MED 282 — الجهاز العصبي
السنة 3 · 60 محاضرة · 7 ساعة معتمدة
العناوين والأهداف منقولة من خطة كلية الطب الرسمية.
1. Brain and spinal cord
Anatomy
- Classify the types of neurons.
- Describe the structure of the different parts of neurons.
- Describe the structure and types of synapses.
- Describe the types of glial cells and their functions.
- Describe the elements of the blood-brain barrier.
- Overview of the main parts of the CNS.
- Identify the main parts of the diencephalon and the main functions of each.
- Identify the basal ganglia nuclei.
- Describe the gross anatomical features of the spinal cord.
- Describe the level of the spinal segments compared with their vertebrae.
- Identify gross features of the spinal cord, nerve roots, and spinal ganglia.
- Describe the internal features of the spinal cord (gray and white matter) in the different regions.
2. Brain meninges, ventricles, and CSF
Anatomy
- Describe the arrangement of the meninges and their relationship to brain and spinal cord.
- Explain the epidural, subdural, and subarachnoid spaces.
- Locate the principal subarachnoid cisterns and arachnoid granulations.
- Describe the ventricles of the brain.
- Discuss the structure of the choroid plexus and the CSF-blood barrier.
- Locate the safe sites for lumbar puncture.
- Identify the brain ventricles on CT and MRI.
3. Cerebral hemispheres
Anatomy
- Describe the organization of the cerebral cortex (layers and columnar organization).
- Locate the motor, sensory, and other cortical areas.
- Identify structures in coronal, sagittal, and horizontal sections of the brain.
- Describe the types of fibers in the internal capsule.
- Describe projection, commissural, and association fibers of the hemispheric white matter.
4. Pathological features of CNS inflammatory conditions
Pathology
- Compare the clinical and pathological findings in bacterial and viral meningitis.
- Know the pathology of tuberculous meningitis and tuberculoma.
- List the types of syphilitic and fungal diseases of the brain.
- Describe viral encephalitis and the morphology of its commoner types.
- Know about prion diseases of the CNS.
5. Management of meningitis
Clinical
- Recognize the urgency in the management of meningitis.
- Know the range of therapeutic choices in meningitis.
- Appreciate the role of non-pharmacological (adjuvant) therapy.
- Understand the differences between adults and children in the management of meningitis.
6. Ticks and prions
Microbiology
- Ticks: definition, morphology, life cycle, pathogenesis, clinical manifestations, laboratory diagnosis, treatment, and prevention.
- Prions: background, structure, classification of diseases, epidemiology, pathogenesis and pathology, laboratory diagnosis, treatment, and prevention.
7. Blood supply of the brain and spinal cord
Anatomy
- Follow each artery to its destination.
- Describe the circle of Willis and its branches.
- Discuss end-artery circulation and watershed zones.
- Describe the venous drainage of the brain.
8. Regulation of cerebral blood flow
Physiology
- Metabolic regulation of cerebral blood flow: effects of CO2, H+, and O2.
- Autoregulation of cerebral blood flow and the myogenic hypothesis.
- Pathophysiology and types of brain edema and cerebral strokes.
9. Vascular diseases of the CNS
Pathology
- Define stroke and TIA, and the brain areas and cells most susceptible to ischemia and hypoxia.
- Describe global ischemic encephalopathy, laminar necrosis, and border-zone (watershed) infarcts.
- Describe regional infarction and its pathology.
- Know the types of intracranial hemorrhage and their pathological features.
- Know the effects of hypertension on the brain.
- Describe subarachnoid hemorrhage and its main causes: berry aneurysms and vascular malformations.
- Describe open and closed brain injury: types, morphology, pathology, complications.
- Describe the pathology of vascular trauma in the CNS.
- Describe diffuse axonal injury and spinal cord trauma.
- List the types of perinatal brain injury.
10. Diencephalon
Anatomy
- Identify the anatomical structure and nuclei of the thalamus.
- Identify the anatomical structure and nuclei of the hypothalamus.
- Identify the afferent and efferent connections of the thalamus.
- Identify the afferent and efferent connections of the hypothalamus.
11. Brain metabolism and neurotransmitters
Biochemistry
- Discuss the synthesis and degradation of GABA.
- Discuss the synthesis and degradation of dopamine, epinephrine, and norepinephrine.
- Discuss the formation and catabolism of serotonin.
- Discuss glutamate metabolism.
- Understand brain peptides as neurotransmitters.
12. Stroke
Medicine
- Define stroke and its subtypes.
- Describe the pathophysiology of stroke.
- Understand the diagnostic procedures in stroke.
- Discuss treatment options and preventive measures.
13. Antidepressants
Pharmacology
- Describe the monoamine theory of depression.
- Describe the classification of antidepressants.
- Describe the pharmacodynamics and side effects of tricyclic antidepressants.
- Describe the therapeutic use and toxic effects of MAO inhibitors.
- Describe the therapeutic use and toxic effects of SSRIs and SNRIs.
- Identify the major drug interactions of antidepressants.
- Describe the pharmacokinetics and pharmacodynamics of lithium.
14. Brainstem
Anatomy
- Identify the gross features of the brainstem.
- Describe its internal structure: ascending and descending pathways, sensory and motor cranial nuclei, substantia nigra, red nucleus, olivary nucleus, reticular formation.
- Describe the main connections of the sensory cranial nuclei.
- Describe the main connections of the motor cranial nuclei.
- Describe brainstem lesions such as medial and lateral medullary syndromes.
15. Antipsychotics
Pharmacology
- Discuss the dopamine receptor types blocked by antipsychotic drugs.
- Describe the classification of antipsychotic drugs.
- Describe their pharmacodynamics and correlate them with clinical uses.
- List the major adverse and behavioral effects of the major antipsychotics.
16. General sensory pathways of the trunk and limbs
Anatomy
- Describe the gracile and cuneate tracts (conscious proprioception, touch, pressure, vibration).
- Describe the dorsal and ventral spinocerebellar tracts (unconscious proprioception).
- Describe the lateral spinothalamic tract (pain and temperature).
- Describe the ventral spinothalamic tract (simple touch).
17. Pain sensation
Physiology
- Mechanisms of fast and slow physiological pain.
- Types of pain: superficial, deep, visceral; acute and chronic; physiological and neuropathic.
- Define hyperalgesia and allodynia with examples of primary and secondary hyperalgesia.
- Explain ways to inhibit pain and describe the brain analgesic system.
18. Opioids
Pharmacology
- Describe the neural mechanisms of pain sensation and its control.
- List the opioid receptors and endogenous opioid peptides and their differences.
- List the major opioid agonists and rank their analgesic efficacy.
- Describe the pharmacodynamics and pharmacokinetics of opioid agonists and their clinical uses.
- List the adverse effects of acute and chronic opioid use.
- Identify opioid antagonists and mixed agonist-antagonists.
- Describe the treatment of opioid dependency.
19. Motor pathways
Anatomy
- Define upper and lower motor neurons with examples.
- Describe the corticospinal (pyramidal) tract and the direct motor pathways to trunk and limbs.
- Describe the indirect (extrapyramidal) pathways such as rubrospinal and reticulospinal tracts.
- Describe the motor pathways to the facial muscles.
- Compare the signs of upper and lower motor neuron lesions.
20. Basal nuclei
Anatomy
- Understand the anatomical and functional definition of the basal ganglia.
- Identify the components of the basal ganglia.
- Describe their connections and the indirect pathways to the lower motor neurons.
- Describe the signs of lesions of the different components.
21. Cerebellum
Anatomy
- Identify the major lobes and regions of the cerebellum.
- Summarize the cerebellar cortex and the deep cerebellar nuclei and their connections.
- Summarize the afferent and efferent connections and their arrangement in the peduncles.
- Describe the major functions and the ipsilateral control of the body.
- Explain the effects of cerebellar lesions and the associated motor disorders.
22. Control of movements and posture
Physiology
- Outline the function of each component of the motor regulatory systems: cortex, brainstem, basal ganglia, cerebellum.
- Discuss the motor cortex's control of motor function.
- Discuss the role of the brainstem in motor control.
23. Epilepsy and headache
Clinical
- Define and differentiate seizure and epilepsy.
- Recognize the clinical types of seizures and epilepsy.
- Understand the clinical evaluation of patients with seizures.
- List the investigations required for seizure patients.
- Understand the outlines of management.
- Summarize the EEG and the mechanisms producing it.
24. Antiepileptics
Pharmacology
- Define epilepsy and the general classification of seizures.
- Understand the cellular mechanisms underlying epilepsy.
- Describe the major drugs for the types of epilepsy and status epilepticus.
- Discuss differences between antiepileptics in mechanism, adverse effects, and drug interactions.
- List the new antiepileptic drugs with their advantages, indications, and adverse effects.
25. Higher functions of the neocortex: learning and memory
Physiology
- Name, locate, and describe the parieto-occipitotemporal, frontal, and limbic association areas and related disorders.
- Describe the language function of the cortex.
- Discuss the neural basis of learning and memory and the common types of aphasia.
26. Degenerative diseases
Pathology
- Know the general features of degenerative diseases and dementias.
- Alzheimer's disease: clinical and morphological findings.
- Parkinson disease, Huntington disease, and amyotrophic lateral sclerosis in brief.
- Acquired nutritional and metabolic diseases of the nervous system in brief.
27. Parkinson's disease
Pharmacology
- Describe the neurochemical imbalance underlying Parkinson's disease.
- Identify the mechanisms of action of the drugs used in its management.
- Describe their therapeutic and toxic effects.
- Identify chemical agents and drugs that cause parkinsonian symptoms.
28. Arousal mechanisms, consciousness, and sleep
Physiology
- Describe the functions of the reticular formation and its nonspecific sensory system.
- Describe the primary EEG rhythms and the behavioral states of each.
- Summarize the behavioral and EEG characteristics of the stages of slow-wave sleep.
- Summarize the characteristics of REM sleep and the mechanisms producing it.
- Describe the normal adult night's sleep and its variation from birth to old age.
29. Sedative-hypnotics
Pharmacology
- Identify the major chemical classes of sedative-hypnotics.
- Describe their clinical uses.
- Describe the sequence of CNS effects over the dose range.
- Describe the pharmacodynamics of benzodiazepines and their receptor interactions.
- Compare the pharmacokinetics of common benzodiazepines and barbiturates and the clinical consequences.
- Describe the adverse effects, drug interactions, and antidotes.
- Understand tolerance and dependence.
30. Development of the CNS
Anatomy
- Describe the formation of the neural tube and neural crest.
- Describe the positional changes of the spinal cord.
- Describe the development of the spinal nerves and their ganglia.
- Describe the development of the meninges.
- Describe the development of the parts of the brain.
- Describe the development of the ventricles and choroid plexuses.
- Describe the development of the pituitary gland.
- Describe the development of the cranial nerves and their ganglia.
31. General anesthetics
Pharmacology
- Understand the physicochemical theories of anesthesia (lipid and protein theories).
- Describe the stages of anesthesia.
- Describe pre-anesthetic drugs and the rationale for their use.
- Identify the main inhalational anesthetics: pharmacodynamics, pharmacokinetics, side effects.
- Describe the commonly used intravenous anesthetics.
32. Subarachnoid hemorrhage and low back pain
Neurosurgery
- A brief of hemorrhages in the CNS from the neurosurgical view.
- Understand the surgical treatment options for low back pain.
33. Imaging of the CNS
Radiology
- Introduce the common radiological investigations in neurological diagnosis and when to use each.
- Use radiological findings to decide the approach to common CNS disorders.
- Understand the radiological approach to neuroradiological emergencies.
34. Drugs of abuse
Pharmacology
- Discuss the differences between stimulants and depressants.
- Describe the pharmacological types of drug dependence.
- Discuss the neurobiology of addiction.
- Describe the major actions of commonly abused drugs.
- Describe the major withdrawal signs and symptoms.
- Identify the likely causes of fatality from commonly abused agents.
- Describe the treatment of drug abuse.
- Discuss the challenge of recent abused substances such as Joker.
35. Bacterial infections of the CNS
Microbiology
- Characteristics, laboratory diagnosis, and management of Mycobacterium leprae, group B streptococcus, and Listeria.
- Bacteriology, laboratory diagnosis, management, and prevention of Clostridium tetani and botulism.
36. Tumors of the nervous system
Pathology
- Classify tumors and describe the general features of primary brain tumors compared with other tumors.
- Know the pathology and prognosis of the types of brain tumors.
- Know the common metastatic tumors and their pathology.
- Know the common spinal cord tumors.
- Describe tumors of the peripheral nerves.
37. Eye and visual pathway
Anatomy
- Discuss the structure of the coats of the eyeball.
- Describe the contents of the eyeball.
- Know how and where the optic nerve leaves the retina.
- Describe the sensory and autonomic nerve supply, blood supply, and lymph drainage of the orbit and eyeball.
- Understand the organization of the visual pathways and reflexes.
38. Physiology of the eye and retina
Physiology
- Describe light refraction by the eye and the refractive indices of cornea, lens, aqueous, and vitreous.
- Define accommodation, its mechanism, and its importance for near vision.
- Define visual acuity and the fovea's role.
- Know the types of photoreceptors.
- Understand phototransduction and the ionic basis of the receptor potential in rods and cones.
- Describe the retinal neurons and their synaptic circuit.
- Know the functions of bipolar, horizontal, and amacrine cells in visual processing.
39. Neurophysiology of vision
Physiology
- Describe the functions of the visual cortex in perception.
- Review the relay stations of the visual pathway.
- List the functions of the lateral geniculate nucleus and superior colliculus.
- Discuss the visual cortex's role in perception.
- Outline the pathways of color and black-and-white vision.
- Describe the major visual cortex cell types and their roles.
40. Introduction to eye diseases
Clinical
- Objectives provided separately by the lecturer.
41. Ear and auditory pathways
Anatomy
- List the structures of the external, middle, and inner ear.
- Discuss the tympanic membrane and external auditory meatus.
- Describe the walls of the middle ear, facial canal, auditory tube, ossicles and their muscles, and mastoid air cells.
- Describe the hearing and balance receptors.
- Follow the course of the VIII nerve to its entry into the brain.
- Understand the organization of the auditory pathway.
42. Hearing physiology
Physiology
- Review the ossicular system and its role in conducting sound to the cochlea.
- Outline traveling waves and how stapes movement deflects the basilar membrane at a particular point.
- Discuss the organ of Corti and how basilar membrane deformation becomes auditory impulses.
- Describe the ionic basis of auditory receptors.
- Explain how pitch and loudness are coded.
- Discuss the mechanisms of sound localization.
43. Physiology of equilibrium
Physiology
- Explain how semicircular canal hair cells detect rotational acceleration.
- Explain how utricle and saccule hair cells detect linear acceleration.
- Describe the vestibular system's role in stabilizing eye movements, and its connections with brainstem and cerebellum.
- List the sensory inputs synthesized into the sense of position in space.
- Describe the caloric test.
44. Introduction to ear diseases
Clinical
- Objectives provided separately by the lecturer.
45. Fungal and parasitic infections
Microbiology
- Objectives to be determined by the lecturer.
46. Cranial nerves, part I
Anatomy
- Describe the course and branches of each cranial nerve from its exit from the brain to its targets.
- List the modalities conveyed by each cranial nerve.
47. Cranial nerves, part II
Anatomy
- Describe the course and branches of each cranial nerve from its exit from the brain to its targets.
- List the modalities conveyed by each cranial nerve.
48. Physiology of peripheral nerves
Physiology
- Review the action potential and its propagation in different nerve types.
- Describe synapses and the factors affecting transmission.
- List the types of nerve fibers and their functions.
- Explain the compound action potential and its clinical significance.
- Define the latent period and calculate conduction velocity.
49. Demyelinating diseases
Pathology
- General features of demyelinating diseases, with emphasis on multiple sclerosis: clinical and morphological characteristics.
- Axonal degeneration and injuries.
- Causes and types of peripheral neuropathies.
50. Local anesthetics
Pharmacology
- Describe the classification of local anesthetics.
- Relate their chemical structures to pharmacological characteristics.
- Describe the mechanism of action and the relation between pH, pKa, and speed of onset.
- List the factors determining nerve fiber susceptibility to blockade.
- List the major toxic effects.
51. Enteroviruses
Microbiology
- Polio, coxsackie, and echo viruses: structure, properties, epidemiology, pathogenesis, clinical presentation, laboratory diagnosis, treatment, and prevention.
52. Cervical and brachial plexuses
Anatomy
- Describe how spinal nerves are formed.
- List the roots contributing to the cervical and brachial plexuses.
- Describe the location of these plexuses.
- List their branches and root values.
- Describe the course and function of each branch.
53. Lumbosacral plexus and nerves
Anatomy
- List the roots contributing to the lumbosacral plexus.
- Describe its location.
- List its branches and root values.
- Describe the course and function of each branch.
54. Introduction to peripheral nerve injury
Clinical
- Objectives provided separately by the lecturer.
55. Autonomic nervous system: sympathetic, parasympathetic, and enteric divisions
Anatomy
- Review the sympathetic system: origin, paravertebral and prevertebral ganglia, sympathetic trunk, splanchnic nerves, thoracic and abdominal plexuses.
- Discuss the sympathetic innervation of the head.
- Review the parasympathetic system: origin, ganglia, plexuses, and the sacral part.
- List the cranial nerves with parasympathetic activity and their targets.
- Describe the enteric division.
56. ANS and central regulation of viscera
Physiology
- Review ANS functions and effector responses to the two divisions' neurotransmitters.
- Understand the ANS as a reflex-based control system.
- Describe autonomic reflexes integrated at spinal cord and brainstem.
- Describe central regulation of autonomic output: nucleus of the solitary tract, limbic system, hypothalamus.
- List the major hypothalamic functions: body rhythm, temperature, appetite, water intake.
57. Cholinergic agonists and antagonists
Pharmacology
- Review acetylcholine synthesis, storage, release, and termination.
- Give examples of inhibitors of acetylcholine synthesis, storage, and release.
- Review the locations and types of acetylcholine receptors.
- Describe the effects of acetylcholine on the major organ systems.
- Correlate the pharmacokinetics of choline esters and cholinomimetic alkaloids with their chemistry.
- List the clinical indications and adverse effects of cholinomimetic agonists.
- Describe the distribution and function of cholinesterase.
- Classify cholinesterase inhibitors with examples.
- Describe the differences between direct and indirect cholinomimetics.
- List the signs and symptoms of organophosphate poisoning.
- Describe the treatment of organophosphate poisoning.
58. Rabies and arboviruses
Microbiology
- Rabies and arboviruses: classification, structure, properties, epidemiology, pathogenesis, clinical presentation, laboratory diagnosis, treatment, and prevention.
59. Adrenergic agonists and antagonists
Pharmacology
- Review epinephrine and norepinephrine synthesis, storage, release, and termination.
- List inhibitors of norepinephrine synthesis, storage, release, and reuptake.
- List the tissues with significant alpha-1 or alpha-2 receptors.
- Describe the systemic effects of a pure alpha agonist.
- Indicate the clinical applications and adverse effects of alpha agonists.
- List the tissues with significant beta-1 or beta-2 receptors.
- Describe the organ effects of a pure beta agonist and of a mixed alpha/beta agonist.
- List the clinical applications and adverse effects of beta agonists.
- Indicate the differences between direct and indirect sympathomimetic amines.
60. Development of the head and neck, eye, and ear
Anatomy
- Describe the development of the face.
- Describe the development and fate of the pharyngeal arches.
- Describe the development of the eye.
- Describe the development of the ear.