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 2 BB2: Brain and Behaviour 2

• Prof Adina Michael-Titus
• a.t.michael-titus@qmul.ac.uk

Teaching Material for this Module

Introduction

The aim of Brain and Behaviour is to develop an understanding of the structure and function in the nervous system and appreciate ways in which this understanding and knowledge is applied and relevant to clinical practice.

By the end of the module students will be able to:

• Describe the physiology and pharmacology of movement disorders
• Describe the different pathways by which pain is transmitted to the brain and how it can be physiologically, psychologically and pharmacologically modulated
• Understand the psychological principles relating to health and health-related behaviours
• Describe the mental state examination, the major signs and symptoms of psychiatric illness and the main principles underlying treatment
• Appreciate the effects on the conscious level of brain disease
• Describe the neurobiological, psychological and clinical basis of addictive behaviour
• Describe the anxiety and mood disorders and explain the rationale underlying their treatment
• Demonstrate effective PBL skills

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Index

• General Outcomes for Neurosciences
• Cerebrovascular Disease (Stroke and TIA)
• Migraine and Headaches
• Parkinson's Disease and Neuro-degenerative Disorders
• Psychotic Disorders

• General Outcomes for Neurosciences
  • Medical knowledge: ANATOMY (TD 8.1)
    • The Brainstem & Cerebellum
      1. Describe the main gross anatomical features of the cerebellum, including its input and output pathways and its lobular arrangement.
      2. Describe the microanatomical arrangement of the cerebellum including the cortical morphology and connections of the deep nuclei.
      3. Describe the functional subdivisions of the cerebellum and the effect of injury in different regions.
      4. Describe the functional significance of the cerebellar connections to the vestibular system
  • Medical knowledge: PHYSIOLOGY (TD 8.2)
    • Basal Ganglia
      1. Describe the morphology and blood supply of the caudate and lentiform nuclei and the associated internal capsule
      2. Describe the principal afferent and efferent connections of the caudate nucleus and putamen (striatum).
      3. Describe the connections of the globus pallidus & subthalamic nucleus.
      4. Explain the circuitry of the substantia nigra and its association with Parkinson's disease.
      5. Describe the role of the basal ganglia in motor control and discuss how their damage can lead to Parkinson’s disease, Huntington’s chorea, ballismus and athetosis.
    • The Neural Control of Movement
      1. Review the main functions of non-neuronal cells in the PNS and CNS in health and disease
      2. Review the main neurotransmitters used by the nervous system
      3. Review the main pathways by which the sensory modalities of touch, pain and proprioception are transmitted from the periphery to the brain, where they decussate, the basic tests used to assess their integrity and the clinical signs associated with damage
      4. Know the main components of the motor system with particular emphasis on the monosynaptic reflex and the corticospinal (pyramidal) tract, their clinical significance, how to test reflexes and how to recognise damage to the motor system
      5. Review the organisation and functions of the cranial nerves, the basic tests used to assess their integrity and the clinical signs associated with their damage
      6. Review the functional organisation of the cerebral hemispheres, including higher mental functions and tests associated with them
      7. Know 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 cover
    • Consciousness, Coma and Persistent Vegetative States
      1. Define what consciousness is and its components.
      2. Describe how consciousness is measured using the Glasgow coma scale
      3. Give a classification of unconscious states.
      4. Define the terminology used for vegetative states.
      5. Explain the prognosis and outcome of the vegetative state.
  • Medical knowledge: PHARMACOLOGY (TD 8.10)
    • Dopaminergic Systems
      1. Describe the dopaminergic pathways in the central nervous system.
      2. List and characterise the main types of dopaminergic receptors.
      3. Describe the mechanism of action of drugs that act on dopaminergic systems.
      4. Review the main circuits involved in the control of movement.
    • 5-HT Transmission
      1. Describe the 5-HT pathways in the central nervous system.
      2. List and characterise the main types of 5-HT receptors.
      3. Describe the mechanism of action of drugs that act on 5-HT systems.
    • Synaptic Transmission
      1. Describe the neuronal structures involved in synaptic transmission.
      2. Describe the main steps involved in neurotransmission.
      3. List and classify major types of neurotransmitters.
      4. Describe the effects of neurotransmitters at postsynaptic level.
      5. Review the basic mechanisms underlying neuronal excitability.
    • Drug Dependence and Addiction
      1. Explain mechanisms underlying pharmacodynamic and pharmacokinetic tolerance.
      2. Give examples of major drugs that cause dependence and induce tolerance.
  • Medical knowledge: PSYCHOLOGY (TD 9 a-g)
    • General Outcomes for Learning and Conditioning
      1. Distinguish different types of conditioning and learning.
      2. Provide examples of psychological treatments based on theories of learning.
    • Drug Dependence
      1. Describe physical and psychological drug dependence.
  • Clinical skills: HISTORY (TD 13 a-b)
    • Examination of the Nervous System - General
      1. Appreciate the anatomical basis of the central neurological examination
      2. Appreciate the anatomical / physiological basis of the peripheral neurological examination
      3. How to gain consent to examine a person / patient’s peripheral neurological system
      4. Know how to position a patient / person correctly prior to examining their peripheral neurological nervous system, gait and cerebellar system.
      5. Know how to identify the common clinical signs that show a patient has neurological deficit and / or the patient is unwell.
      6. Be able to identify the common clinical signs that show a patient has neurological deficit and / or the patient is unwell.
      7. Know how to systematically observe a patient from the end of the bed using the 'feet to face' principle, identifying some common abnormalities of central neurological disease.
      8. Appreciate how to systematically observe a patient from the end of the bed using the 'feet to face' principle, identifying some common abnormalities of peripheral neurological disease.
      9. Be able to demonstrate the appropriate techniques required to perform a systematic examination of a patient’s peripheral neurological system including gait and cerebellar disorders.
      10. Know how to perform the associated clinical examination and investigations required to complete a neurological assessment.
      11. Appreciate how to perform the associated clinical examination and investigations required to complete a neurological assessment.
      12. Appreciate how to complete the neurological assessment of a patient.
    • Examination of the CNS inc. Cranial Nerves
      1. Know how to gain consent to examine a person / patient’s cranial nerves
      2. Know how to position a patient / person correctly prior to examining their cranial nerves.
      3. Be able to demonstrate the appropriate techniques required to perform a systematic examination of cranial nerves II, III, IV, V, VI, VII and XII.
  • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Neurological Imaging
      1. Define the role of functional imaging in the vegetative state.
• Cerebrovascular Disease (Stroke and TIA)
  • Cerebrovascular Accident (CVA / Stroke)
    1. Describe the pathophysiology of stroke in relation to risk factors.
    2. Recognise the common neurovascular syndromes and mechanisms of stroke.
    3. Understand the role of thrombolysis in the treatment of acute ischaemic stroke.
    4. Understand the principles of management of patients who have suffered a stroke.
• Migraine and Headaches
  • General
    1. Can describe the pathophysiology, clinical symptoms and basic treatments of headache
    2. Understand the difference between primary and secondary headaches
    3. Understand the role of genetic and environmental factors in headache (thresholds and triggering / precipitating factors)
• Parkinson's Disease and Neuro-degenerative Disorders
  • Parkinson's Disease
    1. Can describe the pathophysiology, clinical symptoms and basic treatments of movement disorders
• Psychotic Disorders
  • General Outcomes for Psychotic Disorders
    1. Review the neurobiology of schizophrenia.

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