Year 1 BB1: Brain and Behaviour 1
- Dr Xuenong Bo
- x.bo@qmul.ac.uk
Introduction
By the end of this module, students should be able to:
1. To describe the main pathways by which the sensory modalities of low threshold cutaneous sensation (touch, pressure and vibration), pain and proprioception are transmitted from the periphery to the brain.
2. To describe the pathways for the special senses of hearing and vision
3. To be able to state the location of where these pathways crossover (decussate) in the nervous system.
4. To be able to perform the basic tests used to assess the integrity and the clinical signs associated with damage to the main ascending and descending pathways.
5. To outline the main components of the motor system with particular emphasis on the monosynaptic reflex and the corticospinal (pyramidal) tract.
6. To be able to test monosynaptic reflexes, explain their clinical significance, and how to recognise damage to the motor system.
7. To describe the origin, organisation and functions of the cranial nerves, the basic tests used to assess their integrity and the clinical signs associated with damage to them.
8. To be able to relate the main functional regions of the cortex to specific lobes of the brain.
9. To recognise major parts of the central nervous system and vascular system using modern imaging techniques.
10. To be able to describe the distribution of the principal arteries of the brain and spinal cord and the main functional areas of the brain and spinal cord that they supply.
11. To be able to locate specific cutaneous dermatomes on various parts of the body.
Sessions
Lecture: Overview of the Nervous System
Lecture: Organisation of the Spinal Cord
- To be able to identify the major gross anatomical features of the spinal cord and meninges
- To be able to draw a cross section of the spinal cord showing grey and white matter, dorsal and ventral horns
- To be able to identify the main blood supply and venous drainage of the spinal cord
- To be able to describe the pathway of the principal ascending and descending tracts within the white matter
- To be able to describe the basic neurological deficits related to spinal cord injuries
Lecture: Introduction to the Peripheral Nervous System
- Give an overview of the peripheral nervous system
- Describe the essential differences between afferent and efferent nerve
- Describe the different kinds of sensory receptors found in the skin and other organs, and their relationship to the different diameters of sensory nerve fibres.
- Differentiate between mechanoreceptors and chemoreceptors, and describe how action potentials arise from generator (receptor) potentials in each kind of receptor.
- Explain what is meant by a sensory receptive field
- Draw a table showing the different types of primary afferent and efferent fibres found in mammalian peripheral nerves. Indicate the function and conduction velocity of the different fibre types.
- List the changes that occur after nerve injury.
Lecture: Skull Anatomy
Lecture: Neural Control of Movement
Lecture: Spinal Reflexes
- Define the term motor unit and describe how the force of muscle contraction is controlled by impulse frequency and by recruitment of motor units.
- Describe the anatomy and physiology of muscle spindle and Golgi tendon organs.
- Draw a diagram of the monosynaptic reflex arc (for patellar or ankle jerk).
- Describe the control of muscle length and tension involving muscle spindles and tendon organs.
- Describe the role of polysynaptic reflexes in the spinal cord
- Describe the concept of lower motoneurone and upper motoneurone lesions, muscle tone & spasticity.
Clinical Skills: Examination of the Cranial Nerves
Lecture: Peripheral Distribution of Cranial Nerves I&II
Lecture: Somatosensory Pathways
- Describe the anatomy and physiology of the dorsal column-medial lemniscal system, and explain how its integrity may be clinically assessed.
- Describe the anatomy of the spinothalamic tracts
- Explain the role of the different components of the spinothalamic tracts in sensation and pain.
- Describe briefly the clinical manifestations of lesions of the spinal cord
Lecture: Brainstem and Cranial Nerves I
Lecture: Brainstem and Cranial Nerves II
Lecture: Injury and Repair of the Nervous System
- Explain why the possibilities for repair are limited in the CNS
- Describe the process of nerve regeneration in the PNS and the determinants of its success
- List the changes that occur after sensory nerve injury: caudal (distal) to the injury, rostral (proximal) to the injury, in the dorsal root ganglion (cell somas)
Lecture: Neurotransmission in the Nervous System
- Describe how epsps and ipsps are generated at excitatory and inhibitory synapses within the CNS
- Define the term neuromodulator and give examples
- State the main neurotransmitters and understand how the associated receptors mediate their action
- Be able to describe nerve conduction studies and electromyography and how they can detect peripheral nerve abnormalities including impulse conduction failure
- Explain the importance of termination of transmitter action, and give two different examples of how this is achieved
Lecture: Anatomy of the Neck
- Outline the sensory and motor innervation of the larynx and explain the effects of damage to the recurrent laryngeal nerve
- Describe how the vocal folds produce sound and variation in pitch
- Describe the peripheral course of the sympathetic nervous system in the neck
- Describe the attachments and actions of the sternocleidomastoid muscle and give its nerve supply
- Define the boundaries of the anterior and posterior triangles of the neck and state their major contents
Lecture: Visual Pathways
- Explain the "grandmother cell" or hierarchical model of visual perception.
- Explain the functions of the following cortical areas: the posterior parietal association area; the inferotemperal association area; the dorsolateral association area.
- Describe the receptive fields of cells in the visual cortex.
- Describe the effect of lesions at various points within the visual pathways.
- Explain how information from one half of the visual field reaches the contralateral visual cortex.
- Describe normal pupillary and accommodation reflexes and their clinical significance.
- Describe the visual pathway from optic nerve to visual cortex.
Lecture: Physiology of the Eye and Retina
- Describe the visual pathway from photoreceptor to optic nerve.
- Decribe the mechanism of photo-transduction in the photoreceptors.
- Explain the conditions of glaucoma and cataract and their probably causes.
- Describe the structure of the eye and the significance of the cornea, lens, aqueous and vitreous humours.
- Describe the blood supply to the retina and the significance of the choroids.
Lecture: Blood Supply to the Brain
Lecture: Hypothalamus and Pituitary Gland
- Describe the hypothalamo-hypophyseal tract.
- Describe the principal fibre tracts linking the hypothalamus with the brain stem reticular formation.
- Describe the hypophyseal portal system.
- Describe the hypothalamic autonomic and endocrine projections.
- Name the principal hypothalamic nuclei.
- Describe the principal afferent and efferent connections of the hypothalamus.
- Describe the functional organisation of the hypothalamus.
Lecture: Speech and Cortical Asymmetry
- Discuss the differences in function between the right and left hemispheres
- Discuss the evidence that different areas of the cerebral cortex are involved in the production and perception of speech and language, and name these areas
- Describe the functions of the posterior parietal and inferotemporal cortices, and how these functions may differ in the left and right hemispheres.
Lecture: Cerebral Meninges, CSF and the Blood-Brain Barrier
- Explain the role of glia cells in brain homeostasis.
- Explain the structure of the blood-brain barrier, and its functional significance.
- Draw a diagram of the ventricular system of the brain labelling the main structures.
- Describe the composition of cerebrospinal fluid, where and how it is formed.
- Describe the main types of haemorrhage associated with damage to the skull and meninges.
- Describe the anatomical arrangement of the meninges of the brain.
Lecture: Brain Asymmetry and Higher Mental Functions
Lecture: Reticular Formation
- Understand the reticular activating system and the role in sleep and wakefulness.
- Describe the role reticular formation in the control of autonomic nervous system.
- Explain the general functions of reticular formation.
- Describe the structure of reticular formation and the location of main nuclei or neuronal aggregates.
- Know the main afferents and efferents of the reticular formation.
Lecture: Hearing
- Describe the auditory pathways
- Define the unit of sound intensity, and draw a typical human hearing curve.
- Define conduction and nerve deafness, and state tests for these
- Give an account of the anatomy of the cochlea, and explain how it enables us to determine: the frequency and loudness of incoming sound, and explain how the direction of incoming sound may be determined.
- Describe the main functions of the auditory system
Lecture: Basic Imaging of the CNS
Lecture: Introduction to Pharmacology in the CNS
- Define the concept of treatment-resistance, and give examples of causes underlying this phenomenon
- Give examples of side-effects of drugs used in neuropharmacology and describe their impact on disease management
- Explain the importance of the blood-brain barrier and drug transporters as a determinant of therapeutic efficacy
- Define drug targets within a typical chemical synapse in the nervous system
Lecture: Neural Control of Motivational Behaviour
Lecture: BB1 Review
- Functional areas of the brain and link to blood supply.
- Blood supply to the brain: posterior and anterior parts.
- Cranial nerves: brainstem organisation, peripheral course, what deficit would arise if damaged.
- Ascending and descending tracts: where they are located in the spinal cord, where they cross over, what information they carry.
- Reflexes- peripheral nerves
Physiology Practical: Somatosensory
Physiology Practical: Vision
Anatomy Practical: Anatomy of the Spinal Cord
Anatomy Practical: Anatomy of the Brainstem and Cranial Nerves
Anatomy Practical: Bloody Supply and Neuroanatomy of the Brain
Workshop: Visual Awareness
Workshop: Working with the Hearing Impaired
PBL: Altered Sensation
PBL: A Broken Man
PBL: What's happened to my eye?
PBL: A problem with the face
PBL: A sudden loss of function
