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 exam

Parts of the final 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" six 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. The external carotid artery and its branches.
2. The subclavian artery and its branches. The scalenotracheal fossa.
3. The veins of the head and neck. The para- and retropharyngeal 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 structures.
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 brain stem and the cerebellum.
11. Description of the surfaces of the telencephalon.
12. The brain ventricles and their importance.
13. Sections of the brain (demonstration of preparations and MR images).
14. Macroscopic structure of diencephalon and basal ganglia. The Flechsig's cut.
15. The arteries and the veins of the brain. The dural sinuses. Sinus cavernosus.
16. Intracranial segments of the cranial nerves. Their exits from the brain and the skull.
17. The meninges of the brain. Circulation of the CSF. Cisternae.
18. The sympathethic nervous system.
19. The parasympathethic nervous system.
20. The cervical plexus and the sacral plexus.
21. The brachial plexus and the lumbar plexus.
22. The content of the orbit.
23. The parts of the ear. Auditory ossicles and their functions. The structure of the inner ear.
24. Neurocranium.
25. Viscerocranium.

Neuroanatomy 2

1. The structure of the neurons and synapses.
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. Somatomotor nuclei of the brainstem.
8. Visceromotor (autonomic, vegetative) and viscerosensory nuclei of the brainstem.
9. Somatosensory nuclei of the brainstem.
10. The neurosecretion. The hypothalamo-pituitary system.
11. The nuclear groups of the diencephalon.
12. Types of cerebral cortical connections.
13. Functional cerebral cortical centers.
14. The sensory pathways.
15. The somatomotor pathways.
16. The afferent and efferent cerebellar pathways, The functions of the cerebellum.
17. The extraocular muscles and their innervation.
18. The visual pathway. The pupillary light-reflex. The mechanism of accommodation.
19. The lacrimal apparatus, the eyelids and the conjunctiva. The innervation of the lacrimal gland.
20. The nuclei of the vestibular and acoustic systems and their neural connections.
21. The innervation and blood supply of the teeth.
22. The innervation and blood supply of the tongue.
23. The topography and blood supply of the endocrine glands.

Embryology

1. Formation of the trilaminar germ disk and the folding. Primary differentiation of the mesoderm.
2. Neurulation. Development of the spinal cord.
3. Development and derivatives of the primary brain vesicles.
4. The placodes, the neural crest and their derivatives.
5. Development of the skull. Growth of the bones. Malformations.
6. Development of the face, the nasal and oral cavities and the tongue. Malformations.
7. Development of the teeth.
8. Differentiation of the pharyngeal (branchial) arches. Malformations.
9. Differentiation and derivatives of the pharyngeal pouches and clefts. Malformations.
10. Parts and derivatives of the intestinal tube (excluding those of the pharyngeal gut). Malformations.
11. Development of the respiratory system. Malformations.
12. Formation and derivatives of the heart tube. Separation of the heart chambers.
13. Development of the fetal membranes and the placenta. Fetal circulation.
14. Development of the arteries. Malformations.
15. Development of the definitive kidney and the urinary tract.Malformations.
16. Development of the female genital organs. Malformations.
17. Development of the male genital organs. Malformations.
18. Causes of the congenital malformations (with examples!).

Histology slides

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


THE REQUIREMENTS OF THE NEUROANATOMY EXAM FOR DENTISTRY STUDENTS

Suggested literature

• Textbooks: see Literature
• And our WEB pages.