Neurophysiology course

LECTURE TOPICS AND INSTRICTIONAL OBJECTIVES
Neurophysiology (RHS-346)
 
 

1. Functional Neuroanatomy:

 
At the end of this session, the students should be able to:
 

• list the major central nervous system control centres and relate them to their   functional activity or lack of activity.

 
 
 

1. Synaptic Transmission:

 
At the end of this session, the students should be able to:
 

• describe the mechanisms of receptor transduction for the following

neurotransmitters – acetylcholine (Ach).GABA, glutamate, serotonin and enkephalin
                 
 

• describe steps in chemical neurotransmission beginning with the arrival of wave of depolarization at the presynaptic membrane and

ending with graded potential generated at the postsyneptic membrane
 
 

• describe the ionic basis for inhibitory and excitatory post-synaptic

potential and how these changes can alter synaptic transmission
 
                       
3.         Synaptic  Properties:
 
      At the end of this session, the students should be able to:
 

• identify and describe the following synaptic properties-  One-way conduction, synaptic delay, summation, divergence, convergence and   state the effects of hypoxia, acidosis and alkalosis

 
 

• distinguish and provide examples of post-synaptic, presynaptic,

lateral or surround, feed forward,  reciprocal and renshaw cell inhibitions
 
4.         Receptors:
At the end of this session, the students should be able to:
 

• describe the following cutaneous and proprioceptive mechanoreceptors and their functions:  Pacinian corpuscles, meissner’s corpuscle, ruffini endings, Merkell’s disk.  A delta and C free nerve endings, muscle spindle and golgitendon organ

 
 

• list and describe receptor  properties

 
                         
 

1. Sensory Modalities

 
At the end of this session, the students should be able to:
 

• identify and describe the neurophysiological basis of sense modalities

 
-     define and contrast tactile localization and two-point discrimination     
       
 

• explain why the threshold for two-point discrimination changes in different areas of the body e.g. lips, fingertips and back

 
 

• explain intensity discrimination

 
 
6.         Somatosensory System:
 
At the end of this session, the students should be able to:
-     list the submodalities of discriminative touch
 
-     describe functional organization at all levels and submodalities served
by the dorsal column – medial lemniscal and equivalent components of the trigeminal system
  -   contrast the proprioceptive pathways to the cerebellum with that to the cerebral cortex
 
7.         Sensory Tract Lesion:
 
      At the end of this session, the students should be able to:
-     identify and describe the Physiological deficit and the consequences of lesions at different levels of spinal cord
 
8.         Neurophysiology of Pain:
 
            At the end of this session, the students should be able to:
-     describe functional organization at all levels and submodalities served by the anterolateral system and the equivalent components of the spinal trigeminal system
 
-     differentiate the submodalities of nondiscriminative touch, temperature   and pain based on receptor transduction mechanism,localization within          the spinal grey matter and central termination of the pathways
-     describe the control of pain perception including central processing and the role of endorphin
-     describe the mechanism of reffered pain of visceral origin
 
9. Spinal Reflexes:
At the end of this session students should be able to:
 

1. Identify and describe the components of a reflex arc ( receptor or sense organ , afferent neuron , spinal center , interneurons , motor neuron , effector organ ) .
2. Classify reflexes into monosynaptic and polysynaptic ; and into superficial ,deep and visceral reflexes .
3. Describe the muscle spindle and its innervation and actions .
4. Describe the stretch reflex and its components ( dynamic and static ) , and the basis of muscle tone .
5. Explain the spinal and supraspinal influences that modulate the activity of the stretch reflex ( spinal and supraspinal regulation of the stretch reflex ) .
6. Describe the Golgi tendon reflex ( inverse stretch reflex ) and withdrawal(flexor )  reflex .
7. Enumerate and describe some of the properties and components of reflexes and reflex pools:adequate stimulus , irradiation and recruitment ,summation , after discharge , reverberating neurons , reciprocal innervation and reciprocal inhibition , Renshaw cell , final common path , response time ,rebound phenomenon , muscle tone , lengthening reaction ( clasp-knife effect ) , central excitatory and inhibitory states .
8. Describe some of the superficial , deep and visceral reflexes of common clinical use and their spinal centers .

 
 
10. Cortical Motor Areas , and the Major Descending Motor Pathways :
 

1. At the end of this session students should be able to:
2. Enumerate the cortical motor areas ( M1,M2,M3 and Parietal lobe ) and Describe their locations and functions .
3. Appreciate what is meant by upper and lower motor neurons , and the role of the medial and lateral spinal motoneuron groups in execution of movement .
4. Explain the function , origin and termination of the corticobulbar , corticospinal and  extrapyramidal ( vestibulospinal , rubrospinal , reticulospinal and tectospinal ) tracts .

 
   
11. Upper and lower motor neuron lesions ( in the context of the pyramidal
      motor system ) :
       
At the end of this session students should be able to:
 

1. Compare and contrast upper and lower motor neuron lesions .
2. Provide an example of a condition associated with lower motor neuron lesion  e.g., Poliomyelitis or a brachial plexus lesion .
3. Spinal cord lesions : mention few examples of their causes , and provide detailed features of complete transverse spinal cord lesion incurred at the following sites : upper cervical , lower cervical ( quadriplegia ) , thoracic (paraplegia ) , lumbar and cauda equine regions .
4. Correlate the motor features of Brown-Sequard syndrome with its sensory features that were previously studied in the context of sensory lesions .
5. Hemiplegia : Give few examples of causes of hemiplegia , and provide clinical features of such a lesion .

 
12. The Basal Ganglia :
At the end of this session students should be able to:
 

1. Enumerate the basal ganglia and describe their main circuits , neurotransmitters and functions .
2. Explain the following features and phenomena associated with Extrapyramidal disease : dyskinesia , dystonia , tremor , chorea , athetosis , hemiballismus .
3. Give examples from Parkinson's disease and the choreas of Sydenham and Huntington.

 
 
13. The Cerebellum :
At the end of this session students should be able to:
 

1. Describe the functional divisions of the cerebellum ( vestibulocerebellum , spinocerebellum and cerebrocerebellum ).
2. Define the physiological roles of the cerebellum in regulation of movement .
3. Explain the following abnormalities that are associated with cerebellar disease : Cerebellar nystagmus , changes in muscle tone , ataxia , drunken gait , scanning speech , dysmetria ( past-pointing ) , intention tremor , rebound phenomenon , adiadochokinesia and decomposition of movement .      

1. Handout .

 
14. Hypothalamus & Body Temperature Regulation:
At the end of this session students should be able to:
 

1. Describe the hypothalamic control of the body temperature
2. Appreciate temperature related problems eg. Fever, heat stroke, hypothermia etc.

Pre-reading:
 

• Review of medical physiology, Ganong.22nd. edition. Pg 251-255.
• Text book of Medical physiology, Guyton and Hall.

 
 
 
15. Cerebrospinal Fluid
At the end of this session students should be able to:
 

1. Describe the formation & circulation of CSF.
2. Describe the normal constituents & their changes during various pathological conditions