The subject

The Neuroanatomy covers the human central nervous system including its macroscopic, microscopic, and ultrastructural description, as well as its embryonic development. It also involves regions of the head and neck with particular reference to those structures innervated by the cranial nerves. It gives the morphological basis of neuroendocrine integration describing the macroscopic and microscopic anatomy of the endocrine organs, as well as sensory organs (including the skin), and the development of these systems. The course is to give basic morphological knowledge to further clinical studies, including neurology, neurosurgery, ophthalmology, craniofacial surgery, etc.

The course consists of three lectures, two two-hour dissecting room, and one two-hour histology practices, weekly. In the lectures, we intend to give new information on the subject, what the students mostly cannot find in the available textbooks. These information are part of the exam material. The dissecting room and histology room practices are similar to those of Anatomy-1 and Histology-1 courses. Rules and regulations for the use of the dissecting rooms and histology labs are also known from the students' earlier studies.

The exams

Parts of the exam

In most of the cases, the exam begins with the "cadaver walk". Then the student draws the question cards and the two slides. For technical reasons, the exam may start with drawing the questions and slides. In this case, the "cadaver walk" may temporarily interrupt the student's preparation. For preparation to answer the questions and the slides, at least a total of twenty minutes time is provided. Based on its nature, there will be no preparation time given to answer the questions during the cadaver walk.

During the exam a student "collects" seven sub-scores, such as:

The "cadaver walk" results the next sub-score. This is similar to those in the previous exams (no question cards, no preparation time). The basic requirement of a successful exam is a good orientation on the entire cadaver. Separate descriptions of regions, bones and joints are not a part of the exam, but every structure on the cadaver should be recognized. This is the most important part of the exam. A very weak performance in this part of the exam (evaluated with score "0"), in itself results in failing the exam.
The two slides have to be described and justified by this description; the student has to recognize the organ or the parts of the organ on the slide. The student must be familiar with all the histological structures on the slides, and also has to answer questions regarding their functions. Giving the correct "title" of the slide itself is not enough to pass. Proper description of the histological structures in the slides, and a clear reasoning on the "diagnosis" are also prerequisites of passing. Lack of fundamental knowledge on recognition and basic characteristics of the tissues might lead to fail by itself. One receives one score on each slide.
Two questions (on card) of neuroanatomy. One of these questions is more practice oriented, i.e. includes demonstration on the cadaver and/or preparations, the second one is basically theoretical. Results in a total of two scores.
One question in embryology (on card). During the exam - besides your topic - you can get short general questions from the material of the semester. If you cannot answer your embryology topic, the examiner will decide based on the general embryology knowledge whether your knowledge is satisfactory or not.

Evaluation

The final score of the exam is calculated on the basis of the seven sub-scores described above, but it is not necessarily the arithmetic mean of the sub-scores. The orientation on the cadaver and the preparations are considered to be most important. The exam is terminated with fail as soon as the student collects the first "fail" (1) sub-score.

Exam questions

Neuroanatomy 1

1. External carotid artery and its branches
2. Subclavian artery and its branches. The scalenotracheal fossa
3. The veins of the head and neck. Para- and retro-pharyngeal spaces.
4. Sensory innervation of the head and the neck
5. Lymphatic drainage of the head and the neck
6. Muscle triangles in the neck and their contents
7. Muscles of facial expression and mastication. The mechanism of chewing
8. Topography and innervation of the salivary glands
9. Macroscopy of the spinal cord, its meninges and blood supply
10. Macroscopy of the brainstem and the cerebellum
11. Surface of the telencephalon.
12. The lateral ventricle
13. The 3rd ventricle
14. The 4th ventricle
15. The Flechsig cut
16. Mid-sagittal section of the brain (preparations and MR images)
17. Coronal sections of the brain (preparations and MR images)
18. Horizontal sections of the brain (preparations and MR images)
19. The arteries of the brain
20. The veins of the brain. The sinuses of the dura mater. Sinus cavernosus
21. Intracranial segments of the cranial nerves. Their exits from the brain and the skull
22. The meninges of the brain. Circulation of the CSF. Cisterns
23. The sympathethic nervous system
24. The parasympathethic nervous system
25. The cervical plexus and the sacral plexus
26. The brachial plexus and the lumbar plexus
27. The content of the orbit
28. Gross anatomy of the external and middle ear
29. Structure of the inner ear
30. Neurocranium
31. Viscerocranium

Neuroanatomy 2

1. The structure of the neurons and synapses. Classification of the neurotransmitters
2. Receptors and effectors. Regeneration in the nervous system
3. The spinal segment. The spinal nerves. The dermatomes and the Head-zones
4. Ascending pathways of the spinal cord
5. Descending pathways of the spinal cord
6. The stretch reflex. The flexor withdrawal reflex.
7. The somatomotor (and specific visceromotor) nuclei of the brainstem
8. The visceromotor (or general visceromotor) and viscerosensory nuclei of the brainstem
9. The somatosensory nuclei of the brainstem
10. Neuroanatomical basis of motor coordination
11. Hypothalamic nuclei and their connections
12. The neurosecretion. The hypothalamo-pituitary system
13. Thalamic nuclei and their connections
14. Types of cortical connections
15. Functional cortical centers
16. The spinothalamic system
17. The posterior cord – lemniscus medialis system
18. The spinocerebellar system
19. The pyramidal (corticonuclear and corticospinal) pathways
20. The extrapyramidal motor system
21. The structure of the basal ganglia and their connections
22. The limbic system, the dentate gyrus and the hippocampus
23. The afferent and efferent pathways of the cerebellum. The functions of the cerebellum
24. Functions of the external eye muscles. The neural control of the eye movements
25. The visual pathway. The pupil-reflex. Accommodation.
26. The structure of the eye-ball
27. The lacrimal apparatus, the eyelids and the conjunctiva. The innervation of the lacrimal gland
28. The vestibular system (structure, neural connections)
29. The cochlear system(structure, neural connections)
30. The topography and blood supply of the endocrine glands
31. The nuclear complex and the branches of the trigeminal nerve
32. The nuclear complex and the branches of the facial nerve
33. The nuclear complex and the branches of the glossopharyngeal nerve
34. The nuclear complex and the branches of the vagus nerve

Embryology

1. From the ovulation until the implantation
2. Formation of the trilaminar germ disk and the folding
3. Differentiation of the mesoderm. Development of the serous membranes and the body cavities. Malformations
4. Development of the skull. Growth of the bones. Malformations
5. Development of the blood vessels. Malformations
6. Development of the face, formation of the nasal and oral cavities. Malformations.
7. Differentiation of the pharyngeal arches. Malformations
8. Differentiation and derivatives of the pharyngeal pouches and clefts. Malformations
9. The intestinal tube and its derivatives (with the exception of the pharyngeal gut). Malformations
10. Development of the respiratory system. Malformations
11. Formation and derivatives of the heart tube. Partitioning of the cardiac chambers. Malformations
12. Development of the kidney and the urinary tract. Malformations
13. Development of the female genital organs. Malformations
14. Development of the male genital organs. Malformations
15. Formation of the fetal membranes and the placenta. Fetal circulation
16. Neurulation. The structure of the neural tube. Development of the spinal cord
17. Development of the brainstem and the cerebellum
18. Development of the diencephalon and the telencephalon. Development of the commissural pathways and the fornix
19. The placodes, the neural crest and their derivatives. Development of the peripheral nervous system
20. Development of the visual system
21. Development of the acoustic and vestibular system
22. Development of the endocrine glands. Malformations
23. Malformations of the nervous system
24. The external appearance of the embryo and the fetus. The signs of maturity in newborn
25. Causes of the congenital malformations (with examples!)

Histology slides

1. Compact bone (transverse section), Fuchsin
2. Desmal ossification, HE
3. Endochondral bone formation, HE
4. Endochondral bone formation, AZAN
5. Wall of the heart, HE
6. Blood smear, May-Grünwald-Giemsa
7. Bone marrow, HE
8. Aorta, HE
9. Thymus, HE
10. Lymph node, HE
11. Spleen, HE
12. Palatine tonsil, HE
13. Larynx, HE
14. Trachea, HE
15. Lung, HE
16. Lung, orcein
17. Lip, HE
18. Fili- and fungiform papillae, HE
19. Vallate papilla, HE
20. Lingual tonsil, HE
21. Parotid gland, HE
22. Submandibular gland, HE
23. Sublingual gland, HE
24. Sublingual gland, PAS-H
25. Ground tooth, Fuchsin
26. Development of teeth (early), HE
27. Development of teeth (early), AZAN
28. Development of teeth (late), HE
29. Development of teeth (late), AZAN
30. Esophagus, HE
31. Cardia, HE
32. Fundus of stomach, HE
33. Fundus of stomach, PAS-H
34. Pylorus, HE
35. Pylorus, PAS-H
36. Duodenum, HE
37. Jejunum, HE
38. Ileum, HE
39. Colon, HE
40. Appendix vermiformis, HE
41. Rectum (fetal), HE
42. Myenteric plexus, NADPH reaction
43. Human liver, HE
44. Human liver, AZAN
45. Bile capillaries, Golgi
46. Gall bladder, HE
47. Pancreas, HE
48. Kidney, HE
49. Kidney injected with ink, Ink-H
50. Ureter, HE
51. Urinary bladder, HE
52. Testis, HE
53. Epididymis, HE
54. Epididymis, AZAN
55. Spermatic cord, HE
56. Seminal vesicle, HE
57. Prostate, HE
58. Penis, HE
59. Ovary, HE
60. Ovary (corpus luteum/albicans), HE
61. Uterine tube, HE
62. Uterus proliferative, HE
63. Uterus secretory, HE
64. Cervix, HE
65. Vagina, HE
66. Placenta, HE
67. Decidua parietalis, HE
68. Umbilical cord, HE
69. Non-lactating mammary gland, HE
70. Lactating mammary gland, HE
71. Thick skin (palm), HE
72. Skin of the armpit, HE
73. Hairy skin (scalp), HE
74. Hairy skin (scalp - horizontal cut), HE
75. Hairy skin (scalp - horizontal cut), AZAN
76. Pituitary gland, HE
77. Pineal body, HE
78. Thyroid gland, HE
79. Parathyroid gland, HE
80. Suprarenal (adrenal) gland, HE
81. Peripheral nerve, HE
82. Peripheral nerve, AZAN
83. Peripheral nerve, OsO4
84. Peripheral nerve, PAS-H
85. Sensory ganglion, HE
86. Sensory ganglion, AgNO3
87. Vegetative ganglion, AgNO3
88. Motoric end plate, AgNO3
89. Pacinian corpuscle, AgNO3
90. Protoplasmic and fibrous astrocytes, Au-sublimate
91. Spinal cord, HE
92. Spinal cord, Bielschowsky
93. Spinal cord, Nissl
94. Spinal cord, Golgi-Cox
95. Cerebellum vermis, HE
96. Cerebellum vermis, Nissl
97. Cerebellum vermis, Bielsch
98. Cerebellum vermis, Golgi
99. Cerebral cortex,, HE
100. Cerebral cortex, Nissl
101. Cerebral cortex, Golgi
102. Bulbus oculi, HE
103. Optic nerve, HE
104. Lacrimal gland, HE
105. Inner ear, HE

Suggested literature

Textbooks: see Literature
And our WEB pages.