AFAMS Master Lesson Plan (MLP) Nursing Program The Spinal Cord and Spinal Nerves Instructor Serial/Semester Location Start/Finish Time Date LESSON OBJECTIVE Performance: Describe the principal anatomical and functional features of the spinal cord and its coverings, the meninges, and the vertebral column. Conditions: The student will be presented a powerpoint presentation by the instructor and will have all necessary references made available to him/her. Standard: 1. The student will be expected to describe the below information included within the teaching points to the instructor at the end of the lesson and in a written exam. TEACHING POINTS 1. Define the spinal cord anatomy. 2. Describe the spinal cord physiology. 3. Describe the spinal nerves. 4. Describe the homeostatic imbalances associated with the spinal cord. 5. Define the medical terminology associated with the spinal cord. INSTRUCTIONAL STRATEGY Interactive Lecture Method: Instructor and Print (including PowerPoint Presentation) Media: Classroom Environment: OTHER LESSON SPECIFICATIONS Knowledge Lesson Type of Lesson: 1/50 Ratio: Resources: Power point handouts. End of Lesson Test: None Minutes Instructional Time: 215 Reference(s): Tortora, Grabowski: Principles of Anatomy and Physiology, 9th Edition. Chapter 13. LESSON PLAN APPROVAL Signature of Standards Officer Date AFAMS Master Lesson Plan (MLP) Nursing Program The Spinal Cord and Spinal Nerves INTRODUCTION Allocated Time: Review: 5 Minutes You have had previous lectures on anatomy and physiology during the Combat medic course, this lecture will built upon what you have already learned. Objective: This chapter first considers the principal anatomical and functional features of the spinal cord and its coverings, the meninges, and the vertebral column. Next, the spinal cord is discussed in terms of its functions as a conduction pathway and a reflex center. Reflexes are explained, important reflexes are categorized according to type, and several clinically important reflexes are discussed. The disorders of the nervous system considered are neuritis, shingles, and poliomyelitis. Clinical applications include spinal tap (lumbar puncture), use of reflexes to assess neurological impairment, spinal cord transection and muscle function, injuries to the phrenic nerves, injuries to the nerves emerging from the brachial plexus, lumbar injuries, and sciatic nerve injury. Importance: Nurses work in different health care setting so it is important to gain an understainding of this subject as it will apply to clinical setting. Fit: This is the thirteenth chapter on anatomy and physiology. Approach: You will be presented the subject in a lecture format and will be tested using a written exam at a later date. Control Statement: If you have any questions during the lesson please feel free to ask. BODY 1. Teaching Point: Define the spinal cord anatomy. Minutes Allocated Time: We will now go over the spinal cord anatomy. Introduction: Learner Participation: Knowledge Lesson Please follow along with your handouts and take notes. Skill Lesson Powerpoint presentation with associated handouts. Learning Support: 1. Give a general overview of the function of the spinal cord and its interactions with the brain and peripheral nerves. Protective Structures 2. List the protective coverings for the spinal cord. Vertebral Column 1 AFAMS Master Lesson Plan (MLP) Nursing Program The Spinal Cord and Spinal Nerves 3. Review the structure of the vertebrae and associated connective tissue, and how they protect the spinal cord and spinal nerves. Meninges 4. Describe the characteristics and purpose of the three layers, spaces, and attachments of the meningeal structures. External Anatomy of the Spinal Cord 5. Describe the external features of the spinal cord and nerves, and discuss its relative length within the vertebral column during development. 6. Describe the features of the spinal nerves as they emerge from the vertebral column. 7. Discuss how the position of the end of the spinal cord within the vertebral column facilitates cerebrospinal fluid sampling for analysis. Internal Anatomy of the Spinal Cord 8. Describe the anatomic position of gray and white matter within a cross section of the spinal cord, and their relationships with the spinal nerves and tracts leading to and from the brain. 2. Teaching Point: Describe the spinal cord physiology. Minutes Allocated Time: We will now go over the spinal cord physiology. Introduction: Learner Participation: Knowledge Lesson Please follow along with your handouts and take notes. Skill Lesson Powerpoint presentation with associated handouts. Learning Support: 9. List the functions of the spinal cord. Sensory and Motor Tracts 10. Describe the functions of the principal sensory and motor tracts of the spinal cord with respect to sensory receptors, brain integration, and motor operation. 11. Identify the designations for the tracts that transmit specific types of information along ascending and descending neural pathways of the spinal cord. 12. Discuss the significance of axons developing myelin sheaths at different times. Reflexes and Reflex Arc 13. Define a reflex and distinguish between somatic and autonomic reflexes. 14. Describe the components of a reflex arc and its relationship to homeostasis. Stretch Reflex 2 AFAMS Master Lesson Plan (MLP) Nursing Program The Spinal Cord and Spinal Nerves 15. Explain the purpose of the stretch reflex, and then diagram the specific components of the neural circuit pathways through the spinal cord to effectors to show how the reflex operates. Tendon Reflex 16. Explain the purpose of the tendon reflex, and then diagram the specific components of the neural circuit pathways through the spinal cord to effectors to show how the reflex operates. The Flexor and Crossed Extensor Reflexes 17. Explain the purpose of the flexor and crossed extensor reflexes, and then diagram the specific components of the neural circuit pathways through the spinal cord to effectors to show how the reflex operates. 18. Explain how knowledge of reflex circuits helps interpret neurological impairment in the plantar flexion and Babinski reflex tests. 3. Teaching Point: Describe the spinal nerves. Minutes Allocated Time: We will now go over the spinal nerves. Introduction: Learner Participation: Knowledge Lesson Please follow along with your handouts and take notes. Skill Lesson Powerpoint presentation with associated handouts. Learning Support: 19. Discuss the naming and numbering of spinal nerves, the arrangement of spinal nerves relative to the vertebrae, and the attachment of the spinal nerves to the spinal cord. Connective Tissue Coverings of Spinal Nerves 20. Describe the connective tissue coverings of the spinal cord. Distribution of Spinal Nerves Branches 21. Discuss the branching of the spinal nerves once they emerge from the vertebral column. Plexuses 22. Define a plexus, then describe the spinal root origins, interconnections, and names of major nerves of the cervical, brachial, lumbar, and sacral plexuses according to their anatomic destinations. Intercostal Nerves 23. Describe the spinal root origins and destinations of the intercostal nerves. 3 AFAMS Master Lesson Plan (MLP) Nursing Program The Spinal Cord and Spinal Nerves Dermatomes 24. Illustrate the topographic relationship between spinal nerves and the location of sensory receptors for which they transmit impulses. 25. Describe spinal cord injury and list the immediate and long-range effects. Knowledge Lesson: Skill Lesson: Check on Learning In a knowledge lesson, pose questions to the class. In a skill lesson, provide practice and watch students perform a skill. 4. Teaching Point: Describe the homeostatic imbalances associated with the spinal cord. Minutes Allocated Time: We will now go over the homeostatic imbalances associated with the spinal Introduction: cord. Learner Participation: Knowledge Lesson Please follow along with your handouts and take notes. Skill Lesson Powerpoint presentation with associated handouts. Learning Support: 25. Explain the causes and symptoms of shingles, and poliomyelitis. 5. Teaching Point: Define the medical terminology associated with the spinal cord. Minutes Allocated Time: We will now go over the medical terminology associated with the spinal cord. Introduction: Learner Participation: Knowledge Lesson Please follow along with your handouts and take notes. Skill Lesson Powerpoint presentation with associated handouts. Learning Support: 26. Define the medical terms related to the spinal cord. Knowledge Lesson: Skill Lesson: Check on Learning In a knowledge lesson, pose questions to the class. In a skill lesson, provide practice and watch students perform a skill. END OF LESSON TEST Allocated Time: Instructions: Test Questions or Performance Expected: Test Key: CONCLUSION 4 0 Minutes You will tested on this subject at a later date. You will be expected to review and study the material taught in this section in order to pass the associated written test. If you have difficulty with the material please see me so we can review together. AFAMS Master Lesson Plan (MLP) Nursing Program The Spinal Cord and Spinal Nerves Allocated Time: Summary: 5 Minutes Review and re-emphasize the difficult Teaching Points below. 1. 2. 3. 4. 5. Define the spinal cord anatomy. Describe the spinal cord physiology. Describe the spinal nerves. Describe the homeostatic imbalances associated with the spinal cord. Define the medical terminology associated with the spinal cord. Closing Statement: Nurses work in different health care setting so it is important to gain an understainding of this subject as it will apply to clinical setting. Re-motivating Statement: You will be able to utilize this information taught today in all clinical settings. 5