تفاصيل المقرر

المقدمة


The nervous system controls the different body systems such as respiratory, and circulation. It also influence the life style of each individual.
Almost all diseases manifests themselves through the nervous system with symptoms such as pain, sensory disturbance, weakness, disturbed thinking and general weakness.
Many local systemic and metabolic diseases can involve and disturb the integrity, and functions of the nervous system such as head injuries, cerebrovascular accidents and infections. Head injuries are on the increase in the Gezira area due to the construction of the new reads. Bacterial, viral and parasitic infections are, as well, common problems.
To understand all these problems and to be able to diagnose and manage them the student should have a basic sound knowledge of the normal structure, function, pathophysiology, clinical aspect and prevention of the various diseases that affect the nervous system, especially the common ones.



المحتويات


1 different structure of the central nervous system. These include the cerebral hemispheres, pons, midbrain, cerebellum, medulla oblongata and the spinal cord
2 major medical problems that can affect the nervous system
3 different levels of the various areas of the brain, i the major structures, and their functions 4 the CNS tissue
5 the cerebrospinal fluid, sites of obstruction and its clinical presentation in both children and adults
6 the circle of Willis, blood circulation of both the brain and spinal cord.
7 the cranial nerves, their origin, course and distribution.
8 development and developmental anomalies of the nervous system, face and brachial arches
9 the Reflex Arc and the different structure involved in transmission of sensory and motor impulses.
10 the neuromuscular junction.
11 the spinal cord.
12 the light reflex, the normal visual field, the optic pathways
13 the mechanisms and pathways of (pain, temperature, touch, pressure, speech, sleep, taste, hearing and smell)
14 neurological problem. 15 the common infections of the nervous system.
16 hemiplegia.
17 chronic headache.
18 paraplegia.
19 peripheral neuropathy.
20 Head injury ,Spinal cord injury and Nerve injury
21 primary tumours of the nervous system
23 neurological manifestations .
24 psychiatric disorders



المنسقون


Dr. FathAlrhman Erabi
Dr.Esamelden Mohammed
Dr. Mariam Omer Qurashi


المطلوبات


التشريح - علم وظائف الأعضاء والكيمياء الحيوية • الجهاز الحركى،المعرفة الأساسية للوراثيات


الأهداف


1) GENERAL OBJECTIVES:

These objectives acknowledge the fact that the student is going to be a doctor who will be responsible for patients that may have a neurological disorder, neurological manifestation of other system disorders, psychological problem that involves neurological system, or signs of various mixtures of all the three.

2) SPECIFIC OBJECTIVES:

The objectives which must be fulfilled at the end of this course will enable the student to: 2.1 Identify and describe in a dissected specimen the different structure of the central nervous system. These include the cerebral hemispheres, pons, midbrain, cerebellum, medulla oblongata and the spinal cord
2.2 Discuss the major medical problems that can affect the nervous system and relate them to different lesions of the above structure
2.3 Given slides of the different levels of the various areas of the brain, identify the major structures, describe them and state their functions
2.4 Given slides of the CNS tissue identify the tissue and describe it
2.5 Describe the circulation and constituents of the cerebrospinal fluid, name the possible sites of obstruction and discuss its clinical presentation in both children and adults
2.6 Identify, in a dissected specimen, and draw the circle of Willis, and discuss the blood circulation of both the brain and spinal cord.
2.7 Identify the cranial nerves in a dissected specimen, describe their origin, course and distribution. Discuss the clinical importance of their different lesions
2.8 Discuss the development and developmental anomalies of the nervous system, face and brachial arches
2.9 Draw a diagram of the Reflex Arc and describe the different structure involved in transmission of sensory and motor impulses. Mention the clinical conditions which might result from abnormalities of this tract e.g. lower motor neuron lesion
2.10 Draw and describe the neuromuscular junction. Describe the transmission of nerve impulses across it, and give examples of clinical conditions that affect it - e.g. myasthenia gravis, muscle relaxants
2.11 Given a cross - section of the spinal cord, at different levels, identify the different tracts, trace them from their origin to their destinations, discuss their functions and the clinical conditions which would arise from their intersection e.g. lower motor neuron lesion, upper motor neuron lesion – Brown- Sequard syndrome.
2.12 Draw and describe the light reflex, the normal visual field, the optic pathways Discuss the common clinical abnormalities and clinical significance related to intersection of these tracks - e.g. light reflex, hemianopia bitemporal hemianopia, and binasal hemianopia
2.13 Describe the mechanisms and pathways of the following:
pain, temperature, touch, pressure, speech, sleep, taste, hearing and smell
2.14 Given a patient with a neurological problem the student will demonstrate the ability to take a good history conduct a systematic physical examination, eliciting motor and sensory signs, and give a differential diagnosis. He is also expected to discuss the various investigations and to outline both management and control of that problem.

2.15 Discuss the common infections that can involve the nervous system, their etiological agents; pathological processes; clinical picture; investigations, as well as their management and control, e.g.
a) bacterial: meningococcal, diphtheria
b) viral: poliomyelitis, encephalitis, viral meningitis and rabies
c) parasitic: cerebral malaria
d) fungal: cryptococcosis

2.16 When faced with a case of hemiplegia, the student will be to take proper relevant history discuss the possible etiological factors, e.g. cerebral and subarachnoid hemorrhages, embolism, and hypertensive encephalopathy He will also outline its investigations and management.
2.17 When faced with a patient suffering from chronic headache, discuss the differential diagnosis including migraine, temporal arteritis and outline the management
2.18 When confronted with a patient with paraplegia, demonstrate the interviewing and examination skills relevant to the problem and outline the plan for investigations and management. The student is also expected to discuss a wide differential diagnosis including the following Diseases - Pott's diseases of the spine :
- Sub acute combined degeneration of the cord
- Guillain Barre - infective polyneuritis
- Syringomyelia
- Cervical spondylosis
- Compression of the spinal cord

2.19 When faced with a patient with peripheral, neuropathy, the student should have the ability to evaluate patients, discuss the possible aetiological factors and management e.g.
- Diabetes mellitus
- Alcohol
- Nutritional causes including deficiency of vit B group
- Infective polyneuritis
- Carcinomatosis
- Lead
- Purphyria
- Drugs e.g. Isoniazed
2.20 When faced with one of the following emergencies:
a. Head injury
b. Spinal cord injury
c. Nerve injury
The student will be able to demonstrate interpersonal skills in taking a good history, elicit the important neurological signs and manage such a problem effectively.

2.21 When faced with one of the following problems, discuss their aetiology, clinical picture and management
a. Epilepsy
b. Parkinsonism
c. Dementia
d. Muscular dystrophies
e. Hereditary ataxia
f. Cerebral palsy
g. Chorea
2.22 (a) Describe the primary tumours of the nervous system (meningeoma, retinoblastoma, astrocytoma, oligodendroma and neurofibromatosis) their origin, macro and micro- appearances, clinical manifestation, diagnosis and management
(b) Enumerate the possible metastasis to the central nervous system 2.23 Discuss the different neurological manifestations management and prevention of the following nutritional and metabolic diseases :
(a) Vit B12, B1 , B6 e.g.
- subacute combined degeneration of the cord - Beri Beri
- Pellagra
- Wernicke's encephalopathy
- Korsakoff psychosis
(b) Diabetes mellitus
(c) Chronic liver disease
(d) Storage diseases
2.24 Identify the major classifications of psychiatric disorders



طرق التدريس


1 Problem Solving:
The goal of medical education is to prepare the student to practice medicine. He/she should be able to evaluate and manage patients with medical problems effectively, efficiently and humanely. The problems within this course are presented to the student in the same way as it would present in reality. While he/she is working with the problems he/she is expected to generate several hypothesis which are relevant to the problem and at the same time to work in a manner that permits him/her to apply and evaluate his/her skills in clinical reasoning. You will often find it easy and helpful if you work in a small group before discussing them with your tutor in the class. If there are any difficulties you may discuss them with your peers, faculty member or any other resource.
2 Lectures
3 Tutorials
4 Practical class
5 Clinical Rounds
6 Seminars
7 Reading assignments



المصادر


1) Human Resources:

1.1 Anatomist
1.2 Physiologist
1.3 Pathologist
1.4 Surgeon
1.5 Community Physician
1.6 Paediatrician
1.7 Physician
1.8 Radiologist
1.9 Biochemist
1.10 Dermatologist

2) Physical Resources:

2.1 Room for students
2.2 Dissecting Room
2.3 Pathology Laboratory
2.4 Multimedia
2.5 Microscopes
2.6 Neurology and diagnostic sets



وسائل التقويم


1 MCQs = 40%
2 Essays = 20%
3 OSPE = 20%
4 Clinical Exam (PACES) = 10%
5 A/P = 10%



المراجع


كنغهام (3) Curiningham’s
علم الأجنة الانسانى
Human Embryology, by Haines and Mohy Eldin
دليل طلاب الطب A companion to Medical Students by passmore and Robson
كتاب ديفيدسون لمبدأ وعملى الطب الباطنى Davidson’s Principle and Practice of Medicin
كتاب نيلسون لطب الأطفال Nelson Textbook of Paediatrics
كتاب برين لعلم الأعصاب Brain Neurology


الجدول الزمني

Dr. FathAlrhman Erabi &A. Mariam Omer Course introduction SUNDAY:2/4/2017
9:00-10:00

Dr.Mahdi Ali Salih

Introduction : General organization of CNS
2:00 - 11:00

Dr. Ahmed Makki

development of CNS & developmental anomalies

MODAY:3/4/2017
8:00-9:30

Dr.Osman&Dr.Mustafa&Dr.Wail

Dissection :The Neck

10:30-2:00

Dr. Ahmed Makki

Histology of CNS

TUESDAY:4/4/2017
9:30 - 8:00

Dr.Osman&DrMustafa&DrWail

Dissection :The Neck

10:00-1:30

LONGITUDINAL

WEDNSDAY:5/4/2017

Dr.Osman&Dr.Mustafa&Dr.Wail

Osteology of skul1

Thursday:6/4/2017
8:00-9:30

Dr.Osman&Dr.Mustafa&Dr.Wail

Dissection : Scalp, face and temple

10:30-2:00

Dr. Mariam Omer

Dr. Mariam Omer

Dr. Ahmed Makki

Resting membrane potetial and action potential

Synaptic and junctional transmission

Spinal cord (internal and external structures) and meninges

SUNDAY:9/4/2017
8:00-9:30

9:30-11:00

12:00-1:30

Dr. Hayder Elhadi

Dr. Ahmed Makki

Arterial blood supply of the brain Coverings of the brain+Venous sinuses

Arterial blood supply of the brain
Coverings of the brain+Venous sinuses Elective

MODAY:10/4/2017
8:00-9:30

9:30-11:00
1:30 -12:00

Dr. Ahmed Makki

Brain stem

TUESDAY:11/4/2017
8:00-9:00
Dr.Osman&Mustafa&Wail

Dissection: meninges of the brain, dural sinsus and blood supply of the brain
10:30-2:00

LONGITUDINAL

WEDNSDAY:12/4/2017

Dr.EsameldenMohammed

The sensory system(1) (introduction, sensory receptors and modalites of sensation)
The sensory system(2) (Ascending tracts)

Thursday:13/4/2017
8:00-9:30
10:00-11:00

Dr.Osman&DrMustafa&DrWail

Dissection : Tomography and section of the brain

11:30-2:00

Dr.Abdelrhman Ahmed

physiology of pain and Interoduction to Problem(1)

SUNDAY:16/4/2017
8:00-9:30

Dr. Ahmed Makki

Cerebellum

10:30-11:30

Dr.Osman & Dr.Mustafa & Dr.Wail

Dissection of the Spinal Cord & Meninges

11:30-2:00

Dr. Ahmed Makki

Diancephalon (1)

MODAY:17/4/2017
8:00-9:00

Dr. Ahmed Makki

(Diancephalon (2

9:30-11:00

Dr. Hashim Altom

History of the nervous system

11:30-3:00

Dr. FathAlrhman Erabi

ClinicalExamintion of the nervous system

TUESDAY:18/4/2017
8:00-9:00

Dr.Abdelrhman Ahmed

Stretch Reflex – The Reflex Arc1

9:30-11:00

Dr.Osman & Dr.Mustafa & Dr.Wail

Dissection of thr parotid gland and the submandibular area

11:30-2:00

LONGITUDINAL

WEDNSDAY: 19/4/2017

Dr.Esamelden Mohammed

Reflexes 2

THURSDAY:20/4/2017
8:00-9:30

Dr.Abdelrhman Ahmed

Function of the brain stem

10:30-12:00

Elective

12:00-1:30

A. Mariam Omer

physiology of motor cortex

SUNDAY:23/4/2017
8:00-9:30

A. Mariam Omer

Pyramidal tracts and ExtraPyrcmidal tracts

10:30-12:00

Dr.Abdelrhman

Function of the basal ganglia

2:00 - 12:00

Dr.Esamelden Mohammed

Function of the cerebellum

MODAY:24/4/2017
8:00-9:300

Dr.Esamelden Mohammed

EEG and sleep

10:30-12:00

Dr.Esamelden Mohammed

CSF

12:30-1:30

Physicians &Pediatricians

Clinical round (1)

TUESDAY: 25/4/2017
8:00-11:00

Dr.Mohammed Elhasson Taha

Bacteriology of meningitis

11:30-1:00

LONGITUDINAL

WEDNSDAY: 26/4/2017

Dr.EsameldenMohammed

Discrsionof Problem (1)

THURSDAY:27/4/2017
8:00-9:30

Dr.solafa eltayeb

Vascular diseases of the brain

10:30-12:00

Dr.Abdelrhman

Function of the thalamus and hypothalamus

12:00-1:30

Dr. Hussein Zydan

Meningitis

SUNDAY:30/4/2017
8:00-10:00

Dr. Hashim Altom

Cerebrovascular accidents

11:00-12:30

Dr.Mahmoudbdallahsalm

The optic nerve

12:30-2:00

Dr. FathAlrhman Erabi.
Dr.EsameldenMohammed

Mid of Course exam

MODAY:1/5/2017
8:00-9:30

Dr.Fadwa Hashim

Physiology of vision

10:30-12:30

Dr.EsameldenMohammed

Autonomic nervous system

1:00-2:30

Physicians &Pediatricians

Clinical round (2)

TUESDAY: 2/5/2017
8:00-11:00

Dr. Abdalla Abdalkareem

Headache

12:00-1:30

LONGITUDINAL

WEDNSDAY:3/5/2017

Dr. FathAlrhman Erabi

Paraplegia

THURSDAY:4/5/2017
8:00-9:30

Dr.EsameldenMohammed

Limbic system and Behavioral function of the brain

10:30-12:00

Dr. Hashim Altom

Intracranial hypertension

12:00-1:00

Dr. Mamoon Marghani

3rd, 4th and sixth cranial nerves

SUNDAY:7/5/2017
8:00-9:30

Dr. Ahmed Ali

Parkinsonism

10:30-11:30

Dr.Elnassry

Radiology of the brain(1)

11:30-1:30

Dr. FathAlrhman Erabi

Motor neurone disease

MODAY:8:5/2017
8:00-9:30

Dr.Elnassry

Radiology of the brain(2)

10:30-1:30

Physicians &Pediatricians

Clinical round (3)

TUESDAY:9/5/2017
8:00-11:00

Prof. Hayder Elhadi

Epilepsy

11:30-1:30

LONGITUDINAL

WEDNSDAY: 10/5/2017

Dr.Wail Nury

The 7th cranial nerve

THURSDAY:11/5/2017
8:00-9:30

Prof. Hayder Elhadi

Acute flaccid paralysis

10:30-11:30

Dr Mahmoud Hussin

Coma

12:00-1:30

Dr.Abdelsalam Eltayeb

Encephalitis

SUNDAY:14/5/2017
8:00-9:30

Prof. HaiyderElhadi

Cerebral palsy

10:30-12:00

Dr. Ahmed Makki

Cranial nerves( 9th and 10th)

12:00-1:30

Mr.WailNury

The 8th cranial nerve and physiology of hearing

MODAY15/5/2017
8:00-9:00

Mr FaisalNuogud

Spina bifida

10:00-11:30

Dr. Ahmed Makki

Cranial nerves( 11th and 12th)

11:30-2:00

Physicians &Pediatricians

Clinical rounds(4)

TUESDAY:16/5/2017
8:00-11:00

Dr. Hashim Eltom

Dr..Mahmmoud Hussin& Mr.Mohammed Sayed

Peripheral neuropathy

Seminar : Trauma to CNS

11:30-12:00

12:30- 2:00

LONGITUDINAL

WEDNSDAY:17/5/2017

Dr. FathAlrhman Erabi

Myasthenia gravis

THURSDAY:18/5/2017
8:00-900

Dr. Salah Elamin

Demyelinating disease

10:00-11:30

Dr MohammedSaydElmatary

brain tumours

11:30-1:00

Prof. HudaHaroun

Guillain Barre syndrome

SUNDAY:21/5/2017
8:00-9:00

Dr. Ahmed AwadElkarim

Tetanus and Rabies

10:00-11:00

Prof. Osman Khalafallah

Alcohol and the CNS

11:30-1:00

Mr.FaisalNuogud

Ventricular system, CSF circulation and Hydrocephalus

MODAY:22/5/2017
8:00-9:00

Dr.Mahmmoud Hussin & M.MohammedSayed

Seminar : Trauma to CNS

10:00-1:00

Physicians &Pediatricians

(Clinical rounds(6

TUESDAY:23/5/2017
8:00-11:00

Prof. AlibabikerHaboor

Febrile covulsions

12:00-1:30


Vacation Ramadan :25/5/2017- 2/7/2017

Prof. Haiyder Elhadi

Seizures in childhood

SUNDAY:2/7/2017
8:00-9:30

Elective

10:00-02:00

ELECTIVE

MODAY:3/7/2017

Physicians &Pediatricians

ELECTIVE Clinical rounds

TUESDAY:4/7/2017
8:00-10:00
11:00-1:00

LONGITUDINAL

WEDNSDAY:5/7/2017

ELECTIVE

THURSDAY:6/7/2017
8:00-12:00

ELECTIVE

SUNDAY:9/7/2017
8:00-9:00
10:00-2:00

ELECTIVE

MODAY10/7/2017
8:00-10:00
10:30-12:00

ELECTIVE

TUESDAY:11/7/2017
9:00-1200

LONGITUDINAL

WEDNSDAY:12/7/2017

ELECTIVE

THURSDAY:13/7/2017

Written Exam
MCQs
Essays

SUNDAY:16/7/2017

ELECTIVE

MODAY:17/7/2017

OSCE

TUESDAY:18/7/2017

CLINICAL EXAM

WEDNSDAY: 19/7/2017

CLINICAL EXAM

THURSDAY: 20/7/2017

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