ECTS - University of Pisa
Sensory systems
Neuronal information processing
Neuro-endocrine interactions
MODULE OF HUMAN NEUROANATOMY:
Development: neural plate, notochordal plate, neural groove, neural crest. Alar plate and basal plate. Primary vesicles, flexures and secondary vesicles of the neural tube. Main structures derived from each secondary vesicle. Schematization of development of cranial nerves. Brief mentioning of spinal cord development and of neural tube defects.
Gross anatomy of the encephalon: terminology of the components of the CNS. Meninges, epidural space and trauma. Brain ventricles. CSF: circulation, reabsorption, and CSF-brain barriers. Brain hemispheres: main sulci; definition of the different lobes. Overview of the brainstem; external features (naming only elements shown in the slides provided): ventral view, dorsal view. Identifying and naming main structures from sections of brain stem (only those mentioned in slides): mesencephalon (tectum, tegmentum, crus, red nucleus, substantia nigra, PAG); pons (reticular formation, corticospinal tract, middle and inferior cerebral peduncle, dorsal column medial lemniscal pathway); medulla oblungata (pyramid, inferior olivary nucleus, reticular formation, nuclei gracilis and cuneatus, gracile fascicle, cuneate fascicle, inferior cerebella peduncle, medial lemniscus, sensory decussation, motor decussation).
Gross anatomy of the human spinal cord: External features. Denticulate ligaments; cervical and lumbar enlargement; relation of spinal cord myelomeres and spinal nerves with segments of the vertebral column. Spinal cord meninges. Main features of spinal nerves.
Structure of the spinal cord: laminar and nuclear organization of gray matter including detailed description of the types of neurons, afferents and efferents. Ventral and dorsal radicular cells, funicular cells; ascending bundles of spinal cord white matter. Site of termination of afferent fibers of different sizes into the spinal cord grey matter.
Sensitive pathways: brief overview of skin, joint and tendon receptors (muscle spindles only mentioned). Dorsal column-medial lemniscus pathways; dorsal column nuclei sensu strictu, and extended definition of dorsal column nuclei. Dorsal and cuneo-cerebellar tract. Spino-thalamic system: site of origin in the spinal cord; paleo- and neo-spinothalamic system. Trigeminal system: mesencephalic , pontine and spinal trigeminal nucleus.
Thalamus: general features. Reticular thalamic nucleus: specific features and connections. Gross anatomy: details on the different nuclei, basic cytological and functional organization: classical view (relay, association and intralaminar/midline nuclei) and a more recent one (first-order and higher-order nuclei). Detailed description of VPL; connections with the Iry and IIry sensory cortex.
Cortex: brief overview of the gross anatomy of the human cortex, and of Brodmann areas . Main cortical gyri. Details on neocortex cells, layers and basic circuitries. Definition of homotypic and heterotypic cortex and main features of isocortex, mesocortex and allocortex.
Motor systems. Description of motor areas on the lateral and medial surface of the cerebral cortex. Contributions of the different cortical areas to the corticospinal pathway, Area 3,2,1, Area 4 and the giant cells of Betz, Area 6, Area 5,7, Area 8,9, Area 23 and 24. The homunculus motorius and sensitives: overlapping and discrepancies. Pyramidal and extrapyramidal pathways, discrepancies between anatomical and functional criteria, fallacy and reality. Definition of gross, fine and fractionated movements. Cooperation between pyramidal and extrapyramidal systems. Extrapyramidal paths and premotor centers in the brainstem. Replacing the concept of pyramidal and extrapyramidal with medial and lateral systems. Lateral (crossed, ipsilateral) systems: lateral corticospinal path, rubrospinal (or better rubro-reticulo-spinal) and reticulospinal path, definition, origin, and course. Definition of motor unit. Medial systems (ipsi- and contralateral): medial corticospinal path, Medial longitudinal bundle Cortico-bulbar modulation of the dorsal column nuclei activity. Somatotopy of MNs in the ventral horn. The motor unit. Alpha-gamma co-activation the neuromuscular spindles
The reticular formation of the brainstem. The experiments of Moruzzi and Magoun. Cytoarchitecture as a criterion to define the brainstem reticular formation; isodendritic, idiodendritic and allodendritic neurons. The topographic and neurochemical subdivision of the brainstem reticular formation, nuclei of the medial, median, and lateral band.
Cerebellum. Gross anatomy of its external and internal features. Integrating the medio-lateral with antero-posterior gradient to define the cerebellum; spino-cerebellum, pontocerebellum and vestibulo-oculomotor cerebellum. The cerebellar cortex, Purkinje cells, granule cells, parallel fibers, golgi cells, basket and stellate cells, unipolar brush cells, Lugaro cells. Deep cerebellar nuclei, mossy fibers and climbing fibers. The cerebellar glomerulus (synaptic triad). The cerebellar module, microzone somatotopy of climbing fibers and their role in the timing and spacing of motor control.
The basal ganglia. Neostriatum (caudate and putamen) and paleostriatum (globus pallidus). Modern definition enriched of the mesodiencephalic structures (subthalamus and substantia nigra pars reticulata) and deprived of the archistriatum (amygdala and claustrum). The internal capsule, anterior arm, knee (cortico-nuclear fibers) and posterior arm (in the anterior extent corticospinal fibers). The basal ganglia circuitry, output (SNpr+GPint), input (neostriatum, matrix and striosomes) and subthalamic nucleus; direct, indirect and hyper-direct pathways.
