NEUROSCIENCES MODULE

Semester: Three
Year: Second Year MBBS Region/s: Neurosciences

Course Duration:
Six weeks
l. Credit Hours:
6.0 Theory, 3.00 Practical and Demonstration
 Introduction:

Th e N eu r os c ien c es mo d u le is d evelop ed to pr o vid e th e lear n er s with in -depth

k no w led g e ab ou t h ow t h e b r ain is s tru c tur ed an d h o w it wo r ks u nd er n or m a l an d
ab n o r m al cir cu m s tan ces . S tu d en ts lear n the d ev elop m en tal p r o ces s es of th e b r ain in
o r d e r to u n d e rs t an d w h e r e t h e s tr u c t u r es c o m e f r om and ho w ea c h is l ink ed w i t h th e
others.

This module d eals not on ly with the brain but also with the peripheral nervous
system. Students get to know how th e human body carries out its myriad functions,
s ome of which ar e under our control ( e. g. walk ing) while others are not ( e. g. b eating
o f th e h ear t) .

T h e A u to n o m ic N e r vo u s sys t e m, on e of t h e es s e n t i a l sys t em s m a i n ta i n in g our

h om eos t as is , is dealt with in detail. One of the main reasons for this is because
m any m ed ic at ions alt er A u t on om ic fu n c tio n s. ; a do c to r h as t o h ave d etail ed
k no wl ed g e abo u t s uc h m ed i c at ions a nd th e ir i n t er a ct ions.

The N eur os ciences m odule is gear ed to help lear ner s gr aduate f r om nor m al s tructur es
an d fu n c t ions t o p at ho lo g ical o n es . P h arm ac o lo gy is in t eg r at ed to g u id e t h e lear n er s
a b ou t ess en t i a l asp e c ts o f m e d ic a ti ons w h i ch d ir ec t ly aff e c t th e nerv ou s sy s tem.
It is h op ed th at th is m od u le w ill h elp t h e lear n er s ob t ain a c lear vis ion of h o w th e
b r a in work s an d co n tro l s th e b ody fun ct i on s.

The aims of this modules are to help s tudents diagnose common neurological
conditions bas ed on their k nowledge of basic s ciences . They s hould be able to con duct
neurological ex aminations on normal subjects or mannequins so that when th ey meet
real patients, they are adequately trained to deal with the situations.

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 Departments:
+ Anatomy + Physiology
+ Biochemistry + Pathology Clinical
+ Pharmacology + Sciences Medical
+ Community Medicine + Education

Objectives:
By the end of this sub module, students should be able to:
ANATOMY
Describe the development of brain (i.e. forebrain, mid brain & hind brain), the spinal cord, ventricles,
meninges, peripheral & autonomic nerves
Explain the general organization of nervous system and different types
of nerve tissue
Describe the bony features of adult and fetal skull & cranial cavity
Describe microscopic features of nervous tissue, nerve & ganglion when shown under microscope
Explain the meninges of brain & spinal cord with its neurovascular supply and in-foldings
Discuss the Dural venous sinuses with their clinical importance
Discuss the gross anatomy & cross sections of spinal cords at different levels with its neurovascular supply
Describe the ascending and descending tracts with their clinical importance
Describe the formation of spinal nerves
Explain the gross structure, vascular supply, internal structure and clinical importance of the following:
i. brain stem (i.e. medulla, pons and midbrain)
ii. cerebellum and fibres associated
iii. diencephalon (i.e. thalamus, sub thalamus, pineal gland and hypothalamus)
iv. basal nuclei
v. the limbic system
vi. cerebral hemisphere with surfaces, lobes, sulci and gyri
Explain the different cortical areas of brain with their functions and lesions
Describe the white matter of cerebral hemisphere (I.e. commissural, association & projection fibers)
Discuss the clinical correlation associated with the lesions of internal capsule
Discuss the organization of Autonomic Nervous system (ANS)
Describe the microscopic features of different parts of cerebral and cerebellar cortex
Explain the ventricular system of brain, its abnormalities and formation
Explain the circulation of cerebrospinal fluid (CSF)
Describe the blood supply of the brain and spinal cord with clinical manifestations in relation to the blockage
and rupture of blood vessels
Name the cranial nerves
Describe the location of cranial nerve nuclei and their functional components
Enumerate the congenital anomalies of brain & spinal cord

BIOCHEMISTRY
Define CSF and neurotransmitters

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 Classify neurotransmitters based on their structure and modes of action Describe mechanisms of action
of the neurotransmitters
Match names of disorders with abnormal levels of various neurotransmitters (Acetylcholine,
Catecholamines, Dopamine, GABA and Serotonin)
Explain the chemistry of brain lipids (glycolipids)
Explain the biochemical composition of the Blood Brain Barrier
List the chemical composition of normal CSF
Differentiate between normal and abnormal CSF based on its composition
Diagnose different types of Meningitis and Sub Arachnoid Hemorrhage based on CSF analysis reports
Discuss the role of free radicals in degenerative diseases of CNS
Discuss the biochemical importance of vitamin B1 & B6 in neurological disorders.

COMMUNITY MEDICINE
Discuss fatality and disability of CNS related communicable diseases
Discuss the epidemiology, transmission, prevention, risk factors of CNS diseases e.g. Poliomyelitis, Tetanus,
Leprosy, Diphtheria, stroke and Rabies.
Explain the management of Stroke

PATHOLOGY
Describe the pattern of nerve injury and their regeneration
Explain etio-pathogenesis of cerebral edema, hydrocephalus, raised intracranial pressure and types of
brain herniation
Describe traumatic brain injuries and differentiate between different types of intracranial hemorrhage
Discuss cerebrovascular diseases and the consequences of ischemic, hemorrhagic and hypertensive
cerebrovascular accidents

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 PHARMACOLOGY

Introduction To Autonomic Nervous System (ANS)

Describe the organization of ANS and systemic effects of stimulation of sympathetic and
parasympathetic nervous system
List the major neurotransmitters in ANS and the steps in synthesis, storage and release of
neurotransmitters
Explain how drugs can affect different steps of neurotransmission
Describe the major autonomic receptors in ANS, their location and their signal transduction
mechanisms
Discuss the effect of activation of the various autonomic receptors

Introduction to Power Lab

Identify the parts of power lab and its functions
Perform different experiments using powerlab

Parasympathomimetic Drugs
Describe the cholinergic nerves, types and location of cholinergic receptors, their signal
transduction mechanisms and effect of activation of these receptors
Classify the cholinergic agonist drugs
Describe the pharmacodynamics and pharmacokinetics of directly acting cholinomimetic drugs
Explain the mechanism of action of indirectly acting cholinomimetic drugs
Discuss the signs & symptoms, and treatment of organophosphate poisoning

Parasympatholytic Drugs
Identify the muscarinic blocking drugs
Discuss the indications of muscarinic antagonists
Explain the adverse effects and contraindications for the use of muscarinic antagonists
Describe the systemic effects of atropine
Describe the signs & symptoms and treatment of atropine overdose
Describe the nicotinic receptors, their location and signal transduction mechanism
Classify the ganglion blockers and neuromuscular blocking drugs ; describe their mechanism of action
Compare the depolarizing and competitive neuromuscular blockers
Discuss the pharmaco-dynamic and pharmacokinetic properties of neuromuscular blocking drugs

Sympathomimetic Drugs
Describe the adrenergic receptors, their location, signal transduction mechanism and effect of
activation of and receptor subtypes
Classify the sympathomimetic drugs on basis of their receptor affinity and chemical structure
Compare catecholamines and noncatecholamines
Discuss basic pharmacology of epinephrine, norepinephrine and isoproterenol and compare the
cardiovascular effects of these drugs
Discuss basic and clinical pharmacology of other adrenergic agonists including, dopamine,
phenylephrine, methoxamine, clonidine, amphetamine, ephedrine, MAO inhibitors etc

Sympatholytic Drugs
Classify the alpha and beta blocking drugs and describe their mechanism of action
Describe the pharmacokinetics, systemic effects, uses and adverse effects of alpha and beta blockers
Explain the contraindications of alpha and beta blockers
Explain the rationale for clinical use of alpha and beta blockers

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Anti- Parkinson’s Drugs
Describe the pathophysiology of Parkinson’s disease
Discuss the causes of Parkinson’s disease including drug-induced Parkinsonism
Explain the pharmacologic basis for use of levodopa, dopamine agonists, MAO and COMT inhibitors,
Anti-Cholinergic and Amantadine in Parkinson’s disease
Describe the therapeutic and toxic effects of Anti-Parkinsonism drugs

PHYSIOLOGY
Define neuronal membrane potential and explain generation and propagation of nerve impulse
Define synapse and List properties of synapses
Classify sensory receptors and explain their functions including pacinian corpuscle
Describe muscle spindle proprioceptors along with their functions
Describe somatosensory pathways which include dorsal lemniscal and antero-lateral
Describe somatosensory cortex
Explain touch, pressure and temperature sensation
Explain the physiology of pain I
Explain the physiology of pain II
Describe functions of spinal cord and reflexes
Explain motor, vital and non-vital functions of brain stem in respiratory system, CVS, vasomotor centers ,
coughing, sneezing and vomiting reflexes
Enumerate physiologic correlation of various parts of cerebellum and its functions
Describe the basic neuronal circuit of cerebellum along with cerebellar disorders
Explain pyramidal tracts along with Upper Motor Neuron (UMN) /Lower Motor Neuron (LMN
Describe the functions of Diencephalon which includes Thalamus, Sub-Thalamus and Epi-Thalamus
Explain Extra pyramidal tracts of the motor cortex)
Describe functions and integration of Autonomic Nervous System I
Explain functions of Autonomic Nervous System II
Describe structures included in the basal ganglia and their disorders
Describe CSF formation and explain circulation and function
Describe Reticular Activation system, sleep and its disorders including electroencephalography
Explain functional description of limbic System
Describe mechanism of learning and memory
Explain speech and its related disorders

MICROBIOLOGY
Explain the etiology and pathogenesis of meningitis, encephalitis and brain abscess

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 PRACTICALS

ANATOMY
There will be demonstration of the following:
i. Structure of neuron and neuroglia
ii. General organization of nervous system.
iii. Bones of skull
iv. Skull and cranial fossae
v. Different types of nerve tissue
vi. Spinal cord (Ascending and Descending tracts)
vii. Spinal cord lesion, transection and spinal shock
viii. Medulla Oblongata, mid brain and 3rd ventricle
ix. Fourth ventricle & cerebral aqueduct
x. Histology of cerebellar cortex
xi. Meninges of brain and Spinal cord
xii. Spinal cord + arterial supply and venous drainage
xiii. (Histology)
xiv. Microscopic anatomy of Spinal cord, spinal nerve and ganglia, cerebral cortex & cerebellum
xv. Functional areas of cerebral cortex and their associated lesion
xvi. Gray matter of cerebral hemisphere: Basal nuclei
xvii. White matter of cerebral hemisphere projection fibres.
xviii. Internal capsule and related anomalies
xix. Development of brain neurulation and development of forebrain, mid brain and hindbrain (Embryology)
xx. Developmental anomalies of ANS
xxi. Arterial supply of brain and spinal cord

BIOCHEMISTRY
1. Explain the process of Lumber Puncture for taking sample of CSF
2. Estimate glucose in CSF
3. Estimate proteins in CSF
4. Estimate chloride in CSF

PHARMACOLOGY
Power Lab: Introduction To Power Lab And Its Operation For Practicals
1. Identify the components of a power lab and describe their functions
2. Perform any experiment using power lab

Power lab: effect of cholinergic drug on frog Rectus Abdominus muscle.

1. demonstrate the effect of cholinergic agonist on frog rectus muscle and interpret the results.

PHYSIOLOGY
i. Functions of spinal cord and cord reflexes
ii. Motor, vital and non-vital functions of brain stem
iii. Physiology of pain

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 iv. Physiologic correlates of various parts of cerebellum and its function; e f f e c t s of cerebellar
dysfunction
v. Motor cortex (pyramidal tracts, extra pyramidal tracts, UMN/LMN)
vi. Neuron membrane potential: generation and propagation of
vii. nerve impulse.
viii. Synapses, properties of the synapses
ix. Sensory receptors (including muscle spindle) and neuronal circuits
x. Somatic sensation, sensory pathways for transmission of somatic signals into spinal cord,
somatosensory cortex.
xi. Somatic sensation, sensory pathways for transmission o f somatic signals into spinal cord,
somatosensory cortex.
xii. Basal ganglia and disorders
xiii. Cerebral cortex surfaces, lobes, sulci and gyri of cerebral hemisphere.
xiv. Examination of Deep & Superficial reflexes
xv. Functions of diencephalon
xvi. Body temperature
xvii. Functions and integration of autonomic nervous system
xviii. EEG
xix.

SKILL L A B :
Measurement and recording of Vital signs
Examination of nervous system

Mode of Internal Evaluation (Continuous Assessment):

There will be continuous monitoring of attendance
Internal assessment will be held in the form of MCQs, assignments, stages/sub-stages, projects, quiz
and/ or OSPE.
Internal evaluation carries 20% weightage in summative semester examination.

Mode of End of Semester Examination/s:

One Correct MCQs, One Best MCQs, Extended Matching MCQs and OSPE (Observed+ Non Observed
stations)

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SUGGESTED READINGS
SUBJECT RESOURCES
A. GROSS ANATOMY
1. K.L. Moore, Clinically Oriented Anatomy
2. Neuro Anatomy by Richard Snell
B. HISTOLOGY
ANATOMY
1. B. Young J. W. Health Wheather’s Functional Histology
C. EMBRYOLOGY
1. Keith L. Moore. The Developing Human
2. Langman’s Medical Embryology

1. Harper’s Illustrated Biochemistry

2. Lippincott’s Illustrated reviews of Biochemistry
BIOCHEMISTRY 3. Lehninger’s Principles of Biochemistry
4. Biochemistry by Devlin
A. TEXT BOOKS
1. Community Medicine by Parikh
COMMUNITY MEDICINE 2. Community Medicine by M Illyas
3. Basic Statistics for the Health Sciences by Jan W Kuzma
A. TEXT BOOKS
1. Robbins & Cotran, Pathologic Basis of Disease, 9th edition.
2. Rapid Review Pathology, 4th edition by Edward F. Goljan MD
PATHOLOGY/MICROBIOLOGY
1. [Link]
2. [Link]
A. TEXT BOOKS
1. Lippincot Illustrated Pharmacology
PHARMACOLOGY
2. Basic and Clinical Pharmacology by Katzung
A. TEXTBOOKS
1. Textbook Of Medical Physiology by Guyton And Hall
2. Ganong ‘ S Review of Medical Physiology
3. Human Physiology by Lauralee Sherwood
4. Berne & Levy Physiology
5. Best & Taylor Physiological Basis of Medical Practice
PHYSIOLOGY B. REFERENCE BOOKS
1. Guyton & Hall Physiological Review
2. Essentials Of Medical Physiology by Jaypee
3. Textbook Of Medical Physiology by InduKhurana
4. Short Textbook Of Physiology by Mrthur
5. NMS Physiology

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NEUROSCIENCES MODULE, SEMESTER III, 2017-18