I have studied and interviewed groups of medical and science students that have excelled in their course work. It is true that there are specific and detailed guidelines that these students adhere to and credit for their academic success. With some time and applying these study skills to your studies, you can greatly improve your academic performance. The following are study strategies and tips from past honor students of Neuroanatomy.

Study Skill #1 – Develop a mental 3D image of the brain, spinal cord, and all the nerve pathways. The best way to do this is a 3-prong approach using pictures of the gross structure, cross-sections, and your text. Take the pons for example. You should have one or two pictures showing the gross anatomical structure connected to the whole brain stem. Ideally, you would want two different views, such as lateral and anterior. This makes you see the pons in relation to its surroundings and how it connects with them. Your second source will be cross-sections of the pons. It is helpful to start from one end and work your way to the other, caudally to rostrally for example. This allows you to view the composition of the pons and relate the position of specific nuclei and tracts to the gross structure. For example, the abducens and facial nuclei appear at the level of the caudal pons. The third source will be your notes or text. Follow the words as they describe the relationships of the structures. Go back and use your own words to state where the specific nuclei appear and what connects to the pons. This will allow you to see the information from varying views and relationships, and you will begin to construct your own mental image of the human brain.

Study Skill #2 – Terminology is crucial. Similar to general human anatomy, often terms will give clues about their function and route. Neuroanatomy can have terms that are very easy to confuse, like fasciculus versus funiculus. Moreover, the material tends to build on itself so it is important to understand these differences from the start. If you are having trouble, make photocopies of the illustrations and cross-sections with the labels whited out and fill them in on your own.

Study Skill #3 – Use colored pencils. This is the best way to trace the pathways of the nerves and their connections. For example, use blue for first-degree neurons, red for second degree, and so on. This will reinforce the mental picture you are creating by separating the connections with color. It will be easier to remember the location of the cell bodies and recall which neuron decussitates the midline.

Study Skill #4 – Describe the nerve tracts in your own words. This allows your brain to recall on a mental image of the pathway, digest it, and transmit it to paper – which is exactly what an exam question will require you to do. Take the Medial Lemniscus for example. The first-degree neuron has its cell body in the dorsal root ganglion and enters the spinal cord via the medial division. At this point, it gives off collaterals and ascends ipsilaterally in the fasciculus gracilis (or cuneatus) to synapse in the nucleus gracilis (or cuneatus) in the caudal medulla. Then the second-degree neuron ascends and crosses the midline to form the characteristic shape of the Medial Lemniscus tract between the inferior olivary nuclei. It continues to synapse on the thalamus (now on the contralateral side) where third degree neurons send their axons through the internal capsule to the post-central gyrus. Be sure to note the location of cell bodies in addition to where a specific neuron crosses the midline.

Study Skill #5 – Know the stain. This is obvious, but many students make simple mistakes because they do not take the time to note what type of stain they are examining. During an exam take a second to write, “myelin = black, cell bodies = gray” for a Weingarten stain for example. This will also keep you from jumping to conclusions and matching the wrong words with images. For example, in the medulla the nucleus solitaries can be easily confused with the fasciculus solitaries. By noting the color designation, you will prevent a mistake and correctly identify the fasciculus solitarius as a black myelin structure.

Study Skill #6 – Compare cross-sections. This is helpful if you can gather different sections of the same structure. You would want a caudal, mid, and rostral section of the medulla for example. Focus on the identifying features of each level and their relationship to surrounding structures. Ask yourself, “How do I know I am looking at the mid-medulla?” The Hypoglossal nucleus is only present at that particular level. Focus on the exit or entry of cranial nerves at all levels of the brainstem because this will be extremely important when solving nerve lesion problems.

Study Skill #7 – Do practice problems. This is essential for nerve lesion questions. If you are given an image, ask yourself where you are in the brain or brainstem. If a specific tract was lesioned, did it already cross the midline? If a nucleus was destroyed, where does it send fibers? From where does it receive them? It is often helpful to write down the specific structures that are lesioned. Next to them write out their function. Continue beside that to list the clinical symptoms and any clinical tests that would reveal them.

By: Jordan Castle