MEID 608 NEUROSCIENCE LABORATORY SYLLABUS BY JOHN B. GELDERD, Ph.D. The illustrations within the text of this laboratory syllabus were created by Joan Quarles. Selected illustrations within the syllabus were modified from published illustrations by Frank Netter, MD with the permission of Novartis Medical Education, Whippany, NJ. TABLE OF CONTENTS Lab Date Laboratory Session Pages Exam 1 1 January 3rd Gross Anatomy of the Brain 6 – 13 Meninges 14 – 16 2 January 4th Blood Supply 17 – 22 CSF and Ventricles of the Brain 23 – 26 Introduction to the Macroscopic Anatomy of the 3 January 7th 27 – 32 Neuraxis Ascending Sensory Pathways 33 – 36 4 January 8th Sensory Pathways for the Anterior 2/3 of the Head 37 – 39 Exam 2 5 January 14th Pyramidal System 40 – 43 Cranial Nerves 44 – 52 6 January 16th Neuroround 53 Basal Ganglia 54 – 58 7 January 17th Neuroround 59 Cerebellum 60 – 67 8 January 18th Neuroround 68 Exam 3 Vestibular System 69 – 70 9 January 30th Auditory System 71 – 73 10 January 31st Visual System 74 – 77 Diencephalon (Hypothalamus) 78 – 81 11 February 1st Limbic System 82 – 87 Cortex and Review 88 – 93 12 February 4th Neuroround 1 – 2 94 – 97 Labeled Slides from Slide Set 98 – 116 Neuroscience Laboratory Manual 2 INTRODUCTION The purpose of this syllabus is to assist and guide the student through the neuroscience laboratory portion of Neuroscience (MEID 608) in a systematic fashion. It has been prepared specifically for the curriculum at the Texas A&M University College of Medicine. The ultimate goal of the laboratory portion of this course is to provide a "hands on" experience in learning and understanding the FUNCTIONAL anatomy of the human central nervous system (CNS). To assist you in this endeavor, this syllabus will be used in conjunction with the following laboratory materials: 1. The Medical Neuroscience Laboratory Manual (downloaded from eCampus under MEID608 Neuroscience). This file contains the Neuroscience Manual & Slide Set. 2. Two Brain Buckets (shared by a MDL group) containing: #: Whole and Half Brain #A: Horizontally and Coronally Sectioned Brains 3. An Atlas of Neuroanatomy. Each laboratory group will receive one copy of the “Atlas of the Human Brain and Spinal Cord” (Fix, J., 2nd ed.). It is strongly recommended that your laboratory group use your atlas in each laboratory session. Moreover, it will be of value in all phases of this course to help you in understanding the three-dimensional anatomy of the human nervous system. There is also an additional item that should be downloaded from eCampus. This includes a set of annotated Neuroscience slides (Neuroscience Lab Manual Supplement). The file of labeled slides contains representative spinal cord and brainstem sections taken from your slide set. Neuroscience Laboratory Manual 3 NOTE: UNDER NO CIRCUMSTANCES ARE THE BRAIN SPECIMENS TO BE REMOVED FROM THE LABORATORY AT ANY TIME. To assist you in learning the neuroanatomical structures discussed in this laboratory manual, there is an “Objectives” statement at the beginning of each laboratory section. Further, the important structures and/or concepts for each laboratory are in bold print or are underlined. In addition, questions pertinent to the area being studied are interspersed throughout each laboratory session in italicized print. For examination purposes, the location of neuroanatomical structures will be assessed from lecture and the laboratory manual. Lecture handouts and the laboratory manual are considered the ultimate authority in correctly identifying structures and the determination of correct answers for exam questions. As such, contradictory information obtained from external resources (other atlases, websites, annotated slides from your preceding classmates) does not apply. Animations – For many laboratory assignments in this manual, links to video animations are provided. These animations depict the anatomical relationships between important (bold) structures that will assist in your understanding of the three-dimensional organization of the brain. Laboratory Demonstrations -- There will be laboratory demonstrations during most laboratory sessions. These will consist of models and/or pre-dissected wet specimens. Since these demonstrations will be "fair game" for laboratory practical exams, it is recommended that you take the time to view them when they are displayed during normal laboratory hours. Neurorounds – For some laboratory sessions, case studies will be used to integrate lecture and lab material so as to illustrate their clinical implications. These case studies will be administered using two different formats: 1) active learning presentation/discussion in lab; or 2) self-study, written with corresponding questions. Active learning case studies (#1) will be presented by faculty usually during the last 30-40min of lab. Students will be expected to review the lab and associated lecture in advance so as to enable participation in Neuroscience Laboratory Manual 4 the discussion and provide “team-based” responses to questions on pathways and clinical correlates related to the case. Self-study written cases (#2) are provided at the end of corresponding labs. Students should review the case study in advance and begin working on the case during the lab. Each case contains questions about related pathways/function and specific clinical findings. Faculty will be available during the lab to discuss/clarify clinical findings and other aspects of the case but not provide answers to the questions. Answers to these questions will be posted ~2 days after the lab on eCampus. Although there are no specific performance-type grades for the active learning or self- study written case studies, the content of these cases will be covered in some fashion on either the practical or written exams and related questions should be expected on the NBME and USMLE exams. Finally, it will be useful to read through each laboratory assignment, using your brain atlas, prior to the laboratory session. This should help make both lecture and laboratory material easier to comprehend. Neuroscience Laboratory Manual 5 GROSS ANATOMY OF THE BRAIN Learning Objectives: At the end of the laboratory session students will be able to: 1. Utilize their developing anatomical vocabulary to locate and identify external and internal features of the brain. 2. Describe the directional terminology of the central nervous system (CNS) and the location where this terminology axis shifts. 3. Discuss the major subdivisions of the brain and key anatomical structures located within these regions. 4. Demonstrate gray and white matter and relate the specific cellular parts (cell body vs. axons/dendrites) constituting the two. 5. Identify the lobes of the brain, landmarks demarcating their separation and general features of each. ___________________________________________________________________ Before we begin, it is important to understand the directional terminology or nomenclature as it relates to the brain. Below is a diagram (Fig. 1) to assist you in understanding this terminology. It is important that you understand it, since we will be using this terminology in lecture and laboratory throughout the course to describe the relative locations of various CNS structures. Neuroscience Laboratory Manual 6 In this laboratory session, we will be studying what could be called "lump and bump" anatomy. That is, we will be identifying and briefly discussing the gross external and internal anatomy of the brain. The purpose of this laboratory is simply to acquaint you with the appearance and location of structures that we will be revisiting in detail as the course progresses. These structures will also be used as landmarks to locate and identify other anatomical features of the brain. Use your atlas to assist in the identification of the structures listed in this and all future laboratory sessions. Whole and Half Brain Specimens We will begin by identifying the features of the major subdivisions of the brain, using the whole and half brain specimens in your brain buckets. The brain is organized from rostral to caudal as follows: 1) telencephalon, 2) diencephalon, 3) mesencephalon [midbrain], 4) metencephalon [pons], 5) myelencephalon [medulla oblongata] and 6) cerebellum. Items 2 through 5 above are collectively called the brainstem. The telencephalon is composed of the cerebral hemispheres and portions of the basal ganglia. The latter will be studied in a subsequent laboratory session. The cerebral hemispheres are the large, external, convoluted mantles of nervous tissue that overlie the brainstem. The superficial region of the cerebral hemispheres is composed of gray matter. Immediately deep to the gray matter is a relatively thick layer of white matter. To confirm this, look at selected horizontal and coronal sections. How does this compare to what is seen in spinal cord? The cerebral hemispheres are divided into right and left halves at the midline by the prominent interhemispheric (longitudinal cerebral) fissure. The raised areas, or convolutions, on the surface of the cerebral hemispheres are called gyri (sing. - gyrus). The corresponding grooves or depressions are collectively called sulci (sing. - sulcus). The larger, deeper grooves are usually referred to as fissures. Each cerebral hemisphere is divided into lobes (Fig. 2). Observe the brain from a lateral view. From this perspective, it resembles a catcher's mitt with the "thumb" portion located in a ventrolateral position. This "thumb" portion is the temporal lobe. It is separated from