Modules

• Year 1
  • Introduction to Year 1 and FunMed
  • Fundamentals of Medicine
  • Human Development 1
  • Cardiorespiratory 1
  • Metabolism 1
  • Locomotor 1
  • Brain and Behaviour 1
  • Medicine in Society 1
  • Inter-Professional Education 1
• Year 2
  • Introduction to Year 2 and Year Outcomes
  • Cardiorespiratory 2
  • Metabolism 2
  • Brain and Behaviour 2
  • Human Development 2
  • Human Sciences and Public Health 2
  • Locomotor 2
  • Medicine in Society 2
  • Extended Patient Contact 2
  • Moving and Handling Training
  • Year 2 Lifesaver Programme
• Year 3
  • Clinical Science and Professionalism (Weeks 1-3)
  • Cardiovascular, Respiratory and Haematology (CR3)
  • Gastroenterology and Cancer (MET3A)
  • Endocrinology and Renal Medicine (MET3B)
  • General Practice and Community Care
  • Public Health
• Year 4
  • Obstetrics and Gynaecology
  • Child Health
  • Neuroscience
  • Psychiatry
  • Ophthalmology
  • HIV & Sexual Health
  • Musculoskeletal
  • Health Care of the Elderly
  • Dermatology
  • General Practice and Community Care
  • Ear, Nose and Throat
  • Global Health and Ethics
  • ALL CSP WEEKS
  • B&B Classroom Skills
• Year 5
  • Introduction to Year 5 and Year Outcomes
  • Teaching Week 1
  • Acute Medical Care (AMC)
  • Surgery, Anaesthetics and Perioperative Care (SAPOC)
  • Community Care
• Year GEP 1
  • Movement and Posture
  • Carriage of Oxygen
  • Human Sciences and Public Health
  • Digestion, Growth and Metabolism
  • Infection and Immunity
  • Brain and Behaviour
  • Consolidation and Integration
  • Human Development
  • Medicine in Society (GEP)
  • IPE Programme Week (inc. IP Days within Modules)

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Year GEP 1 GEP/M&P: Movement and Posture

• Dr Lesley Robson
• l.g.robson@qmul.ac.uk

Introduction

Intro

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Index

• General Outcomes for the Whole Person
• General Outcomes for Neurosciences
• General Outcomes for the Musculoskeletal System

• General Outcomes for the Whole Person
  • Medical knowledge: ANATOMY
    • Muscles, Nerves and Connective Tissue
      1. Recognise the different types of connective tissue in photomicrographs
      2. Recognise different types of muscle and different components of muscle tissue in photomicrographs
    • Epithelia and Glands
      1. Recognise the various epithelial cell types in photomicrographs and predict their function from their structure
      2. Recognise glandular tissue in photomicrographs, identify the gland type and its likely function
      3. Recognise the basement membrane and list its functions
  • Medical knowledge: PATHOLOGY
    • General Pathology
      1. Describe the types of investigations that can provide tissue for histological analysis, and discuss the clinical value of such analysis
      2. Describe the morphological changes undergone by cancer cells as seen in a photomicrograph
• General Outcomes for Neurosciences
  • Medical knowledge: ANATOMY
    • Autonomic Nervous System
      1. Describe the anatomy of the sympathetic nervous system and explain the main differences between it and the somatic nervous system.
      2. Explain how the anatomy of the parasympathetic nervous system differs from that of the sympathetic.
    • Neural Pathways
      1. Describe the anatomy of the spinal canal and the organisation of the dorsal and ventral roots. Describe the trajectory of the roots, the numbers of cervical, thoracic, lumbar and sacral roots and their relationship to the sympathetic ganglia.
      2. Draw a cross section of the spinal cord showing grey and white matter, dorsal and ventral horns; different laminae and zones of termination of the different types of primary afferent fibres; show the location of flexor and extensor motorneuron cell bodies
      3. Draw a cross-section of the cord to show the principal ascending and descending tracts located within the white matter.
    • Central Nervous System
      1. Understand the concept of dermatomes and their clinical significance
    • Muscles, Nerves and Connective Tissue
      1. Recognise the types of neurones and components of nerve tissue in a photomicrograph.
  • Medical knowledge: PHYSIOLOGY
    • General Outcomes for Nervous System Physiology
      1. Be able to draw a table showing the different types of primary afferent and efferent fibres found in mammalian peripheral nerves. Indicate the function and conduction velocity of the different fibre types.
      2. Be able to describe the essential differences between afferent and efferent nerves.
      3. to obtain quantitative data on the 2-point discrimination thresholds on different parts of the body
      4. Outline the pathway of, and name the enzymes involved in, the synthesis of noradrenaline and adrenaline.
      5. Be able to describe the different kinds of sensory receptors found in the skin and other organs, and their relationship to the different diameters of sensory nerve fibres.the essential differences between afferent and efferent nerves.
      6. Describe the synthesis, storage and release of acetylcholine.
      7. Explain how noradrenaline and adrenaline are released from sympathetic nerves, how they act, and how they are inactivated.
      8. Be able to differentiate between mechanoreceptors and chemoreceptors, and describe how action potentials arise from generator potentials in each kind of receptor.
      9. Differentiate nicotinic from muscarinic effects.
      10. Describe the control of muscle length and tension involving muscle spindles and tendon organs.
      11. Describe the role of polysynaptic reflexes in the spinal cord
      12. Describe the distribution of α- and ß-adrenoceptors and how different tissues/organs respond to adrenoceptor stimulation.
      13. Be able to list the changes that occur after nerve injury.
      14. Give examples of drugs (agonists / antagonists) selective for α- and ß-adrenoceptors, and for subtypes of these receptors. Discuss the therapeutic uses of these drugs.
      15. Describe and explain the effects of anti-cholinesterase drugs (neostigmine, pyridostigmine)
    • Motor Systems
      1. Describe the anatomy and physiology of muscle spindle and Golgi tendon organs.
      2. Describe the concept of lower motoneurone and upper motoneurone lesions, muscle tone & spasticity.
      3. Name cholinergic agonists and antagonists; describe their receptor selectivity and possible therapeutic uses.
      4. Explain the mechanisms of action of different kinds of neuromuscular blocking agents.
    • Somatosensory Pathways
      1. To produce a clear description of the changes in sensory perception in a subject with circulation occluded in one arm. Discuss the neurophysiological processes in the arm that are responsible for these perceptual changes.
      2. to discuss the concept of somatosensory receptive fields on the body surface, how density and size of these fields may affect the localisation of touch stimuli
  • Clinical skills: HISTORY and EXAMINATION
    • Examination of the PNS
      1. to be familiar with the neuroanatomical basis for normal tendon reflexes in a series of skeletal muscles
      2. To observe and appreciate the plantar flexion reflex and recognise the significance of its pathological forms (e.g. Babinski reflex)
    • Examination of the CNS inc. Cranial Nerves
      1. To elicit those reflexes obtainable in the eye (pupil, cornea) and to examine their physiological mechanism
    • Examination of the Nervous System - General
      1. Be able to perform a cutaneous sensory examination (low threshold touch; pinprick; point position sensation; vibration; temperature)
      2. Be able to perform a reflex tendon examination of the following reflexes: beceps, triceps, knee, ankle and plantar flexor
      3. Be able to perform an EMG (electromyography) of the muscles of the upper limb and interpret the data generated
• General Outcomes for the Musculoskeletal System
  • Medical knowledge: ANATOMY
    • Muscles, Nerves and Connective Tissue
      1. Identify and appreciate the relevance of different muscle fibre types.
      2. Review anatomy of tendons and identify myotendinous junctions.
    • Anatomical Positions, Planes and Movements
      1. Be able to explain the parts of the musculoskeletal system, including the axial and epaxial skeleton, and the major types of skeletal muscle.
      2. Be able to explain how muscles are named anatomically.
      3. Be able to explain the anatomical position and language of anatomy.
    • Bones and Joints of the Upper Limb
      1. Be able to identify the bones, their arrangements and joints that comprise the pectoral girdle
    • Innervation of the Shoulder, Arm and Hand
      1. Be able to explain briefly the effect of the most common nerve injuries to the upper limb
    • Surface Anatomy of the Shoulder and Upper Limb
      1. Be able to describe the major surface landmarks of the upper and lower limbs
      2. Relate these to the clinical exams and assessment of the limbs in health and disease
    • Muscles, Tendons and Movements of the Hand
      1. Define the term opposition of the hand.
    • Muscles, Tendons and Movement of the Upper Limb
      1. Name the joints of the elbow, the movements of the elbow, and the muscles that produce these movements.
    • The Brachial Plexus
      1. Be able to explain the formation of the brachial plexus
    • Muscles and Tendons and Movements of the Shoulder Joint
      1. List the movements of the glenohumeral joint and name the muscles that produce these movements.
    • Circulation of the Shoulder, Arm and Hand
      1. Be able to identify the positions where arterial pulsations may be felt in the upper limb
      2. Know and be able to describe the course of the major arteries and veins in the upper limb
    • Circulation of the lower limb and foot
      1. Be able to describe the course of the major arteries in the lower limb.
      2. Be able to identify where arterial pulsations may be felt in the lower limb
      3. Know the mechanisms by which blood returns from the veins of the lower limb to the heart.
    • Muscles, Tendons and Movement of the Hip and Leg
      1. Describe the hip joint and the functional anatomy that provides it with stability
      2. Know the movements possible at the hip joint and the muscles that produce these movements
    • The Knee Joint and Popliteal Fossa
      1. Describe the knee joint and the functional anatomy that provides it with stability
      2. Know the movements possible at the knee joint and the muscles that produce these movements
      3. Can describe the menisci of the knee and explain how they are affected by movement
    • Surface Anatomy of the Hip, Leg and Foot
      1. Be able to describe the major surface landmarks of the upper and lower limbs
      2. Relate these to the clinical exams and assessment of the limbs in health and disease
    • Innervation of the Lower Limb and Foot
      1. Be able to describe the course of nerves in the lower limb.
      2. Describe the formation of the lumbar and sacral plexi
    • Spinal Regions, Vertebrae and Intervertebral Discs
      1. Know the arrangement of the vertebrae in the vertebral column
      2. Know the main features of a typical vertebrae and identify the atypical vertebrae
    • Muscles, Ligaments and Movements of the Back and Vertebral Column
      1. Understand the movements of the vertebral column and how these change with standing and age.
  • Medical knowledge: PHYSIOLOGY
    • General Musculoskeletal Physiology
      1. Be able to explain the process of intramembranous and endochondral bone development
      2. Be able to explain how bones grow postnatally both in length and width
      3. Explain how injury to the median and ulnar nerves effect the function of the hand
      4. Understand the movements that are possible at the various joints of the hand, and the muscles involved
      5. Understand key concepts in endochondral ossification including ossification centres and the epiphyseal growth plate.
      6. Identify bone and sutures in developing intramembranous bone.
      7. Understand the two main categories of grip and the main sub-divisions within each
      8. Understand the functional anatomy and modification of the lower limb for stability and locomotion
    • Joint Structure and Function
      1. Be able to identify the three main types of joints and how, structurally, they influence the amount of movement possible
      2. Understand how the articular cartilage and synovial fluid contribute to the function of synovial joints
    • Skeletal Muscle (Striated Muscle)
      1. Understand the structure of skeletal muscle fibre
      2. Understand the physiology of the skeletal muscle fibre
    • Walking and Posture
      1. Describe the changes of moving from a double to a single support
      2. Describe the events in the normal walking cycle
      3. Understand the actions of the main muscle groups of the lower llimb in the walking cycle
    • Peripheral Systems
      1. Competently be able to draw a reflex arc for control of muscle contraction including tendon organ and muscle spindles
      2. Understand how the force of muscle contraction is controlled by impulse frequency and by the recruitment of motor units
    • Skin
      1. Identify microanatomical structures of the skin and relate these to functional properties.
  • Medical knowledge: PATHOLOGY
    • General
      1. To understand the basics of how joints are affected by disease

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