Thinking and Doing II
Full course description
Thinking & Doing II, the final regular 8-week block of year 2, covers aspects of thinking (cognitive, motivational and emotional disorders as well as disorders of sensory systems such as the visual system, sense of touch and position) and aspects of movement(disorders related to the motor system, bones, muscles and joints). The block offers more in-depth knowledge as well as new subjects as a sequel to the issues discussed in the block on Thinking & Doing in year 1. The brain is the source of movement, posture, touch, vision, cognition, emotion and motivation. Disturbances of these systems may occur in isolation, but also in combination. Therefore, this block will show how subjects are integrated. The subjects will often be approached by means of clinical reasoning, which will be given a lot of attention so as to facilitate the transition to year 3. This implies that educational methods will be applied that are closer to real practice than those used before in the curriculum. The patient’s symptoms and complaints are used as a starting point, which means that a variety of block-related disciplines will be studied based on integrated patient cases. The block thus aims to train the students to consider differential diagnoses based on the patient’s symptoms. Aspects of ophthalmology covered in this block include the anatomy, physiology and pathophysiology of some common eye disorders and causes of visual impairment, including vision and several eye measurements. Thinking & Doing in year 1 focussed on the lower extremities. This block studies anatomy on the basis of spinal column and shoulder problems, the pathophysiology of osteoporosis and osteoarthritis, radicular problems (e.g. herniated disc) and nonspecific back pain, including the social consequences such as incapacity for work. The biospychosocial model will be introduced. Back problems are also used to study neuroanatomy (dermatomes, myotomes, peripheral nerves). Furthermore, the anatomy of the brain will again be addressed, now with special focus on stroke patients. Included are aspects of diagnostics (localisation principles), consequences for the patient, acute and long-term treatment. The block also covers a number of psychiatric disorders, again taking the patient’s symptoms and behaviour as a starting point. The clinical pictures of depression and dementia will be discussed, including the associated biological, psychological and environmental aspects. The students will also learn to conduct a mental state examination, which they will practice as part of their CORE training.
Eye: Anatomy: Functional anatomy of the eye, blood supply, adnexa, papilla and macula Physiology: Physiological optics Emmetropia and accommodation Ametropia, myopia, hypermetropia, astigmatism, presbyopia Functioning of the retinal receptors, organisation and conduction of stimuli Skills: Vision examination, far and close by Diagnostic refraction testing, Amsler, External inspection of the eye and adnexa with penlight/ophthalmoscope and loupe Locomotor/neurology: Anatomy: Spinal column, shoulder, spinal cord and nerve roots, trunk muscles Pathophysiology: Ageing of the spinal column and pathophysiology of osteoarthritis Osteoporosis: bone physiology, pathophysiology, symptoms, diagnostics and risk factors Pathophysiology of fractures and fracture healing Radicular syndrome Nonspecific low back problems Shoulder problems: dislocation, impingement Skills: Methodical examination of the cervical, thoracic, lumbar spinal column and shoulder based on case studies Brain/ neurology: Stroke: diagnostics, acute and long-term treatment Long-term consequences Skills: History taking and physical examination of stroke patients and examination of patients with radicular irritation in the leg (integration examination of the back and neurological examination) Brain/psychiatry: Regulation and dysregulation of emotion, motivation and cognition Biological, psychological, ecological aspects of depression and dementia and aspects of communication Skills: Mental state examination / Clinical reasoning based on symptoms Other aspects Work and health, organisation of healthcare Neurobiology of pain Biopsychosocial model Ethics concerning early diagnostics Gene environmental interaction, genetic vulnerability