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METHODICAL INSTRUCTIONS FOR INDIVIDUAL WORK OF THE STUDENTS IN PREPARATION FOR PRACTICAL CLASSES Subject NEUROLOGY Topic Principles of structure and functioning of nervous system. Motor system. The idea of reflex and reflex arch. Normal reflexes. Accidental moves and their abnormalities. Year IV Faculty Medical 1. Topicality: The knowledge of the principles of nervous system structure and functions is the basis of understanding pathological syndromes and diseases that occur in its pathology. The preservation of the brain motor systems is an important term of accidental moves of a person. Motor system abnormalities happen in the damage of nervous system by many different factors and represent great importance for the diagnostics of the nosologic form of a disease. Motor abnormalities represent one of the main reasons of the life activity damages of the sick, loss of working ability, which has a great social importance. 2. Specific purposes: -to interpret the principles of nervous system structure and functions - to interpret reflex realization - to interpret accidental moves realization -to know normal and pathological reflexes -to have an idea of paralysis (paresis) -to master the methodic of motor system exploration 3. Basic knowledge, skills, competences necessary for learning the topic: № 1. Subject Anatomy Information to learn To describe the CNS structure, the anatomy of the cerebral cortex, the anatomy of the cerebral column, the anatomy of the spinal cord 2. Physiology The principles of the CNS functioning. The physiology of the motor analyzer. 3. Pathophysiology To describe the basic type of the nervous system lesions 4. Histology The peculiarities of the nervous tissues structure. Nervous system development. Nervous system cells: neurons, neuroglia cells. 4. Assignments for individual work during preparation for the classes: The list of basic terms, characteristics, which students must learn during the preparation for the classes: -active and passive moves - hyperreflexia, areflexia, hyporeflexia - atony, hypotonia, hypertonia - pyramidal tract - corticomuscular tract -paresis, paralyses - monoparesis, paraparesis, hemiparesis, tryparesis, tetraparesis, alternating hemiparesis -flexor pathological reflexes -extensor pathological reflexes -reflexes of oral automatism (axial, pseudobulbar) The list of theoretical questions: 1. Main stages of phylo- and ontogenesis of the nervous system. 2. Structural and functional unit of the nervous system. 3. Main anatomo-topographical sections of the nervous system: cerebral hemisphere, basal ganglia, cerebral column spinal cord, radices, spinal ganglia, plexus, peripheral nerves. 4. Functional unit of the nervous system is neuron. Neuron types, their functional meaning. Neurology, its functional meaning. 5. An idea of a reflex and reflex arch, conditional and unconditional reflexes, equal closure of dermal, tendinous and periosteal reflexes.. 6. Anatomic peculiarities and neurophysiology of the accidental moves system. Methodic of the motor system exploration. The list of practical skills that are to be mastered at the classes: 1. Examination of the active and passive moves volume. 2. Methodic of the muscular tonus evaluation. 3. Methodic of the muscle strength evaluation (5-rate scale). 4. Examination of the muscle trophism. 5. Examination of the tendinous, periosteal, dermal reflexes (stylocarporadial, biceps, triceps, patellar, Achilles, abdominal). 6. Methodic of the activation of pathological reflexes (extensor ones of Babinsky, Oppenheim, Gordon, Shiffer; flexor ones of Rossolimo, Bekhterev, Zhukovsky etc.) and pathological synkinesis. 7. Methodic of the activation of clonus and defense reflexes. 5. Students’ self-preparation curriculum: 1. To learn theoretical questions of the topic (see the list of the theoretical questions and information sources). 2. To know the methodic of examination of active and passive moves, muscular strength and tonus, trophism, normal and pathological reflexes. 3. To see the tests and situational tasks (the collection of tests and tasks, the “Reflex Motor Sphere” chapter). 6. Materials for self-control. 1. To draw the scheme of a corticomuscular tract, to draw a table with a picture of the basic symptoms of the central and peripheral paralysis (change of reflexes, muscular tonus, muscle trophism, presence of pathological reflexes). 2. To find correct answers to tests and situational tasks (the collection of tests and tasks – module 1, topical module 1, the “Reflex Motor Sphere” chapter). Information Sources Lecture 1. Shcrobot S.I., Hara I.I. Neurology in lecture (Selected lectures) . Ternopil, TSMU, «Ukrmedknyha», 2008. 319 p. 2. Reinhard Rohkamm. Color Atlas of Neurology © 2004 Thieme. 440 p. 3. Crash course Neurology by Anish Bahra and Katia Cikurel. Copyright 2006, Elsevier, Inc. 244 p. 4. Adams and Victors. Principles of neurology. © 2005 McGraw-Hill . Medical Publishing Division. 5. Mayo Clinic Internal Medicine Review 2006-2007. Chapter 18. Editor-in-Chief Thomas M. Habermann, MD