Modules

• Year 1
  • Introduction to Year 1 and Year Outcomes
  • Fundamentals of Medicine
  • Cardiorespiratory 1
  • Metabolism 1
  • Locomotor 1
  • Brain and Behaviour 1
  • Human Development 1
  • Medicine in Society 1
  • Clinical Communication Skills
  • Student Selected Component (SSC)
• 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
  • Cancer Week
  • Moving and Handling Training
  • Year 2 Lifesaver Programme
  • Clinical Communication Skills
  • Medicine in Society 2
  • Extended Patient Contact
  • Student Selected Component (SSC)
• Year 3
  • Introduction to Year 3 and Year Outcomes
  • Clinical Science and Professionalism (Weeks 1-3)
  • Cardiovascular, Respiratory and Haematology (CR3)
  • Gastroenterology and Cancer (MET3A)
  • Public Health
  • Endocrinology and Renal Medicine (MET3B)
  • General Practice and Community Care
  • Student Selected Component (SSC)
  • Clinical and Communication Skills
• Year 4
  • Introduction and Year 4 Outcomes
  • Obstetrics and Gynaecology
  • Child Health
  • HIV & Sexual Health
  • Musculoskeletal
  • Health Care of the Elderly
  • Neuroscience
  • Dermatology
  • General Practice and Community Care
  • Psychiatry
  • Ear, Nose and Throat
  • Global Health and Ethics
  • Ophthalmology
  • Clinical & Communication Skills
  • Student Selected Component (SSC)
• Year 5
  • Introduction to Year 5 and Year Outcomes
  • Teaching Week 1
  • Teaching Week 2
  • Anaesthesia & ITU (AN & ITU)
  • Breaking Bad News
  • Clinical Pharmacology & Therapeutics
  • Community Care
  • Doctors as Teachers and Educators (DATE)
  • Emergency Medicine (EMERG MED)
  • General (Internal) Medicine (G(I)M)
  • Immediate Life Support (ILS)
  • Student Assistantship
  • Simulation
  • Surgery
  • Student Selected Component (SSC)
• Year GEP 1
  • Cancer Week
  • Movement and Posture
  • Carriage of Oxygen
  • Human Sciences and Public Health
  • Digestion, Growth and Metabolism
  • Infection and Immunity
  • Ethics
  • Brain and Behaviour
  • Human Development
  • Clinical Communication Skills
  • Medicine in Society (GEP)

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Year 1 BB1: Brain and Behaviour 1

• Dr Xuenong Bo
• x.bo@qmul.ac.uk

Teaching Material for this Module

Introduction

By the end of this module, students should be able to:

1. To describe the main pathways by which the sensory modalities of low threshold cutaneous sensation (touch, pressure and vibration), pain and proprioception are transmitted from the periphery to the brain.

2. To describe the pathways for the special senses of hearing and vision

3. To be able to state the location of where these pathways crossover (decussate) in the nervous system.

4. To be able to perform the basic tests used to assess the integrity and the clinical signs associated with damage to the main ascending and descending pathways.

5. To outline the main components of the motor system with particular emphasis on the monosynaptic reflex and the corticospinal (pyramidal) tract.

6. To be able to test monosynaptic reflexes, explain their clinical significance, and how to recognise damage to the motor system.

7. To describe the origin, organisation and functions of the cranial nerves, the basic tests used to assess their integrity and the clinical signs associated with damage to them.

8. To be able to relate the main functional regions of the cortex to specific lobes of the brain.

9. To recognise major parts of the central nervous system and vascular system using modern imaging techniques.

10. To be able to describe the distribution of the principal arteries of the brain and spinal cord and the main functional areas of the brain and spinal cord that they supply.

11. To be able to locate specific cutaneous dermatomes on various parts of the body.

Sessions

• Lecture: Overview of the Nervous System
  1. Name and identify the major parts of the nervous system and describe their primary functions
  2. Describe the basic organisation of the peripheral and central nervous system
  3. Describe the roles of the glial cells in the nervous system
• Lecture: Organisation of the Spinal Cord
  1. To be able to identify the major gross anatomical features of the spinal cord and meninges
  2. To be able to draw a cross section of the spinal cord showing grey and white matter, dorsal and ventral horns
  3. To be able to identify the main blood supply and venous drainage of the spinal cord
  4. To be able to describe the pathway of the principal ascending and descending tracts within the white matter
  5. To be able to describe the basic neurological deficits related to spinal cord injuries
• Lecture: Introduction to the Peripheral Nervous System
  1. Give an overview of the peripheral nervous system
  2. Describe the essential differences between afferent and efferent nerve
  3. 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.
  4. Differentiate between mechanoreceptors and chemoreceptors, and describe how action potentials arise from generator (receptor) potentials in each kind of receptor.
  5. Explain what is meant by a sensory receptive field
  6. 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.
  7. List the changes that occur after nerve injury.
• Lecture: Skull Anatomy
  1. To be able to describe the difference between the skull of a new born and an adult
  2. To be able to name and locate the foramina of the skull
  3. To be able to identify the cranial nerves related to each skull foramina
• Lecture: Neural Control of Movement
  1. Explain the main medical conditions associated with the damage to the motor system.
  2. Describe the main descending motor tracts.
  3. Understand the functions of the specific brain regions in the control of voluntary movement.
  4. Identify the brain regions involved in the control of voluntary movement.
• Lecture: Spinal Reflexes
  1. Define the term motor unit and describe how the force of muscle contraction is controlled by impulse frequency and by recruitment of motor units.
  2. Describe the anatomy and physiology of muscle spindle and Golgi tendon organs.
  3. Draw a diagram of the monosynaptic reflex arc (for patellar or ankle jerk).
  4. Describe the control of muscle length and tension involving muscle spindles and tendon organs.
  5. Describe the role of polysynaptic reflexes in the spinal cord
  6. Describe the concept of lower motoneurone and upper motoneurone lesions, muscle tone & spasticity.
• Clinical Skills: Examination of the Cranial Nerves
• Lecture: Peripheral Distribution of Cranial Nerves I&II
  1. Describe how cranial nerves III, IV and VI move the eyeball
  2. Describe the course and exit foraminae of the cranial nerves from the skull vault especially cranial nerves V, VII, IX, X and XII
  3. Describe the main peripheral targets in the head innervated by cranial nerves V, VII, IX, X and XII
• Lecture: Somatosensory Pathways
  1. Describe the anatomy and physiology of the dorsal column-medial lemniscal system, and explain how its integrity may be clinically assessed.
  2. Describe the anatomy of the spinothalamic tracts
  3. Explain the role of the different components of the spinothalamic tracts in sensation and pain.
  4. Describe briefly the clinical manifestations of lesions of the spinal cord
• Lecture: Brainstem and Cranial Nerves I
  1. Overview functions of the cranial nerves, noting important reflexes
  2. State which cranial nerves are associated with each sub-region of the brainstem and relate this to the organisation of the cranial nerve nuclei
  3. Define the main sub-regions of the brainstem and their functions.
• Lecture: Brainstem and Cranial Nerves II
  1. Explain the consequences of raised pressure in the posterior cranial fossa.
  2. Explain the consequences of vascular or physical lesions to different areas of the brainstem in terms of clinical signs.
  3. Describe the blood supply to the brainstem
  4. List the symptoms associated with damage to cranial nerves
• Lecture: Injury and Repair of the Nervous System
  1. Explain why the possibilities for repair are limited in the CNS
  2. Describe the process of nerve regeneration in the PNS and the determinants of its success
  3. List the changes that occur after sensory nerve injury: caudal (distal) to the injury, rostral (proximal) to the injury, in the dorsal root ganglion (cell somas)
• Lecture: Neurotransmission in the Nervous System
  1. Describe how epsps and ipsps are generated at excitatory and inhibitory synapses within the CNS
  2. Define the term neuromodulator and give examples
  3. State the main neurotransmitters and understand how the associated receptors mediate their action
  4. Be able to describe nerve conduction studies and electromyography and how they can detect peripheral nerve abnormalities including impulse conduction failure
  5. Explain the importance of termination of transmitter action, and give two different examples of how this is achieved
• Lecture: Anatomy of the Neck
  1. Outline the sensory and motor innervation of the larynx and explain the effects of damage to the recurrent laryngeal nerve
  2. Describe how the vocal folds produce sound and variation in pitch
  3. Describe the peripheral course of the sympathetic nervous system in the neck
  4. Describe the attachments and actions of the sternocleidomastoid muscle and give its nerve supply
  5. Define the boundaries of the anterior and posterior triangles of the neck and state their major contents
• Lecture: Visual Pathways
  1. Explain the "grandmother cell" or hierarchical model of visual perception.
  2. Explain the functions of the following cortical areas: the posterior parietal association area; the inferotemperal association area; the dorsolateral association area.
  3. Describe the receptive fields of cells in the visual cortex.
  4. Describe the effect of lesions at various points within the visual pathways.
  5. Explain how information from one half of the visual field reaches the contralateral visual cortex.
  6. Describe normal pupillary and accommodation reflexes and their clinical significance.
  7. Describe the visual pathway from optic nerve to visual cortex.
• Lecture: Physiology of the Eye and Retina
  1. Describe the visual pathway from photoreceptor to optic nerve.
  2. Decribe the mechanism of photo-transduction in the photoreceptors.
  3. Explain the conditions of glaucoma and cataract and their probably causes.
  4. Describe the structure of the eye and the significance of the cornea, lens, aqueous and vitreous humours.
  5. Describe the blood supply to the retina and the significance of the choroids.
• Lecture: Blood Supply to the Brain
  1. Describe major vascular disorders in relation to functional loss
  2. Describe the venous drainage of the brain and spinal cord
  3. Explain the possibilities for a co-lateral circulation through the Circle of Willis
  4. Describe the principal arteries of the brain and spinal cord
• Lecture: Hypothalamus and Pituitary Gland
  1. Describe the hypothalamo-hypophyseal tract.
  2. Describe the principal fibre tracts linking the hypothalamus with the brain stem reticular formation.
  3. Describe the hypophyseal portal system.
  4. Describe the hypothalamic autonomic and endocrine projections.
  5. Name the principal hypothalamic nuclei.
  6. Describe the principal afferent and efferent connections of the hypothalamus.
  7. Describe the functional organisation of the hypothalamus.
• Lecture: Speech and Cortical Asymmetry
  1. Discuss the differences in function between the right and left hemispheres
  2. Discuss the evidence that different areas of the cerebral cortex are involved in the production and perception of speech and language, and name these areas
  3. Describe the functions of the posterior parietal and inferotemporal cortices, and how these functions may differ in the left and right hemispheres.
• Lecture: Cerebral Meninges, CSF and the Blood-Brain Barrier
  1. Explain the role of glia cells in brain homeostasis.
  2. Explain the structure of the blood-brain barrier, and its functional significance.
  3. Draw a diagram of the ventricular system of the brain labelling the main structures.
  4. Describe the composition of cerebrospinal fluid, where and how it is formed.
  5. Describe the main types of haemorrhage associated with damage to the skull and meninges.
  6. Describe the anatomical arrangement of the meninges of the brain.
• Lecture: Brain Asymmetry and Higher Mental Functions
• Lecture: Reticular Formation
  1. Understand the reticular activating system and the role in sleep and wakefulness.
  2. Describe the role reticular formation in the control of autonomic nervous system.
  3. Explain the general functions of reticular formation.
  4. Describe the structure of reticular formation and the location of main nuclei or neuronal aggregates.
  5. Know the main afferents and efferents of the reticular formation.
• Lecture: Hearing
  1. Describe the auditory pathways
  2. Define the unit of sound intensity, and draw a typical human hearing curve.
  3. Define conduction and nerve deafness, and state tests for these
  4. Give an account of the anatomy of the cochlea, and explain how it enables us to determine: the frequency and loudness of incoming sound, and explain how the direction of incoming sound may be determined.
  5. Describe the main functions of the auditory system
• Lecture: Basic Imaging of the CNS
  1. Relate CNS anatomy to structures viewed in MRI, CT and X-rays
  2. Understand the following anatomical planes: Axial, Transverse, Horizontal, Sagittal, Coronal
  3. Describe different types of neuro-imaging techniques available to investigate the nervous system.
• Lecture: Introduction to Pharmacology in the CNS
  1. Define the concept of treatment-resistance, and give examples of causes underlying this phenomenon
  2. Give examples of side-effects of drugs used in neuropharmacology and describe their impact on disease management
  3. Explain the importance of the blood-brain barrier and drug transporters as a determinant of therapeutic efficacy
  4. Define drug targets within a typical chemical synapse in the nervous system
• Lecture: Neural Control of Motivational Behaviour
  1. Describe how hypothalamic lesions can modify motivated behaviour.
  2. Describe the neural control of defecation
  3. Describe the neural control of urination
  4. Describe the neural control of food intake
  5. Describe the neural control of drinking
• Lecture: BB1 Review
  1. Functional areas of the brain and link to blood supply.
  2. Blood supply to the brain: posterior and anterior parts.
  3. Cranial nerves: brainstem organisation, peripheral course, what deficit would arise if damaged.
  4. Ascending and descending tracts: where they are located in the spinal cord, where they cross over, what information they carry.
  5. Reflexes- peripheral nerves
• Physiology Practical: Somatosensory
• Physiology Practical: Vision
• Anatomy Practical: Anatomy of the Spinal Cord
• Anatomy Practical: Anatomy of the Brainstem and Cranial Nerves
• Anatomy Practical: Bloody Supply and Neuroanatomy of the Brain
• Workshop: Visual Awareness
• Workshop: Working with the Hearing Impaired
• PBL: Altered Sensation
• PBL: A Broken Man
• PBL: What's happened to my eye?
• PBL: A problem with the face
• PBL: A sudden loss of function

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