Paraskeva Efrosyni, Hatzoglou Chryssi, Evdoxia Gogou

Teaching Method:

• Lectures (face to face)
• Practical
• Problem based learning (tutoring)

USE OF INFORMATION AND COMMUNICATION TECHNOLOGIES

Lectures:  include power point presentations and video.

The learning process is supported by e-Class 

Attendance of Laboratory Practicals and Tutorials is obligatory.

Assessment:

Written examination at the end of the course

Course overview:

I. The nervous system

II. The endocrine system

III. The reproductive system

The course provide the necessary background for understanding the basic principles / mechanisms of functioning of the nervous system, endocrine glands and reproduction. Its aim is to familiarize students with terms and concepts of the nervous and the endocrine system, their comprehensive understanding of the function of these systems and to introduce students to recognize possible deviations in the operation of these systems from normal. In this context, reference is made to changes in the function of these systems in cases of diseases of the nervous system (e.g. Parkinson’s disease, Dementia) and endocrine (e.g. Diabetes, Thyroid Disease). In this sense, the course is the basis of the pathophysiology and pharmacology of these systems.

General Abilities

• Search, analysis and synthesis of information / data, using the necessary technologies.
• Decision making.
• Autonomous work
• Teamwork
• Promoting free, creative and inductive thinking

1. Neurophysiology 

1. Sensory Physiology

Lesson 1: Introduction to sensory systems

• Sensory receptors
• Neural pathways in sensory systems
• Association cortex and perceptual processing
• Primary sensory coding

Lesson 2: Somatic sensation

• Types of somatic sensation
• Dorsal horn-Dorsal column pathway
• Nociceptors and thermoreceptors
• Classification of pain (deep pain, visceral pain, referred pain)
• Ventrolateral spinothalamic tract
• Modulation of pain transmission
• Morphine and enkephalins
• Somatotopic organization
• Cortical plasticity
• Effects of CNS lesions

Lesson 3: The Eye: I. Optics of Vision

• Parts of the eye and their function
• Retina
• Neural pathways involved in vision
• Photoreceptors
• The image forming mechanism
• Principles of optics
• Common defects of the image forming mechanism
• Lens accommodation
• Correction of refractive anomalies with the use of lenses

Lesson 4: The Eye: II. Receptor and Neural Function of the Retina

• Processing of visual information in the retina
• Photoreceptor potentials
• Bipolar, horizontal, amacrine and ganglion cell function
• Receptive field formation

Lesson 5: The Eye: III. Central Neurophysiology of Vision

• Primary visual cortex organization
• Other cortical areas involved in vision
• Color vision
• Visual fields and binocular vision
• Effect of lesions in the optic pathways
• Eye movements

Lesson 6: The sense of Hearing

• Sound – Sound waves
• The structure of the outer, middle and inner ear
• Physiology of the outer, middle and inner ear
• Sound transmission in the ear
• The tympanic reflex
• Travelling waves
• Electrical responses of hair cells
• Action potentials in afferent nerve fibers
• Functions of the inner and outer ear cells
• Action potentials in auditory nerve fibers
• The central auditory pathway
• Auditory responses of neurons in the medulla oblongata
• Other cortical areas concerned with audition
• Sound localization
• Deafness

Lesson 7: The vestibular system – Smell and taste

• The vestibular system central pathway
• Responses to rotational and linear acceleration
• The function of otoliths
• Spatial orientation
• The olfactory epithelium, olfactory bulbs and olfactory cortex
• Olfactory receptors and signal transduction
• Taste buds and pathways
• Taste receptors and signal transduction

Lesson 8: Synopsis of Lessons 1-7: Problem based learning

2. Motor and Integrative Neurophysiology

Lesson 9: Voluntary and involuntary control of body movement and posture I

• The areas of the brain involved in the design, initiation and execution of skillful voluntary movements
• Hierarchy of motor control within the CNS
• Motor cortex
• Organization of the primary motor, premotor and supplementary motor cortex
• The role of motor cortex in the control of movement
• The starting point, route and end of the pyramid path
• The corticospinal tracts

Lesson 10: Voluntary and involuntary control of body movement and posture II

• Anatomy of the spinal cord and organization of the sensory and kinetic elements of the gray matter. Somatic organization of motor neurons Local control of motor neurons
• α and γ motor neurons
• Structure and function of the muscle stretch receptors (muscle spindles and Golgi tendon organs)
• Spinal cord reflexes

o     The myotatic (stretch) reflex

o     The reverse myotatic reflex

o     The withdrawal reflex

• Consequences of upper and lower motor neuron damage

Lesson 11: Descending motion control systems – Basal ganglia

Descending motion control systems

• Medial brain stem pathways
• Lateral brain stem pathway
• Posture-regulating systems
• Integration of reflexes at the spinal level
• Movement deficits caused by spinal cord injury

Basal ganglia

• Anatomy and principal connections of the basal ganglia
• Function of the basal ganglia in motion control
• Basal ganglia diseases
• Parkinson disease

Lesson 12: Cerebellum 

• The role of the cerebellum in regulating skillful movements
• Anatomic divisions and organization
• Functional divisions of the cerebellum
• Cerebellar cortex neural circuits
• Cerebellar diseases

Lesson 13:  Synopsis of Lessons 9-12: Problem based learning

Lesson 14: Cerebral cortex and limbic system

• Brodmann areas in the visual cortex, auditory cortex, sensory cortex, motor cortex and the areas involved in speech
• Brain areas involved in perception
• Functions of the frontal lobe
• The limbic system
• Main structures of the limbic system
• Main ascending and descending pathways of the limbic system
• Main ascending and descending pathways to the amygdala
• Limbic system functions
• Functions of the hypothalamus
• Functions of the amygdala
• The role of dopamine in the limbic system and disorders of cognition and emotion

Lesson 15: Electrical activity of the brain, sleep–wake states, circadian rhythms

• Thalamus, cerebral cortex, & reticular formation
• Physiologic basis of the electroencephalogram (EEG)
• Clinical uses of the EEG
• Sleep–wake cycle
• α, β, γ, θ and δ rhythms
• Sleep stages: REM sleep
• EEG rhythm during various stages of the sleep–wake cycle
• Neural circuits important in sleep-wakefulness regulation
• Changes in human sleep pattern with age
• Circadian rhythms
• Neurochemical mechanisms promoting sleep & arousal

Lecture 16: The Limbic System – Behavioral and Motivational Mechanisms of the Brain

• Motivation and action
• Reward system
• Major dopaminergic pathways in the brain
• Prefrontal cortex
• Nucleus accumbens
• Amygdala – emotional responses (fear, anxiety, and aggression)

Lecture 17: Cerebral Cortex, Intellectual Functions of the Brain

• Basic anatomical differences between the two hemispheres
• Major differences in the function of the two hemispheres in humans
• Complementary specialization of the hemispheres
• Physiology of language
• Cortex areas involved in speech
• Speech disorders
• Language and age
• Clinical cases

Lesson 18: Learning and memory

• Learning and memory
• Forms of memory
• Neural basis of memory
• Synaptic plasticity and learning
• Habituation and sensitization
• Long term potentiation and long term depression
• Conditioned reflexes
• Working memory
• Long term memory
• Brain areas involved in memory formation
• Alzheimer disease & senile dementia

B.Endocrinology & Reproduction

Lesson 19: Hypothalamic regulation of hormonal functions – Pituitary gland, anterior pituitary hormones, regulation of growth and development

Hypothalamic regulation of hormonal functions 

• Control of posterior pituitary hormones by the hypothalamus
• Oxytocin
• Antidiuretic hormone
• Functional relationship between the hypothalamus and the anterior pituitary
• Hypophysiotropic hormones
• Differences between hypophysiotropic hormones and posterior pituitary hormones
• Significance & clinical implications

Pituitary gland, anterior pituitary hormones, regulation of growth and development

• Cell types in the pituitary gland
• The anterior pituitary hormones and their main functions
• Regulation of anterior pituitary secretion
• The role of “non-consecutive” hormones in the hypothalamus and pituitary gland
• Prolactin: action and control of secretion
• Growth hormone: plasma levels and metabolism
• Growth hormone receptors
• Effects on growth
• Effects on protein & electrolyte metabolism
• Effects on carbohydrate & fat metabolism
• Actions and regulation of insulin-like growth factor I secretion
• Direct & indirect actions of growth hormone
• Hypothalamic & peripheral control of growth hormone secretion
• Stimuli affecting growth hormone secretion
• Physiology of growth and development
• Environmental factors affecting growth
• Growth periods
• The effect of hormones on growth and development: thyroid hormones, insulin, androgens and estrogens, cortisol
• Growth defects
• Catch-up growth

Lesson 20: Thyroid gland

• Structure of the thyroid gland
• Thyroid hormones
• Iodine homeostasis
• Thyroid hormones synthesis and secretion: the role of thyroglobulin
• Transport & metabolism of thyroid hormones
• Regulation of thyroid hormone secretion
• Effects of TSH on the thyroid gland
• Negative feedback control of thyroid hormones and TSH
• Mechanism of thyroid hormone action
• Effects on metabolism – calorigenic action of thyroid hormones
• Effects on the cardiovascular system
• Effects on the nervous system
• Relation of thyroid hormones to catecholamines
• Effects on growth
• Reduced thyroid function
• Hyperthyroidism

Lesson 21: The adrenal glands

• Functional anatomy of the adrenal glands
• Paracrine effects between adrenal medulla and adrenal cortex cells
• Catecholamines
• Effects of catecholamines
• Regulation of adrenal medullary secretion
• Adrenocortical hormone classification
• Synthesis of steroid hormones
• Effect of steroid biosynthesis enzymes deficiencies
• Synthesis, transport and metabolism of cortisol
• Mechanism of cortisol action
• Effects of glucocorticoids on metabolism, tissues and organs
• Secretion in stressful situations
• Regulation of cortisol secretion (CRH, ACTH)
• Synthetic glucocorticoids
• Actions of aldosterone – Regulation of aldosterone secretion
• Disorders of the adrenal cortex (Addison’s Disease, Cushing’s Syndrome, hyperaldosteronism)
• Resistance to stress
• Functions of cortisol in stress
• Functions of the sympathetic nervous system in stress
• Fight or flight response

Lesson 22: Hormonal control of calcium and the physiology of bone

• The role of calcium in human physiology
• Calcium homeostasis in the body (bones, kidneys, gastrointestinal tract)
• Vitamin D
• Regulation of vitamin D synthesis
• Vitamin D effects on calcium homeostasis
• Mechanism of vitamin D action
• The parathyroid glands
• Synthesis & metabolism of parathormone (PTH)
• Regulation of PTH synthesis
• PTH effects on calcium homeostasis
• Calcitonin
• Bone structure
• Bone formation & resorption
• Bone disease
• Hypocalcemia and hypercalcemia
• Disorders of PTH secretion and vitamin D production

Lesson 23: Endocrine functions of the pancreas – Hormone regulation of carbohydrate metabolism

Endocrine functions of the pancreas

• The pancreatic cells and hormones
• Insulin structure and secretion
• Effects of the plasma glucose level on insulin secretion
• Other factors that regulate insulin secretion
• Principal actions of insulin
• Effects of insulin on carbohydrate, fat and protein metabolism
• Response of muscle, adipocytes and liver cells to insulin
• Mechanism of insulin action
• Consequences of insulin deficiency
• Consequences of insulin excess
• Glucagon synthesis
• Regulation of glucagon secretion
• Glucagon action
• Insulin–glucagon molar ratios
• Somatostatin and pancreatic polypeptide
• Effects of islet cell hormones on the secretion of other islet cell hormones
• Diabetes mellitus
• Hypoglycaemia

Hormone regulation of carbohydrate metabolism

• Metabolic events of the absorption phase
• Metabolic events of the post-absorption phase
• Endocrine and neural control of the absorptive and post-absorptive phase: the effects of insulin, glucagon, epinephrine, cortisol and growth hormone.

Lesson 24: Synopsis of Lessons 18-23: Problem based learning

Lesson 25: Sex differentiation and development – Male reproductive physiology

• Sex determination
• Sex differentiation
• Development of genitalia
• The male reproductive system
• Functional anatomy of the testicles
• Sertoli cells and Leydig cells
• Spermatogenesis
• Transport of sperm
• Hormonal control of male reproductive functions

Lesson 26: Reproductive physiology of the female

• The female reproductive organs
• Ovarian function
• Oogenesis
• Follicle growth
• Formation of the corpus luteum
• Ovarian hormones
• Hormonal control of ovarian function (follicular phase, LH surge and ovulation, luteal phase)
• Uterine changes in the menstrual cycle (menstrual phase, proliferative phase, secretory phase)
• Effects of estrogen and progesterone

Lesson 27: Fertilization – Pregnancy – Lactation

• Egg transport
• Sperm transport and capacitation
• Fertilization
• Early development and implantation
• Formation and function of the placenta
• Hormonal and other changes during pregnancy
• Parturition
• Lactation

C. Practical

Exercise 1: Neurological examination-myotatic reflexes

• Brief description of the neurological examination (History- general examination- higher mental functions – walking- motor system – sensory system – cerebellar system)
• Video
• Testing of myotatic reflexes in the laboratory

Exercise 2: Electroencephalogram (EEG) – Epilepsy

• EEG technique and methodology
• Rhythms recorded in EEG
• The EEG in various forms of epilepsy (Video)

Exercise 3:  Reproduction

• Presentation of case reports

1. Ganong’s Review of Medical Physiology

Authors: Kim Barrett, Susan Barman, Jason Yuan, Heddwen Brooks

 Medical Physiology, 3rd Edition

Authors : Walter F. Boron & Emile L. Boulpaep 

Others

– Fundamental Neuroscience, 3^rd Edition

Authors: Squire L.

 -The brain from top to bottom / McGill University

http://thebrain.mcgill.ca/index.php