Neuroanatomy
Syllabus
Medical Neuroscience Lab Curriculum
Lab 1: Anatomy of Brain, Vascular System & Meninges
· Short Prerecorded Prelab (15 minutes)
· 2h hands on lab – gross whole and hemibrain, plastic head model, angiograms
· NO clinical cases
o Recognize the key CNS structures listed in each section.
o Describe the meninges and their relationship to the skull and to the CNS.
o Distinguish the boundaries for the five major divisions of the adult brain.
o Describe the gross structure of the brain, including the demarcations between the various lobes and the other major structures of the brain.
o Describe the major arterial networks that supply the brain along with the venous outflow to the sinuses.
o Localize the gross territories covered by the major arteries of the brain
o Learn how to interpret angiograms.
Lab 2: Finding Structures in the Brain
· Prerecorded Prelab with inbuilt questions (30 minutes)
· 2h hands-on lab – Ventricular models with gross whole brains and gross hemibrains. Gross and embedded coronal and horizontal sections of brain and brainstem.
· NO clinical cases
o Know the three-dimensional organization of the ventricular system.
o Identify the major brain regions that are associated with the subdivisions of the cerebral aqueduct and lateral, third and fourth ventricles.
o Describe the location and extent of the choroid plexus.
o Describe the flow of CSF from its origin in the choroid plexus to its entrance into the superior sagittal sinus.
o Understand the structure of the cisterns and describe their locations and names.
o Identify cross sections of the brain stem at the level of the open and close medulla, pons and mesencephalon.
o Identify key structures on a series of MRI images.
o Recognize the rostrocaudal levels of transverse sections through the brainstem on both the gross brainstem cross-sections and MRI.
Lab 3: Spinal Cord Anatomy and Sensory Pathways
· Prerecorded Prelab focusing on pathways with inbuilt questions (60 minutes)
· 1.5h Lab – Gross spinal cord, gross cross sections of spinal cord, and glass slides
· 0.5h Lab – Clinical cases covering ascending sensory patient problems from spinal cord and brain stem
· Aims of Prerecorded Lab
o Describe the relationship of the spinal cord and its roots to the bony vertebral canal. Discuss how this relationship changes during development.
o Understand why a "lumbar puncture" is performed between L4 and L5.
o Draw a schematic cross section of the spinal cord, indicating the posterior, lateral and anterior funiculi and the posterior and anterior horns. Indicate the locations of the substantia gelatinosa, the intermediolateral cell column, the posterior intermediate sulcus and the dorsal and ventral roots. Describe the contents and function of each.
o In a schematic cross section of the spinal cord, identify the location and describe the contents of fasciculus gracilis, fasciculus cuneatus, the spinothalamic tract and the lateral corticospinal tract. Include in your description an indication of the origin and termination of the fibers in each of these tracts, the kind of information carried, and the side of the body represented.
o Understand the locations of the major long ascending (sensory) pathways through the brainstem as evidenced by sketching the 2 or 3 neurons chains and/or listing the anatomical structures from the stimulus (i.e., touch, pain, and temperature) to its appropriate primary neocortical area.
o Describe the arterial supply of the spinal cord.
o List the sensory functions of cranial nerves CN V, VII, IX and X.
o Find the solitary nucleus and tract in a cross section of the medulla
o Identify the spinal trigeminal nucleus and tract in the medulla, the sensory trigeminal nucleus in the pons, and the mesencephalic trigeminal nucleus in the midbrain of the brainstem.
o Understand the vascular supply to the spinal cord and predict the types of sensory deficits that would occur following disruption of these supplies.
· Aims of In-Person Lab
o List the subdivisions of the spinal cord and identify how many spinal nerves and spinal segments are associated with each.
o Identify the subdivisions of the spinal cord and compare that to their corresponding fixed section on a glass slide
o Understand the concept of a myelin stain
o Identify key landmarks on a glass slide of spinal cord cross section
o Predict, using your working knowledge of the organization of the spinal cord and brainstem, the location of a lesion based on the described somatosensory deficits.
Lab 4: Brainstem Anatomy and Motor Pathways
· Prerecorded Prelab focusing on pathways with inbuilt questions (60 minutes)
· 1.5h Lab – Gross whole and cross sections of brain stem, and glass slides
· 0.5h Lab – Clinical cases covering combination of motor and sensory spinal cord and brain stem patient problems
· Aims of Prerecorded Lab
o Identify the major nuclear groups of the lower motor neurons in the brainstem and spinal cord in transverse sections and compare their rostral-caudal locations to external landmarks.
o Understand the locations of the major long descending (motor) pathways through the brainstem as evidenced by sketching the 2 neurons chains.
o Learn the points of entry/exit of the cranial nerves in relation to surrounding structures.
o Know the location and function of the cranial nerve nuclei involved in motor control, including the motor trigeminal, facial nucleus, and hypoglossal nucleus.
o Know the location and function of the cranial nerve nuclei involved in motor control of the eye and the medial longtitudinal fasciculus (MLF), and understand the role of the PPRF and riMLF in the coordination of conjugate eye movements.
o Know the approximate location and function of the cranial nerve nuclei involved in parasympathetic motor control: dorsal motor nucleus of the vagus (find this nucleus), nucleus ambiguus, Edinger Westphal, Superior and Inferior Salivatory nuclei.
o Correlate the various cranial nerve nuclei with their appropriate nerves.
o Understand the vascular supply to the brainstem and spinal cord and predict the types of sensory/motor deficits that would occur following disruption of this supply at the various levels of the CNS.
· Aims of In-Person Lab
o List the functions of cranial nerves CN III-XII.
o Identify the subdivisions of the brainstem and list the cranial nerves associated with each subdivision.
o Learn the points of entry/exit of the cranial nerves in relation to surrounding structures.
o Identify key landmarks on a glass slide of brainstem
o Indicate the locations of the following surface features of the brainstem: superior and inferior colliculi, cerebral peduncle, basal part of the pons, superior, middle and inferior cerebellar peduncles, pyramid and olive, gracile tubercle, cuneate tubercle, facial colliculus, hypoglossal trigone, and vagal trigone.
o Recognize the rostrocaudal levels of transverse sections through the brainstem on both the gross brainstem cross-sections and MRI.
o Predict, using your working knowledge of the organization of the spinal cord and brainstem, the location of a lesion based on the described somatosensory and motor deficits.
Lab 5: Cerebellum and Basal Ganglia
· Prerecorded Prelab focusing on pathways and nuclei with inbuilt questions (60 minutes)
· 1.5h Lab – Gross whole and half cerebellum, embedded coronal cross sections of basal ganglia
· 0.5h Lab – Clinical cases covering movement disorders
· Aims of Prerecorded Lab
o Recognize and List the major inputs and output of the basal ganglia.
o Know the topographic organization of the deep cerebellar nuclei, their afferent and efferent connections, and their functions.
o Recognize the cerebellar peduncles in brain sections in all 3 planes and learn the axonal pathways that are located within each one.
o Know which thalamic nuclei of the extrapyramidal motor system, the type and source of afferent information for each.
o Understand the neuroanatomical basis of the extrapyramidal diseases.
· Aims of In-person Lab
o Identify the major subdivisions of the basal ganglia and nuclei of the thalamus involved in motor activity in coronal and axial sections.
o Know which thalamic nuclei of the extrapyramidal motor system, the type and source of afferent information for each.
o Identify the basal ganglia and thalamus in MRIs.
o Identify the basic subdivisions and deep nuclei of the cerebellum on gross brain specimens.
o Understand the neuroanatomical basis of the extrapyramidal diseases.
Lab 6: Cortical Functions
· Prerecorded Prelab focusing on pathways and nuclei with inbuilt questions (60 minutes)
· 1.5h Lab – Gross whole and half cerebellum, embedded coronal cross sections of basal ganglia
· 0.5h Lab – Clinical cases covering movement disorders
· Aims of Prerecorded Lab
o Understand the trajectory of the pathways involved in hearing and be able to identify key nuclei including the cochlear nucleus, inferior colliculus, medial geniculate body, superior temporal gyrus and transverse temporal gyrus.
o Understand the trajectory of the pathways involved in vision how the retinal ganglion cells project from the two eyes to the layers of the LGN and on to primary visual cortex. Elucidate how different visual field deficits can arise from lesions along this pathway.
o Learn the general functions of the various areas of the cerebral hemispheres as they relate to audition and speech.
o Describe the trajectory of Papez Circuit/hippocampal pathways using stained cross sections.
o Identify the projections of the amygdaloid nuclear complex and know what CNS regions possess projections from both the hippocampal and amygdaloid components of the limbic system.
o Predict the functional consequences of interruptions to cerebral blood flow to branches of the ACA, PCA and MCA.
· Aims of In-person Lab
o Identify the gyri and sulci of the cerebral cortex, especially those involved in the production of speech.
o Identify the structures of the limbic system on the medial and ventral surfaces of the gross brain, in the horizontal and coronal (1) brain sections, (2) plastic embedded sections and (3) MRIs.
o Study the trajectory of the hippocampus using dissection gross brain.
o Describe the anatomical relationships of the hippocampal formation and uncus to the parahippocampal gyrus, the insula and other parts of the temporal lobe.
o Predict the functional consequences of interruptions to cerebral blood flow to branches of the ACA, PCA and MCA.