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Zakład Patofizjologii Narządu Ruchu

Zakład Patofizjologii Narządu Ruchu

5-year D.D.S. Program, 3rd Year Students

 

Schedule is available here .

 

 
Pathophysiology of Locomotor Organs namely (Clinical Neurophysiology)  
Stage of study: 3rd year of study (Fall Semester)
Type and length of course: seminars and classes 3+12hrs
 
  Totally: 15 hours

 

 

General survey:

Main pathological phenomena diagnosed in muscles and nerves as well as in the supraspinal and spinal cord centers with the clinical neurophysiological methods are presented for students during seminars and clinical examinations with patients. A special attention is put to the pathology in transmission of motor fibers in the facial nerve and sensory fibers in the trigeminal nerve as well as disorders of the face muscles activity. They are explained during practical examinations which are performed by students on healthy volunteers and on patients (with their previous consent) for comparison. All examinations are superintended by leading persons. In fact, this is introducing to the Evidence Based Medicine “Clinical Neurophysiology” of the head area and its disorders diagnostics. Neurophysiological studies in cases of the “Tempomandibular Disorders” joined with the physiotherapeutic treatment is one of the goal, too.

Course Coordinator:

Professor Juliusz Huber (neurophysiologist)
Chair/Department:

Chair of Department of Pathophysiology of Locomotor Organs
Karol Marcinkowski University of Medical Sciences
28 Czerwca 1956r. Street, No 135/147, 61-545 Poznań

Place:

Wiktor Dega Orthopaedic and Rehabilitation Clinical Hospital

enter "D", second floor, "EMG" Department, telephone: (61) 8-310-230
Teachers: Coordinator Professor Juliusz Huber (neurophysiologist) zpnr@wp.pl
Coordinator’s Assistants:

Aleksandra Kulczyk, PhD

Agnieszka Wincek, PhD

Program author:

Professor Juliusz Huber (neurophysiologist)
Course objectives:

Competency Based Curriculum CBC "Pathophysiology of Locomotor Organs".

Upon completing the course the student should be competent at

-recognize the origin of neurogenic and myogenic pathological changes in muscle motor units with the method of clinical neurophysiology with the special reference to the face muscles and muscles of the other parts of the human body (EMG needle-elementary and surface-global recordings)

-recognize the advancement of above changes as transient or constant

-find out the pathological changes in sensory and motor fibers of nerves supplying especially the face area and the other areas of the human body with the methods of clinical neurophysiology (electroneurographical-ENG examinations of M, F, H and A waves as well as the “blink reflex” method)

-recognize the changes in sensory and motor transmission at spinal or supraspinal levels with SEPs (somatosensory evoked potentials examinations performed with electrical pulses) and MEPs (motor evoked potentials induced with the magnetic field) in clinical neurophysiological methods of diagnostics

-recognize the neuromuscular transmission disorders with the method of clinical neurophysiology (“decrement” examinations of high-frequency electrical stimulation of nerves).

Have knowledge of  

-general rules of practical using and proper applying the clinical neurophysiological methods to the diagnostic of sensory and motor innervation of face area and the other human body areas in cases of neurogenic disorders

Be familiar with

-aspects of applying the clinical neurophysiological methods of examination to the diagnostic of sensory and motor innervation of the face area and the other parts of the human body in cases of different pathologies basing on the rules of differential diagnostics (EBM)

Course content:

These topics were chosen and based on the other topics included in:

- Moosey P.A., Holsgrove G.J., Stirrups D. R., Davenport E.S., Essential skills for dentists, Oxford University Press

- Portonf J.E., Leung T., First Aid For the NBDE Part II, A Student to Student Guide, McGraw Hill Medical

- Steinbacher D.M., Sierakowski S. R., First Aid For the NBDE Part I, A Student to Student Guide, McGraw Hill Medical

as follows (divided on three meetings with students):

1.  Motor units based on the clinical electromyography (EMG) approach (classification, neurophysiological properties, activity of motoneurones and the muscle fibres in normal and pathological states)

2.  Motor units under the neurogenic and myogenic states – differences in spontaneous discharges and during the muscle voluntary contraction 

3. Peripheral motor and sensory transmission in electroneurographic studies (ENG; M, F, H and A waves as well as SCV potentials) in normal subjects and in mononeuropathies and polyneuropathies in patients with different movement disorders

4. Supraspinal and spinal cord afferent and efferent transmission neurophysiological examinations with SEPs and MEPs

5. Diagnostic methods of clinical neurophysiology. Their applications in neurology, neuroorthopaedy, neurosurgery and neurorehabilitation: electromyography (EMG) global (surface) and elementary (needle), EMG analysis and the interference pattern, spontaneous activity recorded from muscles, neurogenic and myogenic changes in motor units, electroneurography (ENG; nerve conduction studies), MEPs and SEPs at different levels of the efferent and afferent transmission, sensory perception curves (intensity of current versus stimulus duration curves; IC-SD method) in cases of axonotmesis and neurotmesis and regeneration processes comparing with von Frey's filament method

6. Reference values in neurophysiological examinations, interpretation of results, correlations with other clinical examinations with the special reference to the high-sensitivity neuroimaging examinations

7. Examples of neurophysiological examinations (as above)  among healthy volunteers 

8. Neurophysiological studies of neuromuscular transmission and neuromuscular disorders (Myasthenia gravis, Lambert-Eaton syndrome)

9. Application of neurophysiological methods in degeneration and regeneration nerve studies in patients after brachial plexus injury and carpal tunnel syndrome as well as the facial nerve injuries

10. Examples of complex neurophysiological studies in peripheral mono- and some of polyneuropathies: carpal tunnel syndrome, facial nerve palsy, blink-reflex studies

Suggested literature:

Kingsley R.E., Concise Text of Neuroscience, William and Wilkins,1996.

Johnson E.W., Pease W.S., Practical Electromyography, William and Wilkins,1980.

Lenman J.A.R., Ritchie A.E., Clinical Electromyography, Churchill Livingstone, 1987.

DeMyer W., Neuroanatomy, William and Wilkins, 1998.

Sperelakis N., Banks R.O., Essentials of Physiology, Little, Brown and Company, 1993.

Young P.A., Young P.H., Basic Clinical Neuroanatomy, William and Wilkins, 1997.

If above positions of literature are not available for you in our University Library, the xerox copies will be suitable in the Department of Pathophysiology of Locomotor Organs. Ask for a help in the Secretary Office.

Form of final assessment:

Exam or pass/fail test terms: pass/fail based on multiple choice question test (10 questions) at the end of the course. Term of the test for the particular group of students is the same as with the end of course finishing. Other terms (retakes) are separately discussed for the individual group with Coordinator.  Obligatory the student must practically shows her/his skills with performing  the neurophysiological clinical examination with the patient treated because of movement disorders of different origin (these are really clinical practical examinations). Evidence Based Medicine approach is cordially invited with performing examination of the patient as the final exam as well as the activity of the student during seminars and practical examinations.

Final Tes:

10 points of multiple choice questions test (only one answer is correct). The final test will cover all materials in the course. Test questions will come from information found in the seminar presentations and informations met at the clinical exercises. Obligatory the student must practically shows his/her skills with performing  the neurophysiological clinical examination with the patient treated because of movement disorders of different origin (these are really clinical practical examinations). Evidence Based Medicine approach is cordially invited with performing examination of the patient as the final exam as well as the activity of the student during seminars and practical examinations. Results of the test will be presented at http://orsk.ump.edu.pl/zpnr.hlml with the students number. All they will be confidential.

Assesment of the particular student will be based on The Student Evaluation Form

Assesment of the Tutors will be based on The Course Evaluation Form

Grading scale:

A 5                  90 - 100 % of correct answers

B 4,5               85 - 89 %

C 4                  75 - 84 %

D 3,5               65 - 74 %

E 3                  60 - 64 %

F/failed 2         59 and less %

 

Please also contact:  zpnr@wp.pl or phone (61) 8-310-230,  8-310-233

Students are cordially asked not to be feared with checking their knowledge about details of neuroanatomy and neurophysiology of the central and peripheral nervous systems and their injuries in pathological states (with the special reference to the face muscles activity problems). The literature shown above is only for their special consideration. Further details will be explained during seminars and clinical classes.

 

A brief (short) of seminars and practical examination classes (handout) is available here as "Clinical neurophysiological examinations". One student - one file. No problems. No password.

Power Point presentations from seminars can be given to the students by the course coordinator, but unfortunately the files take 270 MB!, so be sure to be present during seminar to have it.

 

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Data ostatniej modyfikacji: 2015-09-16
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Misja Szpitala / 14 2014

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