Neurology - Clinical skills

A.Y. 2019/2020
Overall hours
Learning objectives
To perform neurological physical examination.
To know how to perform lumbar puncture for removal of cerebrospinal fluid.
To know the techniques of EEG; EMG and study of evoked potentials.
To know the basics for the interpretation of neuro-images
To know the treatment protocols of stroke.
To know the treatment protocols for meningo-encephalitis and status epilepticus
Expected learning outcomes
The course consists of lectures and clinical activity at the patient's bedside and in the ambulatory setting.
Verification of learning takes place at the end of the course through an oral examination of the acquired knowledge.
Course syllabus and organization

Linea: Policlinico

Prerequisites for admission
Professional activities pursue and are an integral part of the objectives and results of the learning expected from teaching, as they confer the skills and abilities useful for applying knowledge in clinical practice.

To achieve the course objectives, the student must have basic knowledge of neuroanatomy and neurophysiology of the central and peripheral nervous systems and the skeletal muscle, as well an adequate knowledge of the elements of general pathology.
In detail, this knowledge implies the following skills in detail:
1. Explain the anatomical relationships of the components of the CNS and the peripheral nervous system;
2. Distinguish the components of the above and subtentorial compartments (posterior fossa);
3. Describe the main functions of the following parts of the central nervous system: frontal lobe, parietal lobe, occipital lobe, temporal lobe, basal ganglia, thalamus, reticular system, spinal cord, together with the principles of generation and transmission of the nerve impulse and its integration in the various physiological pathways.
4. Describe the visual pathways: retina, disc, nerve, chiasm and optic tract, lateral geniculate body, optic radiation and occipital cortex; know the physiology of vision.
5. Describe the relationships of the midbrain, pons and medulla oblongata and locate the nuclei of the cranial nerves in the three regions of the brainstem;
6. Know the vascularization of the CNS and the regulation of the cerebral circulation, in particular the circle of Willis and the distribution of the anterior, middle and posterior cerebral arteries and of the lenticolostriate arteries; the venous sinus system and nature and function of the blood-brain barrier.
7. Identify the components of the ventricular and subarachnoid system and know the mechanisms of the CSF circulation;
8. Know the anatomy-physiology of the spinal cord.
9. Know the different parts of the peripheral nervous system: roots and ganglia, plexuses and course of the main nerve trunks: radial, median, ulnar, femoral, sciatic, tibial, peroneal.
10. Describe the components of the motor unit and the neuro-muscular junction and the organizational and functional principles of the striated muscular system.
11. Know the autonomic nervous system: the component of the sympathetic autonomic nervous system and its relations with the hypothalamus, the distribution of the cranio-sacral parasympathetic, role of the autonomous system in sexual, sphincter, pupillary functions and sweating.
Assessment methods and Criteria
The course is divided into lectures and clinical activities carried out at the patient's bed and in the outpatient setting.
The learning verification takes place at the end of the course through an oral exam that verifies the knowledge acquired during the course.
The test takes place in public session and focuses on the evaluation of knowledge of the semeiotics of the central and peripheral nervous system, on a diagnostic framing ability of the main nosographic pictures, of the respective differential diagnoses, of the use of instrumental tests aimed at diagnosis and of the principles of therapy of neurological diseases.
In particular, the student will have to demonstrate that he has learned how to:
1. Carry out an examination of mental functions including an examination of the state of consciousness and language; differentiate aphasia, dysarthria and confusion; differentiate dominant and non-dominant hemisphere disorders;
2. Examine the cranial nerves; distinguish eye disorders from cortical or brain stem lesions; locate visual disturbances; distinguish central and peripheral facial paralysis; recognize and describe brainstem lesion disorders;
3. Examine the motor functions: tests of strength, tone, trophism, involuntary movements, deep and superficial reflexes; distinguish central and peripheral paralysis;
4. Examine coordination;
5. Examine primary (pain-temperature, position, pallesthesia) and secondary (stereognosia, graphestesia, discrimination) sensory functions; discuss the meaning of a sensory level and sensory dissociation; distinguish the lesions of roots - plexus - nerve trunk - neuromuscular junction - muscle.
6. Examine the stand and locomotion; distinguish disorders from cerebellar lesions hemispherical and vermian;
7. Investigate the presence of signs of meningeal irritation.
Particular emphasis is given to learning the elements characterizing neurological emergencies, such as coma, the increase in intracranial pressure, the state of epileptic illness, subarachnoid hemorrhage, trauma, infections of the nervous system, spinal cord compression.
MED/26 - NEUROLOGY - University credits: 2
Professional training: 30 hours

Linea: San Donato

MED/26 - NEUROLOGY - University credits: 2
Professional training: 30 hours

Linea: San Giuseppe

MED/26 - NEUROLOGY - University credits: 2
Professional training: 30 hours