7/27/2019 Neuroscience Syllabus Fall 2013

1/5

Atlantic University School of Medicine

September-DecemberSemester2013

I. Instructor: Dr.SudhakarAvancha

II. ClassSchedule: MondayFriday8:00AMto10:00AM

III. Of>iceHours: MondaytoFriday

WithoutAppointment(Walk-in):7:30AMto8:00AMandfrom12PM

to1PM ByAppointment:1:00PMto3:00PM

IV. ExamPolicy Therewillbetwomid-termexamsfollowedbyacomprehensiveOinalexam.

Classpresentationsorprojects,groupdiscussion,&clinicalcasestudies,

whichareheldthroughoutthesemester,willalsobeconsidered

appropriatelywhiledeterminingtheOinalgradesofthecourse. AllQuestionsintheexamswillbetypicallyinUSMLEformat.I(incomplete)

orW(withdrawn)gradeswillbereportedtothefOiceoftheRegistrarin

compliancewiththepoliciesofAtlanticUniversitySchoolofMedicine.

V. Grading: Honors=92%andabovePassing=70%to91%;Failing=Belowor70%

VI. Textbook: Requiredtexts:

Snell,RichardS.ClinicalNeuroanatomy,7thedition,Lippincottt,

Williams-Wilkins,2010,ISBN978-0-7817-9427-5,orWestmoreland,

BarbaraandSnell,RichardS.ClinicalNeuroanatomyforMedical

Students,5thedition,Lippincott-Raven,2001,ISBN0-781-72831-2 Crossman,AR,Neary,D.Neuroanatomy:AnIllustratedColourText,3rd

edition,Chrurchill-Livingstone,ISBN0-443-10036-5 Recommendedtexts:

Netter'sAtlasofNeuroscience,DFeltonandANShetty,2ndedition,

Saunders,2010,ISBN978-1-4160-5418-9

Nolte,JandAngevine,JB.TheHumanBraininPhotographsand

Diagrams,2ndedition,Mosby,2000,ISBN0-323-01126-8

Neuroscience Syllabus

7/27/2019 Neuroscience Syllabus Fall 2013

2/5

Goldberg,Stephen.ClinicalNeuroanatomyMadeRidiculouslySimple.

Whileanyeditionisacceptable,thelatestoneis3rd,MedMaster,ISBN

0-94078-o57-7

Fix,JamesD.Neuroanatomy,4thedition,Lippincott-WilliamsWilkins,

2009,ISBN0-7817-7245-1and/orFix,JamesD.HighYield

Neuroanatomy,4thedition,Lippincott-WilliamsWilkins,2009,ISBN978-0-7817-7946-3

Kandel,EricR.,SchwartzJHandJessel,TM.PrinciplesofNeuralScience,

4thedition,2000,McGraw-HillN0-8385-7701-6

LearningObjectives

Purpose:Thepurposeofthiscourseistoprovidethenecessaryknowledgeessentialto

understandingthecomplexitiesofthehumannervoussystem.Emphasiswillbebased

upondevelopingafoundationinthebasicandappliedneuroscienceswhichwillpermitunderstandingofbothnormalandpathologicalstatesofthenervoussystemessential

forclinicalpractice.

Goal:ProvidethestudentwithaOirmknowledge,baseduponroteandcriticalthinking

methodology,ofthehumannervoussystemanditspathologyrelevantforhighquality

medicine.

Objectives:Thecourseinvestigatesbothanatomyandphysiology,theformerincluding

grossandmicroscopicanatomyofnormalandabnormalhumanbrain,brainstem,

cerebellum,spinalcordandperipheralnervestates.Understandingnormaland

abnormalphysiologicalprinciplesinvolvedinthe"web"ofneuronalpathways,theirneurotransmissionandinterfacewithglialstructureswillleadtoanunderstandingof

diseasestates,theirdiagnosisandtreatment.

Thestudentwillthenbeabletoidentifyprinciplesofdevelopment,differentiate

somaticandvisceralcomponents,learnthefunctionalanatomyofthecentraland

peripheralnervoussystem,theirpathwaysandinterdependentstates,whichwilllead

toacriticalthinkingapproachtoanatomicalandfunctionaldiagnoses,aswellas

treatmentofdiseasestates.

Format:Traditionallectureanddiscussionmethodologywillbeusedtoexplorecourse

materialandlaboratoryassignments.Itisnecessarytoenhancebothfocusandselfdisciplinenecessaryaswellascriticalthinkingthroughpresentationofclinicalmaterial

intheformofcasepresentationforthelearningprocess.

Neuroscience Syllabus

7/27/2019 Neuroscience Syllabus Fall 2013

3/5

CourseOutline:

Week1:IntroductiontoandDevelopmentofthecentralnervoussystem(Chapters

oneand29,Snellorequivalent)

Earlyembryologicalstagesinformationoftheneuraltube;speciOicobjectives:

understandingtheectoderm,mesodermandendodermdifferentiation;theneuralplate,

foldandgroove.

Earlydevelopmentofthebrain,primaryandsecondaryvesicles,derivativesofthemature

brainwithspeciOicunderstandingofthetelencephalon,diencephalon,mesencephalonand

rhombencephalon,theimportantOlexures,bloodsupplyandventricularsystem;common

pathologicalstatessuchascraniosynostosis,Chiarisyndromes,meningomyelocele,

hydrocephalus.RelevanceofUSMLEinthiscategory,includingtheheelspottestforinborn

errorsofmetabolismandinfectioussequelaewillbeprovidedbytheinstructor.

Week2and3:Structureandfunctionofneuronesandglia(Chapters2,3Snellandor

equivalent)

BasicstructureoftheneuronewithspeciOicunderstandingoffunction,axonaltransport

andpathology.Axonalterminals,synapseandcentralnervoussystemmyelinationwith

speciOicunderstandingrelevancetoneurotransmissionanddiseasestatessuchasthe

demyelinatingdiseases.Peripheralnervoussystem,nerveOibersandsheathwithspeciOics

inunderstandingneuropathies,theGuillain-Barresyndrome...Structureandfunctionofthe

synapse,synapticintegration,actionpotential,refractoryperiodwithspeciOicsof

neurotransmitterrelease,nerveconduction,actionoflocalanesthestics,drugsandtoxins

affectingtransmssionwithconsiderationforthepotentialforbiologicalandchemical

warfare,peripheralnerveinjury(Walleriandegenerationandrepairwithconceptsof

nervegrowthfactors).

GlialcellsandtheirimportantroleinneuralfunctionasinGABA/Glutamatemetabolism

androleinpotassiummetabolism,bothrelevanttoepilepsyandotherdisorders.Concepts

ofthebloodbrainbarrier,edemaandneoplasticformationfromglialcells.

Week4:Sensoryreceptors:(Chapters5and6Snellorequivalent)

Mechanismofsensoryreceptorstransductionandfunctions;theneuromuscularjunction.

SpeciOicconceptswillbestructureandfunctionasrelatedpainandanalgesia;muscle

activity,myastheniagravisanditsdifferentation.

Week5:Bloodcirculationandsupplytothecentralnervoussystem(CNS)(Chapter

28Snellorequivalentwithangiographypresentation)

ReviewofrelevantCNSdevelopment,arterialandvenoussupply,thecarotidandvertebral

circulation,circleofWillisandotheranastomoseswithwatershedconceptsandspeciOic

conceptsofocclusionofmajorarterialbranchesincerebrumandbrainstem,arteriovenous

malformationandaneurysmformation,strokeandintracerebraletalhemorrhage;

Neuroscience Syllabus

7/27/2019 Neuroscience Syllabus Fall 2013

4/5

angiography.Theeffectsoftrauma,thebloodbrainversuscerebrospinalOluidbrain

barrier.

Week6:MeningesandVentricularSystem(Chapters18,19and27Snellor

equivalent)

Structureandfunctionofmeninges,subarachnoidspaceandcisternswithspeciOicsof

meningiomaformation,meningitis,headacheinvolvingvasculature,transtentorial

herniationandKernohan'snotchconcepts.Thelumbarpunctureandanalysis.

Subarachnoidhemorrhage.VentriclesandcerebrospinalOluidformationandabsorption

withspeciOicsofhydrocephalus,CTandMRIanalysis.

Week7:SpinalCord(Chapters7,20and21Snellorequivalent)

Spinalcord,nerveroots,dermatomes,myotomes,conusandcaudaequinawithspeciOicsof

spinalcordinjury,meningitis,myelogram,cord,caudaequinaandconusmedullaris

syndromes,compressionsandstenosis.Pathwaysinvolvingwhiteandinterfacewithgray

matterwithspeciOicsofpaincontrol,gatetheory,discriminativetouch.Brown-Sequardsyndrome,neurosyphyllis,amyotrophiclateralsclerosis,subacutecombineddegeneration,

Friedrich'sataxia.Multiplesclerosis.Radicularpathologyassociatedwithherpeszoster

andinjurieswillbenotedaswellasconceptsofnerveblocks.Patientevaluationtacticswill

bedescribed.Painreliefwithvariedtacticsincludingablation,stimulationandintrathecal

drugswillbenoted.

Week8and9:TheBrainstem(Chapters8-10,12,23Snellorequivalent)

Structures,pathwaysandnucleitogetherwithcranialnervesascendinganddescending

pathwaysanddecussations;thereticularformation,mediallongitudinalfasciculus;sources

ofneurotransmitters:catecholaminesandserotonin.Thecerebello-pontineangle.SpeciOicswilldescribeParkinsonismanddisease,acousticneuromaandneuroOibromatosis,locked

insyndromeandvariedvascularsyndromes:Wallenberg,BenedicktandWeber...brainstem

injury,cranialnervedysfunction,multiplescerosis...

Week10:TheCerebellum(Chapters10,11and22Snellorequivalent)

Structureandfunctionbeyondcoordination.Divisionsandnucleitogetherwithpeduncular

relationshipsandtargets.Syndromesrelatetovariedsitesandnucleiandinvolvemotor

coordinationaswellbehavioralandsensorymodiOications.Neoplasmsandhematomawill

beaddressedaswellChiarisyndromes.

Week11TheThalamusandHypothalamus(Chapters13,24and25Snellor

equivalent)

ThediencephalonwithfocusonthethalamuswillbenotedwithspeciOicsadressingthe

thalamicpainsyndromeortargetsusedintherapyforpainandinvoluntarymovement

disorders.Therelatedthirdventricleandpinealglandanditsmelatoninfunctionnoted

togetherwithneoplasticdifferentialaswellasVeinofGalenpathology.Thehypothalamus,

Neuroscience Syllabus

7/27/2019 Neuroscience Syllabus Fall 2013

5/5

itsdivisionsandtractsaswellasitsrelationshiptothepituitarygland:anteriorand

posteriorwillbeaddressednotinghomeostasisandtheneuroendocrinesystem,

neoplasms.Thecraniopharyngeoma.Introductiontotheautonomicnervoussystem.

Week12:TheCerebrum(Chapters14and15Snellorequivalent)

Variedanatomicalsectionswillbeanalyzedtogetherwiththeirfunction,dominance,

speech,maleandfemaledifferentiation,memoryfunctiontoincludeexecutivecognitive

functions,sleep,behavior,arousalandageing.SpeciOicsinvolvingPenOield'sstudiesand

epilepsy,subcorticaldegeneration,Alzheimer'sversustreatabledementias,disordersof

circulationwillbenotedsuchasinfarction,neoplasm...Meansofevaluatingthepatient

withstandardneurologicaltacticsandmini-mentalstatusexamwillbegiven.VisualOields...

Week13:ReticularformationandLimbicsystem(Chapters16withreviewof9,12

and13-15Snellorequivalent)

ThelimbicsystemofPapezwillbeexploredtogetherwithitsramiOicationinbehavior

andarousal;olfactionandmemory.Itspathwaysareextensiveincludethethalamusandhippocampusaswellasthecingulategyrusandprefrontalareas.Maleandfemale

differenceswillbenoted.SpeciOicswillbepsychosessuchasschizophrenia,importanceof

theamygdalainbehavioraspotentialforviolence,epilepsy...TheKluver-Bucy

syndrome...thetreatmentofbehavioraldisorderswithcingulotomyandthepotentialof

amygdalotomyforviolence;theroleofamygdalectomyforcomplexpartialseizures.

Week14:TheBasalGanglia(Chapter17withreviewofChapter13Snellor

equivalent)

Theroleofdopaminewithtypeoneandtworeceptorsaswellasthedirectandindirect

pathwaysincludingthesubthalamicnucleusanditsinterfacewithglobuspallidusinteriorandventrolateralthalamus/cerebrum.Substantianigraandtheeffectofoxidative

degeneration.Thebasalgangliahavearichbloodsupplyandthereforearesusceptibleto

variedtoxins.SpeciOicpathologyisnotedinWilson'sdisease,Huntington'schorea,essential

tremorandParkinsonismwillbenotedalongwithotherinvoluntarymovementdisorders

aswellastreatmenttacticsthataremedication,stimulationandablationoftargets.

Week15:TheAutonomicNervousSystem(Chapter26Snellorequivalent)

Thiswillbeanexpansionofpriordiscussionsandincludetheganglia,roleincausalgic

painsyndromes,visceralcontrol(cardiovascular,pulmonary,gastrointestinal);theroleof

sympathectomy,vagalstimulationinepilepsy...Horner'ssyndrome,Hirschsprung'sdiseasewillbenoted...Acetylcholine,nitricoxideandnorepinhrine,epinephrinewillbeaddressed

alongwithreceptorconceptsinpharmacology.

Thesyllabusmayvaryslightly.Thestudentwillbeinformedincasethereare

signi8icantchanges.

Neuroscience Syllabus