Clinical Neuroscience Course Quiz

Lecture 011425

• Course Description includes lectures, objectives, exams, and grading, plus the Moodle website.
• Divisions and Orientation covers CNS and PNS, as well as planes of section.
• Imaging discusses anatomical views (MRI, CT) and functional views (PET, fMRI).
• Cells of the Nervous System are explored, including neurons and glial cells.
• A case study on Multiple Sclerosis is included.

Course Information

• Moodle is the course's online platform for lectures, labs (BIOL 4460/5560 01, PT 5502, OT 5502 01 02: Clinical Neuroscience (JGroome), BIOL 4415L/5515L), plus a link to recorded lectures within "General".
• Weekly posts use PowerPoint presentations in PDF format.
• Each module has learning objectives as well as vocabulary and concepts.
• Labs include objectives and dissections using Atlas Images.
• Reading quizzes (10 total, 50 points each) are done on Moodle and are open book.
• Missed reading quizzes can be replaced with a generated quiz.

Examinations

• Exams are one per module, 100 points each, and non-cumulative.
• Remidiation is possible for Exam ONE only, with a maximum score of 75%.
• The final exam is the fourth midterm exam and is non-cumulative.

Modules

• Modules cover Neurobiology, Neurophysiology & Development, Neuroanatomy, Systems Neuroscience I (sensory pathways), and Systems Neuroscience II (motor and integrative pathways).

Emphases

• Emphasize mechanisms, pathways, pathology, and case studies, specifically for Module I.

Basic Divisions of the Nervous System

• Central Nervous System (CNS): The cerebrum, thalamus, midbrain, pons, cerebellum, medulla, and spinal cord are discussed. Brainstem is composed of the midbrain, pons, and medulla.
• Peripheral Nervous System (PNS): Spinal nerves and autonomic nerves are covered.

Planes of Section

• Sagittal: A midline, longitudinal section.
• Axial: A horizontal section.
• Coronal: A perpendicular section to the long axis.

Computerized Tomography (CT) Scans

• X-ray beams rotate around the patient, creating several views of each slice.
• Different densities like air, blood, bone and brain are distinguished.

Magnetic Resonance Imaging (MRI)

• Two coils are used to change the proton spin and allow alterations to relax, thus measuring time to relaxation (T1, T2 values).
• T2 (horizontal spin relaxation) and T1 (vertical spin relaxation) differ based on tissue type.

BOLD fMRI (Blood Oxygen Level Dependent fMRI)

• BOLD fMRI measures changes in blood oxygenation in the brain.
• More oxy-hemoglobin in specific brain areas indicates increased blood flow.
• This method is used to study brain activity during sensory or motor tasks.

Positron Emission Tomography (PET)

• Radioactively tagged substances are injected into the brain to measure changes in blood flow and glucose metabolism.
• Labels are used for specific receptors to identify activity.
• Measures blood flow changes, and glucose metabolism changes.

Single Photon Emission Computed Tomography (SPECT)

• SPECT uses a wider variety of isotopes to examine specific brain areas than PET, but with less spatial resolution.

Neurons - Functional Morphology and Neurophysiology

• Input Zone: Includes apical and basal dendrites, and the soma (cell body).
• Trigger Zone: Comprises the axon hillock, spike initiation zone, and the initial segment.
• Propagation Zone: Includes the axon, myelin sheath, and Nodes of Ranvier, and collateral branches.
• Output Zone: Contains the axon terminal and synaptic boutons, and synaptic vesicles containing neurotransmitter (NT).

Types of Neurons

• Unipolar/pseudounipolar
• Bipolar
• Multipolar (e.g., pyramidal, Purkinje, stellate, granule)

Neuronal Organelles

• plasma membrane: signaling
• cytoskeletal elements: transport, architecture, signaling
• nucleus: genetic control center
• rough ER/ribosomes: protein synthesis
• smooth ER: protein modifications
• Golgi apparatus: protein modification and packaging
• mitochondria: energy metabolism, ATP generation

Neurophysiology (Module I)

• Includes aspects of plasma membrane, electrical signaling, dendritic arbor, spines, axon hillock/myelinated cable, axon terminals, synaptic boutons; also, protein pumps for ion concentration gradients (e.g., sodium-potassium pump, calcium pumps), ion channels for electrical gradients (non-gated and gated by stimuli), synaptic proteins for NT release/uptake, and receptor proteins for transduction of signal (ionotropic and metabotropic channels).

Neuronal Transport

• Nucleus codes for Messenger RNA (mRNA).
• Rough ER performs ribosomal protein synthesis.
• Smooth ER and Golgi modify and package proteins (lipids, hormones).
• Microtubules & neurofilaments transport within the cell body & neurites, organelles, vesicular neurotransmitters, and enzymes.
• Transmitters can be synthesized in soma/terminal regions depending on their type.

Neurofilaments and Microtubules

• Neurofilaments: 10 nm intermediate filaments, forming the cytoskeleton's architecture.
• Microtubules: Composed of α/β tubulin, involved in axonal transport and cell division.

Axonal trafficking (microtubule-based)

• Anterograde transport (toward terminals): Kinesin.
• Retrograde transport (toward soma): Dynein.

Glial Cells

• Microglia: Resident phagocytic macrophages, responding to injury, infection, scavenging debris.
• Macroglia (CNS): Oligodendrocytes and astrocytes.
• Macroglia (PNS): Schwann cells.
• Gliosis: Reactive glial cell proliferation, associated with glial cell tumors. Examples of glial cell tumors include astrocytoma, glioblastoma multiforme, oligodendrocytoma, ependymoma, and schwannoma.

Glial Cell Functions

• Astrocytes take up excess extracellular potassium and released neurotransmitters, contributing to the blood-brain barrier (BBB).
• Oligodendrocytes and Schwann cells produce the myelin sheath crucial for saltatory conduction in both central (oligodendrocytes) and peripheral (Schwann cells) nervous systems.
• They aid in neuronal framework and migration during development.

Astrocytes

• Most numerous glial cells.
• End feet induce the blood-brain barrier in endothelial junctions.
• Important in potassium and neurotransmitter uptake.

Oligodendrocytes and Schwann cells

• Central myelination: Oligodendrocyte.
• Peripheral myelination: Schwann cell.
• Glial cell membranes are interrupted at the Nodes of Ranvier for sodium and potassium channels.

Case Study: Multiple Sclerosis (MS)

• A 28-year-old woman presents with weakness, numbness, tingling in her left leg; physical examination reveals moderate left weakness and loss of vibratory/positional sense in her legs; MRI shows abnormal signal in the peri-ventricular white matter; initially improved but later experiences abrupt vision loss, vision gradually improves; then develops tremor, balance problems, speaking difficulties, transient vision problems (dysarthria, diplopia). The white matter contains plaques of demyelination (gelatinous discoloration)

Brain/Multiple Sclerosis MRI and Gross Coronal section

• MRI scan shows abnormal signal/plaques in peri-ventricular white matter, suggestive of multiple sclerosis.
• Gross examination of white matter reveals multiple, scattered (randomly distributed) areas of demyelination (gray, gelatinous discoloration), corresponding with clinical signs/symptoms.

This quiz covers the major topics in Clinical Neuroscience, including the structure and function of the central and peripheral nervous systems, imaging techniques, and cellular components of the nervous system. Additionally, it includes a case study on Multiple Sclerosis. Prepare to demonstrate your understanding of these crucial concepts.