Course; Neurosciences Course Instructor; Prof. Sundaresh T. V. Course No; NEUR 710. The neuroscience course at the Windsor University School of medicine is a broad-based, multidisciplinary, course which has a strong emphasis on the clinical application of "traditional" neuroanatomical knowledge. The content of the medical neuroscience course includes not only the basic science concepts introduced in more traditional neuroanatomy courses; it also incorporates neurohistology, neuroembryology, neurophysiology and neuropathology. The usefulness of these concepts is reinforced by numerous clinically-based lectures which emphasize the importance of integrating basic neuroanatomical knowledge with the clinical symptoms presented by a neurological deficit. Other clinically-based lectures present current medical concepts concerning neurodegenerative diseases, pain, sleep, epilepsy, substance abuse, and memory and learning. The didactic lectures are supplemented with numerous lab sessions where the students are given an opportunity to solve frequently encountered neurological cases. A laboratory provides "hands-on" learning experiences in brain and spinal cord anatomy and some clinical testing of cranial nerves. (5 credits; 135 hrs. lecture/lab) 1 Books Recommended : Clinical Neuroanatomy by. Richard R Snell Neuroanatomy through Clinical cases by. Hal Bleumenfeld Other Reference Books Include Ganong’s Medical Physiology. Guyton’s Physiology Book Web Sites Recommended http://www.neuroanatomy.wisc.edu/ http://www.columbia.edu/itc/hs/medical/neuroanatomy/neuroanat/ http://www.radnet.ucla.edu/sections/DINR/ http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/NEURANCA.html Specific course learning objectives: 1. Describe, Draw And Label Major Topographic Features Of The Brain, 2. Explain the major interrelationships between major brain structures, 3. Localize, identify, draw and label major brainstem nuclei and tracts from origin to termination, 4. Describe the major function(s) and interrelationships of brainstem nuclei and tracts, 5. Describe, diagram and label the blood supply to the cerebral cortex, cerebellum, brainstem, and spinal cord, 6. Explain the fundamentals of the localization and diagnosis of neurological lesions. 7. Describe, draw and label major topographic features of the forebrain, 8. Explain the fundamental use of neuroimaging in the detection and diagnosis of major neurological disorders, 9. Describe the major anatomical subdivisions, mapping, and functions of cerebral cortical systems (e.g., motor, sensory, language, cognition, emotion, memory, etc.), 10. Describe and explain clinical abnormalities in the structure and function of cerebral cortical systems, 11. Localize, identify, draw and label major somatosensory systems and pathways from origin to termination, 12. Explain the neurobiological basis and clinical correlates of pain and headache, 2 13. Describe the major function(s), interrelationships and clinical abnormalities of major somatosensory systems, 14. Localize, identify, draw and label major somatomotor systems and pathways from origin to termination, 15. Describe and explain the function of major neurotransmitters and their receptors, 16. Describe the major function(s), interrelationships and clinical abnormalities of somatomotor systems. 17. Describe, draw and label the major neuroanatomical features and functions of the frontal cortex, hippocampus, limbic system, and ventricular system, 18. Explain the neurophysiological basis of the EEG and epilepsy, 19. Describe and explain brain blood flow and metabolism and mechanisms of stroke, 20. Explain the major clinical correlates of and major clinical treatment approaches to stroke, 21. Localize, identify, draw and label the major central visual pathways, 22. Explain the neurophysiology of the retina and central visual system and major related clinical abnormalities and correlates, 23. Localize, identify, draw and label the major central auditory/vestibular pathways, 24. Explain auditory/vestibular functions and major related clinical abnormalities and correlates, 25. Localize, identify, draw and label major neuroanatomical nuclei and pathways of the hypothalamus, 26. Explain the role of the hypothalamus in homeostatic functions of neuroendocrine regulation, water/osmolar balance, temperature regulation, food intake/energy balance, and circadian rhythm regulation, and major related clinical abnormalities and correlates. 3 Course Syllabus and Objectives September 10, 2015 SPINAL CORD At the end of the session the student should be able to explain: The external features of the spinal cord: Beginning And Termination Cervical and lumbar enlargements Dorsal and ventral nerve roots including those which form caudaequina Dorsal root ganglia, and their relation to the intervertebral foramina Meninges: dura matter, arachnoid, pia matter (filum terminale, ligamentum denticulata) Anterior and posterior spinal arteries, radicular arteries, their origin and distribution. September 11, 2015 The internal features of the spinal cord: Dorsal median sulcus, ventral median fissure. Central canal Grey and white matter Dorsal horn: Dorsolateral fasciculus or Lissauer’s tract, Substantia gelationosa, Clark’s column Ventral horn: Alpha & gamma motor (lower motor) neurons, phrenic nucleus Intermediolateral horn: Preganglionic sympathetic neurons Rexed’s lamination 4 Ventral and dorsal grey commissures, ventral white commissures White matter: Dorsal, lateral and ventral funiculi Main differences between grey and white matter of the cervical, thoracic, lumbar and sacral segments September14, 2015 SPINAL REFLEXES; At the end of the session the student should be able to explain the: ‘Reflex’ & ‘reflex arc’ Monosynaptic & polysynaptic reflexes Stretch reflex and reciprocal innervation; gamma reflex loop Flexor reflex and crossed extensor reflex September 15, 2015 SPINAL CORD TRACTS At the end of the session the student should be able to explain the: Propriospinal or intersegmental fibers: Fasciculus proprius Ascending spinal tracts Descending spinal tracts 5 September 16,17,18, 2015 ASCENDING SPINAL TRACTS Functions First, second & third order neurons The function, origin, course, and termination of: Dorsal white column: Fasciculus gracilis, fasciculus cuneatus Spino-thalamic tract Spino-reticulothalamic fibers Spinocerebellar tracts Ventral and Dorsal Spinocerebellar tracts Lesions of the dorsal columns: Tabes dorsalis, subacute combined degeneration, Multiple sclerosis Spinothalamic tract lesions: Syringomyelia, Tumors affecting the tracts. Discherniation Friedreich’s ataxia Cordotomy & Tractotomy September 21,2015 DESCENDING SPINAL TRACTS Functions Upper & lower motor neurons The function, origin, course and termination of: Corticospinal tracts Rubrospinal Tectospinal Vestibulospinal Reticulospinal 6 September22,2015 Upper & Lower Motor Neuron Syndromes Hereditary spastic paraparesis Lesions of the spinal cord: upper cervical, lower cervical, thoracic and lumber cord lesions Hemisection of the cord- Brown-Sequard syndrome September 23-25,2015 BRAIN STEM At the end of the session the student should be able to explain the external features of the brain stem: Parts: Medulla Oblongata, Pons, Mid Brain Relation with cerebellum Medulla Oblongata: Dorsal surface: posterior median sulcus, dorsal columns, gracile and cuneate th tubercles, floor of 4 ventricle, inferior cerebellar peduncle Ventral surface: ventral median fissure, pyramids, decussation of pyramidal fibers, external arcuate fibers Lateral surface: anterolateral & posterolateral sulci, olives th th th th Attachment of 9 , 10 , 11 and 12 cranial nerves 7 MEDULLA PBLONGATA: INTERNAL FEATURES At the end of the session the student should be able to explain the internal Features of the medulla oblongata: • Caudal medulla: Transverse Section of medulla at the level of motor Decussation. Transition from spinal cord, pattern of grey and white matter; trigeminal sensory nucleus (nucleus of spinal tract of trigeminal nerve), pyramidal (motor) decussation • Mid medulla: Transverse Section of Medulla At the level of Mid Olive. Pyramids, gracile and cuneate tubercles, internal arcuate fibers, sensory decussation, medial lemniscus, nucleus of spinal tract of trigeminal nerve • Rostral medulla: pyramids, medial lemniscus, inferior olivary nucleus, nucleus of th spinal tract of trigeminal nerve, spinal lemniscus, 4 ventricle, hypoglossal nucleus, dorsal motor nucleus of vagus nerve, area postrema, vestibular nuclei, nucleus solitarius, medial longitudinal fasciculus, inferior cerebellar peduncle, restiform body, dorsal and ventral cochlear nuclei, nucleus ambiguus, reticular formation Vascular Lesion. Tumors Affecting the Medulla. Medial Medullary Syndrome. Inferior Alternating Hemiplegia crossed hypoglossal Hemiplegia, Signs and Symptoms and Causes of Lesion. Lateral medullary syndrome, Wallenberg’s Syndrome, Alternating hemianesthesia. Symptoms And causes of this lesion and physical Diagnosis 8 September 28-29,2015 Pons: th Dorsal surface: Floor of 4 ventricle. Ventral surface: Basilar groove, basilar artery, transverse pontine fibers, middle cerebellar peduncles th th th th Attachment of 5 , 6 ,7 ,and 8 cranial nerves PONS: INTERNAL FEATURES At the end of the session the student should be able to explain the internal features of the pons: Parts: Ventarl (Basilar) and dorsal (Tegmental) Basilar part: Transverse Pontocerebellar fibers, middle cerebellar peduncle (brachium pontis), longitudinal corticospinal fibers, pontine nuclei. Tegmental part: In caudal pons: medial and spinal lemnisci, trapezoid body, trigeminal th sensory nucleus, abducens nucleus, facial motor nucleus, 4 ventricle, medial longitudinal fasciculi. In rostral pons: medial, spinal and lateral lemnisci, superior cerebellar th peduncle in the lateral wall of 4 ventricle, the thin superior medullary velum th spanning between the two superior peduncles forming the roof of the 4 ventricle, medial longitudinal fasciculi, chief sensory, motor and mesencephalic nuclei of trigeminal nerve. 9 September30,2015 Pontine Syndromes Medial Pontine Syndrome Lateral Pontine Syndrome Raymond’s Syndrome Alternating Abducent Hemiplegia Miller Gubler Syndrome. Alternating Facial Hemiiplegia Vascular Lesions of pons October 1-2,2015. Mid brain: Dorsal surface: Superior and inferior colliculi, superior cerebellar peduncles Ventral surface:basis pedunculi (crus cerebri), interpeduncular fossa Lateral surface: superior and inferior brachium rd th Attachment of 3 and 4 cranial nerves MID BRAIN: INTERNAL FEATURES At the end of the session the student should be able to explain the internal features of the mid brain: Dorsal & ventral portions in relation to the cerebral aqueduct Dorsal portion: Tectum: superior and inferior colliculi (corpora quadrigemina) Ventral portion: Tegmentum: cerebral peduncle, crus cerebri, Substantia nigra In caudal mid brain: inferior colliculi, decussation of superior cerebellar peduncle(brachium conjunctivum), medial, spinal and lateral lemnisci, periaqueductal grey matter, trochlear nerve nuclei, medial longitudinal fasciculi, 10 In rostral mid brain: superior colliculi, pretectal nuclei, medial, spinal and lateral lemnisci, medial longitudinal fasciculi periaqueductal grey matter, occulomotor nerve nuclei, red nucleus, rubrospinal & tectospinal tracts and decussations, central tegmental tract. Substantia nigra: pars compacta, pars reticulata Crus cerebri: corticobulbar, corticospinal and corticopontine fibers October 5 ,2015. RETICULAR FORMATION At the end of the session the student should be able to discuss the: o Location and the structure of the reticular formation: complex matrix of neurons extending throughout the length of brain stem. o Nuclei: Medullary And Pontine reticular formation, Raphe nuclei, locus ceruleus o Ascending and descending connections: Reticulospinal tracts, reticular activating system o Functions: control of respiratory and cardiovascular centers, sleep regulation, modulation of nociceptive mechanism, activation of cerebral cortex, heightening arousal and controlling the level of consciousness 11 October 6,2015. CRANIAL NERVE NUCLEI At the end of the session the student should be able to discuss the: o Functional components of the cranial nerves o Afferent cranial nerve nuclei: Somatic afferent nuclei: Trigeminal sensory nuclei, vestibular and cochlear nuclei Visceral afferent nucleui: Nucleus solitarius, gustatory nucleus o Efferent cranial nerve nuclei: Somatic efferent cell column: Occulomotor, trochlear, abducens and hypoglossal nuclei Brachiomotor cell column: Trigeminal and facial motor nuclei, nucleus ambiguous Parasympathetic cell column: Edinger-Westphal nucleus, superior and inferior salivatory nuclei, lacrimal nucleus, dorsal motor nucleus of the vagus nerve. o Cranial nerve lesions, and how to test the integrity of the cranial nerves: Occulomotor, trochlear nerve and abducens nerve palsy Lesions of the trigeminal nerve: Herpes zoster, syringobulbia Lesion of the facial nerve: Bell’s palsy, herpes zoster, Ramsay Hunt syndrome Lesions of the vestibule-cochlear nerve: Acoustic neuroma Motor neuron disease and IX-XII nerve lesions 12 October 7-8,2015. DIENCEPHALON At the end of the session the student should be able to discuss the parts of the diencephalons and their details: Thalamus Hypothalamus Epithalamus Subthalamus THALAMUS o Location & relations o External features, interthalamic adhesion o Internal organization: Internal Medullary Lamina, Anterior, Medial & Lateral Nuclear Masses, Intralaminar Nuclei, Lateral Medullary lamina, reticular nucleus o Functional organization: specific and non-specific nuclei and their connections Anterior nuclear group Lateral nuclear group: Ventral anterior (VA), ventral lateral (VL), ventral posterior (VP), Lateral & medial geniculate nuclei Medial nuclear group: Mediodorsal nucleus (MD), nucleus reunions Intralaminar nuclear group Reticular nucleus Thalamic lesions: Thalamic syndrome, thalamic pain 13 October 9 ,2015. Hypothalamus o Location and relations o Hypothalamic structures identified on the base of the brain: Mammillary bodies & nuclei, tuber cinereum, infundibulum, pituitary stalk, pituitary gland o Hypothalamic nuclei, their connections and functions: Lateral Medial Anterior: supraoptic, paraventricular, suprachiasmatic, ventromedial nucleus Lesions of the hypothalamus and pituitary gland October 12 ,2015. Epithalamus • Location • Components: Habenular triangle & nuclei, stria medullaris thalami Pineal gland 14 Subthalamus • Location • Components Subthalamic nucleus: location, afferent & efferent connections, (pallidosubthalamic & subthalamopallidal fibers), subthalamic fasciculus and functions Zona incerta Ascending sensory projections: medial leminiscus, trigeminothalamic tract, spinothalamic tract Cerebellothalamic fibers Pallidothalamic fibers (lenticular fasciculus, ansa lenticularis, thalamic fasciculus) Lesions of the sub thalamic nucleus October 13 ,2015. CEREBELLUM At the end of the session the student should be able to discuss its: o External features of the cerebellum: Cerebellar hemispheres Superior and inferior vermis Anterior and posterior notches Fissures: primary, horizontal, posterolateral Lobes: anterior, middle, flocculonodular Cerebellar peduncles: superior, middle, inferior Arterial supply: superior, anterior inferior, posterior inferior cerebellar 15 October 13 ,2015. • Internal features of the cerebellum: �Cerebellar cortex: Cellular organization Molecular layer Purkinje cell layer Granular layer White matter: Afferent fibers: Climbing fibers (Spino-, vestibule-,and pontocerebellar fibers) & Mossy fibers (olivocerebellar fibers) Efferent fibers: axons of the purkinje cells �Cerebellar nuclei Fastigial Globose Emboliform Dentate nucleus 16 October 14-16 ,2015. Functional , morphological and Anatomical ( Division) Classification of cerebellum: Archicerebellum: Flocculonodular lobe and fastigial nucleus Paleocerebellum: Vermis, paravermis, and globose & emboliform nuclei Neocerebellum: Cerebellar hemisphere and dentate nucleus Cerebellar peduncles (Superior, middle & inferior): the origin & th termination of their constituent fibers, course, their relation to 4 ventricle Lesions of the cerebellum and their manifestations: Intention tremors, dysarthria, cerebellar ataxia, nystagmus, Charcot’s triad Midline lesions Unilateral cerebellar hemispheric lesions Bilateral dysfunctions 17 October 19-21 ,2015. CEREBRUM (CEREBRAL HEMISPHERES) At the end of the session the student should be able to describe its: External features of the cerebrum: Two hemispheres, superior (great) longitudinal fissure, corpus callosum Surfaces: Superolateral, medial, inferior Borders: Superomedial, Inferolateral, medial orbital, medial occipital Poles: Frontal, parietal, temporal, occipital The three sulci which are used to divide the hemispheres into lobes: Central sulcus, lateral sulcus (posterior ramus), parieto-occipital sulcus Lobes: Frontal, parietal, temporal, occipital Important sulci & gyri: Frontal lobe: precentral sulcus & gyrus, superior & inferior frontal sulci, superior frontal, middle frontal and inferior frontal gyri Parietal lobe: Postcentral sulcus & gyrus, intraparietal sulcus, superior parietal & inferior parietal lobules Temporal lobe: Superior & inferior temporal sulci, superior, middle & inferior temporal gyri, transverse temporal gyri, Heschl’s convolutions 18 Occipital lobe: calcarine sulcus On the medial surface: callosal sulcus, cingulate sulcus, paracentral lobule, precuneus, cuneus On the inferior surface: olfactory sulcus, orbital gyri, parahippocampal gyrus, uncus, collateral sulcus, occipitotemporal sulcus, occipitotemporal gyri October 19 ,2015. Internal features: Outer grey matter: Cerebral cortex White matter Cerebral nuclei: Basal ganglia (corpus striatum) Cerebral cortex Histological structure: Six layers Regional variations Archicortex, paleocortex, neocortex 19 October 20-22 ,2015. • Functional areas: Frontal lobe: primary motor cortex, premotor cortex, supplementary motor cortex, frontal eye field, motor speech (Brocca’s) area, prefrontal cortex Parietal lobe: primary somatosensory cortex, association cortex Temporal lobe: Primary auditory cortex, auditory association cortex, sensory speech (Wernick’s) area, vestibular area, memory & emotional aspect of behavior, olfaction (limbic system: hippocampus and amygdale) Occipital lobe: primary visual cortex, visual association cortex Brodmann’s mapping (areas) Cerebral cortical lesions and their manifestations: Focal cerebral lesions, Frontal lobe lesions, parietal lobe lesions, Temporal lobe lesions, Occipital lobe lesions, Bilateral cortical disorders October 23,2015. White matter Types of fibers: Association fibers: Long association fibers: superior longitudinal fasciculus, inferior longitudinal fasciculus, arcuate fasciculus, uncinate fasciculus, cingulum Short association fibers Projection fibers: corticospinal, corticobulbar (corticonuclear), corticopontine fibers and thalamocortical projections forming corona radiate, internal capsule (anterior & posterior limbs, genu, retrolenticular & sub lenticular parts) Commissural fibers: corpus callosum (genu, body, splenium, forceps minor & forceps major fibers), anterior, posterior, hippocampal and habenular commissures Lesions of the fibers in white matter and their manifestations: Associative agnosia, damage to corpus callosum, internal capsule lesions 20 October 26 ,2015. Basal ganglia Components: Caudate nucleus: head, body, tail Lentiform nucleus: putamen, globus pallidus (medial & lateral segments) Caudate nucleus & putamen, striatum, neostriatum Globus pallidum, pallidum, paleostriatum Nucleus accumbens Amygdale Claustrum Substantia innominata, nucleus basalis (of Meynert) • Connections: o Striatum: Afferent (cortico-, thalamo-, nigrostriatal fibers, projections from the brain stem raphe nuclei) & efferent connections (striatopallidal, striatonigral) o Pallidum: Afferent (striato-, and subthalamopallidal fibers) & efferent (pallidosubthalamic, pallidothalamic, pallidotegmental fibers) • Functions: extrapyramidal system 21 October 27,2015. Basal ganglia syndromes & diseases Abnormal motor control (dyskinesias): akinesia, hypokinesia, bradykinesia Alteration in muscle tone (hypertonia, hypotonia) Abnormal, involuntary movements: tremors, chorea, dystonia, athetosis, choreoathetosis, myoclonus, tics Parkinson’s disease, Huntington’s chorea, Hepatolenticular degeneration (Wilson’s disease), Sydenham’s chorea. October 28-29 ,2015. LIMBIC SYSTEM At the end of the session the student should be able to describe its: • Major parts Cingulate gyrus Parahippocampal gyrus Dentate gyrus Amygdala Hippocampal formation Septal area Hypothalamus (mammillary body) Anterior nucleus of the thalamus Habenular nuclei Papez circuit 22 Main fiber bundles Fornix Stria terminalis Ventral amygdalofugal pathway Medial forebrain bundle Mammilothalamic tract Mamillotegmental tract Cingulum Functions Limbic lobe disorders: Wernick’s encephalopathy, Korsakoff’s psychosis, temporal lobe or complex partial seizures October 14-16 ,2015. I. BLOOD SUPPLY OF THE CENTRAL NERVOUS SYSTEM At the end of the session the student should be able to discuss the: • Blood supply of the spinal cord Arterial supply: Anterior spinal artery, paired posterior spinal arteries, radicular arteries, great radicular artery (artery of Adamkeiwicz) Venous drainage: Anterior & posterior spinal veins, anterior & posterior radicular veins, internal vertebral (epidural) venous plexus, communication with external vertebral venous plexus, azygos, hemiazygos and ascending lumbar veins 23 Class 32 • Blood supply of the brain Arterial supply: (hypophyseal, ophthalmic, anterior choroidal, posterior communicating, anterior and middle cerebral, anterior communicating posterior spinal arteries, posterior inferior cerebellar artery) tion, course, and branches (anterior inferior cerebellar, labyrinthine, superior cerebellar, posterior cerebral arteries, posterior communicating artery) branches (anterior & posterior perforating arteries) Class 33 Venous drainage: cerebral vein cerebral vein of Galen. 24 sigmoid, occipital, cavernous, confluence of sinuses Class 34 VENTRICULAR SYSTEM AND CEREBROSPINAL FLUID At the end of the session the student should be able to explain the: • Ventricles of the brain: two lateral ventricles, the third ventricle and the fourth ventricle LATERAL VENTRICLES Location: within the cerebral hemisphere Parts: Anterior (frontal) horn lies anterior to the interventricular foramen, body, posterior (occipital) and inferior (temporal) horns Boundaries: 25 : lies anterior to the interventricular foramen; lateral wall (head of caudate nucleus), roof (corpus callosum), medial wall (septum pellucidum) medial wall (bulb of posterior horn, calcar avis) Communications: with the third ventricle through the interventricular foramen Tela choroidea & choroids plexus: choroidal fissure Class 35 rd 3 VENTRICLE Location: Midline cavity in the region of diencephalon Boundaries: 26 o triangle o o o o Recesses: Pineal, chiasmatic and infundibular Communications: with lateral ventricles through the interventricular foramina, th with 4 ventricle through the cerebral aqueduct Boundaries of interventricular foramen Tela choroidea and choroids plexus: location and the formation Class 36 27 th 4 VENTRICLE Location and relations Boundaries: limitans, superior fovea, stria medullaris, inferior fovea, hypoglossal triangle, vagal triangle, vestibular area Apertures & communications: Lateral and median apertures in the inferior rd medullary velum, communication with the central canal of spinal cord, 3 ventricle and subarachnoid space around the brain. Tela choroidea and choroid plexus: formation and location Class 37,38 • Cerebrospinal fluid: Formation, composition, volume Circulation: intraventricular, extraventricular Drainage: arachnoid villi, arachnoid granulations 28 Functions Hydrocephalus Class 39 SPECIAL SENSORY PATHWAYS OLFACTORY PATHWAY At the end of the session the student should be able to discuss the components of the olfactory pathway: • Olfactory mucosa and olfactory nerves • Olfactory bulb • Olfactory tract • Lateral, medial and intermediate olfactory stria • Lateral, medial and intermediate olfactory areas • Entorhinal olfactory association area. • Lesions and manifestations of the olfactory pathway TASTE PATHWAY At the end of the session the student should be able to discuss the taste pathway: • Taste buds 29 • Origin, course and termination of the taste fibers • Nerves carrying the taste fibers • Nucleus solitarius; gustatory nucleus • Solitariothalamic fibers Class 40 VISUAL PATHWAY At the end of the session the student should be able to: • Demonstrate the structure of the eyeball. • Explain the structure of the retina • Discuss the origin, course, relations and termination of the optic nerve • Discuss the components of the visual pathway i.e. optic chiasma, optic tract, lateral geniculate body, superior colliculus, pretectal area, optic radiation (thalamocortical fibers, geniculoclcarine tract), Meyer’s loop, primary visual cortex • Explain binocular vision and visual reflexes • Explain visual field deficits Class 41 AUDITORY & VESTIBULAR PATHWAYS At the end of the session the student should be able to: • Demonstrate the structure of organ of Corti 30 • The origin, course, relations and termination of the vestibulocochlear nerve • Discuss the components of the auditory pathway i.e. cochlear nuclei, dorsal and ventral auditory stria, trapezoid body, superior olivary nucleus, lateral lemniscus, inferior colliculus, medial geniculate body, primary auditory cortex, and auditory association cortex • Discuss the components of the vestibular pathway i.e. vestibular nuclei and their connections, vestibulocerebellar fibers, medial longitudinal fasciculus, vestibulospinal tracts, flocculonodular lobe of cerebellum • Discuss the auditory reflexes • Explain vestibulocochlear nerve disorders; and deafness Class 42,43,44.45 AUTONOMIC NERVOUS SYSTEM At the end of the session the student should be able to: • Explain the anatomy of autonomic nervous system. • Discuss the difference between somatic and autonomic nervous system. • Demonstrate the morphological, physiological and pharmacological differences between the sympathetic and parasympathetic divisions of the autonomic nervous system • Explain the manifestation of the lesions of the sympathetic and parasympathetic nervous system. 31 • Discuss the primary autonomic failure and the Horner’s syndrome We Have Open door Policy for Neuroscience Student’s to see any of our Neuroscience Instructors between 9 AM to 4 PM from Monday to Friday. If you have any other questions please do not hesitate to contact us by e mail sun@windsor,edu and idara4care@yahoo.com 32