PHASE TWO - GI BLOCK

Week One: Stomach

 
PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] Describe the gross anatomy and microstructure of the stomach and duodenum.

[2] Describe gastric movements, stomach emptying and their regulation.

[3] Describe the production, functions and regulation of various gastric secretions and enzymes.
PBL: Stomach and
Peptic Ulcer [4] Discuss the pathophysiology of peptic ulcer disease.
Disease
[5] Outline the causes of peptic ulcer disease.

[6] Discuss the pharmacological basis of the treatment of peptic ulcer

[7] Discuss the epidemiology of peptic ulcer disease

[1] Describe the layout and regional specialisations of alimentary system.

GI Physiology [2] Discuss the motility processes at each level of the alimentary system.
Lecture
[3] Describe the secretory processes control systems which regulate motility and secretion each level of the alimentary system.

[4] Discuss the digestion of foodstuffs and absorption of nutrients at each level of the alimentary system.

[1] Describe the regulation of gastric secretions.

[2] Discuss the pathophysiology of peptic ulcer disease and role of H. pylori.
H. Pylori Lecture
[3] Discuss the pharmacological basis of the treatment of peptic ulcer and H.pylori.

[4] Discuss the epidemiology of peptic ulcer disease.

 Gastric Secretion, [1] Discuss protection of the gastric mucosa against effects of excess gastric secretions.
Protection and
Ulceration Lab [2] Describe the physiological regulation of gastric acid secretion.

[3] Describe the 24 hour intragastric pH profile and the factors which affect it.

[4] Discuss the various methods available to diagnose Helicobacter pylori infection.

[5] Describe the mechanisms by which Helicobacter pylori infection predisposes to duodenal ulcer disease.

[6[ List the different types of drug treatment which might be effective against peptic ulcers, and discuss their mechanism of action.

[1] Understand the concepts of the greater and lesser sacs of the peritoneal cavity and the supra- and infra-colic compartments.

[2] In a dissection of an abdomen, recognise stomach, gall bladder, small intestine, large intestine, greater omentum, lesser omentum,
epiploic foramen.

[3] For the intestines, be able to distinguish jejunum, ileum, caecum, appendix, and the regions of colon: ascending, transverse,
Anatomy Lab descending and sigmoid.

[4] Be able to draw an outline of the stomach and label the oesophagus, cardia, fundus, body, pyloric antrum, pyloric canal, pyloric
sphincter, greater and lesser curvatures.

[5] Understand the histological features of the oesophagus and stomach and relate these features to organ function.

[6] Be able to outline the arterial and venous blood supply of the oesphagus and stomach and their lymphatic drainage.
 
 Week Two: Liver
 
PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL: Intro to Liver [1] Describe the macro and microscopic structure of the liver.
and Functions
[2] Describe the blood supply to the liver and its relationship to the systemic circulation.

[3] Describe the role of liver in processing and metabolism of dietary products returning from the gut.

[4] Describe the metabolism of Bilirubin.

[5] Outline the processes by which the liver detoxifies waste products.

[6] Explain the pathophysiology of portal hypertension and hepatic encephalopathy, diagnosis and management.

[1] List the normal functions of the liver.

Structure and [2] Describe the structure of the liver in terms of its broad anatomy and histology.
Function of the
Liver Lecture [3] Describe the liver’s vasculature, parenchyma and biliary system and its normal connective tissue.

[4] Briefly describe the contents of bile and how it is produced and secreted. Describe how jaundice may arise.

[5] List the so-called “liver function tests” (LFTs) .

[6] Briefly describe what abnormality of any one LFT may mean and outline the pattern of abnormal LFTs in jaundice of different
causes.

[7] Define cirrhosis .

[8] Describe the pathogenesis and possible causes of cirrhosis .

[9] List the possible complications of cirrhosis .

 [10] Describe the effects of liver failure.

Metabolic [1] Describe the role of the liver in carbohydrate, fat and protein metabolism.
Functions of the
Liver Lecture [2] Relate signs and symptoms of liver failure to biochemical abnormalities.

[3] Describe the role of liver in providing endogenous supply of glucose .

[4] Describe the role of liver in the metabolism and distribution of fats.

[5] Describe the lipoprotein-based fat and cholesterol transport system and its role in energy metabolism.

[6] Describe the role of liver in protein metabolism and elimination of nitrogen .

[7] Discuss wide ranging pattern of protein synthesis, and changes of such pattern in disease.

[1] Describe in detail the biochemistry of bile pigments, especially Bilirubin, and explain how it is transformed from a hydrophobic
"un-conjugated" form to a hydrophilic "conjugated" form by the liver.

Bilirubin [2] Explain how the distinct chemical properties of bile salts are important for their function in lipid digestion.
Metabolism
Lecture [3] Describe the mechanisms by which bile secretion from the gall bladder is controlled.

[4] Describe the basis for the classification of jaundice into three groups (pre-hepatic, hepatic and post-hepatic) and uses of the
distinct effects on Bilirubin metabolism within each group to inform diagnosis.

[1] Describe the structure and functions of enteric nervous system.

Gut Motility [2] Normal movements of GI system.

Lecture
[3] Explain the control of GI functions.

[4] Discuss some common disorders of gut motility and their causes .

LFT Lecture [1] Revise the anatomy of the liver.

[2] Describe the normal functions of the liver .

 [3] Discuss about liver marker in health and pathological situation.

[4] Interpret liver function markers to confirm liver disease.

[5] Discuss use of liver function tests in clinical contexts – case review.

GI Investigations [1] Describe about various tools and techniques for GI imaging.
Lecture
[2] Discuss about advantages and disadvantages of various GI imaging techniques/tools.

[3] Discuss about utilisation of GI imaging techniques in various disease conditions.

[4] Discuss diagnosis and treatment of upper GI bleeding.

[5] Discuss diagnosis of lower GI bleeding.

[6] Explain the interdependence of medicine, radiology and pathology in GI investigation and management.

Digestion Lab [1] Pancreatic and other enzymes involved in the digestion of food in the human gut.

[2] The products of digestion and where they are released for absorption.

[3] Different specificities of the pancreatic endopeptidases trypsin and chymotrypsin and the structural basis for these specificities.

[4] The actions of the amylase on dietary carbohydrates, the products released and how this benefits digestion and absorption

[5] Clinical tests available for pancreatic function and interpretation of the results

Anatomy Lab [1] Be able to recognise the right and left lobes of the liver and the quadrate and caudate lobes.

[2] Understand the concept of functional left and right lobes and the contribution to each of the anatomical lobes.

[3] Appreciate the anatomical relations of the liver, be able to define the right and left subphrenic spaces and the hepatorenal recess
and describe their clinical importance

[4] Be able to describe the concept of liver lobules and the liver acinus and to appreciate their relations to portal tracts and central
veins.
 [5] Be able to give an account of the anatomy and function of the gall bladder and the extrahepatic biliary ducts.

[6] Be able to describe the progression of alcoholic liver disease from steatosis through alcoholic hepatitis and cirrhosis to
hepatocellular carcinoma and to recognize the principal features of these conditions on histology.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
Week Three: Pancreas and Small Intestine
 
PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL: Pancreas and [1] Describe the gross anatomy and histology of the small intestine and pancreas.
Small Intestine
[2] Discuss the processes of digestion and absorption in the small intestine and motility.

[3] Discuss the role of pancreatic enzymes in the digestion of foodstuffs.

[4] Describe the regulation of pancreatic secretion.

[5] Outline the causes, diagnosis and treatment of chronic pancreatitis.

[6] Discuss the dietary advice you would give to a patient with pancreatic insufficiency.

[7] Discuss possible strategies for improving patient compliance.

Iron Metabolism [1] Discuss absorption and transport of Iron from GIT
Lecture
[2] Describe utilisation, storage and recycling of Iron in the human body

[3] Discuss regulation of iron metabolism in human body

[4] Discuss about the causes and consequences of ‘Hereditary Haemochromatosis’

Coeliac Disease [1] Describe aetiology and clinical features of coeliac disease
Lecture
[2] Outline the pathophysiology of coeliac disease and the sequelae of malabsorption due to this condition

[3] Discuss the effects of coeliac disease on iron homeostasis in human body

[4] Discuss the diagnosis and management of coeliac disease

 Viral hepatitis [1] Appreciate differing epidemiology and clinical manifestations of Hepatitis viruses
Lecture
[2] Describe the serology of Hepatitis viruses

[3] Discuss treatment options for Hepatitis viruses

Gallstones Lecture [1] Describe the anatomy of the biliary tract

[2] Describe the composition and formation of bile including the enterohepatic circulation

[3] Outline the regulation of gallbladder contraction

[4] Discuss the emulsification of lipids by bile

[5] Outline the causes of obstructive jaundice including gallstones and their effects on liver function tests.

Infectious [1] Describe causes and pathogenic mechanisms of diarrhoea

Diarrhoea Lecture
[2] Discuss Clinical features of gastroenteritis

[3] Discuss investigation and Management of infectious diarrhoea

Pharmacokinetics [1] To define the role of the liver in detoxification and removal of drugs from the body
Lab
[2] To describe the relationship between drug concentration and response.

[3] To describe the relationships between loading dose, volume of distribution and concentration

[4] To describe the relationships between dosing rate, drug clearance and average steady state concentration

[5] To describe the relationships between clearance, volume of distribution and elimination half life

[6] To outline effects of hepatic disease on clearance, volume, half-life and drug dose requirements

Anatomy [1] Be able to name and identify the gross components of the small and large intestines

[2] Appreciate the general positions and gross features of the small and large intestines in the abdomen and be able to distinguish
 them on gross specimens and on radiology.

[3] Be able to identify the individual regions of the small and large intestines.

[4] Be able to distinguish small and large intestines on histology and appreciate the microscopical differences between these two
general regions of bowel and their functional implications.

[5] Be able to describe ways in which the structure of the small intestine is specialized for absorption at the gross, light microscopical
and electron microscopical levels.

[6] Have an overview of the development of the intestines and the causation of common embryological anomalies.

[7] Explain the general pattern of lymphatic drainage of the bowel and its clinical importance
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Week Four: Large Intestine and Diarrhoea
 
PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] Describe the gross anatomy and histology of the large bowel including the anal canal

[2] Discuss the motility of the large intestine and factors affecting it
PBL: Large
Intestine and [3] Describe fluid and electrolyte absorption in the gastrointestinal system
Diarrhoea
[4] Describe the normal flora of the gastrointestinal system

[5] Discuss the pathogenic mechanisms involved in diarrhoeal disease including the role of bacterial toxins

[6] Explain the urea and electrolyte results in the scenario

[7] Discuss the spread and control of enteric infection

Fluid and [1] Explain the importance of the GI tract in maintaining water and electrolyte balance, and potential for large fluid losses in diarrhoea
Electrolyte
Balance Lecture [2] Describe mechanisms of transport of sodium, potassium, glucose and chloride ion in the GI tract

[3] Describe Classification of diarrhoea

[4] Explain the importance of children’s diarrhoea worldwide, its treatment and prevention

[5] Describe body water compartments

[6] Explain the role of osmotic pressure in the movement of fluids between compartments

[7] Describe the effect of main types of fluids (colloids, dextrose, and saline) on the intravascular volume

[8] Discuss the main uses of different types of iv fluids

 [9] Appreciate the importance – and dangers- of disturbed potassium balance

[10] Describe a scheme for monitoring water and electrolyte balance and an approach to fluid replacement

[1] discuss the role of the gut in maintaining fluid balance

[2] describe fluid and electrolyte absorption and its manipulation in the GI system

[3] discuss the effects of diarrhoeal fluid loss on IC and EC compartmental volumes and content
Diarrhoeal Disease
Workshop [4] discuss the types and functions of the normal gut bacteria of the GI tract

[5] discuss the factors determining the normal microbiota of the GI tract and the consequences of disruption

[6] describe the specific and nonspecific defence mechanisms in the gut and how some micro organisms can overcome these defences

[7] list common causes of infective diarrhoea and outline their pathogenic mechanisms

[1] Be able to recognize the duodenum, pancreas and spleen and give an account of the gross morphology and relationships.

[2] Be able to name the parts of the duodenum and of the pancreas.

[3] Appreciate the relationship between the bile duct, the head of the pancreas and the ducts of the pancreas and understand the
Anatomy anatomical arrangement of the common opening of the ducts into the duodenum.

[4] Describe the anatomy of the portal vein and list the organs from which venous blood drains to it. Appreciate the functional
significance of this arrangement.

[5] Describe the microscopical anatomy of the duodenum, pancreas and spleen and appreciate the ways in which their structure
reflects their function.

[6] Be able to give an account of portosystemic anastomoses and to describe their location and clinical importance.
 
 
 
 
 
PHASE 2 - GU BLOCK
Week Five: Female Reproductive Tract

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] Describe the anatomy and histology of the female reproductive tract.

[2] Discuss the biology of female fertility, including gametogenesis.

PBL: Female
Reproductive [3] Describe the different phases of the menstrual cycle.
Tract
[4] Describe the endocrinology of fertility and the mechanism of action of the oral contraceptive pill.

[5] Outline factors that may impair fertility in both sexes.

[1] Name and describe the parts of the female reproductive system.

Gross Anatomy of [2] Name and describe the parts of the male reproductive system and accessory glands.
the Reproductive
Tract Lecture [3] Describe the blood supply, venous and lymphatic drainage of the reproductive system

[4] Understand the peritoneal relationships of the reproductive organs in the female

[1] Understand the development and regression of the duct system in the formation of the urogenital system.

[2] Describe the cellular movements involved in the formation of the indifferent gonad.
Development of
the Urogenital [3] Describe the development of the testis from the indifferent gonad.
System Lecture
[4] Describe the development of the ovary from the indifferent gonad.

[5] Describe some common clinical conditions associated with development of the urogenital system including hypospadias and
intersex disorders
 Female [1] Understand the biosynthesis and mechanism of action of steroid hormones.
reproductive
endocrinology [2] Describe the role of hormones in regulation of ovarian function including ovulation, formation and decline of the corpus luteum.

[3] Describe the endometrial changes (proliferative and secretory phases) that occur throughout the menstrual cycle and correlate
them with changes in the pituitary and ovarian hormones.

[4] Understand some clinical common issues associated with problems in endocrine function.

[1] Describe spermatogenesis and its control.

Endocrine
disruptors and [2] Give an overview of the male endocrine system.
male reproduction
[3] Define endocrine disruptors.

[4] Explain how endocrine disruptors affect male reproduction.

[1] List and recognise the major histological tissue types.

[2] Describe the structures and function of germ cells, Sertoli cells and Leydig cells of the testis.

Human [3] Describe the structure and function of germ cells, granulosa and thecal cells of the ovary.
Reproduction Lab
[4] Describe the cyclical changes in structure of the ovary, uterine tube and uterus.

[5] Discuss the production and function of cervical mucus.

[6] Outline the synthesis of sex hormones.

Gross Anatomy of [1] Describe the anatomy and histology of the male and female reproductive tracts, including their blood supply and venous drainage.
Human
Reproduction 1 [2] Explain the contents of the spermatic cord.

[3] Describe the skeleton of the pelvis.

[4] Identify key features on the ligamentous pelvis and give the attachments of the inguinal ligament.
[5] Understand the clinical relevance of pelvic imaging.
 Week Six: Male Reproductive Tract

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] Describe the anatomy and histology of the male reproductive tract

[2] Describe spermatogenesis in the male

PBL: Infertility and [3] Discuss the differences in gametogenesis between males and females.
Male Reproductive
Tract [4] Describe the physiology of sexual intercourse.

[5] Describe the biology of fertilisation, including the barriers that must be overcome by successful sperm and the blocks to
polyspermy.

[6] Outline assisted reproductive technology (ART).

[1] Describe the development of the testis.

Cryptorchidism
Lecture [2] Understand the anatomy of the inguinal canal and the path and control of testicular descent.

[3] Describe the common disorders and management of sex development including cryptorchidism and hypospadias.

[1] Understand the holy triad of reproductive physiology in the female.

[2] Understand how semen quality is defined and how this relates to fertility.
ART Lecture
[3] Discuss the common causes of infertility and how this is investigated

[4] Explain the steps in the IVF process.

Pelvic Floor [1] Describe the anatomy of the pelvic floor.

Anatomy Lecture
[2] Explain what happens when pelvic floor anatomy goes wrong.
 [3] Develop an understand of how pelvic floor anatomy influences surgery.

[1] Differentiate between diversity and the legal notion of equality.

[2] Give an account of how diversity informs the ethical notion of equity
Equality and
Diversity Lecture [3] Outline the link between prejudice and discrimination

[4] List the 9 diversity strands protected in law.

[5] Summarise forms of discrimination.

[6] Relate discrimination to criminal practice.

[1] Be able to critically appraise results from studies in the medical literature.
Group Work
Session [2] Apply findings from the literature to answer questions raised by specific clinical problems.

[3] Understand the ethical issues involved in medical research.

[1] Describe the inguinal region and the inguinal canal.

Anatomy [2] Describe the coverings of the spermatic cord.

[3] Explain the development of the male and female reproductive tracts.

[4] Understand how weaknesses in the anterior abdominal wall may lead to herniation.

 
 
 
 
 
 
 
 
 Week Seven: Kidney Donation

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] Describe the anatomy of the kidney and urinary tract, especially the structure of the nephron and its blood supply

[2] Describe the functions of the kidney

PBL: Kidney and
Donation [3] Describe the tests that can be performed to ensure kidney function is normal, and discuss their limitations

[4] Understand why kidney stones form and how they can be detected by imaging.

[5] Consider the ethical arguments of making non-directed living kidney donation legal despite the desire to ‘first do no harm’

Renal Function [1] Give an account of the role of the kidneys in controlling the volume of extracellular fluid, metabolic waste removal and electrolyte
Lecture homeostasis

[2] Describe the composition of the nephron and explain the function of each component

[3] Understand the other main functions of the kidneys, including activation of vitamin D, toxin metabolism and regulation of
erythropoietin

[1] Describe the common causes and classification of kidney disease

Examining the [2] List what is measured by semiquantitative urinalysis

Urine and Kidney
Disease Lecture [3] Explain how proteinuria and haematuria are quantified

[4] Be able to identify patients with kidney injury/ disease by eGFR, serum creatinine, dipstick urinalysis and urine quantification

[5] Understand how patients with chronic kidney disease are managed including basic awareness of renal replacement therapies

Measuring Kidney [1] Understand how substances such as creatinine are “cleared “by the kidneys
Function Lecture
[2] Understand how kidney function can be assessed by measurement of glomerular filtration rate
 [3] Explain how estimated GFR measurements are made, and the limitations of this measurement

[4] List typical values for renal blood flow, glomerular filtration rate and urine production

Acid-Base Balance [1] Understand simple acid-base physiology

Lecture
[2] Understand the process of compensation

[3] Be able to recognise the presence of acid-base disorders

Fluid and [1] Describe how the nephron controls excretion of sodium and potassium
Electrolyte
Balance lecture [2] Explain how the kidney controls water reabsorption and secretion

[3] Describe how the countercurrent multiplier system concentrates filtrate in the loop of Henle

[4] Understand how the countercurrent exchange mechanism functions in the Vasa Recta

[5] Understand the channels involved in electrolyte transport

[6] List the main hormones involved in regulating renal function and understand how they act

Imaging and Renal [1] Describe the various methods available to image the kidneys and bladder, and understand the risks associated with some of these
Stone Disease methods

[2] Understand how kidney stones/crystals form, and the different types that exist

[3] Understand the role of serum/urine biochemistry and imaging in diagnosing kidney stones

[4] Discuss the common treatments for kidney stones

Bladder Function [1] Describe the anatomy of the bladder

Lecture
[2] Understand the physiology of bladder voiding

[3] Describe the neurological conditions affecting bladder functions

 [4] Understand the principle causes and management of bladder outflow obstruction

Anatomy Lab [1] Discuss the anatomy of the urinary tract including the urethra in both sexes

[1] Describe the sources and amounts of acid generated within the body, including the influence of diet

Renal Function [2] Summarise the mechanisms by which blood pH is maintained within a narrow range
and Acid-Base
Balance Lab [3] Explain the role of the kidney in acid-base homeostasis

[4] Recognise the clinical importance of simple urine dipstick testing

[5] Perform a urine dipstick analysis of urine and be able to interpret results
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Week Eight: Kidney Failure

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] Describe the mechanism by which bladder volume is sensed and bladder emptying achieved.

[2] Understand the mechanism by which chronic obstruction of bladder outflow can lead to back pressure, dysfunction and damage
to the kidneys.
PBL: Kidney
Failure [3] Describe how reduced GFR causes biochemical changes in the blood, in particular to urea, creatinine and potassium.

[4] Describe the mechanisms by which the kidney regulates acid-base balance.

[5] Describe the causes, investigations and management for patients with chronic kidney disease.

[6] Describe the role of the kidney in excretion of medicines and the importance of considering kidney function when prescribing
medicines and assessing potential medicine toxicity.

[1] Understand the mechanisms involved in renal excretion of drugs.

[2] Describe how impaired kidney function has an effect on drug metabolism and clearance.
Medicine and the
Kidney Lecture [3] Explain the dose adjustment options necessary in patients with compromised kidneys.

[4] Understand the mechanisms and clinical presentation of nephrotoxicity.

[5] Understand the use and misuse of diuretics.

Solid Organ [1] Explain how compatibility between donor organs and recipients is determined
Allo-Transplantati
on [2] Understand how major histocompatibility complex matching is critical in transplantation.

[3] Understand the factors contributing to and the various types of transplant rejection

[4] Understand how donor organs are allocated to recipients in the UK.
 PHASE TWO - ENDOCRINE BLOCK
Week Nine: Diabetes Type 1

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] Describe how blood glucose levels are controlled in a healthy individual immediately after a meal, between meals and after a
prolonged period without food

[2] Describe the synthesis and processing of insulin in β cells of Islets of Langerhans and outline how blood glucose regulates insulin
release

[3] Describe the effects of insulin on relevant tissues (short and long term) and how these effects are achieved.

[4] List the classic presenting clinical features of Type 1 Diabetes Mellitus (T1DM) and explain how it is diagnosed.
PBL - TY1D
[5] Describe the underlying pathophysiology of T1DM, especially the role of autoimmunity.

[6] Describe the changes in blood insulin produced by a healthy pancreas in response to normal eating and fasting patterns and
compare these with the changes when a diabetic patient injects insulin.

[7] State different types of available insulin and different regimes using insulin to control blood sugar.

[8] List the risk factors for hypoglycaemia and how this could be treated

[1] Explain the difference between exocrine and endocrine glands

[2] Understand the importance of the pituitary gland in overall regulation of the endocrine system
Intro to Endocrine
Lecture [3] Outline the basic principles of hormone production and action

[4] Demonstrate a broad understanding of the normal physiological roles of the thyroid, parathyroid and adrenal glands

[5] Understand the difference between the endocrine and exocrine pancreas
 [6] Explain the key differences between type 1 and type 2 diabetes

[1] Describe the types of carbohydrates in the diet

[2] Describe the processes involved in the digestion and absorption of carbohydrates
Carbohydrate
Transport and [3] Describe the different transport systems utilised by metabolic tissues for glucose influx
Metabolism
Lectures [4] Describe the different hexokinase enzymes utilised by metabolic tissues

[5] Outline the processes and critical regulated steps by which glucose is converted to glycogen and vice versa

[6] Outline the processes and critical regulated steps by which glucose is synthesised de novo by the liver

[7] Outline the different routes through which glucose can be metabolised

[1] Outline diagnostic criteria for diabetes, impaired fasting glucose and impaired glucose tolerance

Pathogenesis of [2] Understand that diabetes may be caused by a number of aetiologies and is divide into type 1, type 2, monogenic and secondary
TY1D Lecture causes

[3] Describe the autoimmune basis of type 1 diabetes and how type 1 diabetes relates to other autoimmune diseases

[4] Explain the aetiology of monogenic forms of diabetes, how these are transmitted in families

[5] Outline how autoantibodies can be used to differentiate different forms of diabetes

Endocrine [1] Recognise and describe the anatomical structure of the exocrine and endocrine pancreas and its relations to other abdominal
Histology Lecture organs
and Lab: Pancreas
and Adrenal [2] Describe the histology of the pancreas - recognise and distinguish different cell types
Glands
[3] Explain the basis of immunocytochemical techniques and how they can be used to identify molecular functions of cells

[4] Distinguish, using immunocytochemical observations, between normal and failing function of specific cell types

[5] Identify the usual anatomical position of the adrenal glands

 [6] Describe the histological structure and physiological function of the adrenal cortex

[7] Describe potential adrenal pathologies (eg. Benign adenoma, adrenocortical carcinoma, atrophy in Addison’s disease)

[8] Describe the structure and function of the adrenal medulla

Insulin Production [1] Describe the site and mechanism of insulin and glucagon secretion
and Action
Lecture [2] Outline the processes through which glycogen synthesis and breakdown is regulated by signals generated by insulin, glucagon and
(nor)adrenaline in muscle and liver

[3] Outline the processes through which gluconeogenesis is regulated by signals generated by insulin and glucagon

[4] Describe how insulin and glucagon regulate blood glucose concentration in a healthy individual immediately after a meal, between
meals and after a prolonged period without food.

[5] Describe the mechanism of action of the biguanide, sulphonylurea, incretin-mimetic and DPP4 inhibitor classes of drugs

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Week Ten: Diabetes Type 2

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] describe the typical clinical features of a patient with type II diabetes

[2] understand pathophysiological mechanisms underlying type II diabetes (especially the close link between obesity and insulin
resistance) and explain how these differ from type I diabetes

[3] revise the macrovascular (cardiovascular) consequences of type 2 diabetes and its importance as a cardiovascular risk factor
PBL: T2DM
[4] describe how to minimise cardiovascular risk in diabetes and appreciate the importance of addressing other risk factors as well as
glycaemic control

[5] describe the main classes of drugs used to treat type II diabetes

[6] Understand the consequences of poor diabetic control on the capillaries and small arteries of the eye/kidney/peripheral nerves

[7] Explain the consequences of capillary damage in diabetes and how this can be prevented or how to reduce its rate of progression

Pathogenesis of [1] Understand normal endocrine pancreatic function and role in glycaemic control
Type 2 Diabetes
Lecture [2] Outline genetic factors predisposing to the development of type 2 diabetes

[3] Describe lifestyle and developmental factors predisposing to the development of type 2 diabetes

[4] Understand the development of pancreatic dysfunction and peripheral insulin resistance

[5] Describe the pathogenesis of complications of T2DM

[6] Understand the mechanisms underlying development of ‘secondary’ diabetes

Microvascular [1] Outline key points relating to the epidemiology of microvascular disease in diabetes
Complications of
Type 2 Diabetes [2] Describe the pathogenesis, screening system and management of diabetic retinopathy
 Lecture [3] Explain the underlying mechanisms, screening and treatment of diabetic nephropathy

[4] Explain the pathogenesis, screening, differential diagnosis and treatment of diabetic neuropathy

[5] Summarise the key clinical trials emphasising the importance of glycaemic control in reducing incidence of microvascular
complications

[6] Understand the concept of glycaemic targets and their role in minimising microvascular disease

Glucose Tolerance [1] Explain the 'health and safety' precautions associated with taking and handling blood.
Lab
[2] Measure blood glucose using an electronic device designed for home use.

[3] Describe the method employed in the electronic assay for glucose.

[4] Measure urinary metabolites using Clinistiks and explain the basis of the method.

[5] Construct a graphical representation of your Glucose Tolerance Test and explain its main features.

[6] Describe how the Glucose Tolerance Test of a person with diabetes would differ from that of a healthy individual.

[7] Describe the fate of glucose ingested in the test dose for the Glucose Tolerance Test in both individuals with and without diabetes.

[8] Describe metabolic and hormonal changes occurring in the body during the period of the test.

Metabolic [1] Describe the main acute metabolic complications of diabetes

Complications of
Diabetes Lecture [2] Outline the pathophysiology and biochemical changes observed in diabetic ketoacidosis

[3] Understand the consequences of relative insulin deficiency and the acute metabolic complications that can develop (HONK)

[4] Outline the aims of treatment of diabetic ketoacidosis and HONK with reference to the biochemical and physiological changes that
occur

[5] Describe the symptoms of hypoglycaemia and be aware of the shot and long term dangers of this metabolic complication

[1] Describe the types of lipid in the diet

 [2] Describe the processes involved in the digestion and absorption of dietary lipids

[3] Describe the key intermediates and regulated enzymes of fatty acid synthesis and oxidation
Lipid Metabolism
Lecture [4] Describe the key intermediates and regulated enzymes of triglyceride synthesis and lipolysis in adipose tissue

[5] Describe the different routes through which lipids can be metabolised

[6] Outline the mechanisms by which insulin regulates fatty acid and triglyceride metabolism in liver and adipose tissue

[7] Explain the requirement for essential fatty acids

Diabetes Small [1] State the importance of basal levels of insulin, and the relevance of this to treatment and management of Type 1 Diabetes.
Group Session
[2] Describe how a person with diabetes self manages their condition

[3] Describe the importance of and roles carried out by the multidisciplinary care team in diabetes management

[4] Discuss the roles of diabetes registers in diabetes care and research

[5] Discuss the psychosocial aspects of diabetes treatment and management

[6] Discuss the ethical and legal responsibilities involved in diabetes and their impact on the patient’s lifestyle

 
 
 
 
 
 
 
 Week Eleven: Thyroid

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL: Thyroid [1] Describe the anatomical relationships and the cell structure of the thyroid gland.

[2] Describe how thyroxine (T4) and tri-iodothyronine (T3) are synthesised and transported and how their secretion is regulated.

[3] Explain how thyroid hormones identify their target tissues and outline how T4 and T3 affect cellular functions in target tissues.

[4] Describe the consequences of both increased and decreased thyroid hormone production.

[5] Outline the autoimmune basis of hyper- and hypothyroidism.

[6] Describe the causes of and treatment options for thyrotoxicosis.

[7] State the role of radioactive iodine in the treatment of hyperthyroidism and possible short-term and long-term consequences.

[8] Outline the causes and treatment of hypothyroidism.

The Pituitary [1] Understand the anatomical relationship between the hypothalamus and anterior pituitary
Gland and
Regulation of the [2] Explain the role of the hypothalamus in regulating hormone production from the anterior pituitary
Endocrine System
Lecture [3] Describe the hormones produced by the anterior pituitary and their normal physiological actions on target organs

[4] Describe the function of the posterior pituitary gland and the normal physiological role of posterior pituitary hormones

[5] Describe the clinical consequences of tumours of the pituitary glands

Endocrine [1] Describe the mechanisms of action of commonly prescribed medications for type 2 diabetes
Pharmacology
Lecture [2] Understand main actions of insulin and be aware of the different preparations and delivery methods available
 [3] Explain the actions of bisphosphonates and outline other pharmacological methods of maintaining bone health

[4] Understand how anti-thyroid drugs alter the synthesis and actions of thyroid hormone

[5] Identify the key differences between different preparations of glucocorticoids used in clinical practice

[6] Describe how medications alter prolactin secretion and list the medications which may be used in treating prolactinoma

[7] Outline the actions of vasopressin and describe the different pharmacological preparations available in clinical practice

[1] To understand what is involved where parents disagree with each other over their child’s medical treatment

Family Law and [2] To be familiar with the law surrounding the rights of parents who disagree with doctors over proposed treatment of their child
Ethics Lecture
[3] To know the legal framework relating to patients who are older children expressing their own wishes concerning treatment options

[4] To outline the legislative arrangements where patients are adults lacking capacity

[1] Describe the synthesis of thyroid hormone within thyroid follicles and how this is regulated
The Thyroid
Gland: [2] Outline how thyroid hormone is secreted and how it circulates in the plasma
Anatomy/Physiolo
gy/Disorders [3] Understand how thyroid hormone exerts its action at a tissue level and its major physiological role
Lecture
[4] Explain the causes of hyperthyroidism and the clinical effects of thyroid hormone excess

[5] Describe the causes and clinical effects of hypothyroidism

Anatomy Lab [1] Palpate the living neck and identify its surface landmarks

[2] Identify a goitre and understand its position and why it usually moves on swallowing

[3] Describe the macro- and microscopic structure of the thyroid and parathyroid glands

[4] Recognise an obvious pathological lesion

[5] Describe the histology of the anterior and posterior pituitary gland and be able to differentiate between their endocrine functions
 [6] Describe the relationship between the hypothalamus and posterior pituitary

[7] Appreciate the usual anatomical position of the pituitary and the risk to surrounding structures of pituitary enlargement

[8] Describe the usual physiological function of the anterior and posterior pituitary

Electrolyte [1] Explain how sodium is regulated and the role of angiotensin II, aldosterone and ADH in this process (revision from renal block)
Emergency
Lecture [2] Outline the causes and mechanisms underlying hyponatraemia

[3] List the clinical features of hyponatraemia

[4] Discuss the management of acute and chronic hyponatraemia

[5] Describe the clinical features, causes and management of severe hypernatraemia

[6] Explain the regulation of calcium describing the role of vitamin D and parathyroid hormone (revision from Limbs and back block)

[7] Outline the causes of hypercalcaemia and its treatment

[8] List the symptoms of hypocalcaemia

[9] Outline the management of hypocalcaemia

 
 
 
 
 
 
 
 
 
 
 
 
Week Twelve: Adrenals

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

[1] Outline the anatomy and histology of the adrenal glands.

[2] Describe the synthesis, function and importance of cortisol and aldosterone, identifying their target tissues and mechanisms of
action within those tissues.

[3] Outline the functional relationships between the hypothalamus, the anterior pituitary and the adrenal cortex.

[4] List the tests used to investigate adrenal insufficiency.

PBL: Adrenals [5] Outline investigations used to investigate possible cortisol excess and how iatrogenic and endogenous cortisol excess can be
distinguished biochemically.

[6] Distinguish primary and secondary adrenocortical insufficiency.

[7] Explain how corticosteroid hormones can be replaced and the importance of patient education in ensuring this is done safely.

[8] List the characteristic features, metabolic and biochemical consequences of long-term exposure to excess corticosteroid.

Corticosteroid [1] Understand the anatomical and functional zonation of the adrenal cortex
Production and
Regulation [2] Outline the key steps in the biosynthesis of cortisol and how this is regulated
Lecture
[3] Describe the biosynthetic steps required to synthesise aldosterone and its regulation by the renin-angiotensin system

[4] Describe how both cortisol and aldosterone exert their effects via receptors located in the cell nucleus

[5] Explain the multiple physiological effects of cortisol

[6] Understand the main physiological role of aldosterone

 [7] Describe adrenal androgen production and how this is regulated

[1] Understand how a reference range is determined and what limitations it may have
Biochemical
Investigation of [2] Calculate the concentrations of analytes (calcium and albumin) in serum
Calcium
Homeostasis Lab [3] Calculate the coefficient of variation in a biochemical test

[4] Summarise the relevance of clinical biochemistry measurements in the diagnosis of hypocalcaemia and hypercalcaemia.

The Adrenal Gland [1] Explain the pathophysiology and consequences of glucocorticoid over and underproduction
Lecture
[2] Outline principles of glucocorticoid replacement therapy and the role of patient education in this process

[3] Understand the difference of primary and secondary adrenal insufficiency

[4] Outline the causes and consequences of mineralocorticoid excess

[5] Describe the anatomy of the adrenal medulla and its physiological role

[6] Outline the clinical features of catecholamine excess

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Head, Neck and Neuro
Week Nineteen

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL 1 - Weak Hand [1] Appreciate the anatomical/pathological significance of weakness of one hand and the distinction between a peripheral nerve
and Drooping lesion and a brachial plexus lesion.
Eyelid
[2] Recognise Horner’s syndrome and understand its features and its anatomical basis

[3] Work out the anatomical/pathological significance of upper limb swelling and discoloration in this patient.

[4] Understand how the above three sets of symptoms and signs might indicate a single disease process.

[5] Appreciate the location and nature of a Pancoast tumour and its possible effects on structures at the thoracic outlet.

[6] Give an overview of the likely diagnosis and management of a Pancoast tumour.

Block Intro lecture [1] Appreciate that knowledge of CNS anatomy can enable the site of a lesion to be identified based on combinations of symptoms
and signs

[2] Recognise how damage affecting different parts of the peripheral nervous system is reflected in alterations of sensory and motor
function

[3] Understand the basic layout of the sympathetic and parasympathetic parts of the autonomic nervous system

Chronic Pain [1] List the disadvantages of pain

Lecture
[2] Explain the basic physiological & pharmacological mechanisms of pain

[3] Characterise the different types of pain

 [4] Identify the essential parameters to be assessed in a full holistic appraisal of pain

[5] List the main components of multi-model pain management

[6] Propose a logical regimen to manage some common types of pain conditions

Spinal Cord [1] An understanding of the gross structure, segmental variation and development of the spinal cord
Lecture
[2] An understanding of the major ascending sensory pathways mediating tactile and thermal sensations

[3] An understanding of the major descending motor pathways critical for voluntary movement and the maintenance of posture

[4] An introduction to the anatomical, physiological and functional classification of axons in a peripheral nerve

Signalling in the [1] Explain the ionic basis for the resting membrane potential of excitable cells
Nervous System
[2] Summarize how the nerve action potential is generated

[3] Contrast action potential propagation in myelinated versus unmyelinated nerve fibres

[4] Explain the concept of chemical neurotransmission

[5] Describe how chemical neurotransmitters influence the polarity of the post synaptic membrane

[6] Compare and contrast temporal and spatial summation of synaptic inputs

[7] Explain how convergence of neural inputs can result in integrative abstraction

[8] Summarize methods of localising cerebral function

Brain Lecture [1] An introduction to the main anatomical landmarks of the brain relating to systems involved in sensory perception and voluntary
motor output

[2] An understanding of the ventricular system and sites of cerebrospinal fluid production

[3] An introduction to some neurological disorders affecting sensory perception and cognitive function, and compromised motor
output
 Anatomy Lab [1] Appreciate the anatomical/pathological significance of weakness of one hand and the distinction between a peripheral lesion and
a brachial plexus lesion

[2] To recognise Horner’s syndrome and understand its features and anatomical basis

[3] To be able to work out the anatomical/pathological significance of the upper limb swelling and discoloration in the patient in the
scenario

[4] To understand how the above sets of symptoms in the scenario might indicate a single disease process

[5] To appreciate the location and nature of a Pancoast tumour and its possible effects on structures of the thoracic outlet

[6] To have an overview of the anatomical layout of the anterior and posterior triangles of the neck

Spinal Cord and [1] Describe the differences in the meningeal relationships between vertebral column and cranium
Vertebral Column;
Aches and Pains [2] Recognise dorsal and ventral roots, dorsal root ganglia and cauda equina
Lab
[3] Describe the function difference between ventral and dorsal roots

[4] Know how a spinal segment is defined and understand the significance of the mismatch between spinal cord segments and the
corresponding vertebrae

[5] Recognise the main parts of the spinal cord as seen in cross section (dorsal, ventral and lateral horns of the grey matter, columns
of white matter)

[6] Distinguish the functions of different parts of the spinal grey matter

[7] Describe the structure and function of the following pathways: pyramidal tract, spinothalmic tract and dorsal column/medial
lemniscal pathway

[8] Predict the likely outcome of spinal cord injuries at different segmental levels

[9] Give a definition of pain

[10] Describe the two types of sensory nerve fibres conveying nociceptive information
 [11] With help of an example, define and explain referred pain

[12] Describe and explain ischaemic pain, giving account of its mechanism

[13] Describe and explain the underlying mechanisms of the white reaction and of the triple response of the skin after mild trauma

[14] describe and explain the cardiovascular responses to pain

[15] explain how a TENS machine is thought to modulate the perception of painful stimuli
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Week Twenty

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL 2 - Back Pain [1] Describe the differential diagnosis between serious spinal diseases (‘red flags’), disc prolapse and non-specific low back pain
(‘ordinary backache’).

[2] Describe the normal anatomy of the spinal cord, segmental innervation, dermatomes and myotomes in relation to the clinical
features and diagnosis of disc prolapse

[3] Describe the physiological basis of non-specific low back pain and the neurophysiology of pain.

[4] Describe the management of acute back pain

[5] Describe the role of the GP, physiotherapist, osteopath and chiropractor and of hospital specialists in the management of back
pain.

[6] Consider the factors that contribute to the development and maintenance of chronic pain and disability, and how that might be
prevented.

Development of [1] Describe the development of the neural tube from the neural plate
the the CNS
Lecture [2] Explain what is meant by “neural crest” and list the neural crest derivatives

[3] Describe further differentiation of the neural tube to the spinal cord and development of the spinal nerves

[4] Explain the primary brain vesicles and list their derivatives

[5] Explain the defects spina bifida and anencephaly

Pharmacology of [1] Understand how the function of the brain can be manipulated by drugs
the CNS Lecture [2] Appreciate how drugs may subtly alter brain function by interacting with a neurotransmitter system

[3] Understand the main dopamine pathways in the brain

[4] Gain an impression of how drugs can compensate for aberrant synaptic signalling in the brain.

Anatomy Lab [1] To understand the anatomy of the face to a depth sufficient to allow the student to appreciate structures at risk in wounds at
defined sites on the face

[2] To have knowledge of the blood supply to the face and the arrangement of arterial anastomoses in the region

[3] To appreciate the location of the salivary glands and their ducts

[4] To be aware of the concept and possibility of fistula formation from severed ducts

[5] To understand the anatomy of the facial nerve in the face and to be able to carry out clinical tests of its function

[6] To see the muscles of facial expression: frontalis, obicularis, oculi, orbcularis oris, zygmomaticus major and minor, levator labii
superioris, depressor labii inferioris, levator and depressor anguli oris, risorius and buccinator

[7] To see the two more superficial muscles of mastication, masseter and temporalis. To appreciate that the media and later
pterygoid muscles are also part of the group but are deeply placed

[8] To see the cutaneous branches of the trigeminal nerve and know about their distribution

[9] To understand the actions and innervations of the muscles of mastication and the muscles of facial expression and appreciate
their origins from the first and second pharyngeal arches respectively

Brainstem and [1] Define the term brainstem

Spinal Cord Lab
[2] explain that all the motor cranial nerve nuclei lie in the brain stem

[3] describe how to elicit vestibulo-ocular reflexes and explain their mechanism

[4] describe a spinal reflex and describe the components of a reflex pathway

[5] describe how to elicit a tendon jerk reflex

 [6] know the segmental root levels of common reflexes

[7] describe how a subject can reinforce a reflex and the physiological basis of this

[8] describe how to elicit the plantar reflex and describe the reflex response in a normal adult

[9] describe a babinski-positive response and explain its significance

[10] describe the effects on reflexes

[11] describe and explain the concept and significance of the sensory unit: a single sensory nerve fibre and the receptors with which it
is connected

[12] explain that sensory information is coded in terms of the channel along which nerve impulses are travelling

[13] explain that receptors for a given modality of sensation are distributed in a punctate fashion in the skin, with intervening areas of
the skin which are insensitive to that particular modality

[14] explain how to demonstrate that the density of cutaneous sensory innervation varies for different regions of skin (two point
discrimination)

[15] state how two point discrimination varies over the different parts of the body, how this relates to the amount of somatosensory
cortex which is devoted to different regions of the body and the functional significance of this.

PBL 3: Face [1] Understand the anatomy of the face to a depth sufficient to allow the student to appreciate structures at risk in wounds at defined
Incision sites on the face.

[2] Have knowledge of the blood supply of the face and the arrangement of arterial anastomoses in this region.

[3] Appreciate the location of the salivary glands and their ducts and outline their physiology; be aware of the possible consequences
of severing the ducts.

[4] Understand the anatomy of the facial nerve in the face and be able to carry out clinical tests for facial nerve function.

[5] Be aware of agencies and local projects working to reduce violence in Scotland.
  
  
 
 
 

Week Twenty-One

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL 4: Spinal Cord [1] Describe the pathogenesis of spinal shock.

Injury
[2] Relate clinical findings to the functional anatomy of the spinal cord - motor, sensory and autonomic pathways

[3] Predict the likely outcome of spinal cord injuries at different segmental levels, including effects on respiration and bladder control.

[4] Describe the return of somatic and autonomic reflexes following spinal cord injury.

[5] Discuss the importance of personality, family and other support and rehabilitation in assisting patients in coming to terms with
and adapting to long term disability

[6] Explain what is meant by an upper and a lower motor neurone lesion.

Spinal Injury [1] Give an overview of the functional anatomy of the spinal cord
Lecture
[2] Define spinal shock and explain its effects

[3] Define neurogenic shock and explain its effects

[4] Predict the likely outcome of spinal cord injuries at different segmental levels

[5] Discuss secondary problems following spinal cord injury

Adjustment to [1] Understand the meaning of the terms "sick role" and "illness behaviour"
Chronic Illness [2] Be able to list 5 elements which have been identified as facilitating successful adjustment to chronic illness
and Disability
Lecture [3] List symptoms which may be induced by cytokine activity in chronic illness.

[4] Understand what is meant by" locus of control" and why it is important in chronic illness

[5] Be aware of the potential for positive experiences of illness and how these are relevant to adjustment.

Cognition and [1] Differentiate between grey and white matter and outline their distribution in the brain
Brain in Action
Lecture [2] Recognise that neurons fire in a coordinated and rhythmic manner (oscillations) and that that this is important for perception and
cognition

[3] Appreciate the role of the temporal cortex in processing and recognition of the human face

[4] Appreciate that perceptual coherence may be disrupted in psychiatric disorders such as schizophrenia

[5] Outline the difference between long and short-term memory and their association with different parts of the brain.

[6] Recognise the role of the amygdala in the fear response

[7] Discuss the process of synaptic pruning that occurs during adolescent brain development

Anatomy Lab [1] To describe the course, function and distribution of the facial and vestibulocochlear nerves

[2] To appreciate what is meant anatomically by the sub-occipital retrosigmoid approach

[3] To understand why surgery on the vestibulocochlear nerve might result in damage to the facial nerve

[4] To understand the clinical features of facial palsy. To be able to explain the problems a patient with facial palsy will have in
speaking and eating. To appreciate why the patient in the scenario required a tarsorrhaphy

[5] To understand the principal features of the meninges and other contents of the cranial cavity including the main arteries and
venous channels and the general features of the external and internal anatomy of the brain

[6] To understand the location of the anterior, middle and posterior cranial fossae and be able to describe their contents
 [7] To have knowledge of the anatomy, location in the cranial cavity and function of all 12 cranial nerves

Brain Lab [1] Identify the bones which make up the cranial cavity and appreciate their significance in head injury

[2] Name the 3 meningeal layers, understand their relation to each other and to the skull and interift the major meningeal folds (falx
cerebri and tentorium cerebelli)

[3] Distinguish the relation of the following vessels to the meningeal layers and spaces: middle meningeal artery, cerebral arteries and
their branches, venous sinuses

[4] Appreciate the significance of the relation between meninges and blood vessels in various types of intracranial bleeds

[5] Identify the 4 lobes of the cerebral hemispheres

[6] Identify the following functional areas on the cerebral cortex: motor, somatosensory, auditory, visual and speech

[7] Recognise the normal arrangement of the ventricles of the brain

[8] Describe the pathway between the retina and the visual cortex, as well as the autonomic innervation of the eye

[9] Appreciate the significance of the pupil, eyelids and visual fiends as aids to diagnosis

[10] Explain how to test for the integrity of certain cranial nerves

[11] describe and explain how to discriminate between deafness due to conductive defect compared to CN VIII impairment

[12] describe and demonstrate how to elicit reflexes dependent on the integrity of the brain stem

PBL 5: [1] Understand the terms tinnitus and vertigo and appreciate that they may be symptoms of inner ear dysfunction
Schwannoma
[2] Appreciate the medical conditions “Meniere’s disease” and “schwannoma of the vestibulocochlear nerve”, their nature,
presentation and differential diagnosis

[3] Describe the course, function and distribution of the facial and vestibulocochlear nerves.

[4] Understand the terms “benign” and “malignant” in relation to tumours and appreciate the sequelae of enlarging space occupying
lesions.
 [5] Appreciate what is meant anatomically by the “sub-occipital retrosigmoid approach”

[6] Understand why surgery on the vestibulocochlear nerve might result in damage to the facial nerve.

[7] Understand the clinical features of a facial palsy. To be able to explain the problems a patient with a facial palsy will have in
speaking and eating. To appreciate why the patient required a tarsorrhaphy.
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
Week Twenty-Two

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL 6 - Head [1] List the cranial nerves and briefly outline clinical tests for their function.
Injury
[2] Identify the effects of primary and secondary brain injury in pathological and biochemical terms.

[3] Discuss the clinical assessment and significance of consciousness level and lateralising neurological signs and understand the
concepts of intracranial pressure and cerebral perfusion pressure.

[4] Explain the effects of local ischaemia and hypoxia on the injured brain.

[5] Describe the acute management of head injury.

[6] Discuss recovery of function in the context of CNS plasticity and the limited capacity of the CNS for regeneration.

[7] Discuss the outcome and long-term sequelae of head injury

Pathology of Head [1] Describe a method for the clinical assessment of impaired consciousness
Injury Lecture
[2] Describe the classification of pathology in traumatic brain injury.

[3] Recognise the signs, symptoms and risk factors for sports concussion and how it should be managed.

[4] Recognise the immediate and longer term consequences of traumatic brain injury.

Motor Control [1] Describe the strategies involved in voluntary movements

Lecture
[2] Explain how the cortex, basal ganglia and cerebellum control movement

[3] Describe the descending pathways involved in motor control

 [4] Understand the general principles of the organisation of spinal motor circuitry

[5] Understand the organisation of motor neurons in the ventral horn

Anatomy Lab [1] Describe the anatomy and function of the components of the upper respiratory tract

[2] Understand the anatomical location of the tonsils in the pharynx and their function

[3] Give an account of the general layout of the anatomy of the external, middle and inner ears and the auditory tube, and to
apprecaite the anatomy and the common pathologies that can be seen with an auriscope

[4] To understand the aetiology and anatomico-pathology of otitis media with effusion

[5] Understand the rationale of treating glue ear by insertion of ventilation tubes

Motor Control Lab [1] Draw a diagram of the spinal reflex pathway which must be intact to elicit a tendon jerk

[2] Describe the structures of joint receptors, muscle spindles and tendon organs

[3] Explain why the stretch reflex is important in maintaining posture

[4] List the sources of feedback about body position available to the CNS, and explain why vibrating tendons leads to errors in the
perception of joint angles

[5] Understand the basic principles of axon degeneration and regeneration following injury

[6] Describe the composition of peripheral nerves

[7] Describe the clinical and pathological effects of Parkinson’s disease

PBL 7 [1] Understand the location and function of the tonsils.

[2] Understand the aetiology and anatomico-pathology of otitis media with effusion (serous otitis media or glue ear)

[3] Understand the difference between conductive and sensorineural deafness and how they might be distinguished in clinic.

[4] Understand the rationale of treating otitis media with effusion by insertion of ventilation tubes (grommets).
[5] Appreciate the difficulties that arise as a result of deafness in children and measures that are taken to detect it.

  
 Week Twenty-Three

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL 8 - [1] Identify the CNS pathways involved in the control of movement (distinguish the roles of basal ganglia, cerebellum and motor
Parkinson’s cortex).

[2] Describe dopamine synthesis and function in the CNS with reference to distribution of receptors and dopaminergic neurons.

[3] Briefly outline the other monoaminergic systems in the CNS and their roles.

[4] Describe the clinical and pathological features of Parkinson’s disease

[5] Explain the rationale for using L-dopa as a treatment for Parkinson’s disease and its mechanism of action, indicating the
therapeutic strategies used to maximise its efficacy and minimise its side-effects.

Neurophysiothera [1] Appreciate the role of the neurophysiotherapist in the management of patients with a chronic neurological condition
pist Lecture
[2] Appreciate the problems of adapting to, and living with, a chronic neurological condition such as multiple sclerosis

Age Related [1] Outline the histology of the macula and explain its function
Macular
Degenration [2] Explain how fluid or blood under the macula leads to loss of vision and how this is detected
Lecture
[3] Discuss recent advances in understanding the aetiology and pathogenesis of age-related macular degeneration

[4] Describe the mechanism of action of drugs used to control the growth of new blood vessels in the eye, and consider the financial
and logistical implications for health services.

[5] Discuss the psychological and social implications of blindness

Anatomy Lab [1] Describe the anatomy and actions of the intrinsic and extrinsic muscles of the tongue and their innervations

[2] Describe the lymphatic drainage of the head and neck

 [3] Give an account of the lymphatic drainage of the tongue

[4] Describe the anatomy and relations of the larynx and laryngopharynx

[5] Appreciate the role of the larynx and the other parts of the aerodigestive tract in speech

[6] Understand the events of swallowing.

Visual Pathways [1] Describe the human visual pathways

Lab
[2] Describe the relationship between the visual field and how it projects onto the retina

[3] Describe the effects of lesions in various locations along the visual pathway

[4] Explain the consequences in everyday life of different types of visual field loss

[5] Test pupillary reflexes and recognise an abnormal response

[6] Examine the fundus of the eye detecting the optic disc and differentiating between retinal arterial and venous vessels

PBL 9 - Oral Ulcer [1] Discuss the aetiology and presentation of oral cancer and appreciate its pathology.

[2] Understand the importance of vigilance, particularly by dentists, for detecting oral cancer and other conditions at an early stage.

[3] Give a general description of the lymphatic drainage of the head and neck and explain the lymphatic drainage of the tongue.
Appreciate the way in which lymph node involvement affects management and prognosis.

[4] Name the intrinsic and extrinsic muscles of the tongue and their innervations.

[5] Give a general overview of the structure of the larynx and appreciate the position of the vocal folds.

[6] Appreciate the importance of a multidisciplinary team approach to management of the patient with oral malignancy.

[7] Outline the role of speech therapists in the management of patients following surgery on the mouth and tongue.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Week Twenty-Four

PBL/Lecture/Lab Intended Learning Outcomes (ILOs)

PBL 10 - Age [1] Illustrate the anatomy of the eye including the macula.
Related Macular
Degeneration [2] Discuss the steps in vision that take place in the eye.

[3] Explain how fluid or blood under the macula leads to loss of vision and how this is detected

[4] Discuss recent advances in understanding the aetiology and pathogenesis of agerelated macular degeneration.

[5] Describe the mechanism of action of drugs used to control the growth of new blood vessels in the eye, and consider the financial
and logistical implications for health services.

[6] Discuss the psychological and social implications of blindness.

Oral and [1] To understand the range of practice within Oral and Maxillofacial Surgery.
Maxillofacial
Surgery Lecture [2] To better appreciate how a clear understanding of anatomy can guide and influence surgical treatment

Neuroanatomy [1] Identify the main gross anatomical features of the peripheral nervous system
Workshop
[2] Outline the anatomy of the peripheral nervous system and its relation to the CNS

[3] Identify the gross anatomy of the brain and spinal cord

[4] Identify important landmarks within the brain and indicate their function

[5] Identify parts of the CNS and related structures on radiographs, CT and MRI scans

[6] Describe briefly the synthesis and circulation of CSF

[7] Recognise the main blood vessels associated with the brain