Thinking and Doing II
Full course description
This is the final regular 8-week course of year 2, covering 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 course offers more in-depth knowledge on previously seen topics as well as new subjects as a sequel to the issues discussed in the course 'Thinking & Doing I' 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 course will show how the different topics are integrated. The topics will often be approached by means of clinical reasoning, in order to facilitate the transition to year 3. This implies that educational methods closer to real practice will be applied. The patient’s symptoms and complaints are used as a starting point in most cases, leading to a final clinical case in which a variety of course-related medical disciplines will be integrated. The course thus aims to train the students to consider differential diagnoses based on the patient’s symptoms.
Aspects of ophthalmology covered in this course 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 course studies anatomy of the spinal column and shoulder problems, the pathophysiology of osteoporosis and osteoarthritis, radicular problems (e.g. herniated disc) and non-specific 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 course also covers cognitive and affective processing which are related to several psychiatric disorders. The students will also learn to conduct a mental state examination, which is part of the psychiatric interview.
Course objectives
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
Recommended reading
1. Neuroanatomy through clinical cases: a systematic approach (2010). Hal Blumenfeld. 2. Clinical Ophthalmology: a systematic approach (2011). JJ. Kanski, B. Bowling, KK. Nischal, & A. Pearson. 3. Stahl's essential psychopharmacology: neuroscientific basis and practical application 4. Guyton and Hall textbook of medical physiology (eBook 2016, free access UB). John E. Hall.