MIND, BRAIN & BEHAVIOR (5115)
SEMESTER 1
Fall 2015
Course Directors
Steven Glasser, PhD, Professor, sglasser@auamed.net, Tel: 1-268-484-8900 x 1154
Office Hours: Monday – Friday 11:00 am – 1:00 pm and by appointment
Danny Wedding, PhD, Professor, dwedding@auamed.net, Tel: 1-286-484-8900 X 1587
Office Hours: Monday – Friday 11:00 am – 12:00 pm and by appointment
Lorde-Baltimore Schmidt, Administrative Assistant, Tel: 1-268-484-8900 X 1584
THEME: FUNDAMENTALS OF NEUROSCIENCE
Theme Director:
Steven Glasser, PhD, Professor, bglasser@auamed.net, Tel: 1-268-484-8900 x 1154
Office Hours: Monday – Friday 11:00 am – 1:00 pm and by appointment
Faculty:
Bolanthur Shivaraj, PhD, Professor, bshivaraj@auamed.net, Tel: 1-268-484-8900 x 1052
Eli Tumba Tshibwabwa, MD, Associate Professor, etumba@auamed.net. Tel: 1-268484-8900 X 1101
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THEME: NEUROLOGY
Theme Director:
Madeline Fraser, MD, Associate Professor, mfraser@auamed.net, Tel: 1-268-484-8900 x
1085
THEME: MEDICAL STUDENT & PHYSICIAN WELL-BEING, DOCTOR-PATIENT
RELATIONSHIPS, & MEDICAL ETHICS
Theme Director:
Danny Wedding, PhD, Professor, dwedding@auamed.net, Tel: 1-286-484-8900 X 1587
Office Hours: 11:00 am – 12:00 pm and by appointment
Faculty: Professor Lynn McKnight, lmcknight@auamed.net, Tel: 1-286-484-8900,
Ext. 1586
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TABLE OF CONTENTS
TOPICS
PAGE
BRIEF COURSE DESCRIPTION
4
EVALUATION
4
REQUIRED TEXTBOOKS
5
COURSE GOALS AND OBJECTIVES
6
COURSE CALENDAR
10
3
BRIEF COURSE DESCRIPTION
This four-semester multidisciplinary course is codirected by a developmental
neurophysiologist and a clinical psychologist who will be assisted by senior
faculty from almost every department in the School of Medicine (“Theme
Directors”). The course is designed to integrate what we know about the
human brain and its relationship to human behavior, especially in the context
of medicine, disease and psychopathology. The first semester consists
primarily of presentations and discussions of brain structures and systems
(including development, microscopic and gross anatomy of each component),
their functionality, pathophysiology, and their relevant clinical correlations.
We also will introduce you to clinical neuroimaging. In addition, the initial
lectures in the first semester will overview the explosion of knowledge that has
occurred in the neurosciences during the past two decades, discuss the
philosophical dilemma of mind and body, emphasize the primacy and
importance of the doctor-patient relationship, describe the types of ethical
dilemmas confronted by physicians, and illustrate the critical importance of
self-care for medical students, physicians and other health professionals.
Whenever possible, medical humanities will be used to illustrate the clinical
and scientific issues being discussed. The course is designed to progress
sequentially and logically across four semesters from the study of neurons to
examination of the societal issues confronting medicine in the 21st century.
EVALUATION
All exams this semester will be given in a “Block Exam” format. Mind, Brain &
Behavior questions will be categorized and you will receive a letter grade
based on your performance on those questions. As with all AUA courses, you
will be graded based on a Fail/Pass/High Pass/Honors grading system:
<70% Fail (F)
70-79% Pass (P)
80-89% High Pass (HP)
>90% Honors (H)
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REQUIRED TEXT BOOKS
Theme: MEDICAL STUDENT & PHYSICIAN WELL-BEING,
DOCTOR-PATIENT RELATIONSHIPS, & MEDICAL ETHICS
Required Text Books:
Black, D. W. & Andresean, N. C. (2014). Introductory Textbook of Psychiatry (6th Ed).
Washington, DC: American Psychiatric Association.
Wedding, D., & Stuber, M. L. (2010). Behavior and Medicine (5th Ed.). Cambridge, MD:
Hogrefe.
Reference:
Additional readings (available to all students on Blackboard) will be used to
supplement these lectures.
Theme: FUNDAMENTALS OF NEUROSCIENCE
Required Text Books:
Nolte, J. (2008). The Human Brain: An Introduction to Its Functional Anatomy. Latest
edition.
Guyton A.C., & Hall J.E. (2010). Textbook of Medical Physiology (12th Ed.) W. B. Sunders.
Haines, D.E. (2011). Neuroanatomy: An Atlas of Structures, Sections and Systems (8th
Ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Baynes, J. W. & Dominiczak, M.H. (2014). Medical Biochemistry (4th Ed.) Saunders
Elsevier, Chapter 41.1, Pages 551 – 563. (This book is available in our library; it is also
one of the recommended reference text books for Biochemistry)
Reference:
Additional readings (available to all students on Blackboard) will be used to
supplement these lectures.
5
COURSE GOALS AND OBJECTIVES
Goal 1: Appreciate the majesty and complexity of the human brain, recent advances in
neuroscience, and the challenges of understanding the linkage between brain and
behavior.
LECTURE 1
Objectives:
 Understand that the brain is a complex, multidimensional organ
 Appreciate that there have been tremendous advances in neuroscience in the past two
decades
 Acknowledge the fact that despite these advances, there is still much that is unknown
about the human brain
 Develop a sense of awe regarding the human brain
Goal 2:
Understand the mechanisms for particle movement through semipermeable
membrane and the mechanisms responsible for the establishment of a resting
membrane potential.
LECTURE 2
Objectives:
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Explain the difference between bulk flow and diffusion
Distinguish between the 3 processes not requiring energy with that requiring ATP
Define osmosis
Explain the concept of equilibrium both for changed and unchanged particles
Define permeability and the mechanism that determines an ion’s permeability
Differentiate between Nernst and Goldman Equations
Differentiate between an equilibrium potential and a steady- state potential
Goal 3:
Understand the mechanism underlying the development of an action
potential.
LECTURE 3
Objectives:
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Differentiate between sodium, potassium and chloride gradients and the driving forces
involved in the movement of these ions
Explain the difference between chemical and electrical gradients
Explain the difference between leak channels and voltage gated channels
6
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Explain the roles of sodium, potassium and the sodium/potassium pump in the
generation of the action potential
Differentiate between the absolute and relative refractory periods and their role in
action potential propagation
Explain the mechanism for propagation of the action potential
Define salutatory conduction
Define the role of myelin in conduction
Differentiate between CNS & PNS demyelination and its consequences
Goal 4: Understand the biochemistry of the brain.
LECTURE 4
Objectives:
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Define neurotransmitters
Classify neurotransmitters with well-known examples
Explain the biochemical nature of different neurotransmitters
Outline the pathways for the biosynthesis and degradation of common
neurotransmitters
Explain the neurotransmitter receptors and their general mode of action
Explain certain clinical consequences arising due to derangement in the metabolism
of neurotransmitters
Goal 5: Understand the mechanisms involved in synaptic neurotransmission.
LECTURE 5
Objectives:
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Differentiate between presynaptic and postsynaptic function
Define neurotransmitters and their classification
Explain the roles of depolarization and calcium permeability in
neurotransmitter release
Define the role of agonists and antagonists in synaptic function
Differentiate between voltage and ligand dependent responses
LECTURE 6
Objectives:
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Explain the mechanisms in the generation of excitatory and inhibitory postsynaptic
responses
Differentiate between temporal and spatial summation
Explain the consequences of decemental vs nondecremental conduction
Explain the role of the axon hillock and initial segment in the generation of a post
synaptic response
Differentiate between ionotropic and metabotopic synaptic function
Explain the mechanisms and consequences of axo-axonic synaptic interactions
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Goal 6: Understand the mechanism of skeletal muscle, cardiac muscle and smooth
muscle excitation and contraction.
LECTURE 7
Objectives:
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Explain the specificities found at the neuromuscular junction
Differentiate between an end-plate potential and a skeletal muscle action potential
Identify the sarcoplasmic reticulum and explain its role in muscle contraction
Explain the roles of calcium, thin filaments, and thick filaments in muscle contraction
LECTURE 8
Objectives:
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Compare and contrast skeleton muscle and cardiac muscle action potentials and their
resultant contractions
Explain the mechanism for generating prepotentials in cardiac muscle
Diagram the conduction system in cardiac muscle and explain how it functions
Discuss the mechanisms involved in smooth muscle contraction, and explain how it
differs from striated muscle contraction
Goal 7: Understand nerve muscle dysfunction related to clinical disease.
LECTURE 9
Objectives:
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Explain how muscle weakness can result from dysfunction from many different sites
in the motor system
Give examples of weakness resulting from dysfunction at a specific sites
Identify and give examples of the mechanisms involved in motor dysfunction at
specific sites
Identify specific motor disorders in patients as shown in brief video clips
Goal 8: Understand the organization and function of the autonomic nervous system
LECTURE 10
Objectives:
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Differentiate the functional organization of the somatic motor and autonomic motor
systems
Describe the functional organization of the parasympathetic motor system
Describe the functional organization of the sympathetic motor system
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LECTURE 11
Objectives:
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List neurotransmitters, agonists and antagonists involved in somatic motor function
List neurotransmitters, agonists and antagonists involved in parasympathetic function
List neurotransmitters, agonists and antagonists involved in sympathetic function
Explain how parasympathetic and sympathetic neurotransmissions modify the
function of the organs associated with the autonomic nervous system
Goal 9: Understand the major methods and methodologies used to view the human
brain.
LECTURE 12
Objectives:
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Identify the major methods used to visualize and evaluate the human brain
Describe which modality should be used in different clinical situations
Describe the advantages and disadvantages of each neuroimaging methodology
Goal 10: Understand the functional divisions of the central nervous system.
LECTURE 13
Objectives:
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Understand the basic functional anatomy of the central nervous system
Differentiate between the central nervous system and the peripheral nervous system
and their derivations.
Differentiate between primary brain vesicles and secondary brain vesicles
List the secondary brain vesicles, their principle derivatives and functions
Explain the functional development of telencephalic and diencephalic structures
LECTURE 14
Objectives:
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Draw the components of the brain stem
Identify the components of the mesencephalon and describe their function
Describe the functional organization of the pons
Describe the functional organization of the medulla
Describe the functions of the cerebellum
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List the cranial nerves associated with each region of the brain
LECTURE 15
Objectives:
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Draw a cross section of the spinal cord and include all the major components
Discuss the functional organization of the grey matter of the spinal cord
Discuss the functional organization of spinal white matter
Draw the cortical spinal tract from its origin in the cerebral cortex through the brain
stem, ending on spinal lower neurons
Goal 11: Understand the Organization of the Neuroaxis Based on Clinical
Correlations
LECTURE 16
Objectives:
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Describe clinical dysfunction in patients with lesions at various levels of the neuroaxis
Identify the major disorders associated with damage to the neuroaxis that are likely to
be encountered in clinical practice
Explain how a physician would evaluate a patient presenting with neurologic signs
and symptoms
Goal 12: Understand the ways in which some brains are exceptional, and be able to
give examples of geniuses, child prodigies, savants, and people with extraordinary
memories.
LECTURE 17
Objectives:
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Describe the ways in which people differ intellectually
List the components of Howard Gardner’s concept of multiple intelligences
Give examples of individuals with exceptional memory skills
Describe some of the exceptional abilities exhibited by people who have autism
spectrum disorder
Goal 13: Understand the stress and pressures associated with the practice of medicine,
and be aware of effective methods for coping with these pressures
LECTURE 18
Objectives:
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Describe the relationship between physician stress and substance abuse
Explain what is known about physician suicide vis-à-vis other populations and across
medical specialties
Describe the relationship that exists between physical and mental health
Describe the relationship between the practice of medicine and divorce
Identify creative and effective ways of coping with the stress of medical school and
medical practice
Goal 14: Discuss the Ethical Standards of the American Medical Association and the
American Psychiatric Association, including the guiding principles and decision-making
guidelines physicians use when confronted with ethical dilemmas.
LECTURE 19
Objectives:
 Identify the principle Ethical Standards of the American Medical Association and the
American Psychiatric Association.
 Differentiate the major ethical principles in medicine (e.g., nonmaleficence, fidelity,
autonomy, beneficence).
 Explain the limits of confidentiality including duty-to-warn issues
 Analyze several ethical dilemmas describing relevant ethical principles and decision
making strategies in small groups conducted by Introduction to Clinical Medicine
faculty.
Important Notes:
1. The students are advised to develop the habit of attending the classes regularly
(Please refer to the consolidated Calendar/Schedule of activities), as the overall
attendance of a student should not fall below 80% as per AUA rules.
2. Reading materials for different topics will be uploaded into Blackboard by the
faculty when required.
3. Students
are advised to go through the required text books/reading
materials/other reference text books (if necessary) for each topic in advance
(based on the learning objectives) before attending the lecture classes.
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COURSE CALENDAR
BLOCK 1
DATE
TOPICS
TIME
WEEK 1, Aug 17 - 21
TUE
18
1. Overview: What is the Brain? What is the Mind? Does it Matter? WEDDING/GLASSER
3 – 4 pm
THU
20
2. Resting Membrane & Action Potentials I GLASSER
3 – 4 pm
WEEK 2, Aug 24 - 28
TUE
THU
25
27
3. Resting Membrane & Action Potentials II GLASSER
4. Biochemistry of Neurotransmitters SHIVARAJ
3 - 4 pm
3 – 4 pm
WEEK 3, Aug 31 – Sep 4
TUE
1
5. Synapses I GLASSER
3 – 4 pm
WED
2
6. Synapses II GLASSER
3 – 4 pm
THU
3
7. Nerves & Muscles I GLASSER
2 – 3 pm
THU
3
8. Nerves & Muscles II GLASSER
3 – 4 pm
FRI
4
9. Nerve Muscle Functions with Clinical Applications FRASER
3 – 4 pm
WEEK 4, Sep 7 - 11
MON
7
10. Functions of Autonomic Nervous System I GLASSER
2 – 3 pm
MON
7
11. Functions of Autonomic Nervous System II GLASSER
3 – 4 pm
THU
9
MBB Block 1 Exam Review GLASSER
2 – 3 pm
WEEK 5, Sep 14 – 18
BLOCK 1 EXAM (Thursday, September 17)
BLOCK 2 (3 HOURS)
WEEK 6, Sep 21 - 25
FRI
25
MBB Post Block 1 Exam Review GLASSER
3 – 4 pm
WEEK 7, Sep 28 – Oct 2 (No MBB classes)
WEEK 8, Oct 5 - 9
FRI
9
12. Neuroimaging of the Brain TSHIBWABWA
3 – 4 pm
WEEK 9, Oct 12 – 16
FRI
16
13. Functional Overview I: Cerebral Cortex GLASSER
3 – 4 pm
WEEK 10, Oct 19 – 23
MON
19
14. Functional Overview II: Brain Stem GLASSER
2 – 3 pm
MON
19
15. Functional Overview III: Spinal Cord GLASSER
4 – 5 pm
TUE
20
16. Functional Overview IV: Organization of the Neuroaxis with Clinical Correlation GLASSER/FRASER
4 – 5 pm
WEEK 11, Oct 26 - 30
BLOCK 2 EXAM (Thursday, October 29)
BLOCK 3
WEEK 12, Nov 2 - 6
THU
5
Block 2 Post Exam Review
3 – 4 pm
WEEK 13, Nov 9 – 13 (No MBB classes)
12
WEEK 14, Nov 16 – 20 (No MBB classes)
WEEK 15, Nov 23 – 27
MON
23
17. Exceptional Brains WEDDING
3 – 4 pm
WED
25
18. Medical Student and Physician Well Being WEDDING
4 - 5 pm
THU
26
19. Medical Ethics McKNIGHT
3 – 4 pm
WEEK 16, Nov 30 – Dec 4
WED
2
2 – 3 pm
MBB Block 3 Exam Review
WEEK 17, Dec 7 – 11 (No MBB classes)
WEEK 18, Dec 14 – 18 (No MBB classes)
BLOCK 3 EXAM (Tuesday, December 15)
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