Introduction Overview Rationale

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

Clinical Neuroanatomy for Undergraduates

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

The course provides an overview of the structure of the central nervous system ! Topographical anatomy of the brain and spinal cord

Course format: Lectures Labs Clinical cases Review sessions Content

" ! The organization of the major neural systems underlying sensory, motor and cognitive function.

Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Keys to the (active) learning process Hands-on examination of human brain specimens Interactive brain atlas and glossary exercises Solving anatomical puzzles (clinical cases)

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

CLINICAL NEUROANATOMY method of studying lesions of the human nervous system as a tool to reinforce and amplify learning of the structure and organization of the CNS.

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

not training neurologists ...

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Neuroanatomical training is fundamental .... but why teach clinical neuroanatomy to undergraduates?

As part of pre-medical training

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

* Its an effective method for providing the necessary

anatomical foundation for further study in the neurosciences ! " ! instructional motivational

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration
Non-clinical Neuroanatomy

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Learning objective: Understand the organization of the partial crossing of bers in the optic chiasm. The nasal (medial) retinal bers for each eye, which are responsible for information in the temporal (lateral) hemields, cross the midline at the optic chiasm. Lesions of the middle portion of the optic chiasm therefore produce bitemporal visual eld defects (bitemporal hemianopia). Left eye Right eye
visual field (A) visual field

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

Left

Right (B)

Optic nerve Optic chiasm Optic tract Lateral geniculate nucleus Optic radiation

A B C D (C)

(D)

E Striate cortex

(E)

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

PATIENT PRESENTATION A 50-year-old woman went to an ophthalmologist because of several months of worsening vision that had begun to interfere with her driving. Past history is notable for long-standing menstrual irregularity and infertility.

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

PATIENT PRESENTATION A 50-year-old woman went to an ophthalmologist because of several months of worsening vision that had begun to interfere with her driving. Past history is notable for long-standing menstrual irregularity and infertility.

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

MENSTRUAL IRREGULARITY AND BITEMPORAL HEMIANOPIA

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

the cases: richly illustrate our learning objectives (e.g.organization of the partial crossing of bers in the optic chiasm) signicantly expands the discussion (e.g. spatial relationship of pituitary and chiasm, asymmetry of visual eld cut)

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

interesting and motivating for students

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

examination vs dissection

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration
40 cases presented by students
S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale
Drill sessions

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

9: lesion produces ______?

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: clinical orientation of material for non-medical students

Neuroanatomy Through Clinical Cases Hal Blumenfeld, M.D., Ph.D., Yale University School of Medicine

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbook Lab manual Course website Sylvius Integration

The NeuroExam Video neuroexam.com

Recommended text
Neuroscience 3rd edition Purves, Augustine, Fitzpatrick, Hall, LaMantia, McNamara & Williams

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: directing and focus brain specimen examination

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: organizing and distributing course resources

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: organizing and distributing course resources

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: organizing and distributing course resources

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: organizing and distributing course resources

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: organizing and distributing course resources

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: organizing and distributing course resources

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: content management !

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: 1985, technological limitations; 2005, pedagogical value

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

SylviusVG: Visual Glossary of Human Neuroanatomy

Challenge: 100s of new, unintuitive terms

S. Mark Williams, Ph.D., Leonard E. White, Ph.D., and Andrew C. Mace Sinauer Associates, Inc.

SylviusVG: Visual Glossary of Human Neuroanatomy

CNS quick reference tool

S. Mark Williams, Ph.D., Leonard E. White, Ph.D., and Andrew C. Mace Sinauer Associates, Inc.

SylviusVG: Visual Glossary of Human Neuroanatomy

CNS quick reference tool

S. Mark Williams, Ph.D., Leonard E. White, Ph.D., and Andrew C. Mace Sinauer Associates, Inc.

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Challenge: 100s of new, unintuitive terms ... students are mobile

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

...after class, we go to breakfast and quiz each other on brain structures using the iPod.

SylviusVG: Visual Glossary of Human Neuroanatomy, iPod edition

S. Mark Williams, Ph.D., Leonard E. White, Ph.D., and Andrew C. Mace

SylviusPRO: 3D Dissector and Atlas of the Human Central Nervous System

Challenge: 3D organization of brain is complex

- SylviusPRO: 3D Dissector and Atlas of the Human S. Mark Williams, Ph.D., Leonard E. White, Ph.D., and Andrew C. Mace Central Nervous System (CD or download)
Sinauer Associates, Inc.

SylviusPRO: 3D Dissector and Atlas of the Human Central Nervous System

3D Dissector and Atlas

- SylviusPRO: 3D Dissector and Atlas of the Human S. Mark Williams, Ph.D., Leonard E. White, Ph.D., and Andrew C. Mace Central Nervous System (CD or download)
Sinauer Associates, Inc.

3D Dissector and Atlas

- SylviusPRO: 3D Dissector and Atlas of the Human Central Nervous System (CD or download)

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale Describe the effects of the lesion shown in red

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Challenge: integrating the resources to effectively meet learning objectives

Clinical Neuroanatomy for undergraduates

Introduction Overview Rationale

Problem: Increasing need for neuroanatomical expertise Part of the solution ? teach fundamental neuroanatomy to undergraduates (and graduate students) using clinical cases Benets:

Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration Summary
S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

increase learning efcacy and retention (supposition) offers numerous active learning opportunities wealth of resources, leverage medical school teaching resources Challenges: orientation complexity of clinical material for nonmedical students new terminology, spatial relationships of brain structures

Clinical Neuroanatomy for undergraduates

No Date Wed, August 31 Fri, September 02 Wed, September 07 Fri, September 09 Wed, September 14 Fri, September 16 Wed, September 21 Fri, September 23 Wed, September 28 Fri, September 30 Wed, October 05 Fri, October 07 Wed, October 12 Topic Introduction to the Course Lecture: Organization of the Nervous System I Lecture: Organization of the Nervous System II Lecture: Gross anatomy of the Brainstem and Thalamus Lab Demo: Gross Anatomy of the Brain and Spinal Cord I Lab Demo: Gross Anatomy of the Brain and Spinal Cord II Review: Gross Anatomy of the CNS Exam No.1 Lecture: Introduction to Clinical Cases Lecture: Corticospinal Tract and Other Motor Pathways Cases: Corticospinal Tract and Other Motor Pathways Lecture: Somatosensory pathways Cases: Somatosensory pathways Lecture: Visual System Cases: Visual System

Rea

Introduction Overview Course goals Rationale Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

01 02 03 04 05 06 07 08 09 10 11 12 13

Blum 2

Blum 2 LM 1

Blum 1 LM 2 LM 1

LM 1

Blum C

Blum C

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Block 1

Blum C

Background Fri, October 14 14

15
Wed, October 19 Fri, October 21 Wed, October 26

Blum C

Surface features and internal anatomy of brain and spinal cord

Lecture: Brainstem I (Cranial Nerves) Lecture: Brainstem II (Cranial Nerve Nuclei)

Blum C

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

16 17

Blum C

Blum C

Clinical Neuroanatomy for undergraduates

Introduction Overview Course goals Rationale Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22

Wed, September 21 Fri, September 23 Wed, September 28 Fri, September 30 Wed, October 05 Fri, October 07 Wed, October 12 Fri, October 14 Wed, October 19 Fri, October 21 Wed, October 26 Fri, October 28 Wed, November 02 Fri, November 04 Wed, November 09 Fri, November 11

Review: Gross Anatomy of the CNS Exam No.1 Lecture: Introduction to Clinical Cases Lecture: Corticospinal Tract and Other Motor Pathways Cases: Corticospinal Tract and Other Motor Pathways Lecture: Somatosensory pathways Cases: Somatosensory pathways Lecture: Visual System Cases: Visual System Lecture: Brainstem I (Cranial Nerves) Lecture: Brainstem II (Cranial Nerve Nuclei) Cases: Brainstem/Cranial Nerves Review: Long Tract Pathways and Brainstem Exam No.2 Lecture: Motor modulation I (Cerebellum) Lecture: Motor modulation II (Basal Ganglia) Cases: Basal Ganglia and Cerebellum Lecture: Limbic System and Cerebral Cortex I

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Wed, 2 November 16 23 Block

Blum C

24
S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu

Fri, November 18

Blum C

Introduction to clinical cases THANKSGIVING BREAK 25 Wed, November 23 Long tracts, visual pathways, cranial nerves, cranial nerve nuclei
26
Fri, November 25 THANKSGIVING BREAK

Clinical Neuroanatomy for undergraduates

Introduction Overview Course goals Rationale Course format: Lectures Labs Clinical cases Review sessions Content Resources: Textbooks Lab manual Course website Sylvius Integration

19 20 21 22 23 24 25 26 27 28 29 30

Wed, November 02 Fri, November 04 Wed, November 09 Fri, November 11 Wed, November 16 Fri, November 18 Wed, November 23 Fri, November 25 Wed, November 30 Fri, December 02 Wed, December 07 Fri, December 09

Review: Long Tract Pathways and Brainstem Exam No.2 Lecture: Motor modulation I (Cerebellum) Lecture: Motor modulation II (Basal Ganglia) Cases: Basal Ganglia and Cerebellum Lecture: Limbic System and Cerebral Cortex I THANKSGIVING BREAK THANKSGIVING BREAK Lecture: Cerebral Cortex II Cases: Limbic System and Cerebral Cortex II Cases: Cerebral Cortex II and Review Exam Review and Final Discussion

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Blum C

Block 3 Motor modulation (cerebellum and basal ganglia) Limbic system and cerebral cortex

S. Mark Williams, Ph.D. Department of Neurobiology Duke University Medical Center markw@neuro.duke.edu