a result of illness or injury.

A6 Demonstrate knowledge and understanding of the pharmacological principles of treatment using drugs, their efficacy in the management and symptomatic relief of diseases, as well as their side effects.

A7 Discuss the implications of basic ethical principles, including confidentiality, informed consent, truth telling, and justice, for the care of patients.

A8 recognize the legal background of medical practiceA9 Explain the causes and mechanisms of intoxication.A10 Describe the role of family, community, and culture as factors influencing

patient presentations, interpretations of illness episodes and adherence to treatment episodes.

A11 Demonstrate knowledge and understanding of the natural history of disease and relationships with risk factors and disease prevention.

A12 Recognize and discuss the principles of disease surveillance and screening, disease prevention, communicable disease control, health promotion, and health needs assessment.

A13 Describe strategies to support life-long learning via print and electronic sources to assist in making diagnostic and treatment decisions and to remain current with advances in medical knowledge and practice.

A14 Demonstrate knowledge of how to use the basic medical sciences and clinical skills for clinical decision making and problem solving in the care of patients.

A15 Recognize the scientific basis of health, disease, and medicine in the management of common and high impact conditions in the society.

A16 Demonstrate knowledge of the functional approach to managing chronic conditions, including knowledge of the impact of chronic illness on function.

A17 demonstrate basic knowledge of the global health care delivery system in the community including physicians, hospitals, outpatient centres, health agencies and the role of community agencies in that system.

A18 Recognize the management of common emergencies and the initial and the life saving management steps for other emergencies.

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A19 Identify the "Red flags" indicating seriousness in the different clinical presentations.

Cognitive SkillsBy the end of the program the graduate will be able to:

B1 Recognize, define and prioritize problems.B2 Demonstrate the ability to acquire new information and data. B3 Critically appraise validity and applicability of acquired information to

one’s professional decisions.B4 Organize, record, research, present, critique, and manage clinical

information.B5 Recognize the limitations of knowledge in medicine and the importance of

triangulation of evidence before reaching a decision.B6 Evaluate the patient’s medical problems.B7 Formulate accurate hypotheses to serve as the basis for making diagnostic

and treatment decisions.B8 Reflect on one’s thinking process and decisions and apply rational

processes.B9 Use appropriate intellectual strategies to deal with uncertainties when they

arise.B10 Demonstrate an understanding of research methodology.B11 Formulate research questions.B12 Draw research hypotheses.B13 Choose appropriate research methodologies and designs.B14 Select appropriate methods of data collection.B15 Analyse and interpret collected data.

Interpersonal Skills & ResponsibilityBy the end of the program the graduate will be able to:

C1 Display the personal attributes of compassion, honesty, and integrity in relationships with patients, families, communities and the medical profession.

C2 Exhibit appropriate value for the sensitive nature of the doctor/patient relationship and the importance of active listening, with attention to the patient’s familial, cultural, and spiritual circumstances.

C3 Demonstrate professionalism and high ethical standards in all aspects of medical practice, specifically competence, honesty, integrity, respect for others, professional responsibility and social responsibility.

C4 Exhibit a capacity for self-evaluation, moral reflection and ethical reasoning to form the basis for a self-directed, lifelong engagement in the responsible, committed, compassionate practice of medicine.

C5 Apply the four principles of ethical and legal knowledge, namely respect for autonomy, beneficience, non-maleficience and justice.

C6 Demonstrate awareness and understanding of the legal and professional responsibilities; and report inappropriate medical practice.

Communication, Information Technology & Numerical SkillsBy the end of the program the graduate will be able to:

D1 work effectively as part of a health care team

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D2 communicate effectively with patients, their families and colleagues, both verbally and in writing

D3 retrieve information by all means including electronicallyD4 present information clearly in written, electronic and oral formsD5 work within a changing, multi-task environment

Psychomotor SkillsBy the end of the program the graduate will be able to:

E1 Elicit accurate comprehensive and focused medical history by employing techniques that facilitate the patient’s sharing of information.

E2 Conduct a both effective and accurate comprehensive and focused physical examination.

E3 Formulate a differential diagnosis.E4 Select the appropriate laboratory tests and radiographic studies and interpret

their results and use them in making diagnostic and treatment decisions.E5 Formulate and implement a plan of care for both the prevention and

treatment of disease.E6 Educate patients about their health problems and to motivate them to adopt

health promoting behaviors.E7 Use pharmacotherapeutic agents and other therapeutic modalities

effectively.E8 Demonstrate appropriate technique for performing Basic Life Support and

Advanced Life Support.E9 Undertake tasks to initiate and be involved in the care of acutely ill patients.

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Goal:

The goal of this module is to provide all future physicians, regardless of specialization, the skills to recognize neurological and psychiatric problems and to understand treatment strategies; and to facilitate the professional development of students to become doctor responsive to such needs

AIMS:The aim of this module is to:

1. Identify the histology of the nervous system.2. Understand the overall organization of the CNS and, the fundamental relation

between nervous system structures and function as illustrated by both normal and pathological conditions.

3. Understand the structure and organization of the special senses in relation to normal and abnormal functions.

4. Acquire skills and working knowledge and understanding of the principles and concepts applicable to CNS & special senses in general.

5. Integrate materials from previous modules should give rise to an appreciation of the functional level of the CNS, with particular emphasis on the processing of sensory information and generation of motor out put.

Objectives

On completion of this module the student should be able to:

1. Demonstrate a systematic and coherent knowledge of the anatomical and physiological functioning of the central nervous system and special senses (CNS & SS), recognise the biochemical importance of the neurotransmitters and brain metabolism, and critically appraise the implications of any alteration in the normal control points with respect to pathology, and drug treatment.

2. Discuss and analyses structure-function relationships of the central nervous system.

3. Recognise the basic physiological processes involved in nociception and the possible mechanisms involved in endogenous analgesia. In addition to the pharmacological control of pain, sedatives and hypnotics.

4. Describe the anatomical structure of the eye and ear, and explain the function of each.

5. Describe the mechanism of voluntary movements, recognise the important centres involved and explain the effects of their lesions.

6. List the higher intellectual functions, discuss the mechanism of each, and explain the effects of oxidative stress, demyelination and degenerative diseases on the integrity of the nervous system.

7. Critically evaluate knowledge from a range of sources (lectures, tutorials, practical, problem based learning, clinical presentation, and self directed learning) and utilise it to exercise judgement to evaluate altered functions, and drug therapy.

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8. Accept accountability for achieving personal and/or group outcomes by developing a variety of professional skills (self-directed learning, PBL, and practical sessions).

MODULE OUTCOMES:

It is expected that you will develop the skills to: Localize lesions to specific levels of the central nervous system based on application of basic principles to neurological symptomsRecognize pathological changes in nervous system tissue that underlie neurological diseasesUnderstand the pharmacological therapeutics used to treat nervous system disordersRecognize the psychosocial aspects of patient disabilitiesRecognize the characteristics of behavioral disorders and their treatment that form the basis of psychiatry.

PRE-REQUISITES:Before the students begin the CNS module they should demonstrate the ability to understand:

1. The basic topography of the head and neck and its development.2. Mechanism of action potential and its conduction.3. Synaptic transmission – neurotransmission and receptor in the CNS, PNS, and

ANS and the role of drugs.4. The neuromuscular junction – structure and function- and the neuromuscular

disorders.5. Mechanism of muscle contraction.6. Muscle structure and mechanism of locomotion.7. Connective tissue layers.

TRANSFERABLE SKILLS:

By the end of this module, the student should demonstrate the ability to:1. Assimilate and integrate information from lectures, practical sessions,

tutorials, clinical presentation sessions, and independent learning activities.2. Gain practical skills associated with the dissection of the cadaver and the

examination of the living.3. Interpret two – dimensional images of the CNS from radiographic techniques.4. Explain he pathology of the CNS and drug action in relation to the underlying

processes.

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MODULE FORMAT

The module will consist of lectures, laboratories, problem-based learning in small group session (PBL), and case presentations. These activities are coordinated to provide an integrated, stimulating, and complete course of study. Lectures provide important overviews and insight into module material and focus attention on faculty-designated topics. They may also include other important information involving exam. The student should realize that lectures require further reading to adequately understand each topic. Relevant selections from texts should be located by chapter titles. Information from texts may appear on exams when specific reference is made to it. Laboratories are important interactive learning sessions that are critical for understanding neuroanatomical and clinical concepts. Small group sessions are also interactive periods that require student participation. Both the lab and PBL/case presentations provide an active learning environment in which the student challenges himself to understand and apply module concepts. Objectives listed at the end of each handout from the lectures and laboratories should guide the student in what is considered most important to each topic. In approach to studying, the student should start with these objectives and organize his studies around them.

MODULE STRUCTURE:

This module is composed of:

Course NO.

Course Title Module units Credit hoursL T/S P CL/

PBLSDL

CNS 301 Central nervous system & special senses

46 9 11 2/1 6 6

Principles and concepts applicable to the structure and function of the central nervous system and special senses will be studied by dissection and examination of prosected parts or models of the human body.

Lectures on general aspects of the CNS and special senses will be given for the purpose of conveying deeper understanding of the general concepts and principle underlying normal and abnormal structure and function during the module.

Practical session will be timetabled to enforce theoretical aspects of the subject but will be used for demonstrating skills / procedures and the use of electronic material will be encouraged.

The purpose of the Practical sessions is to provide an active learning experience for the student to explore the basic principles of neuroanatomy. They are crucial to understanding module concepts and they provide a basis for understanding and solving clinical cases involving neurological disorders.

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The Practical sessions are conducted in small groups that depend on collaborative learning in which interaction, sharing of knowledge and discussion of multiple perspectives are essential components of learning.

SMALL GROUP CASE SESSIONS FOR TUTORIAL AND CLINICAL PRESENTATIONS

Tutorial on special topics will be organized for the purpose of enriching the student’s knowledge and overall understanding of CNS & special senses. It allow the students to apply newly acquired knowledge and it is suitable for higher order cognitive objectives Case sessions are an integral part of this module. In which their will be interesting and instructive case lessons. They integrate clinical and basic science information and they provide an active learning environment that encourages the student discussion. This requires that the student should prepare adequately for each session and that they participate with other students in a group team in developing answers. One or two case histories will be used each session and a list of questions will be provided for the student. The student will work with a group of 5 students to prepare answers before the session. On the morning of each session, groups will be chosen randomly to discuss answers. The goal is to discuss the rationale for the student answer in an informal atmosphere where others can contribute to discussion. This provides the opportunity to understand how diagnosis and treatment are determined through the interaction of physicians who have access to specialized patient information.

Problem based learning sessions will promote self directed learning and thus, time will be available for further study by the students using all available learning resources including electronic learning materials.

CROSS MODULAR THEMES

Concurrent and previous modules:1. The work on musculoskeletal system will be closely related to he functional

aspects of the CNS.2. The action of the drugs on autonomic nervous system will closely followed in

appropriate parts of the module.3. The work on the histology of nerves and ganglia will be closely related to this

module.4. The work and knowledge carried out in previous core courses and modules of

the second and third years.

COURSE CONTENT

LECTURES:

Lecture number

Lecture name Department

1 Week 1 Development of the central nervous system Anatomy

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2 Week 1 Functional organization of the CNS Physiology

3 Week 1 Anatomy of the brain Anatomy4 Week 1 Metabolism of the brain Biochemistry 5 Week 1 Anatomy of the brain 2 Anatomy6 Week 1 Cells of the CNS, their response to injury &

hydrocephalusPathology

7 Week 1 Ventricular system & CSF Anatomy8 Week 1 Neurotransmitters 1 Biochemistry

SDL1 Week 1 Cerebrospinal Fluid in Health and Disease

Biochemistry

9 Week 1 Blood supply to the brain and spinal cord Anatomy10 Week 1 Neurotransmitters 2 Biochemistry11 Week 1 Anatomy of the spinal cord and ascending

tracts and brain stem lemniscal system (sensory pathway in the brain stem)

Anatomy

12 Week 1 Sensory receptors, Sensory transduction, and Information processing

Physiology

13 Week 1 Sensory cortex and thalamus Anatomy SDL2 Week 2 Classification of somatic sensation

& physiology of painPhysiology

14 Week 2 The anatomy of the eye Anatomy15 Week 2 Anterior chamber accommodation Physiology16 Week 2 Light reflex, dark adaptation, and the

electrophysiology of Rods and ConesPhysiology

17 Week 2 Anatomy of the ear, and Auditory pathways Anatomy18 Week 2 the pharmacological control of pain Pharmacology19 Week 2 physiological role of the external and

middle ear in the process of hearingPhysiology

20 Week 2 Cochlea (Changing sound energy into neural activity) Neural Mechanisms for Pitch and Loudness Discrimination

Physiology

21 Week 2 Anesthesia (General and Local) Pharmacology

22 Week 2 Anatomy of the motor cortex, and Brain stem1

anatomy

SDL3 Week 2 Functions of thalamus, Somatosensory cortex, and Somatosensory association areas

Physiology

23 Week 3 Neurophysiological principles of synaptic transmission (interneuronal communication

Physiology

SDL Week 3 Anatomy of the Basal Ganglia and Cerebral White Matter

Anatomy

24 Week 3 Anatomy of the Brain Stem 2, and motor descending tracts)

Anatomy

25 Week 3 Cortical Control of Motor Functions, and Physiology

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functions of motor descending tracts 26 Week 3 CNS reflexes (Spinal cord reflexes) Physiology

27 Week 3 The stretch reflex and skeletal muscle tone Physiology

28 Week 3 Anatomy of the Cerebellum and the vestibular system

Anatomy

29 Week 3 Motor function of the cerebellum & basal ganglia

Physiology

30 Week 3 Imaging of the central nervous system including (structural and functional magnetic resonance, positron emission tomography and the measurement of brain electrical and magnetic fields).

Anatomy & Radiology

31 Week 4 Posture and equilibrium (vestibular apparatus and the cerebellum)

Physiology

SDL Week 3 Anatomy of the limbic system Anatomy32 Week 4 Hypnotics / sedatives Pharmacology 33 Week 4 Physiology of the Limbic system, Reticular

activating system, and reticular formation Physiology

34 Week 4 Infectious diseases of the nervous system Pathology35 Week 4 Physiology of speech Physiology36 Week 4 CNS neoplasms Pathology37 Week 4 para. Para 38 Week 4 Functions of the hypothalamus. Physiology39 Week 4 Physiology of sleep Physiology 40 Week 4 para Para 41 Week 4 Oxidative stress & neurodegenerative

disordersbiochesisry

42 Week 4 Demyelinating and Degenerative diseases Pathology43 Week 4 Cognitive function of the brain Physiology44 Week 4 para Para 45 Week 4 Memory processes and Learning theory Physiology

46 Week 4 CNS vascular diseases & trauma PathologySDL Week 4 Antipsychotic agents Pharmacology

PRACTICAL:

Practical number

Content Department

Week 1 P 1 Organization of nervous system, meninges & external features of the cerebral hemispheres.

Anatomy

Week 1 P 2 CSF Biochemistry Week 1 P 3 Examination of cranial nerves Physiology Week 2 P 4 Histology of cerebral & cerebellar cortex,

histology of eye and earAnatomy

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Week 2 P 5 Visual acuity, fundus examination perimeter, and test for color vision

Physiology

Week 2 P 6 Internal structures of the cerebral hemispheres & lateral ventricle.

Anatomy

Week 2 P 7 Hearing tests and eudiometry PhysiologyWeek 3 P 8 Examination of sensory, and motor

systemsPhysiology

Week 3 P 9 Diencephalon, 3rd ventricle, spinal cord & blood supply

Anatomy

Week 4 P 10 Brain stem, cerebellum & 4th ventricle. AnatomyWeek 4 P 11 CNS pathology Pathology

TUTORIALS:

Tutorial number

Content Department

1 Week 2 Brain Anatomy2 Week 2 Cerebral edema and raised intracranial

pressure Medicine

3 Week 2 organization and transmission of pain, thermal sensations and headache

Physiology

4 Week 3 Brain stem and cranial nerves Anatomy5 Week 3 Visual acuity and error of refraction +

Functions of external and middle earPhysiology

6 Week 3 Antiepileptic drugs Pharmacology 7 Week 3 Physiology of muscle tone and stretch reflex

+ Upper and lower motor neuron lesions, and gait disorders

Physiology

8 Week 4 Cerebellar dysfunctions & tremors Physiology & Medicine

9 Week 4 Aphasia & dysarthria Physiology & Medicine

PROBLEM BASED LEARNING (PBL):

Case: discussion

CLINICAL PRESENTATION:

1 Peripheral neuropathies Medicine2 Stroke Medicine

ASSESSMENT:Formative:

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This form of assessment is designed to produce feedback to students to identify deficiencies in the understanding of a subject or a topic: this helps students to improve performance:

a. Identifications of areas for improvementb. Specific suggestion for improvementOne mid module exam (beginning of week 3) will be performed. This includes a mixture of MCQs, and extended matching questions (EMQs). Students are required to attempt all the questions set. The answers will be presented and discussed immediately with the students after the assessment. Results will be published to students.Problem based learning, and independent learning activities will be evaluated according to checklist, which will be available for the tutors at the beginning of the course.

Summative:

This type of assessment is used for judgment or decisions to be made about the student performance it serves:a. Verification of achievement for the student satisfying requirement.b. Motivation of the students to maintain or improve performance.c. Grades.d. Promotion.

In all subjects covered, final exam will be performed. It contains MCQs & EMQs. A wide range of questions is set to give the student an opportunity to show depth of understanding in the area tested.

Final practical examination will be given to students to assess certain transferable skills during the course according to the objectives of the subject.

Course work:

Students are required to complete satisfactory one piece of work during the course. This may involve a variety of activities, from self directed learning to problem – solving papers and short answer questions to “spotters” or presentations during the tutorial classes.

Assessment:

Total mark 100%Mid term exam 30%PBL 10%Summative assessment (final + practical)

60% (50/10)

INSTRUCTORS INFORMATION:Instructor Name Specialty e-mail address

Dr. Hussien malibary Medicine [email protected]. Maha Hegazi Physiology [email protected]

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Prof. Adel Mostafa Anatomy [email protected]. Osman Hassan Pharmacology [email protected]. Enayat Hashem Biochemistry [email protected]. Rana Bokhary Pathology [email protected]. Mohamed Jan Pediatric neurology [email protected]. Esha Elsherief Medicine [email protected]

lectures

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Lecture 1 : Development of the Nervous System

Department: AnatomyLecturer: Teaching Location: Classroom

Learning Objectives:

By the end of the lecture you should be able to:

1. Describe the formation and differentiation of the neural tube.

2. Mention the derivatives of the neural crest. 3. State the development of the spinal cord. 4. Report its congenital anomalies. 5. Mention the development of the brain

vesicles6. Discuss the derivatives of both motor and

sensory laminas in the brain stem.7. Describe the development of the

cerebellum. 8. Define the development of the

diencephalons.9. Recognize the development of the

cerebrum.

Detailed Contents:

Development of neural tube and neural crest derivatives.

Development of the brain vesicles. Development of the spinal cord and its

anomalies. Congenital anomalies of the central

nervous system.

Student Notes:

(Insert here handouts and

additional pages for notes if

needed)

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Continue … Lecture 1 : Development of the Nervous System

Reading: 1. Clinical Neuroanatomy for Medical

Students (Richard S. Snell), 6th edition, 2006.

2. Textbook of Histology (Gartner and Hiatt), 2nd edition, 2001.

3. Langmanۥs Medical Embryology (Sadler T.W.), 9th edition, 2004.

4. Cunningham's Manual of Practical Anatomy 15th edition 2002

Self-assessment

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Lecture 2: Functional organization of the CNS

Department: physiology Lecturer: Dr Azra Teaching Location: Classroom



1. List the different divisions of the nervous system.

2. List the general functions of the cerebrum, diencephalons, BG, limbic system, thalamus, hypothalamus, brain stem, cerebellum, spinal cord alpha and gamma motor neurons, and motor and sensory cortex.

Detailed Contents:

In order to recognize the integration of the brain and spinal cord centers at different levels, the student should understand the individual function of each center.The inter relation between the sensory and motor cortex, and the influence of the cortex on the brain stem and spinal cord centers should be addressed. In addition to the valuable role of the cerebellum and basal ganglia in the integrity of the motor function.

Student Notes:



needed)

18

Continue … Lecture 2: Functional organization of the CNS

Reading: Review of medical physiology 22th ed,

William F. Ganong. Human physiology from cell to system 6th

ed, Lauralee Sheerwood. Human physiology and mechanisms of

disease 13th ed Guyton and HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

Self-assessment1. Which of the following is the function of the

limbic system:a. Control of posture and equilibriumb. Control of motor function.c. Control emotions.d. Perception of sensation. 2. The alpha motor neurons:a. Are not controlled by supraspinal centres.b. Receive information from the gamma motor

neurons.c. Stimulate the skeletal muscle to contract.d. Are controlled by the basal ganglia.

Student Notes:



needed)

19

http://www.amazon.co.uk/Clinical-Neurophysiology-Primer-Andrew-Blum/dp/089603996X/ref=sr_1_33?ie=UTF8&s=books&qid=1226764771&sr=1-33

Lecture 3: Anatomy of the Brain




1. Recognize the subdivisions and different parts of the nervous system.

2. Describe the parts of the forebrain, midbrain, hindbrain and spinal cord.

3. Explain the structure of CNS: The Neuron, Neuroglia and Nerve Fibers.

4. Name the meninges covering the CNS.

Detailed Contents:

Organization of the Nervous System. Terminology and Subdivisions. Nerve cells, Neuroglial cells and Nerve

Fibers. Meninges of the brain and spinal cord.

Student Notes:



needed)

20

Continue … Lecture 3: Anatomy of the Brain

1. Clinical Neuroanatomy for Medical





Self-assessment

Student Notes:



needed)

21

Lecture 4: Metabolism Of The Brain

Department: CLINICAL BIOCHEMISTRY Lecturer: Teaching Location: Classroom



1. Explain the chemical composition of the brain, nervous tissue and myelin

2. Discuss the metabolism of the brain and nervous tissue in fed state and in starvation

3. Amino acid metabolism in brain

Detailed Contents:

1. Chemical composition of the brain: complex lipids and brain proteins

2. Chemical composition of myelin and the process of demyleination that leads to certain diseases

3. Energy sources of the brain and nervous tissue in fed state and in starvation

4. Amino acid metabolism in the brain

Student Notes:



needed)

22

Continue … Lecture 4: Metabolism Of The Brain

1. Textbook of Biochemistry with clinical correlation 4th ed.

Editor: Thomas M.DevlinPublisher: Wiley-Liss

2. Harper’s Biochemistry 23rd ed. Editor: Robert K. Murray, Daryl K.Garnner Publisher: APPLETON 7 LANGE3. Wills’ Biochemical basis of Medicine 3rd ed.Editor: Brian Gillham, Despo K. Papachristodoulou, J.Hywel Thomas Publisher: Arnold, a member of the Holder Headline Group

Self-assessment

Student Notes:



needed)

23

Lecture 5: Anatomy Of The Brain 2

Department: Lecturer: Teaching Location: Classroom



1. Identify the different lobes of the cerebrum, sulci and gyri on the different surfaces of the cerebral hemisphere.

2. Locate and comment on the sulci and gyri on the different surfaces of the brain.

3. Describe the functional areas of the cerebral cortex.

4. Demonstrate the structures at the base of the brain and the interpeduncular fossa.

Detailed Contents:

Cerebral hemispheres: General structure, lobes, surfaces, borders, gyri, sulci on each surface and insula.

Functional cortical areas, surface anatomy of the main sulci, interpeduncular fossa and base of the brain.

Student Notes:



needed)

24

Continue … Lecture 5: Anatomy Of The Brain 2






Self-assessment

Student Notes:



needed)

25

Lecture 6: Cells of the CNS & their Response to Injury & hydrocephalDepartment: Pathology Lecturer: Teaching Location: Classroom



The different cells composing the central nervous system & how they will respond to injury.

The pathogenesis, classification & complications of hydrocephalus.

Detailed Contents:

The different cells composing the central nervous system & their response to injury:

1) Neurons2) “Macro”glial (neuroglial) cells:

A. AstrocytesB. OligodendrocytesC. Ependymal cells

3) Microglial cells4) Choroid plexus cells5) Meningeal cells

Hydrocephalus: Definition, causes, classification, & morphology.

Student Notes:



needed)

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Continue … Lecture 6: Cells of the CNS & their Response to Injury & hydrocephal

Reading:

Robbins Basic Pathology, 8th edition “2007”

Self-assessment

Student Notes:



needed)

Lecture 7: Ventricular System and Cerebrospinal Fluid

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(anatomy)




1. Describe the parts and boundaries of each part of the lateral ventricle.

2. Describe the parts and boundaries of the third and fourth ventricles.

3. Recognize the connections of the four ventricles.4. Explain C.S.F circulation. 5. Name the cerebral meninges and

subarachnoid cisterns.

Detailed Contents:

Lat. Ventricle: parts (body and three horns), relations of each part and connections.

Third ventricle: parts, boundaries, relations and communications.

Fourth ventricle: parts, boundaries, relations and foramina.

C.S.F. (formation, circulation, drainage and functions).

Meninges of the brain and subarachnoid cisterns.

Student Notes:



needed)

Continue … Lecture 7: Ventricular System and Cerebrospinal Fluid (anatomy)

28






Self-assessment

Student Notes:



needed)

29

Lecture 8 : NEUROTRANSMITTERS (1)



By the end of the lecture you should be able to:1. Specify the criteria and properties of neurotransmitters2. Classify neurotransmitters that found in brain and nervous tissue 3. Discuss synthesis , storage release and catabolism of some neurotransmitters 4. Comprehend the definition of neuropeptides in the brain that mediate sensory and emotional responses as enkephalins endorphins and substance P

Detailed Contents:

1. Criteria and properties of neurotransmitters2. Chemical neurotransmitters may be

excitatory or inhibitory3. Synthesis, storage , release and catabolism

of some neurotransmitters(Catecholamines)

Student Notes:



needed)

Continue … Lecture 8 : NEUROTRANSMITTERS (1)

30

Reading: 1. Textbook of Biochemistry with clinical correlation 4th ed.Editor: Thomas M.DevlinPublisher: Wiley-Liss

2. Harper’s Biochemistry 23rd ed. Editor: Robert K. Murray, Daryl K.Garnner Publisher: APPLETON 7 LANGE3. Wills’ Biochemical basis of Medicine 3rd ed.Editor: Brian Gillham, Despo K. Papachristodoulou, J.Hywel Thomas Publisher: Arnold, a member of the Holder Headline Group

Self-assessment

Student Notes:



needed)

31

Lecture 9: Blood Supply of the Brain and Spinal cord (anatomy)




1. Describe course and distributions of the cerebral blood vessels.

2. Identify arteries sharing in circulus arteriosus.3. Demonstrate the arterial supply of each cortical

area. 4. Determine the venous drainage of the

brain.5. Summarize the blood supply of spinal cord.

Detailed Contents:

Blood supply of the brain: Arteries: carotid system, vertebrobasilar

system, circulus arteriosus. The anterior, middle and posterior cerebral

arteries: course, relations, branches and distribution.

Venous drainage of the brain: superficial and deep veins.

Arterial supply of the spinal cord: spinal and radicular arteries.

Venous drainage of the spinal cord.

Student Notes:



needed)

Continue … Lecture 9: Blood Supply of the Brain and Spinal

32

cord (anatomy)






Self-assessment

Student Notes: (Insert here handouts and


needed)

33

Lecture 10: NEUROTRANSMITTERS (2)



By the end of the lecture you should be able to: 1. Specify the criteria and properties of neurotransmitters2. Classify neurotransmitters that found in brain and nervous tissue 3. Discuss synthesis , storage release and catabolism of some neurotransmitters 4. Comprehend the definition of neuropeptides in the brain that mediate sensory and emotional responses as enkephalins endorphins and substance P

Detailed Contents:1. Synthesis , storage, release and catabolism of:

Acetylcholine 5-hydroxytryptamine (Serotonin) 4-aminobutyrate (GABA)

2. Neuropeptides in the brain that mediate sensory and emotional responses as enkephalins , endorphins and substance P

Student Notes:



needed)

34

Continue … Lecture 10: NEUROTRANSMITTERS (2)


2. Harper’s Biochemistry 23rd ed. Editor: Robert K. Murray, Daryl K.Garnner Publisher: APPLETON 7 LANGE

3. Wills’ Biochemical basis of Medicine 3rd

ed. Editor: Brian Gillham, Despo K. Papachristodoulou, J.Hywel Thomas Publisher: Arnold, a member of the Holder Headline Group

Self-assessment

Student Notes:



needed)

Lecture 11: Anatomy of the Spinal Cord, Ascending tracts & Sensory Pathway in the Brain Stem

35

Department: anatomy Lecturer: Teaching Location: Classroom



1. Identify the external features of the spinal cord.

2. Recognize the relation between spinal segment and vertebral level.

3. Describe the meninges of the spinal cord and its fixation.

4. Identify the different nuclei of the grey matter of the spinal cord and function of each.

5. Discuss the different ascending tracts of the spinal cord.

6. Describe the lemnisci of the brain stem.

Detailed Contents:

External features, enlargements, conus medullaris, spinal segments.

Relation of the spinal cord to the vertebral level.

Age changes, meninges and fixation. Internal structure, nuclei of the posterior,

anterior and lateral horns Tracts of posterior, lateral and anterior

white matter. Lemnisci of the brain stem. Blood supply (arteries and veins).

Student Notes:



needed)

36

Continue … Lecture 11: Anatomy of the Spinal Cord, Ascending tracts & Sensory Pathway in the Brain Stem






Self-assessment

Student Notes:



needed)

37

Lecture 12 : Sensory receptors, Sensory transduction, and Information processingDepartment: PhysiologyLecturer: Dr Zenab Teaching Location: Classroom



1. Define sensory receptors.2. Name the properties of sensory receptors,

and explain specificity.3. Define receptor potential and explain its

mechanism.4. Identify the relation between the sensation

& the frequency of discharge in a sensory nerve & the intensity of stimulation.

5. Define Weber-Fechner Law & its modification.

6. Explain adaptation, and classify receptors according to adaptation.

7. Explain coding for sensory information.

Detailed Contents:

The forms of energy that are converted by the receptors into an action potential.Know the principle sensory modalities. The student should be able to describe the characteristics of these receptors, and explain the way by which they generate impulses in afferent nerves. He should be able also to list the properties of receptor potentials, define sensory unit, receptive field, and recruitment of sensory unit.

Student Notes:



needed)

38

Continue … Lecture 12: Sensory receptors, Sensory transduction, and Information processing

Reading:

Review of medical physiology 22th ed, William F. Ganong.

Human physiology from cell to system 6th ed, Lauralee Sheerwood.

Human physiology and mechanisms of disease 13th ed Guyton and Hall

The Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

Self-assessment

Student Notes:



needed)

39


Lecture 13: the anatomy of the Sensory Cortex and Thalamus

Department: anatomyLecturer: Teaching Location: Classroom



1. Identify the different sensory and associational areas of the cerebral cortex.

2. Describe the relations and nuclei of the thalamus.3. Recognize main connections of the thalamic

nuclei.

Detailed Contents:

The cerebrum: surfaces, lobes, fissures, gyri and sulci.

The sensory and associational areas in the cerebral cortex.

Thalamus: gross morphology, relations, thalamic nuclei and their connections.

Student Notes:



needed)

40

Continue … Lecture 13: the anatomy of the Sensory Cortex and Thalamus






Self-assessment

Student Notes:



needed)

Lecture 14: Anatomy of the Orbit

41



By the end of this lectures you should be able to:

1. Demonstrate the contents of the orbit.2. Describe the microscopical pictures of the

different layers of the eye ball and retina.

Detailed Contents:

Contents of the Orbit: Muscles, nerves, vessels and ligaments.

Histological structure of the eye.

Student Notes:



needed)

Continue … Lecture 14: Anatomy of the Orbit

Student Notes:

42






Self-assessment



needed)

43

Lecture 15: physiology of the eye (Anterior chamber accommodation)Department: physiology Lecturer: Dr Sawswn Roheim Teaching Location: Classroom

Learning Objectives: By the end of this lectures you should be able to:

1. Describe the eye as a camera.2. Explain Accommodation allows the eye to

focus on near objects 3. List and explain the function, of cornea,

lens, and aqueous humour Detailed Contents:

The human eye is a globe of about 24 mm diameter. Its operation resembles in many aspects that of a photographic camera. Light enters via the transparent cornea, and by means of an optical system (cornea and lens) an inverted image is formed on the retina. Neural elements within the retina convert the light energy (photons) into receptor potentials and nerve impulses (action potentials). The eye is capable for accommodation for near vision so alteration can be done in order to fix a near object on the retina. The structure of the anterior chamber of the eye (the cornea, the lens, and aqueous humour are functioning in a proper physiological way in order to see, and protect the inner structure of the eye.

Student Notes:



needed)

Continue … Lecture 15 : physiology of the eye (Anterior

44

chamber accommodation)

Reading:Review of medical physiology 22th ed, William F. Ganong.Human physiology from cell to system 6th ed, Lauralee Sheerwood.Human physiology and mechanisms of disease 13th

ed Guyton and HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

Self-assessment

Student Notes:



needed)

Lecture 16 : Light reflex, and retinal function (dark adaptation, and electrophysiology of Rods and Cones)

45


Department: physiologyLecturer: : Dr Sawswn Roheim Teaching Location: Classroom



1. list the properties of the retina2. explain the mechanism of light reflex3. describe the mechanism of dark adaptation4. explain the mechanism of rods and cones

stimulation

5. explain the spectral sensitivities of rods and cones

Detailed Contents:

Exposure of the eye to light causes a direct reflex constriction of the stimulated eye and indirect constriction of the other eye. How this reflex is organized and its clinical significance is addressed to the students. Also the eye can adapt to dark The human retina contains two types of light sensitive receptor cells: cones (concentrated primarily in the central region of the fovea), and rods (largely in the periphery). Both types of cells contain light sensitive molecules referred to as photopigments in their outer segments. Their stimulation leads to firing of action potentials which are conducted through the optic nerve to the visual cortex in order to see the image.

Student Notes:



needed)

Continue … Lecture 16 : Light reflex, and retinal function (dark adaptation, and electrophysiology of Rods and Cones)

Student Notes:

46


William F. Ganong. Human physiology from cell to system 6th

ed, Lauralee Sheerwood. Human physiology and mechanisms of


Self-assessment



needed)

Lecture 17: Anatomy of the ear and auditory pathways

Department: Anatomy Student Notes:

47


Lecturer: Teaching Location: Classroom



1. Demonstrate the external auditory meatus.2. Recognize the walls and structures inside

the middle ear.3. Discuss the parts of the auditory pathway.4. Demonstrate the order neurons.

Detailed Contents:

Structure of the external ear. Walls and CONTENT of the middle ear. Auditory pathway and its different order

neurons and its connections.



needed)

Continue … Lecture 17: Anatomy of the ear and auditory pathways

Student Notes:

48






Self-assessment



needed)

Lecture 18: Pharmacological control of pain

Department: Pharmacology Student Notes:

49




1. Identify the term opioid, opiate, opiopeptins

2. List the receptors activated by opioid analgesics and the endogenous opioid peptides

3. Describe the main pharmacodynamic and pharmacokinetic properties of agonist opioid analgesics and list their clinical uses

4. List the main adverse effects of acute and chronic use of opioid analgesics

Describe the clinical uses of the opioid receptor antagonists.

Detailed Contents:

1. Classification of opioid analgesics,

2. Opioid receptors and their distribution3. Strong agonists (morphine as a prototype)4. Mechanism of action, pharmacokinetics5. Acute effects of morphine, and chronic

effects6. Clinical uses and adverse effects, opioid

dependence Partial agonists, and antagonists



needed)

Continue … Lecture 18: Pharmacological control of pain

Student Notes:

50

Reading:

Self-assessment



needed)

Lecture 19:the physiological role of the external and middle ear in the process of hearingDepartment: Physiology Student Notes:

51

Lecturer: : Dr Sawswn Roheim Teaching Location: Classroom


By the end of the lecture you should be able to:1. explain how the tympanic membrane as well as the bony ossicles play a role in conduction of the sounds 2. demonstrate the role of the middle ear structures in the process of hearing

Detailed Contents:

The detailed functions of the tympanic membrane and the middle ear structures (bones and muscles) in relation to hearing process will be addressed in details. As well as the protective reflexes against extremely high sounds



needed)

Continue … Lecture 19: The physiological role of the external and middle ear in the process of hearing

Student Notes:

52


William F. Ganong. Human physiology from cell to system

6th ed, Lauralee Sheerwood. Human physiology and mechanisms of


Self-assessment



needed)

Lecture 20: Cochlea and hearing process: “Changing sound energy into neural activity & Neural Mechanisms for Pitch and Loudness Discrimination”

53


Department: Physiology Lecturer: : Dr Sawswn Roheim Teaching Location: Classroom


By the end of the lecture you should be able to:1. explain how mechanical energy of sound is converted to nerve impulses by organ of corti in the cochlea2. describe the mechanism of pitch and loudness discrimination

Detailed Contents:

The detailed functions of the inner ear in relation to hearing process, and how the cochlea is stimulated will be addressed in details. As well as the mechanism of pitch & loudness discrimination



needed)

Continue … Lecture 20:

Student Notes:

54


William F. Ganong. Human physiology from cell to

system 6th ed, Lauralee Sheerwood. Human physiology and mechanisms

of disease 13th ed Guyton and HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

Self-assessment



needed)

Lecture 21: Anesthesia Department: Pharmacology Student Notes:

55




By the end of this lectures you should be able to:

1. Identify the main inhalation anesthetic agents and describe their pharmacodynamic properties

2. Describe the relationship of the blood: gas partition coefficient of an inhalation anesthetic with its speed of onset of anesthesia and its recovery time

3. List the factors that influence inhalation anesthetic biodisposition

4. Describe the main pharmacokinetic and pharmacodynamic characteristics of the intravenous anesthetics

Detailed Contents:

1. Inhalation anesthetics, gases and volatile liquids

2. Pharmacokinetics of inhalation anesthetics and their elimination from the body

3. Pharmacodynamic effects of inhalation anesthetics

5. Intravenous anesthetics



needed)

Continue … Lecture 21: Anesthesia Pharmacology

Student Notes:

56

Reading:

Self-assessment



needed)

Lecture 22: Anatomy of the motor cortex, and Brain stem1


57




1. Describe the different motor centers in the cerebral cortex.

2. Plan the pathway for the pyramidal tract.3. Define the parts of the extrapyramidal tracts.4. Differentiate between both pyramidal and

extrapyramidal tracts.

Detailed Contents:

Motor centers of the cerebral cortex. Pyramidal tract: pathway, decussations,

neurons and lamination. Extrapyramidal tracts (rubrospinal,

reticulospinal, olivospinal, vestibulospinal and tectospinal),



needed)

Continue … Lecture 22: Anatomy of the motor cortex, and Brain stem1

Student Notes:

58






Self-assessment



needed)

Lecture 23 : Neurophysiological principles of synaptic transmission (interneuronal communication)Department: physiology Student Notes:

59

Lecturer: Dr Maha Hegazi Teaching Location: Classroom



Describe the mechanism of action of chemical and electrical synapse.

Compare between the function of pre and post synaptic receptors.

List the types, and explain the mechanisms of post-synaptic potentials.

List the types of summation of postsynaptic potentials

Discuss the mechanism, and types of synaptic inhibition

List the properties of synaptic transmission & describe each one.

Detailed Contents:

Neurones usually talk to each other via synapses where the electrical signals are briefly turned into a chemical signal that is squirted into the second cell and triggers a "new" electrical signal. This lecture describes how these chemical synapses work. It covers: Structure of a chemical & electrical synapse including presynaptic terminal, voltage-gated Ca++ channels, synaptic vesicles, synaptic cleft, postsynaptic thickening, post and presynaptic receptors, transmitter inactivation; Postsynaptic potentials including (excitatory postsynaptic potentials, and inhibitory postsynaptic potentials),in addition to synaptic properties.



needed)

Continue … Lecture 23 : Neurophysiological principles of synaptic transmission (interneuronal communication)

Student Notes:

60





Self-assessment



needed)

Lecture 24: Anatomy of the Brain stem2 and Motor Descending tracts


61





1. Recognize the external features of the brain stem

2. Identify the corticospinal and corticobulbar tracts in the brain stem.

3. Describe the nuclei and the extrapyramidal tracts passing through the different parts of the brain stem.

Detailed Contents:

External features (ventral and dorsal surfaces) of the brain stem.

The corticospinal and corticobulbar tracts passing through the brain stem.

The extrapyramidal tracts passing through the brain stem.



needed)

Continue … Lecture 24: Anatomy of the Brain stem2 and Motor Descending tracts

Student Notes:

62






Self-assessment



needed)

Lecture 25: Cortical Control of Motor Functions, functions of motor descending tracts & Processing Of Signals In The CNSDepartment: : physiology Student Notes:

63

Lecturer: Dr Zenab Teaching Location: Classroom



1. List the specific function of cortical motor areas &.describe the effect of their lesions

2. List the function of pyramidal & extrapyramidal tracts and explain the effects of their lesions.

3. Differentiate between the upper motor neurons & the lower motor neurons.

explain how the signal is processed and transmitted in the CNS within the reflex arc (role of convergence, divergence, occlusion, summation, reverberating circuits, recruitment and after-discharge . in addition to signal limitation, sharpening)

Detailed Contents:

The site, functions, and characters of the motor cortical areas in order to understand the effects of their lesions. The importance of the related cortical structures located within the motor area 6 with stress on their specific functions. The organization of function of the motor cortical areas in concern with planning and execution of the motor act. The course of UMN & LMN. Know that the extrapyramidal tract does not supply the head, and understand the function of the motor tracts in relation to their site in the spinal cord. In addition to description of the role of afferent, interneurons, and efferent in the signal processing within the CNS



needed)

Continue … Lecture 25:

Student Notes:

64

Reading:





Self-assessment



needed)

Lecture 26 : CNS reflexes (Spinal cord reflexes)

Department: physiology Student Notes:

65


Lecturer: Dr Azra Teaching Location: Classroom


At the end of the lecture you should be able to:

1. list all the central human reflexes:2. describe the different spinal cord

reflexes (superficial visceral & deep)3. Describe the neural pathway involved

in flexor withdrawal reflex and crossed extensor reflexes the role of reciprocal innervation).

Explain the causes of central delay and its relation to the synapses.

Detailed Contents:

The basic component of a reflex arcThe functions of alpha & gamma motor neurons, motor unites & renshaw cellThe superficial spinal cord reflexes (The plantar, The abdominal, The cremasteric, The anal, The withdrawal (flexor), The crossed extensor, The positive supporting, and the scratch reflexes)The visceral spinal cord reflexes and their centers.

The spinal reflexes of clinical importance (superficial reflexes and tendon jerks)



needed)

Continue … Lecture 26 : CNS reflexes (Spinal cord reflexes)Student Notes:

66



6th ed, Lauralee Sheerwood. Human physiology and mechanisms


Self-assessment



needed)

Lecture 27 : The stretch reflex and skeletal muscle tone


67


Lecturer: Dr Maha Hegazi Teaching Location: Classroom



1. Describe the muscle spindle, the mechanism of its stimulation and its role in the stretch reflex.

2. list the functions, types, and properties of the stretch reflex

3. Explain the mechanism and list the importance of muscle tone.

4. Explain the importance of supraspinal control of the stretch reflex (gamma, and alpha motor neurons) during rest and voluntary movement.

5. Explain the function & importance of Golgi tendon’s organs.

Explain the mechanism of clonus & lengthening reaction of the hypertonic paralyzed muscle.

Detailed Contents:

Nervous pathway of the stretch reflex:The structure & innervations, mechanism of stimulation, and function of the muscle spindles.Responses of the muscle spindles to stretch:How the γ motor neurons are controlledThe control of the stretch reflex.The loading reflex (alpha gamma co-activation) (cerebellar influence).The differences between stretch & inverse stretch reflexesThe effects of neural lesions (UMN,&LMN) on the dynamic and static stretch reflexes.



needed)

Continue … Lecture 27 : The stretch reflex and skeletal muscle tone

Student Notes:

68



5th ed, Lauralee Sheerwood. Human physiology and mechanisms


Self-assessment



needed)

Lecture 28: anatomy of the Cerebellum and Vestibular System


69




At the end of the lecture you should be able to:1. Describe the external features, lobes and subdivisions

of the cerebellum.2. Comment on the function of each lobe of the

cerebellum.3. Identify the internal structures and nuclei of

cerebellum.4. Illustrate the cerebellar peduncles and fibers passing

through each one.5. Determine the blood supply of the cerebellum.6. Discuss the different parts and connections of

the vestibular system.

Detailed Contents:

External features, lobes, fissures, functional subdivisions, internal structure (structure of cortex and cerebellar nuclei).

Cerebellar peduncles and fibers passing through them function of the cerebellum, blood supply and manifestations of cerebellar lesions.

Vestibular nuclei, connections and vestibular nerve.



needed)

Continue … Lecture 28: anatomy of the Cerebellum and Vestibular System

Student Notes:

70






Self-assessment



needed)

71

Lecture 29 : Motor function of the cerebellum & basal gangliaDepartment: physiology Lecturer: Dr Zenab Teaching Location: Classroom



1. list the connections of The Basal Ganglia

2. list the neurotransmitters In The Basal Ganglia

3. list and explain the functions of The Basal Ganglia

4. list and describe the manifestations of parkinsonism

5. Describe the structure of the cerebellar cortex &explain the functional importance of its neural circuit.

6. list the motor functions of cerebellum & explain the mechanism of each one.( control of equilibrium & postural movements, control of the stretch reflex, control of voluntary movements

7. Explain the role of spinocerebellum and cerebrocerebellum in voluntary control

Detailed Contents:

Modulatory effects on motor reactions involve basal ganglia and cerebellum. The anatomical connections will be introduced first and more functional aspects about typical response patterns of neuronal discharges will be discussed. Their complex interplay enables rapid corrections of movements and comparison with expected output, respectively.

Student Notes:



needed)

72

Continue … Lecture 29 : Motor function of the cerebellum & basal ganglia

Student Notes:

73





Self-assessment



needed)

Lecture 30: Imaging of the central nervous system: Structural and functional magnetic resonance, positron

74


emission tomography and the measure brain electrical & magnetic fields Department: Anatomy& RadiologyLecturer: Teaching Location: Classroom



1. Define and use the various sections or views of the brain including:

Coronal (frontal) sections Horizontal sections Sagittal sections

2. Interpret radiological images (CT and MRI scan) which demonstrate the normal anatomy of the brain.

Detailed Contents:

Demonstration of the structures present in the horizontal, coronal and sagittal sections of the preserved and brain.

Demonstration of the structures present in the Plastinated brain sections.

Identification of the CT and MRI images of the brain

Interpretation of the radiological images with the specimens of the brain sections



needed)

Continue … Lecture 30 :

Student Notes:

75




Self-assessment



needed)

Lecture 31:Physiology of posture and equilibrium (vestibular apparatus and the cerebellum)Department: physiology Student Notes:

76

Lecturer: Dr Zenab Teaching Location: Classroom



1. List the functions of the utricle & saccule.

2. Describe the structure of the macula (otolith organ) and explain how it is stimulated or inhibited in rotation (depolarization & hyperpolarization).

3. Describe structure and function of the semicircular canals.

4. Describe the role of the SCCs in angular acceleration.

5. List methods of stimulation of SCCs.6. List the effects of stimulation of SCCs.7. Define nystagmus & vertigo, and list

their causes and mechanism.

Detailed Contents:

Balance is maintenance of steady position. It is essential for coordination of motor responses, eye movement, and Posture.Highly sophisticated system involving integration of visual, vestibular, proprioceptive and superficial sensory information Sensory organs in the inner ear sense dynamic and static position of the head. Detects linear and angular acceleration of the head. Enables conscious awareness of the position of head and body in space and reflex control of eye movements, posture and body motion



needed)

Continue … Lecture31 :Physiology of posture and equilibrium (vestibular apparatus and the cerebellum)

Student Notes:

77





Self-assessment



needed)

Lecture 32 : Hypnotics/sedatives

Department: Pharmacology Student Notes:

78





1. Identify the major classes of sedative hypnotics

2. Describe the pharmacodynamics of benzodiazepines and barbiturates, including their mechanisms of action

3. List their clinical uses , adverse effects and their drug interactions

4. Identify the distinctive properties of buspirone, zolpidem and zaleplon

Detailed Contents:

1. Benzodiazepines subgroups, 2. pharmacodynamic and

pharmacokinetic properties, 3. clinical uses 4. Adverse effects5. Advantages of BDZ use over

barbiturates6. Zolpidem, 7. buspirone,

zaleplon



needed)

Continue … Lecture 32 : Hypnotics/sedatives

Student Notes:

79

Reading:

Self-assessment



needed)

Lecture 33: Physiology of the Limbic system: (Emotion, behavior), Reticular activating system and reticular formation

80

Department: physiology Lecturer: Dr Maha Teaching Location: Classroom



List the component of the limbic system. List the function of the limbic system List the connections in the reticular

formation. list the functions of reticular activating

system.

Detailed Contents:

Functions of the limbic syolfactory sensation(smell), control of the feeding behavior, autonomic functions, sexual behavior, emotions, motivation

Functions of the reticular formation:Control of the level of consciousness via the ascending reticular activating system. regulation of the stretch reflex and muscle tone via the reticulospinal tracts, pain inhibition via the raphe magnus nucleus, control of sleep by 2 specific centers, and control of visceral functions (e.g. Cardiac activity) by controlling the lateral horn cells.

Factors affecting the activity of the RAS

Student Notes:



needed)

81

Continue … Lecture 33





Self-assessment

Student Notes:



needed)

Lecture 34: Infectious Diseases of the Nervous System

82


Department: Pathology Lecturer: Teaching Location: Classroom



1. Discuss the causative organisms & routes of entry of the various CNS infections.

2. Discuss the detailed pathological aspects “etiology, types & morphology” of the different types of meningitis.

3. Discuss the detailed pathological aspects “etiology, types & morphology” of the different types of encephalitis & meningoencephalitis.

Detailed Contents:

Meningitis: Acute purulent meningitis Acute (aseptic) lymphocytic meningitis Chronic and granulomatous meningitis Parenchymal infections Generalized (encephalitis): Viral encephalitis Spongiform encephalopathies Localized (brain abscess, tuberculomas &

toxoplasmosis)

Student Notes:



needed)

83

Continue … Lecture 34: Infectious Diseases of the Nervous System

Reading:

Robbins Basic Pathology, 8th edition “2007”

Self-assessment

Student Notes:



needed)

Lecture 35: physiology of the speech

84

Department: physiology Lecturer: DrMaha Teaching Location: Classroom



Define speech.

List the types of speech (spoken &

written).

Describe the mechanism of speech .

List the types, and mechanisms of speech

disorders (APHASIA & DYSARTHRIA.

Detailed Contents:

Speech is the means of communication between persons, and it is either spoken or written speech. It requires integrity of the categorical hemisphere. It has sensory and motor aspects.

Student Notes:



needed)

Continue … Lecture 35: physiology of the speech

Student Notes:

85





Self-assessment



needed)

Lecture 36: CNS Neoplasms

Department: Pathology Student Notes:

86





The classification of the CNS neoplasms. Discuss the gross as well as the microscopic

morphological features and the origin of each of the primary neoplasms, in addition to brief discussion on their prognosis & clinical behavior.

Discuss the effects & origin of the most common metastatic brain tumors.

Detailed Contents:

Classification of the primary CNS tumors:

4. Gliomas:A. AstrocytomasB. OligodendrogliomasC. Ependymomas 2. Primitive neuroepithelial neoplasms

“PNETs”3. Neuronal neoplasms4. Meningiomas & other meningeal

neoplasms5. Tumors / hamartomas of blood vessels6. Germ cell tumors (GCTs)7. Primary brain lymphoma (PBL)8. Peripheral nerve tumors

Metastatic tumors



needed)

Continue … Lecture 36: CNS Neoplasms

Student Notes:

87

Reading:

: Robbins Basic Pathology, 8th edition “2007”

Self-assessment



needed)

Lecture 37: Trypanosomiasis (CNS infections)

88

DEPARTMENT: Medical ParasitologyMALE TUTOR: Prof. Mahmoud FouadFEMALE TUTOR: Dr. Muna Abdelfatah Learning Objectives:

At the end of the lecture you should be able to:1. State the Geographical distribution of

Trypanosoma gambiense parasite studied2. Briefly describe the parasite life-cycle for

Trypanosoma gambiense parasite studied3. State the infective and diagnostic stage,

pathogenic stage and mode of infection for Trypanosoma gambiense infection

4. Describe the pathogenesis pathway for Trypanosoma gambienseparasite studied

5. Discuss the clinical significance of the disease process (acute and chronic phases and main complication arising) for Trypanosomiasis infection

6. Name the specimen of choice for recovery of Trypanosoma gambiense parasite studied

7. Name the drug(s) of choice and alternative therapy for Trypanosoma gambiense parasite studied

8. Briefly describe the main aspects of prevention and control for each parasite studied

Detailed Contents:

1) Main aspects of Life-cycle in relation to disease In man2) Pathogenic stage and mode of infection3) Pathogenesis of disease in man4) Associated clinical manifestations 5) Main method of diagnosis and material Examined6) Main drug of choice and alternative therapy7) Main aspects of prevention and control

Remember1) Parasites of the CNS2) Chronic disease3) Sleeping sickness main manifestation4) Affects the blood and CNS

Student Notes:



needed)

89

5) Main complications arising6)Vector transmitted7)Parasite detected in blood examination 8) Treatment and management of disease

1. Organ Based Parasitology for Medical Students, A.M. Amin et.al (2007), Dar Khawarizim for Academic Publishing and Distribution.

2. Basic Clinical Parasitology, Franklin A. Neva and Harold W. Brown, (2007) Publisher Prentice Hall International Edition

3. Medical Parasitology, Edward K. Markell et.al. (2007) Publisher W.B. Saunders

4. Clinical Parasitology, A Practical Approach. Elizabeth A. Zeibig (2007) Publisher W.B. Saunders Company

5. Atlas of Medical Parasitology and Tropical Medicine, Peters and Gillies (2006)

Internet websites: Key word Medical Parasitology; Parasitology; Small Intestinal Parasites; Large Intestinal Parasites; Liver Parasites; emedicine.com (choice specific parasites); CDC.com; and many other web-links.

Briefly answer the following short question:

1) Briefly explain the clinical manifestation associated with CNS phase of the disease?2) Describe the material examined and the stage of parasite observed to confirm your diagnosis?

90

Lecture 38 :Functions of the hypothalamus.

Department: physiologyLecturer: Dr Azra Teaching Location: Classroom


At the end of the lecture you should be able to:Nervous connections of the hypothalamusfunctions of the hypothalamusRage & placidityEffects of hypothalamic lesions

Detailed Contents:

Hypothalamus is a part of the diencephalons located below & anterior to the thalamus (forming part of the wall & floor of the 3rd ventricle). It is a main component and the major output control pathway of the limbic system, so their functions are closely interrelatedControl of autonomic functionsControl of endocrine glandsRegulation of body temperatureControl of water balanceControl of food intakeControl of circadian (= diurnal or 24 hours) rhythmsRegulation of sexual functionsRelation to sleepControl of motivation, memory & learningEmotional expression

Student Notes:



needed)

91

Continue … Lecture 38: Functions of the hypothalamus.

Reading: Review of medical physiology 22th ed, William F. Ganong.Human physiology from cell to system 6th ed, Lauralee Sheerwood.Human physiology and mechanisms of disease 13th

ed Guyton and HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

Self-assessment

Student Notes:



needed)

Lecture 39 :Physiology of SLEEP

92


Department: physiology Lecturer: Dr Maha Teaching Location: Classroom



1. List the types of sleep2. List physiological changes during sleep3. Describe distribution of sleep stages (sleep

cycles)4. List the mechanisms (theories) of sleep5. Explain the sleep/wakefulness cycle6. list and explain reasons for sleep

disturbances

Detailed Contents:

Sleep is a physiological state of temporary unconsciousness. Its duration varies inversely with age (average 18 hours in infants, 8 hours in adults and 6 hours in old persons).The sleep/wakefulness 24-hours rhythm is determined mainly by synchronization with the 24-hours light/dark cycle. However, it is also affected by various habits & conditioned reflexes, as well as by many psychological and physical factors.There are two types of sleep (Slow wave sleep),& its stages, as well as (Rapid Eye Movement sleep) “REM, desynchronized or paradoxical” The sleep/wakefulness 24-hours rhythm is determined mainly by synchronization with the 24-hours light/dark cycle.However, it is also affected by various habits & conditioned reflexes, as well as by many psychological and physical factors.

Student Notes:



needed)

Continue … Lecture 39 :Physiology of SLEEP

Student Notes:

93

Reading:





Self-assessment



needed)

Lecture 40: Cysticercosis / Amoebic Encephalitis (CNS infections)DEPARTMENT: Medical Parasitology Student Notes:

94


MALE TUTOR: Prof. Mahmoud FouadFEMALE TUTOR: Dr. Muna AbdelfatahLOCATION: Learning Objectives:


1. State the Geographical distribution of Cysticercus cellulosae and Free living amobae parasites studied

2. Briefly describe the parasite life-cycle for Cysticercus cellulosae and Free living amoeba parasite studied

3. State the infective and diagnostic stage, pathogenic stage and mode of infection for Cysticercosis and Amoebic encephalitis infection

4. Describe the pathogenesis pathway for Cysticercus cellulosae and Free living Amoebae parasite studied

5. Discuss the clinical significance of the disease process (acute and chronic phases and main complication arising) for Cysticercosis and Amoebic encephalitis infection

6. Name the specimen of choice for recovery of Cysticercus cellulosae and Free living Amoeba parasite studied

7. Name the drug(s) of choice and alternative therapy for Cysticercus cellulosae and Free living Amoeba parasite studied


Detailed Contents


Remember



needed)

95

1) Parasites of the CNS and Eye

2) Acute and Chronic disease3) Neurocysticercosis and Amoebic meningio-encephalitis 4) Main complications arising5) Difficulties in laboratory diagnosis7) Treatment and management of disease







Briefly answer the following short question:1) Briefly explain the clinical manifestation associated with CNS phase of the disease?2) Describe the material examined and the stage of parasite observed to confirm your diagnosis?

Lecture 41: Oxidative stress and Neurodegenerative

96

disorders




1. Identify the role of mutation of mitochondrial DNA in age-related neurodegenerative disorders

2. Demonstrate the role of oxidative stress as risk factor for neurodegenerative diseases

3. Focus on the role of oxidative stress and lipid peroxidation in causing AD dementia and non-AD dementia

4. Classify the markers of oxidative stress in some neurodegeneative disorders

5. Discuss the endogenous and dietary antioxidants and their importance in lowering the risk for neurodegenerative disorders

Detailed Contents:

1. Role of mutation of mitochondrial DNA in neurodegenerative disorders

2. Oxidative stress as a risk factor in neurodegenerative diseases

3. Lipid peroxidation and oxidative stress and their role in causing dementia: AD and non-AD types

4. Markers of oxidative stress in AD, PD and Amyotrophic lateral sclerosis

5. Importance of dietary and endogenous antioxidants in lowering the risk for neurodegenerative disorders



needed)

Continue … Lecture 41: Oxidative stress and Neurodegenerative disorders

97



3. Wills’ Biochemical basis of Medicine 3rd ed.Editor: Brian Gillham, Despo K. Papachristodoulou, J.Hywel Thomas Publisher: Arnold, a member of the Holder Headline Group

Self-assessment

Student Notes:



needed)

Lecture 42: Demylenating & Degenerative Diseases of the CNS

98

Department: Pathology Lecturer: Teaching Location: Classroom



Identify the different degenerative & demylenating CNS diseases (Classification).

Discuss Alzheimer disease, Parkinson disease, Huntington disease & multiple sclerosis in detail.

Detailed Contents:

Degenerative diseases “Proteinopathies”: Degenerative diseases affecting cerebral

cortex: (dementia) Alzheimer disease Others

Degenerative diseases of basal ganglia & brain stem: (movement disorders)

Idiopathic Parkinson disease Huntington disease Others Spinocerebellar degenerations Degenerative disorders affecting motor

neurons

Demyelinating diseases Acquired demyelinating diseases: Multiple sclerosis Others Inborn errors of metabolism affecting

myelin “leukodystrophies”

Student Notes:



needed)

Continue … Lecture 42: Demylenating & Degenerative Diseases of the CNS

Student Notes:

99

Reading: Robbins Basic Pathology, 8th edition “2007”

Self-assessment



needed)

Lecture 43: Cognitive function of the brain


100

Lecturer: Dr Maha Teaching Location: Classroom



1. Define cognition : acquiring, handling, storing and using knowledge

2. Know brain regions that are responsible for distinct operations

3. Understand how do we plan & coordinate complex motor patterns

4. Know what is consciousness? Does it depend on the brain?

Know how is memory organized? And if it can be trained

Detailed Contents:

The sequence of brain perception and action Perception, attention , planning action, learning & memory, language , knowledge, AND reasoning



needed)

Continue … Lecture 43: Cognitive function of the brain

Student Notes:

101

http://brainmuseum.org/functions/index.html





Self-assessment



needed)

Lecture 44: Onchocerciasis(Special Senses infections)

DEPARTMENT: Medical Parasitology Student Notes:

102


MALE TUTOR: Prof. Adnan AminFEMALE TUTOR: Dr. Muna AbdelfatahLOCATION: Learning Objectives:

1. State the Geographical distribution of Onchocerca volvulus parasites studied

2. Briefly describe the parasite life-cycle for Onchocerca volvulus parasite studied

3. State the infective and diagnostic stage, pathogenic stage and mode of infection for Onchocerciasis infection

4. Describe the pathogenesis pathway for Onchocerca volvulus parasite studied

5. Discuss the clinical significance of the disease process (acute and chronic phases and main complication arising) for Onchocerciasis infection

6. Name the specimen of choice for recovery of Onchocerca volvulus parasite studied

7. Name the drug(s) of choice and alternative therapy for Onchocerca volvulus parasite studied


Detailed Contents:


Remember1) Parasites of the Eye and skin2) River blindness3) Onchocercoma and skin changes 4) Main complications arising5) Skin biopsy means of diagnosis



needed)

103

6) Vector transmission7) Treatment and management of disease







Briefly answer the following short question:

1) Briefly explain the clinical manifestation associated with the Eye phase of the disease?2) Describe the material examined and the stage of parasite observed to confirm your diagnosis?

Lecture 45: Memory processes and Learning theory

104

Department: physiology Lecturer: Prof Maha Hegazi Teaching Location: Classroom



1. the types of memory2. mechanisms of memory3. consolidation of memory4. encoding of memory5. types of amnesia

6. the 2 main ways of learning

Detailed Contents:

1. Reflexive (non-declarative) memory2. Declarative memory

Immediate (sensory) memory, Primary (short-term or recent) memory,And Secondary (long-term or remote) memory3. Mechanism of consolidation of memory 4. Centers of memory encoding & storageTypes of learning

1. Non-associative learning Habituation:, and Sensitization:2. Associative learning Classical conditioning, Re-conditioning,

Discriminative conditioningOperant conditioning, and Avoidance conditioning

Student Notes:



needed)

Continue … Lecture 45: Memory processes and Learning theory

Student Notes:

105

Reading:





Self-assessment



needed)

Lecture 46: CNS vascular diseases & trauma

Department: Pathology Student Notes:

106





Discuss in details the various cerebrovascular lesions as well as the CNS trauma & be aware of their clinical importance.

Detailed Contents:

Cerebrovascular diseases: Global hypoxic-ischemic encephalopathy Strokes: Infarcts Primary “spontaneous” intracranial

hemorrhages Hypertensive cerebrovascular disease

Central nervous system trauma: Epidural hematoma Subdural hematoma Traumatic parenchymal injuries



needed)

Continue … Lecture 46: CNS vascular diseases & trauma

Student Notes:

107

Reading: Robbins Basic Pathology, 8th edition “2007”

Self-assessment



needed)

108

Practical

109

Practical 1: Organization of nervous system, meninges & external features of the cerebral hemispheres.TUTOR: Department: anatomySUMMARY:

OBJECTIVES:

1. Identify the meninges, dural folds and subarachnoid cisterns.2. Demonstrate the different lobes of the cerebrum, sulci and gyri on the different

surfaces of the cerebral hemisphere.DETAILED CONTENT:

Identification of the meninges, dural folds, dural sinuses and subarachnoid cisterns.

Demonstration of the different lobes and fissures of the cerebral hemisphere. The sulci and gyri on the supero-lateral surface The sulci and gyri on the medial surface The sulci and gyri on the inferior surface

READING:

110

Practical 2: CSF biochemistry Cerebrospinal fluid

TUTOR: Department: clinical biochemistry SUMMARY:

OBJECTIVES:

1) Recognize and perform biochemical tests on the CSF that are most reliable diagnostically and analytically accessible

2) Suggest a preliminary diagnose for the medical disorders that affects the central nervous system as meningitis, multiple sclerosis….etc

3) Explain the changes that occur in the CSF analytes as a result of diseases

DETAILED CONTENTS: 1) Collection of a CSF sample 2) CSF glucose:

Transport of glucose into the CSF Evaluation of plasma and CSF glucose levels at the same time Normal CSF glucose level and the significance of increased or

decreased CSF glucose3) CSF lactate:

Relationship between glucose consumption and CSF lactate level Significance of increased CSF lactate levels

4) CSF proteins:Significance of CSF proteins Relationship between CSF proteins and serum proteins Normal CSF protein level and the significance of increased or

decreased CSF proteins

READING:

111

Clinical chemistry 5th ed. Editor: William J Marshall, Stephen Bangert Publisher: Mosby

Practical 3 examination of the cranial nerves, motor, and sensory system

TUTOR: Dr Badra Department: physiology SUMMARY:

OBJECTIVES:

Learning objectives:By the end of this practical class the student should know how to examine for: sensory and motor functions of the 12 cranial nerves

CRANIAL NERVE EXAMINATION:1. I: Olfactory 2. II: Optic 3. III-IV-VI: extraoculars 4. V: Trigeminal 5. VII: Facial 6. VIII: Vestibulocochlear 7. IX-X: Glossopharyngeal, Vagus 8. XI: Accessory 9. XII: Hypoglossal

READING:

112

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_xii%23cn_xii

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_xi%23cn_xi

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_ix-x%23cn_ix-x

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_viii%23cn_viii

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_vii%23cn_vii

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_v%23cn_v

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_iii-iv-vi%23cn_iii-iv-vi

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_ii%23cn_ii

http://www.clinicalexam.com/pda/n_cranial_nerves_exam.htm#cn_i%23cn_i

Practical 4: Histology of cerebral & cerebellar cortex, histology of eye and ear.

TUTOR: Department: anatomy

SUMMARY:

OBJECTIVES:

: By the end of the practical session the student should be able to:

1. Demonstrate of the different layers and cells of the cerebral cortex.2. Demonstrate of the different layers and cells of the cerebellar cortex.3. Demonstrate of the cochlea and organ of Corti.4. Demonstrate of the different layers of the retina and cornea.

DETAILED CONTENT: Demonstration of the different layers and cells of the cerebral cortex. Demonstration of the different layers and cells of the cerebellar cortex. Demonstration of the cochlea and organ of Corti. Demonstration of the different layers of the retina and cornea.

READING:

113

Practical 5: Visual acuity, fundus examination perimeter, and test for near vision, light reflex, and colour vision

TUTOR: Prof Sawsen Roheim Department: physiology SUMMARY:

OBJECTIVES:

Learning objectives: By the end of this practical class the student should know how to:

1. Test for visual activity2. Do fundus examination3. Test for eye movements4. Elicit changes that accompany near vision5. examine for light reflex6. examine for color vision Detailed content:7. Snellen test letter chart used to measure visual acuity8. The normal finding in fundus examination9. Muscle involved in eye movements & how to test for it.10. Changes that take place in the eye for near vision accommodation.11. Light reflex component and mechanism12. Detailed mechanism and requirement for color vision

READING:

114

Practical 6: Internal structures of the cerebral hemispheres:

TUTOR: Department: anatomySUMMARY:

OBJECTIVES:

By the end of the practical session the student should be able to:1. Identify the different types of the white matter in the cerebrum.2. Demonstrate the different parts of corpus callosum. 3. Distinguish the different parts of horizontal section including the basal ganglia.4. Locate the different fibers passing through the different parts of internal capsule.5. Identify the different parts of the basal ganglia.

DETAILED CONTENT: Lentiform nucleus, Caudate nucleus, Amygdaloid body and Claustrum. Associational, commissural and projectional fibers. Horizontal section of the cerebrum, internal capsule (components, fibers

passing through, blood supply and lesions).

READING:

115

Practical 7: hearing tests & audiometry

TUTOR: Prof Sawsen Roheim Department: physiologySUMMARY:

OBJECTIVES:

Learning objectives:The students should know:

1. Pitch & loudness of sound (what does they mean).2. Definition & types of deafness.3. Causes of nerve & conductive deafness.4. The use of audiometer in diagnosis of deafness.5. Different hearing tests and their significance.

Detailed content:Differences between pitch & loudness. Auditory Sensation (Weber's test, Rinne's test,)Audiometry uses to systematically determine the difference (in dB) between the actual (measured) threshold of hearing and the standard (normal) threshold for specific frequencies within the audible range.Clinical Implications of deafness

Transferable skillsStudents will be able to examine for hearing quality either with Audiometry, or

with tuning forks

READING:

116

Practical 8: Examination of sensory and motor systems:

TUTOR: Dr Bdra Department: physiologySUMMARY:

OBJECTIVES:

1. Sensory system.Motor systemMOTOR SYSTEM EXAMINATION: Muscle strength and tone, Babinski response, Exam of superficial reflexes & tendom jerk SENSORY SYSTEM EXAMINATION Light touch, crude touch, pain, temperature, position sense, and Vibration sense EXAMINATION FOR CEREBELLAR FUNCTTION(A) COORDINATION TESTS IN THE UPPER LIMBS1. Finger-nose test: 2. Finger to finger test: 3. Tests for adiadocokinesia: (B) COORDINATION TESTS IN THE LOWER LIMBS1. Heel-knee test (point to point testing): 2. Test the gait while walking along a straight line first in the normal way then heel to toe.3. Test for a positive Romberg’s sign (C) FIXATION TEST (FOR DETECTION OF NYSTAGMUS)Ask the patient to fix his eyes at an object on one side of the head, and notice if nystagmus occurs.

READING:

117

http://www.neurologychannel.com/neuroexam.shtml#sensory%23sensory

http://www.neurologychannel.com/neuroexam.shtml#motor%23motor

Practical 9: Diencephalon, ventricular system, CSF, spinal cord & blood supply


OBJECTIVES:

By the end of the practical session the student should be able to:1. Demonstrate the parts of the diencephalon; the thalamus, hypothalamus,

metathalamus and epithalamus.2. Demonstrate the parts and boundaries of the lateral and third ventricles.3. Identify the external features of the spinal cord.

DETAILED CONTENT: Demonstration of the parts of the diencephalon: thalamus, hypothalamus,

metathalamus, epithalamus and subthalamus. Thalamus: gross morphology, relations, and thalamic nuclei Hypothalamus: parts, and nuclei. Lat. Ventricle: parts (body and three horns), relations of each part and

connections. Third ventricle: walls, relations and communications. Identification of the external features of the spinal cord, its enlargements,

conus medullaris and spinal segments.

READING:

118

Practical 10: Brain stem, cerebellum & 4th ventricle.


OBJECTIVES:

Learning objectives:By the end of the practical session the student should be able to:

1. Demonstrate the external features of the medulla oblongata.2. Demonstrate the external features of the pons3. Demonstrate on the external features of the midbrain4. Identify the external features, lobes and subdivisions of the cerebellum.5. Identify the cerebellar peduncles.6. Identify the walls and openings of the fourth ventricle.

DETAILED CONTENT: Demonstration of the external features of the medulla oblongata and the

cranial nerves attached to it. Demonstration of the external features of the pons and cranial nerves

related. Identification of the external features of the midbrain. Identification of the external features, lobes, fissures, functional subdivisions

of the cerebellum. Cerebellar peduncles and fibers passing through them. Walls, relations and openings of the fourth ventricle.

READING:

119

Practical 11: CNS Pathology

TUTOR: Department: pathologySUMMARY:

LEARNING OBJECTIVES:

During this practical session the following specimens will be shown & discussed with the students:

1) Subarachinoid Hemorrhage2) Cerebral Intraventricular Hemorrhage3) Suppurative Meningitis4) Glioblastoma Multiforme5) Brain Metastasis6) Meningioma

READING:

120

Tutorial

121

Tutorial 1: brainTUTOR: Department: AnatomySUMMARY:

OBJECTIVES:

By the end of this tutorial , students should be able to understand and explain:

LEARNING OBJECTIVES: By the end of the lecture the student should be able to: Recognize the different types of the white matter in the cerebrum. Locate the different fibers passing through the different parts of internal capsule. Clarify the blood supply of internal capsule. Name the parts of the diencephalon: thalamus, hypothalamus, metathalamus,

epithalamus and subthalamus. Recognize the nuclei and the functions of the hypothalamus. Differentiate between the parts of metathalamus and their main connections.

DETAILED CONTENT: Different types of the white fibers of the cerebrum: Associational,

commissural and projectional fibers. Horizontal section of the cerebrum, internal capsule (components, fibers

passing through, blood supply and lesions). Parts of the diencephalon: thalamus, hypothalamus, metathalamus,

epithalamus and subthalamus. Hypothalamus: parts, nuclei and their function. Metathalamus: medial and lat. geniculate bodies and their connections.

READING:

122

Tutorial 2: Cerebral edema and raised intracranial pressure

TUTOR: Department: MedicineSUMMARY:

OBJECTIVES:


by the end of the tutorial the student should know:1-normal value of CSF pressure

2-physiology of CSF circulation

3-causes of increased intracranial pressure

4-causes of cerebral edema

READING:

123

Tutorial 3: organizations and transmission of pain, thermal sensations and headache

TUTOR: Dr Zenab Elrefaey Department: physiology SUMMARY:

OBJECTIVES:

By the end of this tutorial, students should be able to understand and

explain:

List the types of thermal sensations, site of receptors, and explain paradoxical cold sensation

List the tracts by which pain and thermal sensations are transmitted Explain the mechanism of pain ,list its types, and site of perception Give examples and explanation of referred pain Define headache, and list its types. List the three types of primary headache, their causes & characters. List the extra and intra cranial causes of headache as well as the

pain sensitive structure in the head. Explain the endogenous pain control system, the gate theory

caused by stimulation of the ascending DCS or descending suraspinal tracts.

Define the endogenous pain opiate system and explain the mechanism of its action.

Detailed content: Headache involves pain in the head. It is a common disease that may be caused by intra, or extra cranial causes. The understanding of these causes facilitate management of headache, and moreover may lead to early diagnosis of life threatening diseases.The understanding of the endogenous opiate system that helps in pain alleviation, may also add in helping those who are agonized by their pain

READING:

Review of medical physiology 22th ed, William F. Ganong. Human physiology from cell to system 5th ed, Lauralee

Sheerwood.

124

http://www.chclibrary.org/micromed/00059570.html



Tutorial 4 : Brain stem and cranial nerves

TUTOR: Department: anatomy

SUMMARY:

OBJECTIVES:

By the end of this tutorial , students should be able to understand

and explain:

1. Describe the external features of the medulla oblongata, the pons and the midbrain

2. Identify the nuclei present in medulla oblongata, the pons and the mid brain.

3. Recognize the lemnisci and decussations in the brain stem4. Arrange the cranial nerve nuclei in their functional columns.5. Determine the nuclei of deep origin of each cranial nerve.

DETAILED CONTENT: Medulla: external features, internal structures, decussations,

nuclei of cranial nerves, other nuclei and their connections Pons: external features, internal structure, nuclei, their

connections and lemnisci Midbrain: external features, internal structure, cerebral

peduncles, nuclei, their connections, and decussations. Functional classification of cranial nerve nuclei & deep origin of

each cranial nerve. Central nervous system (CNS)

READING:

125


Tutorial 5 Visual acuity and error of refraction + Functions of external and middle ear

TUTOR: Dr Sawsen Roheim Department: physiology

SUMMARY:

OBJECTIVES:


and explain:

1. define refraction and list the refraction media of the eye2. explain the mechanism of formation of a clear image on the retina3. Explain the mechanism of myopia, hypermetropia, and

presbyopia, and explain methods of correction4. describe the steps involved in the perception of sound5. describe the mechanism of magnification of sound by the middle

ear ossicales and its significance

Detailed content:Errors of refraction are common visual disorders that are associated with change in the orbit length or change in the smoothness of the cornea.In order to understand why errors of refraction happen, the student has to understand the meaning of visual acuity.sound transmission and mechanism of hearing by the ear external and middle in relation to their structure will be introduced in details. The function of tympanic membrane ,the mechanism of sound magnification, the attenuation reflex, and the function of the Eustachian tube .

READING:


126

Human physiology from cell to system 5th ed, Lauralee Sheerwood. Human physiology and mechanisms of disease 12h ed Guyton and

HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

Tutorial 6 antiepileptic drugs

TUTOR: Department: Pharmacology

SUMMARY:

OBJECTIVES:

Objectives:

At the ed of the tutorial, the student should be able to:

1. List the major drugs used for partial seizures, generalized tonic-clonic

seizures, absence and myoclonic seizures and status epilepticus

2. Identify themechanism of antiseizure drug action

3. Describe the main pharmacokinetic features and adverse effects of major

antiseizure drugs

4. Identify the new antiseizure drugs and their important characteristics

5. Describe the factors that must be considered in designing a dosage

regimenfor an antiseizure drug and the selection of antiseizure drugs during

pregnancy

READING:

127


Tutorial 7: Physiology of muscle tone and stretch reflex + Upper and lower motor neuron lesions, and gait disorders

TUTOR: Prof Maha Hegazi Department: physiology SUMMARY:

OBJECTIVES:


and explain:

1. Describe the relation between stretch reflex and muscle tone2. List the factors (physiological & pathological that affect the muscle

tone3. Compare upper & lower motor neuron lesions4. List the effects of complete & hemisection of spinal cord(site,

extend, muscle state, tendon reflex, …etc)5. Explain clonus and lengthening reaction6. List types of gait disorders and list the cause for each

Detailed content: Types of stretch reflex and the mechanism of inverse stretch reflex. The supraspinal control of the stretch reflex nd the alpha-gamma co-activation (cerebellar stretch reflex). The consequence of motor lesions on the stretch reflex The mechanism of rigidity and spasticity (alpha and gamma) in UMNL and BG lesion. Describe the +ve babiniski sign and t list non pathological causes. Give examples of gait disorders in different neurological lesions

READING:


Sheerwood.

128



Tutorial 8: cerebellar dysfunction & tremors

TUTOR: Dr Zenab Elrefaey Department: physiology

SUMMARY:

OBJECTIVES:


1. List and explain the functions of cerebellum2. Explain the manifestations of neucerebellar syndrome.3. Define ataxia, list its types & compare between motor & sensory

ataxia. 4. List types of tremors and give examples

Explain the mechanism of static and dynamic tremors.

Detailed content: The mechanism by which the cerebellum controls the motor functionwell be explained. In addition to its role in posture & equilibrium control. Cerebellar lesion affects the motor function and manifested as a neurocerebellar syndrome

READING:


Sheerwood. Human physiology and mechanisms of disease 12th ed Guyton

and HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

129



Tutorial 9: Aphasia & dysarthria

TUTOR: Dr Azra Department: physiology

OBJECTIVES:


and explain:

Define aphasia & dysarthria List the types, causes and presentation of Sensory

(receptive) aphasia (fluent aphasia) List the types of Motor (expressive) aphasia Demonstrate the clinical presentation of each type of motor

aphasia Define and explain the cause of global aphasia

Define dysarthria, list its causes and give examples

Detailed content: know the common clinical types of aphasia, & how to locate the site of cortical injury

define & understand dysarthria, causes if UMNL or LMNL

READING:

Reading: Review of medical physiology 22th ed, William F. Ganong. Human physiology from cell to system 5th ed, Lauralee Sheerwood. Human physiology and mechanisms of disease 12th ed Guyton and

HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

130


Self Direct Learning

131

SDL 1 Cerebrospinal Fluid in Health and Disease

TUTOR:

Department: CLINICAL BIOCHEMISTRY

SUMMARY:

OBJECTIVES:

By the end of this , students should be able to understand and explain:

1. Discuss the function, production and reabsorption of cerebrospinal fluid

2. Discuss the normal chemical composition of cerebrospinal fluid3. Interpret some pathological changes in composition of

cerebrospinal fluidDETAILED CONTENTS

1. Major functions of cerebrospinal fluid2. Production of CSF, reabsorption and blood brain barrier of

CSF3. Normal CSF composition4. Some pathological changes in CSF with relation to some

certain diseases

READING:

1. Textbook of Biochemistry with clinical correlation 4th ed.Editor: Thomas M.DevlinPublisher: Wiley-Liss

132


Direct Learning 2: Classification of somatic sensation & physiology of pain

TUTOR: Dr Zenab Elrefaey Department: PhysiologySUMMARY:

OBJECTIVES:

After completing this lecture, students should be able to 1. Classify somatic sensations2. List types of mechanoreceptive sensation3. List the receptors, the afferent nerve & the pathway for each

sensation.4. Explain the characters of pain sensation.5. Compare between the perception of cold & hot sensation and site of

thermoreceptors.6. Know the stimulus & the mechanism of pain production.7. List classification of pain sensation and describe the characteristics of

each 8. Explain the mechanism of referred pain

Detailed content: Classification the somatic sensations. The types of mechanoreceptive sensation. The receptors for each sensation, the afferent nerve & the pathway. The concept of thermal sensation, the differences between the

perception of cold & hot sensation and site of thermoreceptors. Differences between fast & slow pain. Understand the cutaneous pain, its characters & pathway. The cause, characters and the pathway for deep pain.

133

The mechanism of visceral pain, its characters, the afferent nerve, & pathways.

READING:

Review of medical physiology 22th ed, William F. Ganong. Human physiology from cell to system 6th ed, Lauralee Sheerwood. Human physiology and mechanisms of disease 13th ed Guyton and

HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)Direct Learning 3: Functions of thalamus, Somatosensory cortex, and Somatosensory association areas TUTOR: Dr Azra

Department: PhysiologySUMMARY:

OBJECTIVES:


and explain:

After completing this lecture, students should be able to 1. List the functions of the thalamus and explain each one2. list the somatosensory areas 3. describe the characters, function of each area and the effects of

lesions

Detailed content:The perception of sensation at the level of thalamus makes it a sensory center through which we can feel. We may not understand its type or make interpretation of sensation because this highly sensory function needs the cortex The functional parts of the sensory cortex associate with perception of

different types of sensation, moreover the sensory association area help in

adding meaning to the sensation

READING:

134


Review of medical physiology 22th ed, William F. Ganong. Human physiology from cell to system 5th ed, Lauralee Sheerwood. Human physiology and mechanisms of disease 12th ed Guyton

and HallThe Clinical Neurophysiology Primer by Andrew S. Blum and Seward B. Rutkove (Hardcover - 26 Jun 2007)

Direct Learning 4: Anatomy of the Basal Ganglia and Cerebral White Matter TUTOR: Department: anatomySUMMARY:

OBJECTIVES:


1. Describe the different parts of the basal ganglia.2. Recognize the different types of the white matter in the cerebrum.3. Comment on the different parts of corpus callosum. 4. Distinguish the different parts of horizontal section including the basal ganglia.5. Locate the different fibers passing through the different parts of internal capsule.

Clarify the blood supply of internal capsule.

DETAILED CONTENT: Lentiform nucleus, Caudate nucleus, Amygdaloid body and Claustrum. Associational, commissural and projectional fibers. Horizontal section of the cerebrum, internal capsule (components, fibers

passing through, blood supply and lesions).

READING:

135


Direct Learning 5: Anatomy of the limbic System TUTOR: Department: SUMMARY:

OBJECTIVES:


1. Name the different components of the limbic system.2. Define the piriform area.3. Identify the amygdaloid body4. Locate the septum pellucidum. 5. Report on the Hippocampal formation. 6. Follow the fornix.

DETAILED CONTENT:

• Structure and function • Olfactory bulb and tract• Piriform area• Amygdaloid nucleus and septum pellucidum • Hippocampal formation• Fornix

READING:

136

1. Clinical Neuroanatomy for Medical Students (Richard S. Snell), 6th edition, 2006. 2. Textbook of Histology (Gartner and Hiatt), 2nd edition, 2001.3. Langmanۥs Medical Embryology (Sadler T.W.), 9th edition, 2004.4. Cunningham's Manual of Practical Anatomy 15th edition 2002

SDL6: Antipsychotic, agents

TUTOR: Department: PharmacologySUMMARY:

OBJECTIVES:


1. Describe the dopamine hypothesis of schizophrenia2. List the major receptors blocked by antipsychotic drugs3. Describe the pharmacodynamics of typical neuroleptics and their

clinical uses and adverse effects4. Identify the main characteristics and clinical uses of the newer

atypical neuroleptics5. Describe the pharmacodynamics and pharmacokinetics of lithium

Topics 1. Typical neuroleptics (chlorpromazine), the dopamine hypothesis ,

pharmacokinetics, clinical uses, and adverse effects2. Other atypical neurolepics, their pharmacokinetics and

pharmacodynamic effects3. Lithium in bipolar depression

137

READING:

Lippincott’s Pharmacology, 3rd Edition, & Basic and Clinical

Clinical presentation:

138

Department: Medicine

Case 1: Cereberovascular accident (cerebral stroke):

Objectives:Learning objectives: by the end of the lecture the student should know1-defention of stroke 2- types of stroke3-clinical presentation of hemorrhagic stroke4-clinical presentation of ischemic stroke5-causes of ischemic stroke6-causes of hemorrhagic stroke7-the principle management of stroke

Detailed content: Types of stroke :hemorrhagic and ischemic stroke Symptoms and signs of both stroke types Differentiation between both types of stroke Details mechanisms of stroke Investigation :radiological finding Management: emergency care, basic principles

Case 2: Peripheral neuropathy:

Learning objectives:

139

1-anatomical function of the nerves 2-classisfication of peripheral nerve insult 3-clinical presentation 4-review some causes of peripheral neuropathy

140

goals and objectives - kau.edu.sa1].doc · web viewtable of content. nervous system and special...

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