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Neurophysiology
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Constructing Objectives |
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Electrophysiology NEU
2. Write the Nernst equation,
and explain the effects of altering either the intracellular or
extracellular Na+, K+, Cl-, or Ca2+
concentration on the equilibrium potential for that ion. NEU
3. Describe the normal
distribution of Na+, K+, Ca2+, and Cl-
across the cell membrane, and using the chord conductance equation, explain
how the relative permeabilities to these ions create a resting membrane
potential. NEU
4. Describe ionic basis of an
action potential. NEU
5. Contrast the generation and
conduction of graded potentials with that of action potentials, identifying
on the neuron the area in which each occurs. NEU
6. Describe the basis for the
calculation of the space constant and time constant of neuron process. NEU
7. Define membrane capacitance
and identify how membrane capacitance affects the spread of current in
myelinated and demyelinated neurons. NEU
8. Compare conduction
velocities in a compound nerve, identifying how the diameter and myelination
lead to differences in conduction velocity, and the use of these differences
to classify neurons as group Ia, Ib, II, III, IV fibers or as Aalpha,
Abeta, Adelta, b, and c fibers. NEU
9. Describe the ionic basis for
inhibitory and excitatory post-synaptic potentials and how these changes can
alter synaptic transmission. NEU
10. Distinguish the effects of
hyperkalemia, hypercalcemia, and hypoxia on the resting membrane and action
potential. NEU 11. Describe the effects of demyelination on action potential propagation and nerve conduction.
Neurochemistry NEU
13. Describe chemical
neurotransmission, listing in correct temporal sequence events beginning
with the arrival of a wave of depolarization at the pre-synaptic membrane
and ending with a graded potential generated at the post-synaptic membrane. NEU
14. Define the characteristics
of a neurotransmitter. NEU
15. Learn the synthetic
pathways, inactivation mechanisms and neurochemical anatomy and mechanisms
of receptor transduction for the following neurotransmitters: NEU 16. Learn the major receptor classifications and representative receptor agonists and antagonists for the above transmitters. NEU
17. Describe the relationships
between neurotransmitter dysfunction and neuropathology.
Cerebrospinal
Fluid, Blood Brain Barriers NEU
19. Identify on a diagram the
meninges and subarachnoid spaces. NEU
20. Describe formation and
reabsorption of cerebral spinal fluid, including the anatomy and function of
the choroid plexi. NEU
21. Describe the normal pressure, volume, and composition of the
CSF. NEU
22. Describe how CSF can vary
in certain pathological conditions. NEU 23. Describe the endothelial basis of the blood-brain barrier, and predict the consequence of this barrier for the central nervous system distribution of intravenously administered hydrophilic and hydrophobic drugs Spinal
Cord Physiology NEU
25. Describe the anatomical
location, function, and afferent neurotransmission of muscle spindle and
Golgi tendon organs. NEU
26. Trace the neuronal activity
initiated by striking the patellar tendon with a percussion hammer (the
patellar tendon reflex) that leads to contraction of a muscle.
Contrast this reflex with the inverse myotactic reflex. NEU
27. Describe the role of the
gamma efferent system in the stretch reflex, and explain the significance of
alpha‑gamma co-activation. NEU
28. Describe the properties of
the flexor reflex initiated by touching a hot stove.
Identify when pain is sensed, when flexor contraction occurs, and the
neuronal connections and role of the crossed extensor reflex. NEU
29. Describe the clinical tests
and findings that allow a physician to distinguish between upper and lower
motorneuron disorders, including the Babinski sign. NEU
30. Describe the anatomy and
functions of the major ascending and descending spinal cord tracts,
including any crossing of midline. NEU
31. Describe the use of
dermatones, sensory deficits, and motor deficits to identify local spinal
cord lesions, and spinal cord hemisection.
Describe the immediate and long-term consequences of spinal cord
transection. Nerve
Conduction/EMG Studies NEU
33. Describe the repetitive
nerve stimulation procedure for assessing the integrity of the neuromuscular
junction. NEU 34. Compare the different EMG findings in neuropathy and myopathy. NEU
35. Describe the physiological
deficit and the consequence for patients with myasthenia gravis.
Autonomic
Nervous System NEU
37. List the sensory input of
the ANS. NEU
38. List the major central
nervous system control centers of the ANS. NEU
39. Describe the functional
effects of normal and abnormal ANS activity or lack of activity.
Brainstem
Reflexes NEU 41. For each brain stem reflex, list the stimulus and its receptor, the afferent pathway, the brain stem nuclei involved, the efferent pathway and the resulting effect. NEU
42. Contrast the effects of
intra-axial and extra-axial brain stem lesions
Cerebrovascular
System NEU 44. Describe cerebrovascular disorders (stroke, aneurysm, migraine headache) as to primary cause and effect, including how excitotoxic mechanisms can lead to neuronal death following stroke or injury. Somatosensory
System NEU
46. List the submodalities of
discriminative touch. NEU
47. Describe the following
cutaneous and proprioceptive mechanoreceptors and their function: Pacinian
corpuscles, Meissner’s corpuscles, Ruffini endings, Merkle cell, A-delta
and C free nerve endings, Golgi tendon organ, muscle spindle. NEU
48. Describe functional
organization at all levels and submodalities served by the dorsal column-medial
lemniscal and the equivalent components of the trigeminal system. NEU
49. Differentiate between feed-forward
and feedback inhibition within neuronal circuits, and provide physiological
examples of each. NEU
50. Contrast the proprioceptive
pathways to the cerebellum with that to the cerebral cortex. NEU
51. Differentiate the
submodalities of nondiscriminative touch, temperature and nociception based
on receptor transduction mechanism, localization within the spinal gray
matter, and central termination of the pathways. NEU
52. Describe functional
organization at all levels and submodalities served by the anterolateral
system and the equivalent components of the spinal trigeminal system. NEU
53. Describe the control of
pain perception, including central processing and the role of endorphins. NEU
54. Describe gating mechanism
theory for control of pain transmission, and relate it to the use of TENS (transcutaneous
electrical nerve stimulation) and spinal cord stimulation. NEU
55. Describe pain perception
and the central pain syndrome, for example, the thalamic pain syndrome. NEU
56. Describe the peripheral and
central mechanisms of primary hyperalgesia and secondary NEU
57. Describe the mechanism of
referred pain of visceral origin. Visual
System NEU
59. Describe the process of
accommodation, contrasting the refraction of light by the lens in near
vision and in far vision. NEU
60. Describe the refractive
deficits that account for myopia, hyperopia, presbyopia, and astigmatism,
and their correction by eyeglasses or contact lenses. NEU
61. Describe the electrical
responses produced by bipolar cells, horizontal cells, amacrine cells, and
ganglion cells, and comment on the function of each. NEU
62. Contrast the transduction
process for rods and the three types of cones, including the range of
spectral sensitivity, including the ionic basis of these responses. NEU
63. Describe the neuronal
circuitry basis for antagonist center-surround receptive fields of retinal
ganglion cells. NEU
64. Describe the receptive
field properties of all neuron types in the visual pathway (retina to
lateral geniculate to visual cortex). Describe how convergence, divergence,
and afferent surround inhibition affect visual neuron receptive fields. NEU
65. Predict the visual field
defects resulting from the following lesions in the visual pathway: retinal
lesion, optic nerve lesion, optic chiasm, optic tract, lateral geniculate
nucleus, optic radiations, primary visual cortex. NEU
66. Describe the topographic
representation of the visual field within the primary visual cortex,
including the topics of retinotopic organization, orientation selectivity,
and ocular dominance. NEU
67. Describe the processing of
information in the visual cortex, and the consequence of a lesion in the
higher visual association areas. NEU
68. List and compare four
functional properties of scotopic and photopic vision. NEU
69. Explain the differing light
sensitivities of the fovea and optic disk. Smell
and Taste NEU
71. Describe olfactory
pathways. NEU
72. Describe taste receptors
and transduction mechanisms. NEU
73. Describe taste pathways.
Auditory
System NEU
75. Draw the human audibility
curve and explain the changes that occur with aging. NEU
76. Explain the frequency
analysis performed by the cochlea on the basis of its physical properties. NEU
77. Explain how deformations of
the basilar membrane are converted into action potentials in auditory nerve
fibers. NEU
78. Diagram the auditory
pathway including all central connections. NEU 79. Describe how pitch, loudness, and localization of sounds in space is coded by central auditory neurons. NEU
80. Distinguish conductive,
central, and sensorineural deafness, and list the tests used to assess them.
Vestibular
System NEU
82. Describe the structure,
normal stimulus, transduction at the receptor level, and function of the
semicircular canals. NEU
83. Describe the central
connections of the vestibular nerve (the two targets of first order
afferents and the four targets of second order afferents), and relate these
to the three major functions of the vestibular apparatus. NEU 84. Describe the neural mechanisms of nystagmus, past pointing, and caloric testing, and relate the direction of the nystagmus to the direction of rotation or which ear (left or right) was irrigated with cold or warm water. NEU
85. List and describe four
clinical signs of vestibular system dysfunction. NEU 86. Describe the different kinds of gaze (voluntary) eye movements and reflex eye movements.
Medial
and Lateral System Control of Movement NEU
88. Draw a cross section of the
spinal cord and discuss the organization of the sensory and motor components
of gray matter. Describe the
somatotopic arrangement of motor neuron pools. NEU
89. List the medial and lateral
motor systems. Describe
their origin, pathway, and termination within the spinal cord.
Compare their functions in motor control. NEU
90. Describe the effects of
lesions in medial and lateral systems. Cerebellum
and Basal Ganglia NEU
92. List three functional
divisions of the cerebellum, detailing the input and output connections of
each. Be able to differentiate
the functions of each and their integration with lateral and medial motor
systems. NEU
93. Draw and label the
circuitry of the cerebellar cortex, assign the functional role of each
neuron type and give its synaptic action (excitatory/inhibitory).
Be able to describe how this circuit functions as a timing mechanism
and how it produces synergy in opposing muscle groups. NEU
94. On the basis of input-output
organization, somatotopic organization, and overall function, predict the
neurological disturbances that can result from disease or damage in
different regions of the cerebellum. NEU
95. Contrast the spinal
proprioceptive pathways to the cerebellum with those to the cortex. NEU
96. List and describe the major
interconnections between components of the basal ganglia and the motor
cortex. Identify the
neurotransmitters determining the flow of information in the system. NEU
97. Describe the overall
function of the basal ganglia in movement control and initiation in
association with medial and lateral motor systems. NEU 98. List the appropriate signs of rigidity, dyskinesias, akinesia, and tremor for Parkinsonism, chorea, hemiballism, and athetosis. Assign a likely lesion site or chemical system defect for each clinical syndrome. NEU 99. Describe the rationale for treatment of Parkinsonism with anticholinergic drugs, l-DOPA, or transplantation of catecholamine-producing cells.
Cerebral
Cortex NEU
101. Compare the effects of
electrical stimulation of motor cortex and premotor cortex, relating the
expected results to the control of voluntary movement. NEU
102. Describe the origin,
course, and termination of the pyramidal tract. NEU
103. Compare the consequences
of upper motor neuron loss to lower motor neuron loss. NEU
104. Draw a “flow diagram”
for the brain regions involved in planning, initiating, and properly
executing a skilled voluntary movement. NEU
105. Identify Brodmann areas
for visual, auditory, somatic sensory, motor, and speech areas. NEU
106. Identify the cortical
areas that receive projections from the following thalamic nuclei: ventral
lateral, dorsomedial, pulvinar, medial geniculate, lateral geniculate,
ventral posterolateral, and posteromedial. NEU
107. Describe the cortical
areas important for language. NEU
108. Describe the cortical area
important for spatial relations. NEU
109. Describe the functions of
the prefrontal association cortex. NEU
110. Define and explain the
physiological basis of evoked potentials and the electroencephalogram (EEG).
List the main clinical uses of each. NEU
111. Describe the primary types
of rhythms that make up the EEG and the behavioral states that correlate
with each. NEU
112. Describe the origin of
spontaneous electrical activity of the cerebral cortex. NEU
113. Distinguish EEG activity
from evoked potentials and the uses of evoked potentials. Sleep NEU
115. Distinguish slow
wave sleep and paradoxical sleep. NEU
116. Describe the neural
systems important for the regulation of sleep-waking. NEU 117. Describe the neurochemical systems important for sleep and waking. NEU
118. Describe narcolepsy and
sleep apnea. NEU
119. Describe the mechanisms
important in the production of coma. NEU 120. Describe the changes in the sleep cycle across the life cycle.
Seizure
Disorders NEU
122. Describe characteristics
of generalized and partial seizures.
Hypothalamus NEU
124. Describe the major
functions of the hypothalamus and its nuclei/areas. NEU 125. Describe the role and mechanisms of the hypothalamus as it relates to thirst, hunger, temperature regulation, and the defense mechanism. Limbic
System NEU
127. Describe the major
afferent and efferent connections of the hippocampus. NEU
128. Describe the major
afferent and efferent connections of the amygdala. NEU
129. Describe reinforcement
functions of the limbic system. NEU
130. Describe the functions of
the hippocampus. NEU
131. Describe the functions of
the amygdala. NEU 132. Describe the role of dopamine in the limbic system in disorders of thought and disorders of mood.
Aging
of the Brain NEU
134. Describe dementia. NEU
135. Describe the
characteristics of Alzheimer’s disease. Memory
and Lateralization NEU
137. Explain the mechanisms
proposed for short term and long‑term memory storage. NEU
138. List the major differences
in hemispheric function in humans.
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Electrophysiology