MED1022 Study Guide 2014

MED1022 Study Guide
2014
MED1022 Study Guide 2014
Contents
WEEK 1.................................................................................................... 1
WEEK 2.................................................................................................. 15
WEEK 3.................................................................................................. 31
WEEK 4.................................................................................................. 47
WEEK 5.................................................................................................. 61
WEEK 6.................................................................................................. 77
WEEK 7.................................................................................................. 95
WEEK 8................................................................................................ 109
WEEK 9................................................................................................ 121
WEEK 10.............................................................................................. 137
WEEK 11.............................................................................................. 153
WEEK 12.............................................................................................. 171
READINGS .......................................................................................... 187
ii
WEEK 1

Week 1
WEEK 1
Weekly Learning Objectives
By the end of this week it is expected that students will be able to:
discuss some of the issues and challenges related to doctors mental and physical health
define epidemiology and describe its use in public health
describe the different criteria for establishing causation
define the biopsychosocial framework in terms of the biological, psychological, sociocultural,
and life-cycle forces in development
describe and compare different life stages (from birth to death)
outline the embryology of the limbs
describe the anatomical features of the pectoral girdle, shoulder. and upper limb
outline the main motor fibre connections between the central nervous system and the
peripheries
describe the technology and elements of radiographic techniques and appreciate their use in
medicine
begin to appreciate the concept of clinical reasoning
outline key components of the clinical examination
practice history taking and examination of the musculoskeletal system
use this weeks PBL to integrate learning

Week 1
WEEK 1
Lecture04/01-P1 - Introduction to clinical examination
Theme:
IV
Discipline:
Clinical Skills
CMS Lecturer / Tutor

Dr Les Segal
Department of General Practice
Faculty of Medicine, Nursing & Health Sciences
Email: Les.Segal@monash.edu
Objectives:
After participating in this session, students should be able to:
describe the important general features of clinical physical examination
discuss advantages and disadvantages of peer physical examination
discuss the importance of privacy, confidentiality and limit setting during peer examination
Content synopsis:
The lecture will describe the important components of general physical examination. Issues addressed
will be the common barriers faced by students when they examine their peers or patients and barriers
for examinees. Practical solutions will be given and Monash policy discussed.
Keywords:
peer physical examination, consent, confidentiality
Readings:
Prescribed
Clinical Skills Student Participation Information Sheet on Moodle
Lecture will be uploaded on Moodle
Yes

Week 1
WEEK 1
Lecture04/01-P2 - Introduction to clinical reasoning
Theme:
IV
Discipline:
Clinical Skills

Dr Ian Presnell
School of Psychology & Psychiatry
Email: ian.presnell@monash.edu
Objectives:
After participating successfully in this session and related activities, students should be able to:
understand the different models used by medical students and experienced doctors in arriving
at a diagnosis
have applied the hypothesis testing modal to a series of non clinical and clinical situations
use the Dreyfuss model of skill acquisition to examine clinical reasoning with regard to
diagnosis
have a hypothesis testing interviewing model that is not content dependent to apply to
interviewing
be aware of common errors in clinical reasoning
Content synopsis:
Students will be guided through a consideration of which of 2 processes (data collection and
hypothesis testing) doctors use to arrive at a diagnosis when interviewing a patient. They will apply the
hypothesis testing modal to a series of non clinical and clinical situations. The Dreyfuss modal of skill
acquisition will be used to reinforce the application of the modal and orient students to the current
(presumed) competence in this skill and their anticipated development. The effect of specific patient
groups on the applicability of this modal (in particular on the type and range of hypotheses) will be
discussed Common errors in clinical reasoning will be discussed.
Readings:
Prescribed
Epstein O, Perkin GD, de Bono DP & Cookson J 2004 Clinical Examination 4th ed Mosby Ch 1
Cole SA & Bird J 2000 The Medical Interview 2nd ed Mosby, Unit 1 Ch 1-5
Recommended
The powerpoint presentation of this lecture will be available on Moodle at least one week prior
to the lecture.
Not advised at time of printing

Week 1
WEEK 1
Lecture03/01-P1 Embryology of the limbs
Theme:
III
Anatomy
Discipline:

Professor Paul McMenamin
Department of Anatomy & Developmental Biology
Email: paul.mcmenamin@monash.edu
Objectives:
After participating in this session, it is expected that students will be able to:
understand the timing, position and pattern of formation of the limb buds
understand the differentiation of the limbs
understand the origin of limb mesenchyme and mesoderm and their differentiation
appreciate that the limbs rotate in their orientation (ontogeny/phylogeny)
appreciate the factors that influence the pattern of innervation of the limbs
consider some congenital abnormalities and relevance of understanding limb development to
your future as a doctor
Content synopsis:
An overview of basic embryology to set the scene for when the limb bids appear.
A synopsis of how limb buds grow and which embryonic tissues contribute.
A summary of how limb development governs the pattern of motor and sensory innervations of
the limbs.
Readings:
Langmans Medical Embryology
Larsons Human Embryology
Yes

Week 1
WEEK 1
Practical_ANAT_03/01-P1 & P2 to 16-P1 & P2 - Upper limb I
Theme:
III
Discipline:
Anatomy

Dr Colin McHenry, Dr Justin Adams, Dr Galaxy Wong
Email: colin.mchenry@monash.edu
Demonstrators
PECTORAL REGION, SHOULDER REGION AND AXILLA
General aims and objectives this weeks classes
Gain an appreciation of the osteology of the bones of the pectoral girdle and shoulder joint.
Study some of the muscles of the pectoral girdle and shoulder region familiarise with the
concepts of muscle attachments, action, nerve supply.
Gain an understanding of the importance of knowing the position of local lymph nodes in
relation to disease spread.
Understand the concept of the axilla and its boundaries and contents.
Appreciate the concept of the neurovascular bundle of the limb passing through the
cervico-axillary canal (apex of the axilla) to enter the axilla.
Understand the formation of the brachial plexus from spinal nerves C5-T1.
Learn the major branches of the brachial plexus.
IMAGING-RADIOLOGY SESSION
Understand the fundamentals of plain radiography (different methods of obtaining images and 5
basic densities visible on X ray).
Study the sternum, clavicle, scapula and shoulder joint in X rays.
Ensure you can identify all the major bony landmarks of each of these bones (this will be
covered also in the Prosections session.
Study MRI and CT images of the pectoral region, axilla and shoulder.
Discuss very briefly the different appearances of tissues of various density in a CT compared to
an MRI.
Study and discuss imaging modalities of breast this will introduce you to the concept of cancer
and spread via lymph nodes.

Week 1
WEEK 1
Tutorial_04/01-P1 to 20-P1 Introduction to musculoskeletal history taking and
examination
Theme:
IV
Clinical Skills
Discipline:
Year 1 Clinical Skills Coordinator

Dr Nadida Kachkouche
Email: nadida.kachkouche@monash.edu
Associate Professor Jan Coles

Email: jan.coles@monash.edu
Objectives:
After participation in this tutorial students should be able to:
take a musculoskeletal history
recognise risk factors for musculoskeletal disorders
describe the general principles underlying musculoskeletal examination
Content Synopsis:
In this tutorial students will:
discuss the general principles of musculoskeletal history with their tutor (30 minutes)
discuss the risk factors for musculoskeletal disorders with their tutor (5 minutes)
practice taking a musculoskeletal history (60 minutes)
discuss with their tutor the general principles underlying musculoskeletal examination
(20 minutes)
Key words/phrases:
Risk factors, systems review, history of the presenting complaint, past history
Readings:
Prescribed
Talley N & OConnor S 2014 Clinical examination: A systematic guide to physical diagnosis
7th ed. Elsevier Australia Ch 23 & 24 pg 291-296 & 297-300
Recommended
Epstein O, Perkin G, De Bono D & Cookson J 2008 Clinical Examination 4th ed. Mosby Elsevier
Limited pg 267-272

Week 1
WEEK 1
Lecture03/01-P1 Musculoskeletal system of the upper limb
Theme:
III
Discipline:
Anatomy

Dr Colin McHenry
Objectives:
An overview will be given of the bones of the upper limb.
An overview will be given of the major joints of the upper limb and how they contribute to limb
function.
Students will get a brief explanation of the major muscle groups that cause movements across
the aforementioned joints.
The shoulder joint will be used to illustrate how to study a joint in thorough detail.
Content Synopsis:
This is the first time student will use their principles lectures from semester one to focus on a specific
anatomical problem.
We will use the shoulder joint as a narrative to help them appreciate the complexity of the structure
functions of this relationship.
Readings:
Moore & Dalley, Upper Limbs chapter introduction
Yes

Week 1
WEEK 1
Lecture03/01-P3 - Introduction to human lifespan development
Theme:
III
Discipline:
Human Lifespan Development

Dr Glenn Melvin
Department of Psychiatry
Email: glenn.melvin@monash.edu
MUSC Lecturer / Tutor

Dr Paul Jambunathan
School of Medicine & Health Sciences
Monash University Sunway Malaysia
Email: paul.jambunathan@monash.edu
Objectives:
At the end of this session, students are expected to be able to:
define the biopsychosocial framework in terms of the biological, psychological, sociocultural,
and life-cycle forces in development, and understand how they interact to shape development
describe and compare different life stages (from birth to death) within major developmental
theories
understand the importance of the individuals position in the lifespan to their behaviour and
cognitions
describe all eight of Ericksons Psychosocial Developmental Stages
explain how an individuals genes (nature) and environment (nurture) interact with each other to
influence development
Content synopsis
This module is a brief overview of:
the basic forces in the biopsychosocial framework, specifically the Biological, Psychological,
Sociocultural
the timing of these forces and how they make a difference in their impact across the lifespan?
the influence of Nature versus Nurture
major theoretical perspectives in human development across the lifespan, specifically
Psychodynamic (Erikson), *Learning (Bandura), Cognitive (Piaget, *Nave Theories), Lifespan
(Baltes)
*these aspects will be expanded on in later modules.
Key words/Phrases
Biopsychosocial Framework, Life Span Perspective, Developmental Theories, Nature/Nurture
Readings:
Prescribed
Kail RV & Cavanaugh JC 2013 Human Development: A Lifespan View 6th ed. Belmont CA:
Thomson/Wadsworth Ch 1 pg 5-22 (Thinking About Development)
Recommended online activity
Go to the following link http://www.learner.org/discoveringpsychology/development/ (Human
Lifespan Development: our amazing capacity for change), click on start flash activity and
explore each of the three domains (bio/psycho/social) across the lifespan (click on each
photograph from newborn to elderly).
Notes will be uploaded on Moodle
Yes

Week 1
WEEK 1
Lecture02/01-P1 Introduction to population health
Theme:
II
Discipline:
Population Health

Professor Robin Bell
School of Public Health & Preventive Medicine
Monash University, Alfred Hospital
Email: robin.bell@monash.edu
Sub Discipline:
Epidemiology

Associate Professor Quek Kia Fatt
Email: quek.kia.fatt@monash.edu
Objectives:
On the successful completion of this session, students will be able to:
define epidemiology and describe how it is used in public health
explain the concepts of sufficient and necessary in causation
describe the different criteria for establishing causation including temporal relationship,
plausibility, consistency, strength, dose-response relationship, reversibility and study design
explain the concept of confounding and describe how to control for confounding in order to help
establish causation
Keywords:
Epidemiology, public health, causation, necessary, sufficient, confounding
Assessment:
Formative:
Summative:
Small group work during tutorial

Revision quizzes (on Moodle)
Multi-choice and extended matching exam questions
Assignment on research design
Preparation for and contribution to, tutorials during the semester
Readings:
Prescribed
Basic Epidemiology by R Bonita, R Beaglehole & T Kjellstrom WHO 2nd ed. 2006
Ch 1 What is epidemiology pg 1-11
Ch 5 Causation in epidemiology pg 83-96
Twitter Feed
Please follow @PennyRobaus and @RobinBellAus and the #SPHPM twitter feed imbedded into
Moodle. Information page about Twitter will be placed on Moodle.
10

Week 1
WEEK 1
Tutorial_02/01-P1 to 20-P1 - Introduction to epidemiology and causation
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
On the successful completion of this unit, students will be able to:
define epidemiology and describe how it is used in public health
explain the concepts of sufficient and necessary in causation
describe the different criteria for establishing causation including temporal relationship,
plausibility, consistency, strength, dose-response relationship, reversibility and study design
establish causation
Keywords:
Epidemiology, public health, causation, necessary, sufficient
Assessment:
Formative:
Summative:

Learning materials:
Basic Epidemiology by R Bonita, R Beaglehole & T Kjellstrom WHO 2nd ed 2006. This book is to
be brought to class with you
Quiz questions - available on Moodle
Glossary available on Moodle
Videos to be viewed prior to the tutorial where indicated. Links will be provided in Moodle.
Readings:
Prescribed pre reading
11

Week 1
WEEK 1
Lecture03/01-P4 - Introduction to motor systems
Theme:
III
Discipline:
Physiology

Professor Marcello Rosa
Department of Physiology
Email:
Sub Discipline:
Neuroscience

Dr Badariah Ahmad
Email: badariah.ahmad@monash.edu
Objectives:
describe the differences between reflexive and voluntary movements
explain the importance of sensory information for motor control
describe the components of a motor unit
describe the connectivity and role of the upper and lower motor neuron systems
describe the symptoms of selective upper and lower motor neuron lesions
describe the general connectivity of brain regions involved in initiating and controlling
movements
explain the features of somatotopic organisation
Content synopsis:
This lecture outlines the main motor fibre connections (descending tracts) between central nervous
system and the peripheries eg pyramidal tracts and extra-pyramidal tracts. It details the voluntary and
reflexive motor regulation from different motor areas in the brain. It also introduces the concept of
body mapping or somatotopic organisation in the CNS. The voluntary nature of the motor system
and the importance of sensory input from the environment are also discussed in the lecture.
Keywords:
Upper and lower motor neuron; gamma motor neuron; somatotopic organisation; motor homunculus
motor cortex; Basal ganglia; cerebellum; brainstem; hyper-reflexia; hyper-tonia
Readings:
Recommended
Neuroscience Exploring the Brain 3rd ed. Bear, Connors & Paradiso Ch 14
Yes
12

Week 1
WEEK 1
Lecture03/01-P5 Principles of medical imaging I
Theme:
III
Discipline:
Anatomy
Sub Discipline:
Radiography

Associate Professor Marilyn Baird
Department of Medical Imaging & Radiation Sciences
Email: marilyn.baird@monash.edu
Objectives:
describe the technology involved in producing a plain radiograph
list measures used to protect the patient and staff from the effects of ionising radiation
list the elements comprising radiographic technique
understand the need for radiographers to control image quality factors
distinguish film screen radiography from computed radiography
list the criteria applied to plain radiographic projections when judging their adequacy and
capacity to answer the clinical question
distinguish between bones, joints and soft tissues on plain radiographs
describe the use of contrast media in radiography
distinguish between contrast studies of viscera from contrast studies of closed cavities
Content synopsis:
The x-ray tube and assembly, x-ray table, x-ray bucky, and control panel; units of radiation, the
ALARA principle, patient dose; exposure factors; radiographic contrast, radiographic density, image
resolution, distortion, magnification, collimation; x-ray film screen combinations and film processor;
computed radiography imaging plates, image processor and image archiving; radiographic
terminology, radiographic positioning principles, standardisation of radiographic projections, concept of
the central ray; visualisation of long bones, short and irregular bones, flat and pneumatic bones, and
accessory bones on images, determining ossification and skeletal age, visualising epiphysial plates
and growth on images, the radiological joint space, bony articular surfaces, fat soft tissue interfaces,
air-soft tissue interfaces and distinguishing intraluminal air or gas on images; contrast enhancement in
radiography; upper and lower GI studies, contrast radiography of the hepato-biliary system, urography
and cystography; angiography.
Readings:
Prescribed
Ch 24 Radiographic Anatomy and Imaging in Eizenberg N 2008, General Anatomy principles
and applications Sydney: McGraw-Hill
Recommended
Bontrager KL & Lampignano JP 2010, Textbook of radiographic positioning and related
anatomy St Louis: Elsevier
Yes
13

Week 1
WEEK 1
Lecture01/01-P1 Mental health enhancement
Theme:
Discipline:
Health Enhancement Program

Dr Craig Hassed
Email: craig.hassed@monash.edu
Objectives:
appreciate some of the challenges related to doctors health
understand some of the precursors for poor doctors health which have their origins in medical
student years
reflect upon some aspects of medical culture which may perpetuate poor health behaviours
understand some of the ways in which one can recognise a troubled peer
have a way of responding to such a situation if it should arise in a peer or oneself
Content synopsis:
This interactive seminar will explore some of the issues and challenges related to doctors mental and
physical health. Such challenges include burnout, depression, suicide, sleep problems, substance
abuse, and relationship problems. Some aspects of medical culture may play a role in perpetuating
these problems. Time will be spent exploring how to recognise a potentially troubled peer and what
sorts of actions might be appropriate in such circumstances. Indicators could include effects on
academic performance, interpersonal problems, emotional upsets, effects on cognition, poor health
habits, and effects on actions.
Keywords:
doctors health, depression, substance abuse, burnout, suicide, sleep problems, marriage, troubled
peers
Readings:
Prescribed
Course notes on Moodle
14
WEEK 2
15

Week 2
WEEK 2
define and calculate measures of frequency of disease, including risks, rates, incidence and
prevalence, risk difference, attributable fraction, population attributable risk and relative risk
describe patterns of health and disease using measures of mortality and morbidity
outline the anatomy of the peripheral nervous system and vascalature of the upper limb
understand the principles and applications of positive psychology
describe the anatomical features of the breast, axilla & arm
understand the basic principles of sensory processes
understand the mechanisms of reflexes and effector systems
describe early cognitive, physical, personality and social development
understand the basic principles of pharmacology and pharmacokinetics
practice musculoskeletal system examination of the shoulder
16

Week 2
WEEK 2
Lecture03/01-P6 Anatomy of the breast and axilla
Theme:
III
Discipline:
Anatomy
Sub Discipline:
Developmental Anatomy

Associate Professor Anthony Buzzard
Department of Surgery, Alfred Hospital
Email: anthony.buzzard@monash.edu
Objectives:
describe the anatomy of the breast (position, relations, blood supply, histological structure and
lymphatic drainage)
describe the boundaries, contents and openings of the axilla
describe the clinical anatomy of the arm
Content synopsis:
The important clinical and surgically relevant structures in the pectoral region, axilla and arm will be
discussed.
Keywords:
Breast, axilla, arm, lymph nodes
Readings:
Moore & Dalley, Upper Limbs chapter
Yes
17

Week 2
WEEK 2
Lecture03/01-P7 - Neural integration connections and pathways
Theme:
III
Discipline:
Physiology
Sub Discipline:
Neuroscience

Dr David Reser
Email: david.reser@monash.edu
Objectives:
After participating successfully in this session and related activities, it is expected that students will
have learnt:
the functional architecture of brain nuclei
the concept of cortical and subcortical processing networks, and parallel vs hierarchical
processing
feed forward vs feedback projections
population coding of information
neurotransmitter modulation of function
effects of brain lesions
fibers of passage vs local functional deficits
behavioural disorders and global brain states
Content synopsis:
the computing architecture of the brain (gray vs white matter, pyramidal vs non-pyramidal
neurons)
recurrent networks
parallel vs hierarchical information processing
memory consolidation in cortex
the concept of a cortical network
effects of lesions on information acquisition and processing
Keywords:
pyramidal neuron, feedback, feedforward, cortical laminae, gray matter, white matter, distributed
network, sparse coding, modulatory neurotransmitter, fiber of passage, mood disorder, depression
Readings:
Prescribed
Moodle notes on Neural integration.
Recommended
Siegel & Sapuru Ch 5
Siegel & Sapuru Ch 25 & 28
Yes
18

Week 2
WEEK 2
Lecture03/01-P8 - Pharmacokinetics I - Absorption and distribution
Theme:
III
Discipline:

Dr Elizabeth Davis
Department of Pharmacology
Email: elizabeth.davis@monash.edu
Pharmacology
Associate Professor Sunil Gurtu
Email: sunil.gurtu@monash.edu
Objectives:
describe how drugs are absorbed and distributed in the body
explain the terms pharmacokinetics, therapeutic index, bioavailability, volume of distribution,
half life, plasma protein binding
discuss how a knowledge of pharmacokinetics of a drug is important when considering the route
of administration, the dosing schedule, and ways of achieving safe therapeutic levels
Content synopsis:
This lecture will consider processes of pharmacokinetics of a drug, including absorption and
distribution within the body, and its relevance for routes of drug administration and dosing.
Keywords:
pharmacokinetics, absorption, distribution, routes of administration, bioavailability
Readings:
Prescribed
Basic and Clinical Pharmacology, ed BG Katzung, 12th ed. Lange Medical Books/McGraw Hill
Pharmacokinetics & Pharmacodynamics: rational dosing & the time course of drug action Ch 3
pg 37-51
Rang HP, Dale MM, Ritter JM, Flower RJ & Henderson G Pharmacology 7th ed. Churchill
Livingstone, Edinburgh; Drug absorption and distribution Ch 8 pg 99-114
Recommended
Birkett DJ Pharmacokinetics Made Easy 2nd ed. Ch 2 pg 8-14, Ch3 pg 15-22, Ch 5 pg 31-40,
Ch 8 pg 60-66, Ch 12 pg 97-106
Yes
19

Week 2
WEEK 2
Practical_ANAT_03/01-P3 & P4 to 16-P3 & P4 - Upper limb II
Theme:
III
Discipline:
Anatomy

Demonstrators
THE SHOULDER JOINT, ARM, ELBOW JOINT and FOREARM
General Aims and Objectives:
to learn about the bony, ligamentous, and muscular elements around the shoulder joint which
permit the high mobility of this joint
appreciate that this mobility has a cost in terms of stability
allow students to appreciate the concept of muscular compartments using the arm as an
example
to learn the anatomy and function of the elbow joint
to appreciate the clinical anatomy of the cubital fossa especially the position of nerves and
vessels as they cross the elbow region and the clinical implications of such relations during for
example venepucture procedures
appreciate the broad organization of the flexors in the forearm and the actions they perform
across the elbow, wrist and joints in the hand
understand the mechanisms of pronation and supination
IMAGING SESSION
Examine X rays of the shoulder joint. Discuss with tutors how recognising the normal anatomy
will aid in identifying pathology such as dislocations, arthritis and other common conditions.
Discuss arthroscopy and look at the images. These are difficult to interpret and we do not
expect you to identify details but just consider the principle and why they are performed.
Now examine MRI images of the shoulder to reinforce your understanding of the rotator cuff and
realtion of the axilla to the shoulder joint.
Examine images of the lower humerus and elbow joint.
Consider different views of the elbow as seen in X-rays.
Examine some angiograms of the upper limb.
Examine X rays of the wrist joint and distal forearm.
20

Week 2
WEEK 2
Tutorial_04/01-P2 to 20-P2 Musculoskeletal examination of the shoulder
Theme:
IV
Discipline:

Clinical Skills

Objectives:
After participating in this tutorial students will be able to:
review the anatomy and surface anatomy of the shoulder
take a basic history of musculoskeletal problems in the shoulder and relate the clinical
examination to the anatomy of the shoulder
perform a structured musculoskeletal examination of the shoulder
explain the clinical problem of rotator cuff syndrome
Content synopsis:
Clinical skills (2 hours)
Tutors will discuss the history taking of a patient presenting with shoulder complaint (10 minutes)
Tutors will demonstrate the musculoskeletal examination of the shoulder (25 minutes)
Students will identify shoulder anatomy landmarks to their tutor during the examination (10 minutes)
Students will practice musculoskeletal examination of the shoulder (60 minutes)
Discussion of the rotator cuff syndrome (10 minutes)
General principles of musculoskeletal examination
ask
look
feel
move
measure/ tests
compare
Key words/phrases:
Subluxation, dislocation, rotator cuff, system review
Readings:
Prescribed
7th ed Elsevier Australia Ch 24 pg 308-312 & 337-338
Epstein O, Perkin G, De Bono D & Cookson J 2008 Clinical Examination 4th ed Mosby Elsevier
Limited pg 279-281
21

Week 2
WEEK 2
Lecture03/01-P9 The peripheral nervous system and vasculature of the upper limb
Theme:
III
Discipline:
Anatomy

Dr Justin Adams
Email: justin.adams@monash.edu
Objectives:
describe the nerves and vessels of the upper limb
understand the relations of the neurovascular structures particularly superficial veins suited for
venepuncture
demonstrate the surface markings of pulses
demonstrate the sites that nerves and vessels are most at risk
understand the concept of nerve entrapements
Content synopsis:
The nerves and vessels of the upper limb will be described including their origins, pathways, important
relations and functions.
Keywords:
median nerve, ulnar nerve, radial nerve, myotomes, dematomes, cutaneous nerves,
musculocutaneous nerve, axillary artery, brachial artery, ulnar artery, radial artery, cubital veins
Readings:
Moore & Dalley
Yes
22

Week 2
WEEK 2
Lecture03/01-P10 - Pharmacokinetics 2: Metabolism and excretion
Theme:
III
Discipline:

Dr Elizabeth Davis
Pharmacology
Objectives:
describe the mechanisms for biotransformation of drugs in the body
identify factors such as age, nutritional status, disease and inter-individual variation that can
affect the rate of biotransformation
identify the major and minor routes of drug elimination
explain the concept of drug clearance
explain the terms loading dose, maintenance dose and steady state concentration
explain the difference between first order kinetics zero order kinetics, and its clinical relevance
discuss the importance of patient factors (such as impaired renal or hepatic function) upon drug
elimination
Content synopsis:
This lecture will consider ways in which drugs are cleared from the body and factors which can
influence this age, nutritional status, disease and inter-individual variation, induction/inhibition of liver
enzymes. The concepts zero order and first order kinetics, steady state, loading dose and
maintenance dose will be introduced.
Keywords:
clearance, elimination kinetics, biotransformation, cytochromeP450, drug-drug interactions, enzyme
induction, zero order kinetics, first order kinetics
Readings:
Prescribed
Basic and Clinical Pharmacology, ed BG Katzung 12th ed. Lange Medical Books/McGraw Hill
pg 37-51; Drug biotransformation Ch 4 pg 53-68
Livingstone, Edinburgh; Drug metabolism and elimination Ch 9 pg 115-122; Pharmacokinetics
Ch 10 pg 123-131
Recommended
Birkett DJ Pharmacokinetics Made Easy 2nd ed. Ch 1 pg 1-7, Ch 4 pg 23-30, Ch 6 pg 41-50,
Ch 7 pg 51-59, Ch 9 pg 67-75
Yes
23

Week 2
WEEK 2
Lecture03/01-P11 - Introduction to sensory systems ONLINE
Theme:
III
Discipline:
Physiology

Associate Professor Ramesh Rajan
Email: ramesh.rajan@monash.edu
Sub Discipline:
Neuroscience

Dr Badariah Ahmad
Objectives:
After having attending this lecture and studied the lecture notes, students should have learned:
the sensory modalities
the different senses have common anatomical and functional features
each sensory system however has a separate pathway from the receptor to the cerebral cortex,
which determines the modality
the forms and classification of sensory receptors
sensory receptors are specialized to transduce a particular form of stimulus energy
that a receptor transforms its selected form of energy into an electrical signal or receptor
potential
the receptor potential results from the opening/closing of specialized ion channels in the
receptor cell membrane
the receptor potential results in action potentials in primary afferent nerves
the pattern of action potentials encodes information about stimulus intensity and duration
Content synopsis:
Overview of sensory systems from receptor to cerebral cortex.
The main types of sensory receptors.
Classification of sensory receptors.
Characteristics of sensory stimuli.
Stimulus transduction- the conversion of a stimulus into a receptor potential.
Generation of nerve impulses in sensory neurons.
Examples of chemical and mechanical stimulus transduction.
Coding of stimulus parameters by nerve impulses.
Keywords:
sensory receptor. primary afferent nerve. central pathway. thalamus. primary sensory cortical area.
modality. stimulus energy. stimulus transduction. receptor potential. gated ion channels. generator
potential. action potential code. receptive field. adaptation rate.
Readings:
Recommended
Guyton 11th ed. Textbook of Medical Physiology Ch 46 Sensory Receptors and neuronal
Circuits for processing pg 572-584
Sherwood 3rd ed. Fundamentals of Physiology Ch 5 The Central Nervous System pg 109-143
Marieb 8th ed. Human Anatomy & Physiology Ch 12 The Central Nervous System pg 467-476
Yes
24

Week 2
WEEK 2
Tutorial_02/01-P2 to 20-P2 - Measuring disease-descriptive epidemiology
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
define and calculate measures of frequency of disease, including risks, rates, incidence and
prevalence and explain their inter-relationships
describe patterns of health and disease using measures of mortality and morbidity
define and calculate measures used for the comparison of disease occurrence including: risk
difference, attributable fraction, population attributable risk and relative risk
Keywords:
risk, rate, incidence, prevalence, mortality, morbidity, relative risk, risk difference, attributable risk
Assessment:
Formative:
Summative:

Assignment on study design
Learning materials:
Basic Epidemiology by R Bonita, R Beaglehole & T Kjellstrom WHO 2nd ed 2006. This book is
to be brought to class with you
Readings:
Prescribed
Ch 2 Measuring health and disease pg 15-35
Ch 3 Types of studies: Odds ratio pg 46
25

Week 2
WEEK 2
Lecture01/01-P5 What is a doctor 1?
Theme:

Professor Ben Canny
Deputy Dean, MBBS
Email: Ben.Canny@monash.edu
Objectives:
In a series of four interactive sessions, students will have the opportunity to interact with four
engaging, accomplished and diverse medical practitioners some established and distinguished,
others in formative stages of their professional careers.
The speakers have agreed to describe the professional and personal lives, share their formative
influences and reflect on their broad range of interests that shape and fulfil their careers. The speakers
come from a range of backgrounds: clinical, academic, laboratory, administrative, NGO, public health
and between them reflect a range of outcomes that a medical degree can lead to.
The purpose of the sessions is to expose students to a consideration of what is a doctor? and the
vast array of activities that you can be involved in.
This material is not examinable, but may be the most important sessions of your medical training. If
you want to open up your world, dont miss them!
No
26

Week 2
WEEK 2
Lecture03/01-P12 - Newborn and Infant Development
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
describe the names and significance of newborn reflexes, the use of these to determine health
of the newborn and the significance of persistent reflexes
describe the hereditary and environmental influences on temperament
describe physical and motor development from birth to 2 years of age
understand sleep patterns of the newborn and sleep disturbances
describe the individual and environmental influences on prenatal development and provide
examples of prenatal causes of developmental disability
Content synopsis:
This module covers early development, health issues of early development and temperament,
including:
assessments of newborn health, newborn reflexes, the Apgar and the Brazelton Neonatal
Behavioural Assessment Scales
heredity and the environmental influences on temperament, dimensions of temperament
including emotionality, activity, and sociability
the physical, motor and sensory development from birth to 2 years of age, including growth of
the body, and the emerging nervous system, moving and grasping, early motor skills,
locomotion, fine motor skills, sensory perception
sleep patterns of the newborn and sleep disturbances Individual and environmental factors that
can affect prenatal development during pregnancy, including maternal nutrition and stress,
drugs, infectious diseases, exposure to lead, mercury, and X-rays.
procedures used in ultrasound, amniocentesis, and chorionic villus sampling and the kind of
information each provides about prenatal development. Problems of prenatal development and
genetic counselling for prevention of some inherited disorders.
Key words/Phrases:
Motor Skills, Reflexes, Temperament, Brain development, Sleep, Sleep Disturbances, Embryo,
Prenatal Development, Prenatal Abnormalities, Teratogens
Readings:
Prescribed
Thomson/Wadsworth Ch 3 pg 82-93 (The Newborn, Early Motor Skills), Ch 2 pg 59-69
(Influences on Prenatal Development)
Recommended
Thomson/Wadsworth Ch 2 pg 42-58 (Heredity and From Conception to Birth) pg 70-77 (Labour
& Delivery)
Yes
27

Week 2
WEEK 2
Lecture01/01-P2 Positive psychology 1
Theme:
Discipline:
CMS Lecturers
Dr Joanna Mitchell
Email: joanna.mitchell@monash.edu
Dr Craig Hassed
Objectives:
After participating in these sessions, it is expected that students will be able to:
know the current extent of evidence supporting its use
understand and apply the happiness equation
personally apply some of the strategies for enhancing wellbeing
Content synopsis:
Positive Psychology is a new and expanding field of psychology which has created enormous interest
among researchers, clinicians and the general public over recent years. It focuses less on the risk
factors for poor mental health and focuses more on the attitudes, capacities and practices which can
cultivate positive states of psychological health. These lecture/seminars will draw heavily on the work
of Martin Seligman and focus on topics such as:
human flourishing
the role of pleasure, engagement and meaning
The Happiness Equation of H = S + C + V (Happiness = Set range + Circumstances + Voluntary
variables)
the predictors of happiness
the role of positive emotions and strategies to cultivate them
learned optimism
identifying and cultivating signature strengths
impacts of positive and negative psychological states on health and performance
Keywords:
positive psychology, happiness, human flourishing, pleasure, engagement, meaning, The Happiness
Equation, emotions, learned optimism, signature strengths
Readings:
No readings listed for this session.
28

Week 2
WEEK 2
Lecture03/01-P13 - Early cognitive development
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
describe and compare the basic assumptions of contemporary theories of cognitive
development
describe the major cognitive and behavioural changes that take place during infancy and
childhood in the areas of attention and memory
describe the major age-related changes that take place in childrens theory of mind.
apply, at an introductory level, their knowledge of cognitive development to clinical encounters
with children
be aware of the impact of motor, sensory and social impairments on cognitive development
Content synopsis:
This module focuses on cognitive development in childhood and covers:
Contemporary theories of cognitive development, including information processing, attentional
development, core-knowledge (nave theories), and sociocultural approaches
Childrens understanding of the concepts of life and death
Memory development
The development of theory of mind
Key words/Phrases:
Cognition, Learning, Information Processing, Memory, Connectionist Theories, Core-Knowledge,
Theory of Mind
Readings:
Prescribed
Thomson/Wadsworth Ch 4 pg 124136 (Piaget), 137-141 (Information Processing),
144-146 (Vgotsky) & 146-151 (Language Development)
Recommended
Morrison V, Bennett P, Butow P, Mullan B & White K 2012 Introduction to Health Psychology in
Australia 2nd ed Sydney, Pearson Ch 1 Lifespan, ageing and beliefs about health pg 14-17
Kail RV & Cavanaugh JC 2013 Human Development: A Lifespan View 6th ed. Belmont CA,
Thomson/Wadsworth Ch 3 pg 114-118 (Becoming self aware)
Yes
29

Week 2
30
WEEK 3
31

Week 3
WEEK 3
outline the impact of colonisation and government legislation on the health and well-being of
Indigenous Australians explain the concepts of reliability, validity, errors and confounding in
epidemiological studies
describe the characteristics of study designs used in epidemiology, ranging from case series,
descriptive studies, ecological studies, cross-sectional studies, case-control studies, cohort
studies to randomized controlled trials and meta- analyses
describe the anatomy of the upper limb (wrist and hand)
describe the anatomy of the forearm and elbow joint
describe the physiological and molecular mechanisms of muscle contraction
describe the mechanism and strength of muscle contraction
describe the muscle fibre types
describe muscle energy supply and adaptability
describe pharmacogenomics and its role in drug development
perform a structured musculoskeletal system examination focusing on the elbow, wrist & fingers
32

Week 3
WEEK 3
Lecture03/01-P14 Anatomy of the hand
Theme:
III
Discipline:
Anatomy

Dr Colin McHenry
Objectives:
understand the bones of the hand and wrist, the joints, muscles nerves and vessels
they should be able to relate this normal anatomy to examples of the surgical, orthopaedic and
clinical applications of hand and wrist anatomy
understand the wrist joint and its movements
describe the anatomy of the carpal tunnel, anatomical snuffbox, palmar aponeurosis
describe the short intrinsic muscles of the hand and their actions
describe the long or forearm muscles that act on the hand and their nerve supply and be able to
understand the basis of clinical tests of hand function
Content synopsis:
This lecture covers the anatomy of the wrist and hand
Keywords:
carpal tunnel, anatomical snuffbox, wrist, hand, fingers
Readings
Moore & Dalley, upper limb section, text dealing with wrist and hand
Yes
33

Week 3
WEEK 3
Lecture03/01-P15 Pharmacogenomics
Theme:
III
Discipline:

Dr Richard Loiacono
Email: richard.loiacono@monash.edu
Pharmacology
Dr Amudha Kadirvelu
Email: amudha.kadirvelu@monash.edu
Objectives:
After participating in this session and related activities, students should be able to:
describe the role of pharmacogenetics in variable responses to drugs
describe the role of polymorphic CYP P-450 enzymes in drug metabolism
describe polymorphisms that can directly and indirectly affect the drug response
define pharmacogenomics and describe its role in prospective drug development
Content synopsis:
This lecture describes how genetically predetermined differences in individuals leads to variations in
drug effectiveness and/or susceptibility to drug side effects. The effects of single nucleotide
polymorphisms (SNPs) in enzymes important in metabolising drugs and in specific receptors on
therapeutic effectiveness of drugs are highlighted. The growing important role of pharmacogenomics
for the individualisation of drug therapy is expanded upon.
Keywords:
polymorphism, variation in drug metabolism, variation in drug response, pharmacogenetics,
pharmacogenomics
Readings:
Recommended
Livingstone, Edinburgh Pharmacogenetics, pharmacogenomics & personalised medicine
Ch 11 pg 132-138
Yes
34

Week 3
WEEK 3
Lecture03/01-P16 - Muscle function - mechanism of contraction and cross bridge
function
Theme:
III
Discipline:
Physiology

Dr Wayne Sturrock
Email: wayne.sturrock@monash.edu
Sub Discipline:
Muscle Physiology

Dr Badariah Ahmad
Objectives:
explain in detail the basic structure of skeletal muscle at the level of the whole muscle and an
individual muscle cell
illustrate and explain in detail the main features of the thick and thin filaments in muscle
describe the mechanism whereby shortening of a muscle occurs during contraction
list in sequence the four major steps in the crossbridge cycle
describe the mechanism by which calcium regulates the contraction of skeletal muscle
Content synopsis:
Basic introduction to the different types of muscle found in the body.
Overview of the structure of skeletal muscle.
Description of the arrangement of the thick and thin filaments into sarcomeres.
Description of the main features of the thin and thick filaments.
Consideration of the sliding filament mechanism of contraction and how it leads to shortening of
the sarcomere.
Consideration of the interaction of myosin and actin in the crossbridge cycle and the role of
ATP.
Coverage of how calcium ions regulate the switching on and off of contraction through their
binding to troponin on the thin filament.
Keywords:
striated muscle; muscle fibres; myofilaments; sarcomere; sliding filament mechanism; crossbridges;
myosin ATPase activity; troponin and tropomyosin
Readings:
Sherwood Human Physiology 3rd ed. Ch 8 Muscle Physiology pg 203-235
Silverthorn Human Physiology An Integrated Approach 5th ed. Ch 12 Muscles pg 407-464
Guyton & Hall, Medical Physiology 11th ed. Ch 6 Contraction of Skeletal Muscle pg 73-83,
Ch 7 Excitation of Skeletal Muscle: Neuromuscular Contraction and Excitation-Contraction
Coupling pg 85-91 & Ch 84 Sports Physiology pg 1055-1060
Yes
35

Week 3
WEEK 3
Practical_ANAT_03/01-P5 & P6 to 16-P5 & P6 - Upper limb III
Theme:
III
Discipline:
Anatomy

Demonstrators
FOREARM, WRIST and HAND
General Aims and Objectives
Gain an appreciation of the general arrangement of the flexor and extensor muscles of the
forearm and their role in wrist movements and the power grip.
Understand the anatomy and movements of the wrist joint.
Appreciate the location of the major nerves as they cross the wrist and the clinical significance
of knowing this anatomy.
Understand the arrangement, insertions and the actions of the long flexors on the hand.
Study the short or intrinsic muscles of the hand and appreciate their role in fine movements of
the digits, especially opposition of the thumb.
Consider the range of movements of the hand
Study the position of superficial and neurovascular structures in the hand in relation to
vulnerability to cuts and their management.
To study and learn the motor and sensory innervation of the hand.
IMAGING SESSION
Appreciate the normal bony anatomy of the wrist and hand using plain X-ray.
Recognize major soft-tissue structures on MRI.
Compare the appearance of the wrist of a child and adult on imaging.
Appreciate the common injuries affecting the wrist and hand.
36

Week 3
WEEK 3
Tutorial_04/01-P3 to 20-P3 Musculoskeletal examination of the elbow, wrist, hand
and fingers
Theme:
IV
Clinical Skills
Discipline:


Objectives:
explain the functional anatomy of the elbow, wrist and hand
perform a structured musculoskeletal examination of the elbow, wrist and hand
take a basic history of musculoskeletal problems in the upper limb
relate the clinical examination to the anatomy and physiology of the upper limb
begin to understand pathological processes that may affect the elbow, hand and wrist, and their
clinical findings
Content synopsis:
Clinical skills (2 hours)
Tutors will discuss the history taking of a patient presenting with elbow, wrist and hand complaint
(20 minutes)
Tutors will demonstrate the examination of the elbow, wrist and hand to the students (25 minutes)
Students will identify elbow, wrist and hand anatomy landmarks to their tutor during the examination
(10 minutes)
Students will practice the examination of the elbow, wrist and hand (60 minutes)
Readings:
Prescribed
7th ed. Elsevier Australia pg 300-308 & 339
Recommended
Limited pg 283-290
Recommended viewing
Talley & OConnor DVD Examination 7
37

Week 3
WEEK 3
Lecture03/01-P17 - Muscle function - EC coupling and mechanics of contraction
Theme:
III
Discipline:
Physiology

Dr Wayne Sturrock
Sub Discipline:
Muscle Physiology

Dr Badariah Ahmad
Objectives:
illustrate or describe the relationships between the plasma membrane, transverse tubules and
sarcoplasmic reticulum in skeletal muscle cells
explain the role played by the sarcoplasmic reticulum in skeletal muscle
list in sequence the main steps in excitation-contraction coupling in skeletal muscle
distinguish between isometric, isotonic and eccentric muscle contractions
recognise and explain the consequences of skeletal muscles and bones of the skeleton working
together as lever systems
describe and explain the length-force relationship of muscle
Content synopsis:
Description of the membrane systems in skeletal muscle.
Consideration of the function of the sarcoplasmic reticulum in calcium uptake, storage and
release.
Consideration of the ordered sequence of events that couple excitation of a skeletal muscle to
contraction.
Description of the mechanical nature of different types of contractions.
Consideration of the mechanical advantages and disadvantages of the arrangement of muscles
and bones in lever systems.
Description of the relationship between a muscles length and the contractile force that it can
generate, and explanation of this based on the overlap of the thick and thin filaments within the
sarcomere.
Keywords:
T-tubules; sarcoplasmic reticulum; excitation-contraction coupling; calcium pump; muscle relaxation;
isometric contraction; isotonic contraction; eccentric contraction; length-force relation
Readings:
Silverthorn Human Physiology An Integrated Approach, 5th ed. Ch 12 Muscles pg 407-464
Yes
38

Week 3
WEEK 3
Lecture03/01-P18 - Muscle function - grading the strength of contraction
Theme:
III
Discipline:
Physiology

Dr Wayne Sturrock
Sub Discipline:
Muscle Physiology

Dr Badariah Ahmad
Objectives:
describe the relation between muscle contractile force and shortening speed
appreciate that muscle power output is related to both the force and velocity of contraction
explain how the frequency of excitation affects skeletal muscle contractions
describe in detail the organisation of nerves and muscles into motor units
describe the functional importance of motor units
describe how the strength of contraction can be graded in a whole skeletal muscle
Content synopsis:
Description of the dependence of muscle shortening speed on load, and consideration of the
role of the muscles myosin ATPase activity in determining muscle speed.
Introduction of the concept of power output by muscle.
Twitch, summated and tetanic contractions will be described and the mechanism of summation
and tetanus will be considered.
Definition of a motor unit and consideration of the main features of the arrangement of a whole
muscle into motor units.
The functional importance of motor units in allowing for the grading of contraction strength and
the sharing of contractile work between muscle fibres.
Summary of the mechanisms whereby the strength of contraction of skeletal muscle can be
graded.
Keywords:
twitch contraction; summated contraction; tetanic contraction; force-velocity relation; maximum
shortening velocity; power output; motor units; motor unit recruitment
Readings:
Yes
39

Week 3
WEEK 3
Theme:
Discipline:
CMS Lecturers
Dr Joanna Mitchell
Email: joanna.mitchell@monash.edu
Dr Craig Hassed
Objectives:
After participating in these sessions, it is expected that students will be able to:
know the current extent of evidence supporting its use
understand and apply the happiness equation
personally apply some of the strategies for enhancing wellbeing
Content synopsis:
Positive Psychology is a new and expanding field of psychology which has created enormous interest
among researchers, clinicians and the general public over recent years. It focuses less on the risk
factors for poor mental health and focuses more on the attitudes, capacities and practices which can
cultivate positive states of psychological health. These lecture/seminars will draw heavily on the work
of Martin Seligman and focus on topics such as:
human flourishing
the role of pleasure, engagement and meaning
The Happiness Equation of H = S + C + V (Happiness = Set range + Circumstances + Voluntary
variables)
the predictors of happiness
the role of positive emotions and strategies to cultivate them
learned optimism
identifying and cultivating signature strengths
impacts of positive and negative psychological states on health and performance
Keywords:
positive psychology, happiness, human flourishing, pleasure, engagement, meaning, The Happiness
Equation, emotions, learned optimism, signature strengths
Readings:
40

Week 3
WEEK 3
Tutorial_02/01-P3 to 20-P3 - Exposure assessment, error, validity, reliability and
confounding
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
define exposure and list common methods of measuring exposure
explain random error and systematic error in epidemiologic studies
establish causation
explain the difference between the concepts of validity and reliability
Keywords:
exposure, error, random, systematic, confounding, validity, reliability
Assessment:
Formative:
Summative:

Learning materials:
be brought to class with you.
Note:
This tutorial includes a practical exercise on shoulder measurement (available on the

Population Health part of the MED1022 section of Moodle) so there are no extra readings for
this tutorial.
Readings:
Prescribed
Basic Epidemiology by R Bonita, R Beaglehole & T Kjellstrom WHO 2nd ed 2006
Ch 9 Environmental and occupational epidemiology pg 145-161
Ch 3 Types of studies: potential errors in epidemiologic studies pg 51-58
41

Week 3
WEEK 3
Lecture03/01-P19 Muscle function - energy supply, fibre types and adaptability
Theme:
III
Discipline:

Dr Wayne Sturrock
Physiology
Professor Iekhsan Othman
Email: iekhsan.othman@monash.edu
Objectives:
understand that there are three metabolic pathways by which muscle cells can produce ATP
appreciate the importance of carbohydrates as a fuel source for high intensity muscle work
understand the classification of skeletal muscle fibers into 3 types
appreciate the main biochemical and contractile differences between the different muscle fiber
types
appreciate the functional role and capacity of the different fiber types
understand the basic nature of fatigue in skeletal muscle
appreciate the adaptations that skeletal muscle can undergo in response to its pattern of activity
Content synopsis:
Description of the three energy producing pathways in muscle (immediate, anaerobic and
aerobic pathways).
Classification of skeletal muscle fibres into three types based on their speed of contraction and
metabolic pathways.
Consideration of the main differences between the different muscle fiber types and the
consequences of these differences for their functional performance.
Consideration of the factors that can contribute to muscle fatigue, and of the intracellular
mechanisms that may be involved in muscle fatigue.
Description of how skeletal muscle adapts to endurance training.
Description of how skeletal muscle adapts to strength training.
Keywords:
creatine phosphate; ATP; glycolysis; oxidative metabolism; muscle glycogen; muscle fibre types; rate
of fatigue; oxidative capacity; muscle hypertrophy
Readings:
Yes
42

Week 3
WEEK 3
Lecture_INDIGENOUS/01 Indigenous Health
Theme:
Discipline:
Indigenous Health

Mr Hilton Gruis
Department of Rural & Indigenous Health
Phone: 5128 1002
Email: hilton.gruis@monash.edu
Objectives:
Discuss the impact of colonisation and past and present policy on Australian Aboriginal and
Torres Strait Islander peoples health at the organisational, community, and individual level.
Describe different indigenous worldviews (at the international level), speaking positions and
goals in relation to their health and well-being.
Content synopsis:
This lecture looks at the impact of colonisation and government legislation on the health and wellbeing of Indigenous Australians. It also provides students with an overview of the complexity of
Aboriginal health and ill health and examines access to health care systems and evaluates how
Indigenous communities, remote, rural and urban practise self-determination in the delivery of health
care and well-being.
Key Words/phrases:
Aboriginal; Torres Strait Islander; Social Determinants of Health
Readings:
Recommended
Taylor K & Guerin P 2010, Health Care and Indigenous Australians: Cultural Safety in Practice,
Palgrave McMillian, South Yarra
Yes
43

Week 3
WEEK 3
Lecture02/01-P2 Study design
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
describe the characteristics of the following study designs used in epidemiology, ranging from
case series, descriptive studies, ecological studies, cross-sectional studies, case-control
studies, cohort studies to randomized controlled trials and meta-analyses
given a description of a particular epidemiological study, identify the study design used
describe the features of a case-control study, potential sources of error in this study design and
explain how to calculate an odds ratio
describe the features of a cohort study, explain the strengths and weaknesses of this study
design and list the advantages that this study design has over that of a case-control study
describe the features of a randomized controlled trial and list the key features of the design that
make it the gold standard of research studies
list the advantages and disadvantages of each study design
identify and describe situations in which one might choose to use one study design rather than
another
Keywords:
study designs, levels of evidence, case series, ecological studies, cross-sectional studies, casecontrol studies, cohort studies, randomised controlled trials, meta-analyses
Assessment:
Formative:
Summative:

Readings:
Prescribed
Ch 3 Types of studies pg 39-60
Ch 4 Basic biostatistics: meta-analysis pg 81-82
Ch 5 Causation: study design pg 95-96
Ch 11 First steps in practical epidemiology pg 177-186
44

Week 3
WEEK 3
Lecture04/01-P3 - Clinical examination of the motor system
Theme:
IV
Discipline:
Clinical Skills

Adjunct Clinical Associate Professor Ernest Butler
Department of Medicine
Monash Medical Centre
Email: ernest.butler@monash.edu
Objectives:
After participating in this session and related activities, students should be able to describe a basic
examination of the motor examination of the peripheral nervous system.
Content synopsis:
The lecture will cover and outline the key elements of an organised and basic examination of the
motor elements of the peripheral nervous system.
Readings:
See clinical skills tutorial readings Week 6.
No
45

Week 3
46
WEEK 4
47

Week 4
WEEK 4
describe physical and social development in childhood
describe the development, structure and function of the nerves and vessels of the upper limb
describe the anatomy and organisation of the neurovascular components of the upper limb
describe bacterial pathogenesis
Introduction to Rural Health Program
recognise the important of place to health, illness, injury and health service delivery
describe the health, illness, community services and facilities available in a rural location
recognise how rural health differs across gender, age, race and sexual orientation
compare and contrast medicine in a rural context with their metropolitan experiences to date
48

Week 4
WEEK 4
Lecture03/01-P20 - Early and middle childhood development
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
On the successful completion of this session, students are expected to be able to:
describe the development of attachment and the differences between secure, avoidant,
resistant, and disorganized attachment
describe the different types of play and the importance of changes in peer interactions during
infancy and the preschool years
identify play behaviours that may be present in children with autism spectrum disorders
describe in depth the first three stages of Eriksons theory of psychosocial development
Content synopsis:
This module covers the major biopsychosocial factors in the transition from infancy to childhood
including an introduction to Eriksons theory of psychosocial development, development of attachment,
peer interactions and the importance of play on social development.
Key words/Phrases:
Attachment, Play, Psychosocial, Peer Interactions
Readings:
Prescribed
Thomson/Wadsworth Ch 5 pg 168-175 (attachment) & 183-190 (social development)
Recommended
Kail RV & Cavanaugh JC 2013 Human Development: A Lifespan View. 6th ed. Belmont CA:
Thomson/Wadsworth Ch 7 pg 266-272 (peers)
Yes
49

Week 4
WEEK 4
Lecture03/01-P22 Lower limb overview
Theme:
III
Discipline:
Anatomy

Dr Colin McHenry
Objectives:
briefly give an overview of the lower limb skeleton and joints
give a synopsis of the major muscle groups
give an overview of how lower limb anatomy differs from the upper limb and how it has some
similarities
consider the differences between the pectoral and pelvic girdles
Keywords:
Hp joint, knee joint, ankle joint, walking
Readings:
Prescribed
Moore & Dalley, Lower Limb chapter
Yes
50

Week 4
WEEK 4
Lecture03/01-P23 Bacterial pathogenesis 1
Theme:
III
Discipline:
Microbiology
Sub Discipline:
Bacteriology

Professor Julian Rood
Department of Microbiology
Email: julian.rood@monash.edu
Objectives:
recognise the significance of infectious disease as a global health issue
understand the mechanisms by which bacteria invade the human body and overcome host
defences
develop an appreciation for how bacteria can adhere to host cells and invade them
Content synopsis:
Bacterial pathogens and infectious disease.
The criteria establishing the connection between bacteria and disease (Kochs postulates).
Classical and emerging bacterial causes of infectious diseases.
Epidemiology.
Bacterial virulence factors and common themes in bacterial pathogenicity toxins, adhesion,
secretion and invasion.
Entry into the human body and adhesion.
Keywords:
bacterial pathogens, Kochs postulates, bacterial virulence, bacterial pathogenicity, epidemiology,
Mims model, bacterial toxins, bacterial adhesion, bacterial secretion, bacterial invasion
Readings:
Recommended
Goering et al 2013 Mims Medical Microbiology, Mosby 5th ed.
Cossart P, Boquet P, Normark S & Rappouli R 2000 Cellular Microbiology, ASM Press,
Washington, DC
Salyers AA & Whitt DD 2002 Bacterial Pathogenesis: A Molecular Approach 2nd ed. ASM Press,
Washington, DC
Yes
51

Week 4
WEEK 4
Tutorial_INTEGRATED_03_04/01 to 20 Upper limb revision Integrated Anatomy and
Clinical Skills
Theme:
III and IV
Anatomy and Clinical Skills
Discipline:

Professor Paul G McMenamin


Objectives:
take a basic history of musculoskeletal problems in the upper limb
review the anatomy and surface anatomy of the shoulder, elbow, wrist and hand
explain the functional anatomy of the shoulder, elbow, wrist and hand
perform a structured musculoskeletal examination of the shoulder, elbow, wrist and hand and
locate the position of major sites where pulses can be felt in the upper limb and know the
relations of the arteries in these locations
locate the major veins in the upper limb in relation to venepuncture
locate, describe and if possible palpate the major pathways of the ulnar, median, radial, and
axillary nerves in the upper limb
appreciate the distribution of the dermatomes and cutaneous nerve territories in the upper limb
(and know the difference between these two terms)
Content Synopsis:
Students have covered anatomy, history taking and examination of the musculoskeletal system of the
upper limb in the previous three weeks.
This is a 2 hour session (1 hour Anatomy and 1hour Clinical Skills) 5 anatomy tutors and 5 CS tutors
are needed for this tutorial
In CS tutorial (1 hour), tutors will divide the students into groups of three.
Students will be given a case to practice history taking, reflect on the positive and negative findings,
the pattern of the symptoms and the risk factors and try to generate a list of 3 or 4 possible differential
diagnosis. They will then examine the patient (peer student), ask for the examination findings
positive and negative and then reflect again on the findings and re-evaluate your working diagnosis.
Cases will then be discussed as a group with your tutor.
Readings:
All prescribed and recommended readings from anatomy and clinical skills weeks 1, 2 & 3.
52

Week 4
WEEK 4
Lecture_Rural/01-P1 Rural Health: Setting the Scene
Discipline:
Rural
*NB No content provided at the time of printing. Please check Moodle for material or contact
the School of Rural Health.
53

Week 4
WEEK 4
Lecture_Rural/01-P2 Dealing with chronic illness in a rural area
Discipline:
Rural
Please note, further details will be provided on Moodle as required.
54

Week 4
WEEK 4
Tutorial_Rural/01-P1 to 20-P1 Rural health understandings
Discipline:
Rural

Dr Margaret Simmons
Gippsland Medical School, School of Rural Health
Phone: 5122 6157
Email: margaret.simmons@monash.edu
Objectives:
At the completion of the Rural Health Understandings tutorial, students should be able to:
develop and apply a social perspective on health with particular reference to rural contexts
identify a range of factors that can impact on health and well-being in rural communities
recognise the diversity of rural communities and the need for a community approach to health
explore implications for the role of health care practitioners in rural settings
Content synopsis:
The Rural Health Understandings tutorial provides an overview of rural health issues from a social
perspective, exploring what is meant by rurality and the range of factors that can impact on health and
wellbeing in rural communities. It will explore what students about rurality and look at the diversity of
rural communities and reflect on doctoring in such communities.
Keywords:
Social perspectives of health a social or sociological perspective that focuses on the many social
influences on health and illness.
Rurality there is no agreed definition of rurality, however in health studies, access to health care
and services often defines whether people are considered rural. About a third of Australias population
live outside metropolitan areas which are often described as rural and/or remote or regional.
Readings:
No prescribed readings for this session.
55

Week 4
WEEK 4
Tutorial_Rural/01-P2 to 20-P2 Indigenous cultural safety
Discipline:
Rural
56

Week 4
WEEK 4
Tutorial_Rural/01-P3 to 20-P3 Rural assignment group tutorial
Discipline:
Rural

Ms Laura Major
Manager, Rural Education Program
School of Rural Health
Phone: 9905 1521
Email: laura.major@monash.edu
Objectives:
At the completion of this session, students should be able to:
identify the importance of the rural context on health, illness, injury and health services delivery
in relation to people with a chronic illness and their carers
describe some of the clinical and non-clinical services and facilities available to people who
have the condition (described in the case scenario related to the 2013 rural assessment task)
and their carers in a rural location by producing a concept map
understand the importance of coordination of care for people with complex or chronic conditions
understand the importance of teamwork and collaboration in caring for people with complex or
chronic conditions
Content synopsis:
During this session, students will work on the Year 1 rural assignment. Students will work together to
gather and pool information from a variety of sources in order to map the services that could be
accessed/utilised by an individual described in the assignment scenario.
Keywords:
rural, rural health, context, community, access, equity, culture, gender, diversity, regional, remote
Readings:
Websites
Echidna health services profiles
www.med.monash.edu.au/srh/resources/echidna/index.html
Please note: Further details will be provided on Moodle as required.
No
57

Week 4
WEEK 4
Lecture_Rural/01-P3 Rural Health: Voices of the region
Discipline:
Rural

Professor Judi Walker
Phone: 9905 1521
Objectives:
Following the Voices of the Region session, students should be able to:
discuss the impact of context on health, illness and well being
identify the issues outlined by key stakeholders relating to health and health care in rural
settings
frame questions for stakeholders that can contribute to their own understanding of health and
health service delivery in rural settings
the importance of contexts on health, illness, injury and health services delivery
the health, community services and facilities available in a rural location
Content synopsis:
During this session, students will have the opportunity to develop greater insight into rural
communities and the factors that influence health by attending presentations by keynote speakers
from rural communities where each speaker will share their perspectives on working and living in a
rural context.
Keywords:
Rural, rural health, context, community, access, equity, culture, gender, diversity, regional, remote
No
58

Week 4
WEEK 4
Lecture_Rural/01-P4 Rural Health Q&A - Panel discussion and debrief
Discipline:
Rural

Professor Judi Walker
Phone: 9905 1521
Objectives:
Following the Community Perspectives: Rural Q & A session, students should be able to:
relate responses of stakeholders to the importance of contexts on health, illness, injury and
health services delivery
consider community perspective of the community services and facilities available in a rural
location
Content synopsis:
During this session, students will have the opportunity to develop greater insight into rural
communities and the factors that influence health by attending a rural Q & A forum with
representatives from rural communities and discussing a range of issues influencing health that are
important to rural communities
Keywords:
Rural, rural health, context, community, access, equity, culture, gender, diversity, regional, remote
Readings:
No
59

Week 4
60
WEEK 5
61

Week 5
WEEK 5
describe the concept of random sampling from a population, sampling variability and interpret
confidence intervals
explain standard error of mean, confidence interval for a mean and confidence intervals
between two means
describe physical and social development in adolescence
describe strategies for improving personal performance
outline the principles and applications of mindful practice and self-monitoring
describe Millers levels of performance and outline concepts related to learning
describe physical and social development in adolescence
outline structure and organization of the autonomic nervous system
understand the autonomic circuitry in the central nervous system and major visceral afferent
pathways
understand nerve signalling in the autonomic nervous system (ANS)
understand feedback control of key autonomic centres in the brain
describe a basic understanding of the autonomic nervous system (ANS)
describe bacterial invasion of and survival in cells
demonstrate the key steps for taking a basic focused history of the peripheral nervous system
62

Week 5
WEEK 5
Lecture03/01-P24 - Overview of autonomic nervous system
Theme:
III
Discipline:

Professor Helena C Parkington
Email: helena.parkington@monash.edu
Physiology
Dr Ishwar Parhar
Email: ishwar.parhar@monash.edu
Objectives:
After participating successfully in this session and related activities, students should understand:
the general anatomical arrangement of the autonomic nervous system (ANS)
the main functions of the ANS
the sympathetic and parasympathetic divisions of the ANS
how the ANS can achieve such a wide range of functions
the role of the adrenal medulla in ANS function and our ability to survive trauma
Content synopsis:
The major role of the ANS is to ensure internal body homeostatis in a variable world. The ANS
ensures that we survive today to reproduce tomorrow. To achieve this, the ANS provides input to most
systems of the body, increasing or suppressing individual organ activity to ensure functioning of the
body as a whole. The diverse activity required to achieve these objectives means that diversity is a
prominent factor in the ANS. The two major divisions of the ANS will be discussed. Then we will
consider how further refinement of activity can be achieved by the use of multiple neurotransmitters,
and multiple receptors for each neurotransmitter. The human sexual response will be used to
demonstrate how these two divisions, multiple transmitters, and receptor variability work in harmony to
bring about complex functions. The role of the adrenal medulla will also be discussed.
Readings:
Pre Reading
Moodle notes on Neurotransmission
Recommended
Bear MF, Connors BW & Paradiso MA 2007, Neuroscience: exploring the brain Ch 15
Wilson-Pauwels, Stewart, Akesson, Autonomic Nerves. BC Decker (had really useful clinical
examples, and basic explanations)
Yes
63

Week 5
WEEK 5
Theme:

Professor Ben Canny
Deputy Dean, MBBS
Email: ben.canny@monash.edu
Objectives:
No
64

Week 5
WEEK 5
Lecture03/01-P31 Discriminative somatic sensation
Theme:
III
Discipline:
Physiology
Sub Discipline:
Neuroscience/Physiology

Objectives:
After having attending this lecture and studied the lecture notes, students should have learned:
the receptors and primary afferents responsible for discriminative touch
the response properties of the receptors
the receptors and primary afferents responsible for the sense of joint position and movement
how the receptors signal joint position and movement
the organization of the discriminative somatic sensory pathway to the cerebral cortex
how sensation from the body is organized in somatosensory cortex
Content synopsis:
The receptors responsible for discriminative touch and the response properties and receptive fields of
the receptors. How touch discrimination varies over the body. The structure and properties of muscle
spindles and their role in signalling joint position and movement. The ascending discriminative sensory
pathway from receptor to cerebral cortex. How sensation from the body is mapped in the cerebral
cortex.
Keywords:
discriminative touch. encapsulated cutaneous receptors. receptive field. adaptation. joint position
sense. muscle spindles. thick nerve fibres. low threshold mechanoreceptors. dorsal column-medial
lemniscal system. primary somatosensory cortex. topographical organization. somatotopy
Readings:
Siegel & Sapru Ch 9 & 15
Moodle notes on Discriminative somatic sensation
Yes
65

Week 5
WEEK 5
Practical_ANAT_03/01-P9 & P10 to 16-P9 & P10 - Lower limb I
Theme:
III
Discipline:
Anatomy

Demonstrators
Objectives:
describe the important features of the femoral shaft and surrounding muscles
define the boundaries of the thigh compartments and describe their contents
describe the major arteries and nerves of the thigh
demonstrate the surface anatomy of the thigh
Content synopsis:
This practical comprises six tasks as follows:
1.
Review the features of the shaft of the femur, explaining the clinical relevance of these
features.
2.
Categorise and review the muscles of the thigh.
3.
Review the femoral artery and its branches, the femoral and great saphenous veins, and the
inguinal lymph nodes.
4.
Review the femoral, obturator, and lateral cutaneous nerve of the thigh, also reviewing the
clinical applications of these nerves.
5.
Review the boundaries of the femoral triangle and the adductor canal.
6.
Classify the surface anatomy features of the thigh and femoral triangle, demonstrating them
and indicating clinical situations when this knowledge may be useful.
Keywords:
femur, thigh, anterior thigh compartment, medial thigh compartment, posterior thigh compartment,
femoral nerve, obturator nerve, lateral cutaneous nerve of the thigh, femoral triangle, adductor canal,
surface anatomy
Readings:
Lab book and Moore & Dalley, Lower Limb chapter
66

Week 5
WEEK 5
Tutorial_04/01-P4 to 20-P4 - Peripheral nervous system history taking
Theme:
IV
Clinical Skills
Discipline:


Objectives:
After participating in this tutorial, students will be able to:
take of a basic neurological history
discuss the general principles of peripheral neurological examination
identify the risk factors for peripheral neurological disease
Content synopsis:
In this tutorial you will:
discuss neurological history (30 minutes)
discuss the risk factors for peripheral neurological disease (10 minutes)
discuss the general principles of peripheral neurological examination (15 minutes)
practice taking a neurological history (60 minutes)
Key words/Phrases:
Risk factors, systems review, vertigo, paraesthesia, anaesthesia, seizures or fits
Readings:
Prescribed
7th ed Elsevier Australia pg 393-399 & 436-437
Recommended
Limited pg 362-369 & 373-380
67

Week 5
WEEK 5
Theme:
III
Discipline:
Microbiology
Sub Discipline:
Bacteriology

Objectives:
understand how bacteria invade non-phagocytic cells
understand how bacteria avoid host cell defences
know how bacteria can grow and survive in phagocytic cells
Content synopsis:
Evasion of host defences. Interaction with non-phagocytic and phagocyctic cells.
Secreytion systems.
Survival and growth within phagocytes.
Intracellular niches occupied by bacterial cells.
Escape from the phagolysosome.
Cell to cell spread.
Keywords:
phagocytes, lysosomes, zipper and trigger invasion mechanisms, type III secretion systems,
opsonosation, actin polymerisation, intracellular pathogens
Readings:
Recommended
Goering et al, 2013 Mims Medical Microbiology, Mosby 5th ed.
Washington, DC
Washington, DC
Yes
68

Week 5
WEEK 5
Lecture03/01-P33 - Pain and temperature sensations
Theme:
III
Discipline:
Physiology

Sub Discipline:
Neuroscience

Dr Badariah Ahmad
Objectives:
After having attending this lecture and studied the lecture notes, a student should have learned:
that somatic sensation is generally Sub Divided into discriminative and none discriminative
components
that pain and temperature sensations are classified as non-discriminative
that these sensations are subserved by unencapsulated receptors and thin diameter primary
afferent fibres
the pathway to the cerebral cortex for non-discriminative sensation
the properties of thermoreceptors
the properties and types of nociceptors
how nociceptors are activated and sensitized
Content synopsis:
Overview of somatic sensation.
Why somatic sensation is Sub Divided into discriminative and non-discriminative components.
The primary afferents that subserve pain and temperature and their pathway to the cerebral
cortex.
Classification and function of thermoreceptors.
The types of nociceptors and their roles in sharp and burning pain.
Stimulus transduction by nociceptors.
Receptor sensitization.
Keywords:
pain and temperature. non-discriminative sensation. nociceptors and thermoreceptors. thin nerve
fibres. the spinothalamic tract or anterolateral system.crossing of pathway in spinal cord.
thermoreception. nociception. polymodal receptor.tissue damage and inflamation. receptor
sensitization. hyperalgesia.
Readings:
Recommended
Guyton 11th ed Textbook of Medical Physiology Ch 48 Somatic Sensation pg 598-609
Sherwood 3rd ed Fundamentals of Physiology Ch 5 The Central Nervous System pg 109-143
Yes
69

Week 5
WEEK 5
Lecture03/01-P21 - Adolescent development
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
On the successful completion of this session, students are expected to be able to:
describe physical development and the causes of puberty
summarise the tasks of adolescence and recognise the implications of cognitive impairment for
these tasks
describe health conditions prevalent in adolescents
describe biological, social and behavioural aspects of coupling and sexuality in adolescence
understand the main threats to health in early adulthood, and the tension between autonomy
and duty of care for adolescents with and without cognitive impairments
describe in depth the last five stages of Eriksons theory of psychosocial development
Content Synopsis:
Physical changes associated with puberty, the growth spurt, sexual maturation and hormones,
environmental and genetic influences.
Health conditions of adolescence including bulimia, anorexia, over weightness.
Adolescent sexuality, including dating, sexuality, contraception, sex education, sexually
transmissible infection.
Negative health related behaviours, including drug use, dietary habits, and the beginnings of
chronic illness.
The second half of Eriksons model of development will be described with examples from each
of the stages.
Keywords:
Puberty, Menarche, Spermarche, Anorexia and Bulimia Nervosa, Body Mass Index, Nutrition,
Sexuality, Contraception, STIs, Sex Education, Smoking, Binge Drinking
Readings:
Prescribed
Thomson/Wadsworth Ch 8 pg 286-300 (Pubertal Changes, Health), Ch 10 pg 261-265 (Physical
Development & Health) & Ch 9 pg 324-328 (Romantic Relationships and Sexuality)
Recommended
Thomson/Wadsworth Ch 9 pg 316-323 (Identity & Self Esteem) & Ch 10 pg 362-367 (Cognition)
70

Week 5
WEEK 5
Tutorial_02/01-P4 to 20-P4 Study design
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
describe the characteristics of the following study designs used in epidemiology, ranging from
case series, descriptive studies, ecological studies, cross-sectional studies, case-control
studies, cohort studies to randomized controlled trials and meta-analyses
given a description of a particular epidemiological study, identify the study design used
describe the features of a case-control study, potential sources of error in this study design and
explain how to calculate an odds ratio
describe the features of a cohort study, explain the strengths and weaknesses of this study
design and list the advantages that this study design has over that of a case-control study
describe the features of a randomized controlled trial and list the key features of the design that
make it the gold standard of research studies
list the advantages and disadvantages of each study design
identify and describe situations in which one might choose to use one study design rather than
another
Keywords:
case control, cohort, randomised controlled trial, meta-analysis, cross-sectional, ecological
Assessment:
Formative:
Summative:

Learning materials:
Readings:
Prescribed
71

Week 5
WEEK 5
Acad_Briefing_SITE_VISIT_04/01 - Geriatric site visit academic briefing
Theme:
IV
Discipline:
Clinical Skills

Professor Barbara Workman
Email: barbara.workman@monash.edu
Objectives:
After participating in this session and related activities, students should be able to prepare for your
FIRST YEAR CLINICAL SKILLS SITE VISIT which will be held in a Geriatric Medical Unit.
Content synopsis:
The lecture will cover what to expect during the visit.
The first visit will focus on musculoskeletal examination, and the second visit will focus on neurological
examination.
Because you are visiting a hospital, there will be other important clinical experiences besides learning
and practising your clinical examination skills.
You will have the opportunity to practise your communication skills with patients and other health
professionals, learn about professional behaviour in a hospital environment, and learn about some of
the conditions which affect muscles and nerves and see how the examination provides diagnostic
information.
You will have the opportunity to develop an understanding of a subacute hospital facility including the
range of conditions treated, resources available, and how this clinical environment differs from an
acute hospital. You may have the opportunity to learn about the roles of other health professionals in a
multidisciplinary team.
You will be able to reflect on what the patient has been through to get to where they are in their
progression from acute or elective presentation to ultimately returning home.
Keywords:
geriatric medicine, musculoskeletal examination, neurological examination
Readings:
Prescribed
Epstein O, Perkin GD, de Bono DP & Cookson J 2000 Clinical Examination 2nd ed. Mosby
Ch 10 pg 255-295
Tutorial notes for musculoskeletal examination will be in your workbook
Tutorial notes for neurological examination will be in your workbook
Yes
72

Week 5
WEEK 5
Lecture03/01-P35 Pain
Theme:
III
Discipline:
Physiology

Sub Discipline:
Neuroscience

Dr Badariah Ahmad
Objectives:
After having attending this lecture and studied the lecture notes, students have learned:
that pain has important protective, warning and healing functions
the sources of head pain
how visceral pain is generated and why it can be referred to the surface of the body
that pain can be generated pathologically without nociceptor activation
the main classes of analgesic drugs and where they act in the nociceptive system
that the body has an intrinsic descending inhibitory pathway that can modulate nociceptive input
Content synopsis:
The functions of pain.
Life without pain.
Neurogenic inflamation and healing.
Head pain and its sources.
How visceral pain arises.
Localization of visceral pain and referred pain.
Abnormal forms of pain.
Main types of analgesic drugs and their sites of action.
The intrinsic analgesic system.
Activation of the intrinsic analgesic system for the clinical relief of pain.
Keywords:
warning ,healing and protective functions. headache. visceral and referred pain. abnormal pain.
analgesia. non-steroidal anti-inflamatory drugs and neurogenic inflamation. opiodes and presynaptic
inhibition. intrinsic analgesic system. endogenous opiodes.
Readings:
Yes
73

Week 5
WEEK 5
Lecture02/01-P3 Sampling
Theme:
II
Discipline:
Population Health

Ms Penny Robinson
Email: penny.robinson@monash.edu
Sub Discipline:
Epidemiology

Objectives:
describe the concept of random sampling from a population
explain the concept of sampling variability
describe the principles of how statistical theory is used to quantify the uncertainty in the result of
a single study
explain the difference between population parameters and sample statistics
explain the following terms: standard error of the mean, confidence interval for a mean,
confidence interval for the difference between two means
interpret confidence intervals in published research papers
Keywords:
Sampling, random, population parameters, sample, statistics, standard error, confidence interval
Assessment:
Formative:
Summative:

Readings:
Prescribed
Ch 4 Basic biostatistics: concepts and tools pg 63-82
74

Week 5
WEEK 5
Lecture03/01-P29 Autonomic nervous system - central system
Theme:
III
Discipline:
Physiology

Professor Helena C Parkington
Email: helena.parkington@monash.edu
Sub Discipline:
Neuroscience

Dr Ishwar Parhar
Email: ishwar.parhar@monash.edu
Objectives:
After participating successfully in this session and related activities, students should understand:
the main brain nuclei involved in autonomic nervous system responses
the pathways from the periphery to these central nuclei
the relationships, anatomical and functional, between the central control centres and centres of
hormonal output within the brain
the impact on key hormones, released in the periphery, that influence autonomic control centres
in the brain
outputs from the brain, via the spinal cord
examples of autonomic reflexs that use central connections
Content synopsis:
This lecture will focus on autonomic circuitry in the central nervous system and the major visceral
afferent pathways projecting to it. We will also examine mechanisms whereby hormones, secreted by
peripheral tissues (eg adipose tissue, the pancreas, the intestinal tract) influence key autonomic
centres in the brain with consequences on autonomic output and hence feedback control. How
malfunction of this system can give rise to disease.
Keywords:
vagal and other visceral afferent fibres, major central areas, hypothalamus, brainstem centres
including rostral venterolateral medulla.
Readings:
Bear MF, Connors BW & Paradiso MA 2007 Neuroscience: exploring the brain Ch 15
Davies A, Blakeley AGH & Kidd C 2001 Cardiovascular control pg 600-601 & 606-607 Human
Physiology 1st ed. Churchill Livingstone
Berne RM & Levy MN 1998 Central control Ch 15 pg 241-246 Cardiovascular reflexes
Ch 28 pg 450-454 Physiology 4th ed. Mosby, St Louis
Wilson-Pauwels, Stewart, Akesson, Autonomic Nerves. BC Decker
Yes
75

Week 5
76
WEEK 6
77

Week 6
WEEK 6
define methods of describing central tendency and variability
explain the concepts of hypothesis testing, p value and statistical power
describe how the following statistical tests are used: t-test, chi square, correlation and
regression
appreciate the developmental focus on children and adolescent health behaviour
discuss gender identity formation and gender issues in health
describe the differences between bacterial endotoxins and exotoxins
outline the mode of action of bacterial exotoxins
describe emerging infections and factors affecting disease transmission
recognise the significance of emerging infectious diseases
describe the technology and elements of computed tomographs (CT), magnetic resonance
(MR) and ultrasound imaging and appreciate their use in medicine
describe the anatomical organisation of the lower limb
describe the surface anatomy and organisation of the muscular and neurovascular components
of the hip and gluteal region
describe the surface anatomy and organisation of the neurovascular components of the thigh
understand that persistent pain as a common health problem major approaches to management
outline somatic sensation and the neurophysiological basis of pain and temperature sensations
describe the process of modulation of conduction and nerve signalling
describe analgesics, aspirin and NSAIDS - their mode of action and major side effects
demonstrate the key steps for taking a basic focused history and performing a structured
examination of the peripheral nervous system
describe and undertake an organised, basic physical examination of the peripheral nervous
system (gait, sensory system, motor system)
78

Week 6
WEEK 6 OR 7
Practical_PHYSIOLOGY_03/01 to 04 - Nerve conduction
Theme:
III
Discipline:
Physiology

Dr David Reser
Email: david.reser@monash.edu
Sub Discipline:
Neuroscience
Dr Farshad Mansouri
Objectives:
have learnt:
the basic principles of nerve conduction measurements
how to calculate conduction velocity of the motor fibres of the ulnar nerve
Content synopsis:
Introduction to the technique and instructions on the safe use of the equipment. Students then
measure the conduction velocity of their own ulnar nerve motor fibres. This involves activating the
nerve fibres with an electrical stimulator and recording the electrical activity generated by muscles in
the hand that are innervated by the ulnar nerve.
Keywords:
conduction velocity, myelinated fibres, motor fibres, electrical stimulation, electromyographic activity
Readings:
Pre Reading
Moodle notes on Ulnar nerve conduction
79

Week 6
WEEK 6
Lecture03/01-P30 Principles of medical imaging II
Theme:
III
Discipline:
Anatomy
Sub Discipline:
Radiography

Associate Professor Marilyn Baird
Department of Medical Imaging & Radiation Sciences
Email: marilyn.baird@monash.edu
Objectives:
describe the technology involved in producing computed tomograms (CT) images of the human
body
describe the technology involved in producing magnetic resonance (MR) images of the human
body
describe the technology involved in producing ultrasound images of the human body
apply the ALARA principle to CT
understand the key safety issues associated with MR imaging
understand the potential for biological effects when using ultrasound for medical imaging
compare and contrast CT image reconstruction techniques with those used in MRI and
ultrasound
understand the concept of windowing in CT
describe the Doppler effect in medical ultrasound
distinguish between the organs and blood vessels of the body on CT, MRI and ultrasound
images
distinguish between bones, joints and soft tissues on CT, MRI and ultrasound images
understand the role of contrast media in CT, MRI and medical ultrasound
Content synopsis:
The CT x-ray tube, gantry and detectors, differences between third generation and multislice CT;
magnetisation of the body, RF application and detection, magnet and coils, MR control processing and
storage; ultrasound transducers, ultrasound reflection, absorption and scatter, acoustic impedance
and echogenicity; real-time imaging; radiation safety in CT; contraindications to MR imaging; biological
effects of medical ultrasound; pixels and voxels in CT and MRI, window level and window width in CT;
tissue properties in MRI; the concept of T1 and T2 weighted images in MRI; distinguishing soft tissues
in MR images; the Doppler effect and its use in imaging the blood vessels; colour Doppler and pulsed
Doppler; CT and MRI images of the head, thorax and abdomen; musculo-skeletal CT and ultrasound;
ultrasound of the abdominal organs; contrast enhanced CT; the use of gadolinium in MRI.
Readings:
Prescribed
Ch 25 Sectional Anatomy, CT and MRI in Eizenberg N, Briggs C, Adams C & Ahern G 2008,
General Anatomy principles and applications Sydney: McGraw-Hill
Ch 26 Ultrasound Imaging in Eizenberg N 2008, General Anatomy principles and applications
Sydney: McGraw-Hill
Recommended
anatomy, St Louis: Elsevier
Yes
80

Week 6
WEEK 6
Lecture01/01-P4 Improving performance 1
Theme:
Discipline:

Dr Craig Hassed
Objectives:
understand Millers Levels of Performance
appreciate what constitutes effective team learning
understand the role of context in learning
understand surface, achievement and deep learning as outlined in Biggs model
reflect on Coveys Seven Habits of Highly Effective People
Content synopsis:
A range of strategies for cultivating effective and sustainable performance will be explored in this
2-hour interactive seminar. Firstly, Millers Levels of Performance, from knows to knows how to
shows how and to does will be explored. The characteristics of effective team learning will be
discussed as will the role of context in learning. Biggs model of learning will also be explored. Finally,
Coveys Seven Habits of Highly Effective People will be examined and how they can be applied in
daily life.
Keywords:
Millers Levels of Performance, team learning, teamwork, contextual learning, Biggs model of
learning, Seven Habits of Highly Effective People.
Readings:
Prescribed
81

Week 6
WEEK 6
Theme:
III
Discipline:
Microbiology
Sub Discipline:
Bacteriology

Objectives:
understand the important role that bacterial toxins play in many infectious diseases
be aware of the differences between bacterial endotoxins and exotoxins
understand the mode of action of the major classes of bacterial exotoxins
understand how bacteria cause the cell and tissue damage that leads to the clinical signs of
disease
Content synopsis:
Major classes of bacterial toxins: endotoxins and exotoxins.
The role of endotoxin in the pathogenesis of Gram negative infections.
The mode of action of exotoxins that act at the cell surface, including pore-forming toxins.
The mode of action of exotoxins that modify intracellular targets.
Cholera toxin and diphtheria toxin.
Keywords:
bacterial pathogen, endotoxin, lipopolysaccharide, exotoxins, pore-forming toxins, simple and
compound A-B toxins, cholera toxin, diphtheria toxin, ADP-ribosyltransferases
Readings:
Recommended
Washington, DC
Washington, DC
Yes
82

Week 6
WEEK 6, 7, 8 OR 9
SiteVisit_04/01-P1 to 06-P1 - Site visit 1 - Geriatric medicine facility (focusing on
musculoskeletal examination)
Theme:
IV
Discipline:
Clinical Skills

Objectives:
practice communication skills with patients and health professional staff
develop professional behaviours
identify the roles of health professional team members
describe common conditions that affect muscles and nerves
perform a basic musculoskeletal examination
Content synopsis:
examination.
Because you are visiting a hospital, there will be other important clinical experiences besides learning
and practising your clinical examination skills.
You will have the opportunity to practise your communication skills with patients and other health
professionals, learn about professional behaviour in a hospital environment, and learn about some of
the conditions which affect muscles and nerves and see how the examination provides diagnostic
information.
You will have the opportunity to develop an understanding of a subacute hospital facility including the
range of conditions treated, resources available, and how this clinical environment differs from an
acute hospital. You may have the opportunity to learn about the roles of other health professionals in a
multidisciplinary team.
You will be able to reflect on what the patient has been through to get to where they are in their
progression from acute or elective presentation to ultimately returning home.
Keywords:
geriatric medicine, musculoskeletal examination
Readings:
Revise tutorial notes for musculoskeletal examination from your clinical skills workbook and
textbook.
83

Week 6
WEEK 6
Tutorial_04/01-P5 to 20-P5 - Peripheral nervous system upper limb examination
Theme:
IV
Clinical Skills
Discipline:


Objectives:
perform a structured examination of the peripheral nervous system of the upper limb
take a basic history of neurological problems in the upper limb
explain some pathological processes that may affect the upper limb peripheral nervous system,
and their clinical findings
Content Synopsis:
Tutors will demonstrate a motor and sensory examination of the upper limb. Motor examination
includes coordination (30 minutes).
Students will outline/discuss the distribution of dermatomes in the upper limb (10)
Students will practice the examination of the motor and sensory peripheral nervous system of the
upper limb (60 minutes).
Students will discuss with their tutor how this examination may be modified after an injury, for example
a forearm fracture or shoulder dislocation (15 minutes).
Key words/phrases:
Upper motor neuron, lower motor neuron, reflexes, tone, clonus, hypertonia, hypotonia
Readings:
Prescribed
Talley N & OConnor S 2014 The Nervous System in Clinical Examination: A systematic guide
to physical diagnosis pg 437-448 & 340-341 7th ed Elsevier Australia
Further Recommended
Limited pg 362-366, 373 & 376-380
84

Week 6
WEEK 6
Practical_ANAT_03/01-P9 & 10 to 16-P9 & 10 - Lower limb II
Theme:
III
Discipline:
Anatomy

Dr Colin McHenry
Demonstrators
LEG, ANKLE & FOOT
Aims and Objectives
Study the muscles of the leg, their principle actions and innervation keeping in mind the
arrangement into three compartments.
Students should be able to identify all the bones in the foot and in particular identify all the bony
palpable landmarks.
Students should understand the osteological basis of the arches of the foot.
Students should understand the main planes of movement in the foot and which joints these
occur at.
Students should understand the importance of the ligaments of the foot in stability of the joints.
That students gain a basic understanding of the short muscles in the foot.
That students appreciate the location of the major neurovascular structures in the leg and foot
and appreciate the similarities to the hand.
IMAGING SESSION
Recognize the normal bony anatomy of the foot on plain Xray.
Appreciate the appearances of the ankle and foot on cross-sectional images.
Appreciate common pathology and injury patterns on imaging.
85

Week 6
WEEK 6
Lecture03/01-P32 Anatomy of the hip and thigh region
Theme:
III
Anatomy
Discipline:

Dr Galaxy Wong
Email: galaxy.wong@monash.edu
Objectives:
describe the osteology of the femur and the hip bone that comprises the hip joint
describe the joint, its capsule and ligaments
describe how the joint moves and the muscles responsible for those movements
describe common congenital hip dysplasia
discuss issues arising from fractures of the neck of femur and shaft of femur
Keywords:
Hipjoint, walking, fracture of neck of femur, hip dislocation, hip dysplasia
Readings:
Yes
86

Week 6
WEEK 6
Theme:
Discipline:

Dr Craig Hassed
Objectives:
understand Millers Levels of Performance
appreciate what constitutes effective team learning
understand the role of context in learning
understand surface, achievement and deep learning as outlined in Biggs model
understand the principles and applications of mindful practice and self-monitoring
reflect on Coveys Seven Habits of Highly Effective People
Content synopsis:
A range of strategies for cultivating effective and sustainable performance will be explored in this
2-hour interactive seminar. Firstly, Millers Levels of Performance, from knows to knows how to
shows how and to does will be explored. The characteristics of effective team learning will be
discussed as will the role of context in learning. Biggs model of learning will also be explored.
Elements of mindful practice such as self-monitoring will be discussed. Finally, Coveys Seven Habits
of Highly Effective People will be examined and how they can be applied in daily life.
Keywords:
Millers Levels of Performance, team learning, teamwork, contextual learning, Biggs model of
learning, Mindful practice, Seven Habits of Highly Effective People.
Readings:
Prescribed
87

Week 6
WEEK 6
Lecture03/01-P34 - Epidemiology and emerging infections
Theme:
III
Discipline:
Microbiology

Dr Freya Fowkes
Department of Epidemiology and Preventive Medicine
Email: freya.fowkes@monash.edu
Objectives:
define morbidity and mortality
list the potential reservoirs of infection for infectious disease
list the possible modes of transmission between reservoirs of infection and infected individuals
define an emerging infection and give examples from the past 25 years
list the six factors influencing the emergence of infective disease
outline response strategies to emerging infections
discuss avian influenza as an example of an emerging infection
Content synopsis:
This lecture will define the concepts of morbidity, mortality and emerging infection, including examples,
mechanisms of transmission, factors influencing the emergence of infective disease and possible
response strategies.
Keywords:
morbidity, mortality, emerging infection, reservoir of infection, mechanism of transmission,
demographics, behaviour, technology, industry, environment, land use, travel, commerce, microbial
adaptation, microbial change, public health breakdown, response strategies, avian influenza
Readings:
Prescribed
Goering et al, Mims Medical Microbiology 5th ed. Ch 32
Yes
88

Week 6
WEEK 6
Tutorial_02/01-P5 to 20-P5 Biostatistics
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
define methods of describing central tendency (mean and median) and variability (standard
deviation, range, inter-quartile range)
explain the basis of using a sample to make inferences about a population
explain the concepts of hypothesis testing, p value and statistical power
describe how the following statistical tests are used in epidemiology such as t-test, chi square
test, correlation and regression
Keywords:
central tendency, variability, sampling to make inferences about populations, hypothesis testing,
statistical power, t-test, chi-square, correlation, regression, survival analysis, meta-analysis
Assessment:
Formative:
Summative:

Learning materials:
Basic Epidemiology by R Bonita, R Beaglehole & T Kjellstrom WHO 2nd ed. 2006. This book is
to be brought to class with you
Readings:
Prescribed
This is a long tutorial, so there are no extra readings on Moodle.
This is a long tutorial so there is no small group work in this tutorial so there are no extra readings on
Moodle.
89

Week 6
WEEK 6
Lecture03/01-P28 - Youth and health behaviour
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
Students should be able to demonstrate:
A recognition of the child as an indicated patient upon referral
Understanding of the link between childrens developmental milestones and health and illness
behaviour
Understanding of the biological, psychological and social factors that influence child and
adolescent health and illness behaviour
Content synopsis:
This lecture will take a developmental focus on children and adolescent health behaviour.
Acknowledgement of the child as indicated patient will be discussed. The influence of developmental
milestone on the manifestation of health and illness behaviour will be discussed. The impact of the
child or adolescents stage of development, social environment, family life and biological factors will be
explored with regards to health behaviour.
Key words/Phrases:
Attachment, maternal deprivation, breastfeeding, immunisation, family functioning, risk taking
behaviour
Readings:
Prescribed
Australia 2nd ed Sydney, Pearson
Ch 4 Immunization Behaviour pg 122-126
Ch 10 The Medical Consultation pg 323-327
Ch 7 School-based Interventions, Out-of-School Activities & Peer Education pg 238-242
Recommended
Australia 2nd ed Sydney, Pearson Ch 15 Illness a Family Affair pg 506-508
Anderson & Wild 2006, Little Children are Sacred Report Summary
www.inquirysaac.nt.gov.au/report_summary.html
Yes
90

Week 6
WEEK 6
Lecture03/01- P36 - Gender identity formation, gender issues in health
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
define gender identity and explain how children develop gender identity
explain gender differences (including stereotypes)
describe theories of gender identity formation
describe the influence of gender schema on behaviour and activities
describe how theories inform medical practice (infant gender re-assignment surgery)
discuss the psychological and ethical complexities when evaluating the success and
appropriateness of such practice
Content synopsis:
This session covers the development of Gender Identity during childhood and the special issue of
intersex conditions and infant gender re-assignment surgery.
Gender Identity will cover:
Gender identify formation during infancy, and across childhood and adolescence, the impact of
gender stereotypes.
The relationship between psychosocial theory and medical practice through a review of cases of
infant surgical gender reassignment.
Key words/Phrases:
Gender Identity, Gender Identity Formation, Gender Stereotypes, Gender Differences, Role Modelling,
Social Learning Theory, Infant Surgical Gender Reassignment, Intersex Conditions
Readings:
Prescribed
Thomson/Wadsworth Ch 5 pg 191-199 (Gender Roles and identity)
Recommended
Kail RV & Cavanaugh JC 2013, Human Development: A Lifespan View 6th ed. Belmont CA,
Thomson/Wadsworth Ch 12 pg 431-437 (Discrimination)
Papers of interest
Minto C, Alderson J, Balen A & Creighton S 2001 Management of intersex (letter) The Lancet,
358, 2085-2086
Reiner WG 2005 Gender identity and sex-of-rearing in children with disorders of sexual
differentiation, Journal of Pediatric Endocrinology & Metabolism 18 (6) 549-553
Warne G, Grover S, Hutson J, Sinclair A, Metcalfe S, Northam E & Freeman J 2005 A long-term
outcome study of intersex conditions, Journal of Pediatric Endocrinology & Metabolism 18 (6)
555-567
For information on intersex conditions, visit The Intersex Society of North America (ISNA)
http://www.isna.org/
91

Week 6
For a perspective on womens health, visit following website of Womens Health Victoria
http://www.whv.org.au/health_policy/gender.htm
For perspectives on womens and mens health conditions, visit the following websites of the
Australian Federal Government
http://www.healthinsite.gov.au/topics/Men_s_Health and
http://www.healthinsite.gov.au/topics/Women_s_Health
Notes will be uploaded on Moodle and not left in the printed content
92
Yes

Week 6
WEEK 6
Lecture02/01-P4 - Outbreak investigation
Theme:
II
Discipline:
Population Health

Dr Katherine Gibney
Email: katherine.gibney@monash.edu
Sub Discipline:
Epidemiology

Objectives:
explain the difference between endemic and epidemic disease
describe the steps involved in the investigation and control of an epidemic
describe how to use a case-control or a cohort study to investigate an epidemic
describe the principles of health surveillance
Keywords:
communicable disease, epidemic, endemic, outbreak investigation
Assessment:
Formative:
Summative:

Readings:
Prescribed
Ch 7 Communicable diseases: epidemiology surveillance and response pg 117-132
93

Week 6
WEEK 6
Lecture04/01-P4 - Clinical examination of gait and sensory system
Theme:
IV
Discipline:
Clinical Skills

Adjunct Clinical Associate Professor Ernest Butler
Email: ernest.butler@monash.edu
Objectives:
describe an organised physical examination of the gait
describe a basic examination of the sensory elements of the peripheral nervous system
Content synopsis:
The lecture will cover and outline the key elements of an organised and basic examination of the gait
and sensory elements of the peripheral nervous system.
Readings:
See clinical skills tutorial readings Week 6
No
94
WEEK 7
95

Week 7
WEEK 7
describe social and environmental determinants of health
describe the impact of socioeconomic disadvantage on life expectancy and other health
outcomes
describe the anatomy and organisation of the neurovascular components of the knee and leg
discuss developmental psychopathology in childhood and adolescence
outline viral pathogenesis and the effect upon host cells
identify the criteria for identification of an outbreak and the strategies employed in its
investigation
describe disease modifying antirheumatic drugs (DMARDs) and the pharmacological treatment
of gout
explain the physiology of pain and the mechanisms of analgesia
describe analgesics, aspirin and NSAIDS - their mode of action and major side effects
perform an organised, basic physical examination of the hip and lower limb
perform an examination of the musculoskeletal system of the lower limb
96

Week 7
WEEK 7
Lecture03/01-P38 Clinical oriented anatomy of knee and leg
Theme:
III
Discipline:
Anatomy

Dr Galaxy Wong, Dr Colin McHenry
Email: galaxy.wong@monash.edu
Objectives:
The principle topics covered will be the:
bones of the knee joint and the role of the patella
importance of the ligaments (intracapsular and extracapsular) in stability
locking of the knee and the role of popliteus
factors affecting stability
muscles and actions on the knee
bursae in and around the knee
Keywords:
popliteal fossa, patella, distal femur, proximal tibia, proximal fibula, popliteus, tibial nerve, common
peroneal, knee, leg
Readings:
Moore & Dalley, Lower Limb/Knee chapter
Yes
97

Week 7
WEEK 7
Lecture03/01-P37 - Modulation of conduction and nerve signalling local anaesthetics
Theme:
III
Discipline:
Pharmacology

Dr Richard Loiacono
Sub Discipline:
Neuroscience

Objectives:
describe how local anaesthetics work
identify the different types of local anaesthetics
explain why local anaesthetics have a relatively selective action
describe the different ways local anaesthetics are used
identify the side-effects of local anaesthetics
Content synopsis:
This lecture will examine:
cell excitability and conduction of action potentials
the mode of action of local anaesthetics
the different classes of local anaesthetics and their chemical properties
the administration, use and unwanted effects of local anaesthetics
Keywords:
local anaesthetics, pain, action potential, nerve conduction
Readings:
Prescribed
Basic and Clinical Pharmacology, ed BG Katzung, 12th ed Lange Medical Books/McGraw Hill,
Local anaesthetics Ch 26 pg 449-464
Yes
98

Week 7
WEEK 7
Tutorial_04/01-P6 to 20-P6 - Musculoskeletal examination of the hip and lower limb
(knee, ankle and foot)
Theme:
IV
Clinical Skills
Discipline:


Objectives:
appreciate the dermatomes of the lower limb
perform a basic organised physical examination of motor elements of the peripheral nervous
system in the lower limb
perform a basic organised physical examination of the sensory elements of the lower limb
relate the clinical examination to relevant surface anatomy and physiology
Content synopsis:
Clinical Skills (2 hours)
Tutors will demonstrate a motor and sensory examination of the lower limb. Motor examination
includes coordination (20 minutes)
Students will demonstrate/discuss the distribution of dermatomes in the lower limb (5 minutes)
Students will practise the examination of the motor and sensory peripheral nervous system
(60 minutes)
Students will discuss with tutors how this examination may be modified after an injury, for example a
hip or tibia/fibula fracture (5 minutes)
Students will revise the examination of the hip, knee, ankle and foot (25 minutes)
Keywords:
Readings:
Prescribed
7th ed Elsevier Australia pg 448-461, 380-384 & 464
Recommended
Limited pg 293, 305-306, 362-363, 366-368, 373-374 & 377-379
99

Week 7
WEEK 7
Practical_ANAT_03/01-P11 & P12 to 16-P11 & P12 - Lower limb III
Theme:
III
Discipline:
Anatomy

Demonstrators
Objectives:
This week students will have the chance to completely review lower limb anatomy.
Keywords:
hip joint, thigh and flexor, extensor and adductor compartments, knee joint, popliteal, fossa, leg, ankle,
foot, vessels and nerves of the lower limb, homology with upper limb
Readings:
100

Week 7
WEEK 7
Lecture03/01-P40 - Viral pathogenesis 1
Theme:
III
Discipline:
Microbiology

Associate Professor Heidi Drummer
Email: heidi.drummer@monash.edu
Objectives:
understand the general replication cycle of DNA (viral pathogenesis 1) and RNA viruses (viral
pathogenesis 2)
understand the possible effects of human DNA virus (viral pathogenesis 1) and human RNA
viruses (viral pathogenesis 2) on host cells
understand mechanisms of viral tumour induction
explain in simple terms the life cycle of a retrovirus (HIV)
Content synopsis:
The general replication scheme for DNA and RNA viruses will be described, along with the possible
effects of human viruses on cells, such as the manipulation of cell cycle control. The HIV retrovirus will
be used as one example of a life cycle of a virus. Antigenic variation of RNA viruses will be discussed.
Keywords:
DNA viruses, RNA viruses, retrovirus, tumour inducing viruses, antigenic variation
Readings:
Prescribed
Recommended
Murray PR, Rosenthal KS & Pfaller MA (eds) 2009 Medical Microbiology 6th ed. Mosby/Elsevier
Press, Philadelphia
Wagner EK, Hewlett MJ, Bloom DC & Camerini D (eds) 2008 Basic Virology 3rd ed. Blackwell
Publishers, Oxford
Yes
101

Week 7
WEEK 7
Theme:
III
Discipline:
Microbiology

Associate Professor Heidi Drummer
Email: heidi.drummer@monash.edu
Objectives:
understand the general replication cycle of DNA ( viral pathogenesis 1) and RNA viruses (viral
pathogenesis 2)
understand the possible effects of human DNA virus (viral pathogenesis 1) and human RNA
viruses (viral pathogenesis 2) on host cells
understand mechanisms of viral tumour induction
explain in simple terms the life cycle of a retrovirus (HIV)
Content synopsis:
The general replication scheme for DNA and RNA viruses will be described, along with the possible
effects of human viruses on cells, such as the manipulation of cell cycle control. The HIV retrovirus will
be used as one example of a life cycle of a virus. Antigenic variation of RNA viruses will be discussed.
Keywords:
DNA viruses, RNA viruses, retrovirus, tumour inducing viruses, antigenic variation
Readings:
Prescribed
Recommended
Press, Philadelphia
Publishers, Oxford
Yes
102

Week 7
WEEK 7
Lecture03/01-P42 - DMARDs and treatment of gout
Theme:
III
Discipline:

Dr Richard Loiacono
Pharmacology
Dr Amudha Kadirvelu
Objectives:
describe the current concept of therapy for rheumatoid arthritis
identify the DMARDs most commonly used in the management of rheumatoid arthritis
describe the rationale of use of biologic agents in the management of rheumatoid arthritis
describe the management of gout
Content synopsis:
This lecture will discuss the current concept of rheumatoid arthritis management and examine the use
of DMARDs in the management of rheumatoid arthritis. Management of gout will also be discussed.
Keywords:
Rheumatoid arthritis, DMARDs, biologic agents, gout
Readings:
Prescribed
Basic and Clinical Pharmacology, ed BG Katzung, 12th ed. Lange Medical Books/McGraw Hill,
Non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, nonopioid
analgesics & drugs used in gout Ch 36 pg 635-657
Yes
103

Week 7
WEEK 7
Tutorial_02/01-P6 to 20-P6 - Outbreak investigation
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
explain the difference between endemic and epidemic disease
describe the steps involved in the investigation and control of an epidemic
describe how to use a case-control or a cohort study to investigate an epidemic
describe the principles of health surveillance
Keywords:
communicable disease, epidemic, endemic, outbreak investigation
Assessment:
Formative:
Summative:

Learning Materials:
Readings:
Prescribed
Basic Epidemiology by R Bonita, R Beaglehole & T Kjellstrom WHO 2nd ed 2006.
104

Week 7
WEEK 7
Lecture03/01-P43 Ankle and foot
Theme:
III
Discipline:
Anatomy

Dr Colin McHenry
Objectives:
This lecture will focus on the clinical anatomy of the ankle and foot.
It will discuss problems arising from the ankle joint.
It will demonstrate the importance of the knowing surface anatomy of the foot and ankle.
It will discuss common clinical problems in the foot.
Keywords:
ankle, foot, ankle joint, tibia, fibula, tarsals, metatarsals, ligaments, sole of the foot, long tendons,
dorsalis paedis artery, plantar artery, saphenous veins, plantar nerve, saphenous nerve, peroneal
(fibular) nerves, tarsal tunnel, surface anatomy
Readings:
Moore & Dalley
Yes
105

Week 7
WEEK 7
Lecture03/01-P45 Bipedalism and walking
Theme:
III
Discipline:
Anatomy

Dr Colin McHenry
Objectives:
To give students an understanding of the adaptations required to walk on 2 legs instead of 4
and how the human foot especially is adapted for walking.
Concepts of evolution and function will be central to the discussion as will the clinical
consequences of pathological alterations to this highly adapted anatomy.
Content synopsis:
In the lab students have the opportunity to learn the detailed anatomy of the lower limb including the
bones, joints, ligaments, muscles, nerves and vessels. However, it is less seldom that time is taken to
consider how the human lower limb is adapted for bipedalism. Whilst we are not the only animal to
walk on two legs (think birds, kangaroos), we are the only primate. This lecture will look at the
functional considerations of walking on two limbs in terms of locomotion and it will highlight how the
features of anatomy that one sees in the foot especially in a human that are different from 4-legged
mammals and consider how this has evolved. Understanding bipedalism and how the hip, knee, ankle
and sub-tarsal joints operate will help you as future doctors understand the various forms of limps and
abnormalities which have a profound effect on patient wellbeing.
Keywords:
Locomotion, anatomy, foot, upright stance, arches of the foot
Readings:
Prescribed
Moore & Dalley has a section on walking
Recommended
Students would be advised to look at the last episode of David Attenboroughs Planet Earth
DVD and the new series The Human Planet. The new BBC Series Origins of Us is also
interesting.
Yes
106

Week 7
WEEK 7
Lecture03/01-P39 - Analgesics, aspirin and NSAIDs
Theme:
III
Discipline:

tba
Pharmacology
Dr Amudha Kadirvelu
Objectives:
list the different classes of medication used to relieve pain
discuss the role of simple analgesics and NSAIDs in the management of pain and inflammatory
disorders
describe the mode of action and major side effects of simple analgesics; selective (COX-2) and
non-selective NSAIDs
Content synopsis:
This lecture will examine the use of pharmacological agents in the management of pain and
inflammatory disorders. Particular emphasis will be placed on the simple analgesics, selective
(COX-2) and non-selective non-steroidal anti-inflammatory (NSAID) drugs.
Keywords:
simple analgesics, aspirin, paracetamol, non-steroidal anti-inflammatory drugs, cyclooxygenase
Readings:
Prescribed
Yes
107

Week 7
WEEK 7
Lecture02/01-P6 Social and environmental determinants of health
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
describe the impact of socioeconomic disadvantage on life expectancy and other health
outcomes for Australian Aboriginal and Torres Strait Islander peoples
list three important social determinants of health
provide three examples of how ones neighbourhood can influence level of physical activity
Assessment:
Formative:
Summative:

Readings:
Prescribed
Ch 1 What is epidemiology? pg 1-12
not advised at time of printing
108
WEEK 8
109

Week 8
WEEK 8
define the terms sensitivity, specificity, positive and negative predictive values and explain how
predictive value is affected by prevalence
explain the value of screening in relation to the natural history of a disease
explain length time and lead time bias in relation to a screening program
list the requirements for a medical screening program
apply a population health framework for disease prevention
summarise the strengths and weaknesses of strategies for disease prevention
discuss developmental psychopathology in childhood and adolescence
discuss developmental psychopathology in adulthood and later life
describe the anatomy of the lower limb (ankle and foot)
describe the consequences of common microbial infections of skin and muscle
describe the general principles of the examination of the peripheral nervous system
perform an examination of the peripheral nervous system of the lower limb
describe the mode of action of opioid analgesics
describe the major side effects associated with the use of opioid analgesics
describe analgesic ladder
110

Week 8
WEEK 8
Tutorial_04/01-P7 to 20-P7 Examination of the PNS in the lower limb
Theme:
IV
Clinical Skills
Discipline:


Objectives:
After participating in this tutorial, students will be able to:
appreciate the dermatomes of the lower limb
perform a basic organised physical examination of motor elements of the peripheral nervous
system in the lower limb
perform a basic organised physical examination of the sensory elements of the lower limb
relate the clinical examination to relevant surface anatomy and physiology
Content synopsis:
Tutors will demonstrate a motor and sensory examination of the lower limb. Motor examination
includes coordination (20 minutes)
Students will demonstrate/discuss the distribution of dermatomes in the lower limb (5 minutes)
Students will practise the examination of the motor and sensory peripheral nervous system
(60 minutes)
Students will discuss with tutors how this examination may be modified after an injury, for example a
hip or tibia/fibula fracture (5 minutes)
Students will revise the examination of the hip, knee, ankle and foot (25 minutes)
Keywords:
Readings:
Prescribed
to physical diagnosis pg 448-461, 380-384 & 464 7th ed Elsevier Australia
Recommended
Limited pg 293, 305-306, 362-363, 366-368, 373-374 & 377-379
111

Week 8
WEEK 8
Practical_ANAT_03/01-P13 & P14 to 16-P13 & P14 Lower limb revision
Theme:
III
Discipline:
Anatomy

tba
Demonstrators
*NB No content provided at the time of printing. Please check Moodle for material or contact
the Department.
112

Week 8
WEEK 8
Lecture03/01-P46 - Centrally acting analgesics opioids
Theme:
III
Discipline:

Dr Richard Loiacono
Pharmacology
Dr Amudha Kadirvelu
Objectives:
describe the mode of action of opioid analgesics
describe the major side effects associated with the use of opioid analgesics
describe the analgesic ladder
Content synopsis:
This lecture will examine the use of pharmacological agents in the management of pain. Particular
emphasis will be placed on the opioid analgesics.
Keywords:
analgesics, opioids, morphine, tolerance, dependence, naloxone
Readings:
Prescribed
Opioid analgesics and antagonists Ch 31 pg 543-564
Yes
113

Week 8
WEEK 8
Theme:

Professor Ben Canny
Deputy Dean, MBBS
Objectives:
No
114

Week 8
WEEK 8
Lecture03/01-P44 - Developmental psychopathology 1: childhood and adolescence
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
describe major theories in developmental psychopathology
describe the possible causes and treatments of developmental psychopathology
describe the psychological and behavioural problems exhibited by adolescents
describe the warning signs of psychopathology in adolescents
Content synopsis:
This module is on Developmental Psychopathology and includes:
psychological and behavioural problems in adolescence
psychopathology specific to childhood (eg attention deficit hyperactivity disorder) disorders that
often onset during adolescence, (eg schizophrenia) and their sequelae
Key words/Phrases:
Depressive disorder, Juvenile Delinquency, Adolescent Suicide, Diagnostic and Statistical Manual of
Mental Disorders-5, Attention Deficit Hyperactivity Disorder, Schizophrenia
Readings:
Prescribed
Psychological Problems & Development in White F, Hayes B & Livesey D 2010 Developmental
Psychology: From Infancy to Adulthood 2nd ed. French Forest, Australia, Pearson Ch 12
pg 438-442 Developmental Psychopathology & pg 444-452 ADHD & Schizophrenia
Recommended
Thomson/Wadsworth Ch 9 pg 334-339 (The Dark Side)
Yes
115

Week 8
WEEK 8
Tutorial_02/01-P7 to 20-P7 Health promotion
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
define primordial, primary, secondary and tertiary levels of prevention and explain the
differences between them
summarize the strengths and weaknesses of individually targeted versus population wide
prevention
Keywords:
Primordial, primary, secondary, and tertiary prevention
Assessment:
Formative:
Summative:

Learning materials:
Readings:
Prescribed
Ch 6 Epidemiology and prevention: chronic non-communicable diseases pg 99-113
Ch 10 Epidemiology, health policy and planning pg 165-175
116

Week 8
WEEK 8
Lecture03/01-P47 - Infectious diseases of the skin and musculoskeletal system
Theme:
III
Discipline:
Microbiology

Associate Professor Anton Peleg
Email: anton.peleg@monash.edu
Objectives:
recognize the characteristic lesions of the skin caused by a variety of infectious agents
name the major bacterial, fungal viral pathogens of the skin and muscle
explain why some skin lesions are infectious, others non-infectious
Content synopsis:
This lecture describes the consequences of microbial infection of the skin, muscle and bone, with
emphasis on the first. Students are introduced to the nature of lesions, causative organisms and
clinical aspects of disease. The emphasis is on the most common infections caused by bacteria, fungi
and viruses.
Keywords:
Staphylococcus aureus, Streptococcus pyogenes, fasciitis, leprosy, mycoses, dermatophytes viral
systemic spread, papillomavirus, poxvirus, herpesvirus, measles, myocarditis, arthritis, osteomyelitis
Readings:
Prescribed
Mims Medical Microbiology 5th ed. Elsevier Mosby, Ch 26 Infections of the skin, soft tissue,
muscle and associated systems
Yes
117

Week 8
WEEK 8
Lecture03/01- P48 Developmental psychopathology 2: adulthood and later life
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
describe major psychopathology across the lifespan
describe treatments and prevention programs for psychopathology
understand the family, peer and cultural contexts for developmental psychopathology
Content synopsis
This module covers Developmental Psychopathology across the lifespan and includes:
developmental psychopathology in during adulthood, personality disorders, anxiety disorders,
depressive disorders
psychopathology of the elderly, specifically, major depression, suicide
consideration is given to family and cultural contexts of developmental psychopathology
Key words/Phrases
Developmental psychopathology, personality disorder, anxiety disorder, depressive disorder
Readings:
Prescribed
pg 458-461 Personality Disorder, 462-465 Major Depression & 468-472 Contexts and
Psychological Problems
Yes
118

Week 8
WEEK 8
Lecture02/01-P7 - Diagnosis and screening
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
define the terms sensitivity, specificity, positive and negative predictive values and explain how
predictive value is affected by prevalence
explain the value of screening in relation to the natural history of a disease
explain length time and lead time bias in relation to a screening program
list the requirements for a medical screening program
Keywords:
Diagnosis, screening, sensitivity, specificity, positive predictive value, negative predictive value
Assessment:
Formative:
Summative:

Revision quizzes (on MUSO/Moodle)
Learning materials:
Readings:
Prescribed
Ch 8 Clinical epidemiology pg 133-143
Ch 6 Epidemiology and prevention: chronic non-communicable disease pg110-114
119

Week 8
120
WEEK 9
121

Week 9
WEEK 9
describe the major causes of death in the six WHO regions of the world
explain the difference in communicable and non-communicable causes of death in these
regions
outline major causes of death in WHO regions of the world
outline risk factors for cancer and distinguish between primordial and primary prevention of
cancer
review nerves and vessels of the lower limb
describe the anatomy of the spinal canal, thoracic and lumbar spine
describe the anatomy of the spinal canal and contents
describe neurotransmitters and their role within the nervous system in relation to pharmacology
discuss steroidal anti-inflammatory drugs, their mode of action and side effects
describe the use of steroidal anti-inflammatory drugs in the management of pain and
inflammation
describe therapeutic agents which effect neurotransmitters in the parasympathetic nervous
system, their mode of action and side effects
demonstrate physical examination of the back and spine
122

Week 9
WEEK 9
Lecture03/01-P49 Thoracic and lumbar spine
Theme:
III
Discipline:
Anatomy

Dr Priscilla Barker
Email: Priscilla.Barker@monash.edu
Objectives:
After participating successfully in this session and related activities, it is expected that students will:
understand the basic structure of the typical vertebra
understand how this varies between the regions of the spine and how this relates to function
understand the important relations of the vertebral column
have a broad understanding of the factors that influence mobility in the lumbar and thoracic
regions
understand the muscle groups involved in movements of the thoracic and lumbar spine
have learnt the structure and function of the thoracic and lumbar spine, comparing the two
Content synopsis:
The vertebrae, joints and muscles of the back will be covered.
Keywords:
thoracic, lumbar, vertebrae, disc, back muscles, facet joints, mobility, back pain
Readings:
Moore & Dalley, Lower Limb chapter on vertebral column
Yes
123

Week 9
WEEK 9
Lecture03/01-P50 - Steroidal anti-inflammatory drugs
Theme:
III
Discipline:
Pharmacology

Professor Wayne Hodgson
Email: wayne.hodgson@monash.edu

Dr Amudha Kadirvelu
Objectives:
discuss the role of steroidal anti-inflammatory drugs in the management of pain and
inflammatory disorders
describe the mode of action and major side effects of steroidal anti-inflammatory drugs
Content synopsis:
This lecture will examine the use of pharmacological agents in the management of pain and
inflammatory disorders. Particular emphasis will be placed on the steroidal anti-inflammatory drugs.
Keywords:
anti-inflammatory agents, corticosteroids, inflammation
Readings:
Prescribed
Ch 39 Adrenocorticosteroids & adrenocortical antagonists, pg 697-713
Yes
124

Week 9
WEEK 9
Lecture03/01-P51 Review of nerves and vessels of lower limb
Theme:
III
Discipline:
Anatomy

Dr Colin McHenry, Dr Galaxy Wong
Email: Colin.McHenry@monash.edu
Objectives:
describe the nerves and vessels of the lower limb
understand the relations of the neurovascular structures and the problems presented by upright
stance in relation to venous drainage
review the sites that nerves and vessels are most at risk
review the organisation of the nerves and vessels and compare them to the upper limb
Content Synopsis:
The nerves and vessels of the lower limb will be described including their origins, pathways and
important relations.
Keywords:
sciatic nerve, tibial nerve, common peroneal (fibular) nerve, femoral artery, anterior tibial artery,
posterior tibial artery, peroneal artery
Readings:
Moore & Dalley
Yes
125

Week 9
WEEK 9
Practical_ANAT_03/01-P15 & P16 to 16-P15 & P16 - Back I
Theme:
III
Discipline:
Anatomy

Dr Priscilla Barker
Email: Priscilla.Barker@monash.edu
Demonstrators
Objectives:
have learnt the structure and function of the thoracic and lumbar spine, comparing the two.
Content synopsis:
The vertebrae, joints and muscles of the back will be covered.
The pathway of typical spinal nerves.
The arrangement of the parts of the vertebrae and how they vary between regions.
The radiographic appearance of the spine in various views.
The muscles of the back and the other muscles such as abdominal muscles and thoracolumbar
fascia in stability to the spine.
The anatomy of the intervertebral disc.
The anatomy of the facet joints in relation to the movement.
Keywords:
thoracic, lumbar, vertebrae, disc, back muscles
Readings:
Moore & Dalley, chapter on vertebral column
126

Week 9
WEEK 9
Tutorial_04/01-P8 to 20-P8 Examination of the back and spine
Theme:
IV
Clinical Skills
Discipline:


Objectives:
perform a structured musculoskeletal examination of the spine, including relevant neurological
examination (covered in previous tutorials)
take a basic history of musculoskeletal conditions of the back
relate the clinical examination to the anatomy and physiology of the back and spine
recognise some pathological processes that may affect the back and spine, and their
associated clinical findings
Content synopsis:
Students will discuss with their tutor the basic history of musculoskeletal conditions of the back and
spine (10 minutes)
Demonstration of the examination of the back and spine by the tutor (20 minutes)
Students will practice examination of the back and spine (45 minutes)
Students will practice/revise the examination of the PNS of the lower limbs (15 minutes)
Students will practice/revise the examination of the PNS of the upper limbs (15 minutes)
Pathological anatomy and revision of history (case studies) (10 minutes)
General principles of musculoskeletal examination:
ask
look
feel
move/measure
specific tests
compare
Key words:
Intervertebral space, spinous process, disc, cervical, thoracic and lumbar spine
Readings:
Prescribed
7th ed Elsevier Australia pg 312-315
Further Recommended
Limited pg 274-276
127

Week 9
WEEK 9, 10, 11 OR 12
SiteVisit_04/01-P2 to 06-P2 - Site visit 2 - Geriatric medicine (neurological)
Theme:
IV
Discipline:
Clinical Skills

Objectives:
practice communication skills with patients and health professional staff
develop professional behaviours
identify the roles of health professional team members
describe common conditions that affect muscles and nerves
perform a basic neurological examination
Content synopsis:
examination.
See notes from geriatric site visit 1.
Keywords:
geriatric medicine, musculoskeletal examination
Readings:
Revise tutorial notes for neurological examination from your clinical skills workbook and
textbook.
128

Week 9
WEEK 9
Lecture03/01-P55 - Nerve signalling in the ANS
Theme:
III
Discipline:

Dr Elizabeth Davis
Pharmacology
Dr Amudha Kadirvelu
Objectives:
list the main neurotransmitters of the ANS
identify the major receptor types and subtypes mediating actions of the ANS
Content synopsis:
This lecture will focus on the postjunctional receptors mediating the responses to stimulation of the
parasympathetic and sympathetic nerves of the autonomic nervous system.
Keywords:
acetylcholine; noradrenaline;
-adrenoceptors
muscarinic
receptors;
nicotinic
receptors;
-adrenoceptors;
Readings:
Prescribed
Introduction to autonomic pharmacology Ch 6 pg 79-96
Yes
129

Week 9
WEEK 9
Lecture02/01-P8 - Cancer prevention
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
describe the three major risk factors for cancer world wide
explain the differences between primordial and primary prevention of cancer
use the framework convention for tobacco control to create a global framework for obesity
control
Assessment:
Formative:
Summative:

Keywords:
genetic environmental familial carcinogen incidence mortality
Readings:
Prescribed
Ch 6 Epidemiology and prevention: chronic non-communicable diseases
Ch 10 Epidemiology health policy and planning pg 165-176
130

Week 9
WEEK 9
Lecture03/01-P54 Spinal canal and contents
Theme:
III
Discipline:
Anatomy

Dr Priscilla Barker
Email: priscilla.barker@monash.edu
Objectives:
have learnt:
the basic anatomy of the spinal cord
the nomenclature of the spinal nerves
how the spinal nerves are formed
how the spinal nerves exit the vertebral column
the nerve fibre content of the dorsal and ventral roots
the structures innervated by the dorsal and ventral roots
that the spinal nerves give rise to the peripheral nerves
Content synopsis:
An outline of the external and internal anatomy of the spinal cord.
Variations along the length of the spinal cord.
Segmentation according to the spinal nerves.
Nomenclature of the spinal nerves and corresponding vertebrae.
How the spinal nerves exit the vertebrae.
Formation of spinal nerves from dorsal and ventral roots.
Keywords:
spinal cord, segmentation, cervical and lumbo-sacral enlargements, dorsal and ventral horn, dorsal
root, dorsal root ganglion, ventral root, motor nerve, sensory nerve, primary afferent, dermatome,
myotome.
Readings:
Moore & Dalley
Yes
131

Week 9
WEEK 9
Tutorial_02/01-P8 to 20-P8 Screening and diagnosis and revision
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
After participating in this session and related activities, students should be able to revise Theme II
content for semester 2.
Content synopsis:
This tutorial will be in the form of a quiz. We will concentrate on the material presented in the lecture
on screening and diagnosis.
Keywords:
Revision, screening and diagnosis
Assessment:
Formative:
Summative:

Learning materials:
Readings:
132

Week 9
WEEK 9
Lecture03/01-P58 - Drugs acting at the ANS 1
Theme:
III
Pharmacology
Discipline:

Dr Elizabeth Davis

Dr Amudha Kadirvelu
Objectives:
discuss the sites at which drugs can act to modulate neurotransmission in the parasympathetic
nervous system
describe the consequences of the actions of drugs acting at these sites
identify drugs which act at each of these sites
Content synopsis:
This lecture will consider how drugs can act at parasympathetic nerve endings to alter cholinergic
neurotransmission. This will include drugs acting presynaptically to modulate storage, release, uptake
and metabolism of acetylcholine as well as drugs acting to stimulate or block postsynaptic cholinergic
receptors.
Keywords:
acetylcholine; muscarinic receptor
anticholinesterases; botulinum toxin
agonists
and
antagonists;
ganglion
blocking
drugs;
Readings:
Prescribed
Cholinoceptor-activating & cholinesterase-inhibiting drugs Ch 7 pg 97-113; Cholinoceptorblocking drugs Ch 8 pg 115-128
Yes
133

Week 9
WEEK 9
Theme:
III
Discipline:
Pharmacology

Dr Elizabeth Davis
Sub Discipline:
Neuroscience

Dr Amudha Kadirvelu
Objectives:
discuss the sites at which drugs can act to modulate neurotransmission in the sympathetic
nervous system
describe the consequences of the actions of drugs acting at these sites
identify drugs which act at each of these sites
Content synopsis:
This lecture will consider how drugs can act at sympathetic nerve endings to alter noradrenergic
neurotransmission. This will include drugs acting presynaptically to modulate storage, release, uptake
and metabolism of noradrenaline as well as drugs acting to stimulate or block postsynaptic
noradrenergic receptors.
Keywords:
noradrenaline; adrenergic neurone blocking drugs, indirectly acting sympathomimetics, selective
adrenoceptor antagonists; neuronal uptake blockers, MAO inhibitors.
Readings:
Prescribed
Adrenoceptor agonists & sympathomimetic drugs Ch 9 pg 129-149; Adrenoceptor antagonist
drugs Ch 10 pg 151-168
Yes
134

Week 9
WEEK 9
Lecture02/01-P5 Life and death in the world
Theme:
II
Discipline:
Population Health

Sub Discipline:
Epidemiology

Objectives:
describe the major causes of death in the six WHO regions of the world
explain the difference in communicable and non-communicable causes of death in these
regions
Assessment:
Formative:
Summative:

Readings:
Prescribed
135

Week 9
136
WEEK 10
137

Week 10
WEEK 10
understand the developmental aspects of normal ageing
understand the change in health behaviours across the lifespan
describe major psychopathology across the lifespan, treatments and prevention programs
understand the changing perceptions, anxieties and feelings about death with age
describe the anatomy of the thorax heart and pericardium
describe the anatomy of the back
comprehend the anatomy and relations of the mediastinum and the structures it contains
describe the anatomical walls of the thorax and the structure and relationships of the heart and
pericardium within it
recognize the histological and microanatomical composition of the heart and vessels and relate
these to the functions these structures perform
explain the functions of the cardiovascular system, its haemodynamics, the nature of cardiac
muscle, the electrical activity of the heart and the basis for the ECG, the cardiac cycle and the
roles of arteries in the distribution of blood flow
perform and understand taking a focused medical history of the cardiovascular system,
including cardiovascular systems review and assessing for common cardiovascular risk factors,
whilst demonstrating appropriate communication skills
138

Week 10
WEEK 10
Lecture04/01-P5 - Cardiovascular system - history and examination
Theme:
IV
Discipline:
Clinical Skills

Professor Barry McGrath
Email: barry.mcgrath@monash.edu
Objectives:
describe the important features of medical history-taking for the cardiovascular system
understand the main techniques of physical examination for the cvs
discuss common cardiovascular risk factors
perform a cardiovascular systems review
Content synopsis:
The lecture will describe the important components of medical history-taking and physical examination
for patients with cardiovascular disease, and will discuss the clinical significance of these symptoms
and signs.
Glossary of Terms:
Ischaemia, angina, dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea, oedema, claudication,
syncope, palpitations hypertension, hypercholesterolaemia, systolic, diastolic, sphygmomanometer,
diabetes mellitus, praecordium, jugular venous pressure (JVP).
Keywords:
cardiovascular system (CVS), medical history, systems review, chest pain, symptom, sign, risk factor
Readings:
Prescribed
Epstein O, Perkin GD, de Bono DP & Cookson J 2008 Clinical Examination 4th ed Mosby pg 7
Systems review: cardiovascular system Ch 6 provides an overview of important features of the
CVS and of history and examination technique
or
Talley NJ & O'Connor S 2014 Clinical Examination: A systematic guide to physical diagnosis
7th ed MacLennan & Petty Sydney pg 14 Systems review and Ch 3, 4 & 5 provide an overview
of important features of the CVS and of history and examination technique
Recommended
7th ed MacLennan & Petty Sydney Ch 1 to 5
Cole SA & Bird J 2000 The Medical Interview: the three-function approach 2nd ed Mosby
St Louis, MO, USA Ch 13 Review of Systems pg 101-3 this chapter provides a brief overview of
this part of the medical history
Refer to clinical skills tutorial notes on CVS history and examination.
Yes
139

Week 10
WEEK 10
Lecture03/01-P57 Chest wall and diaphragm
Theme:
III
Discipline:
Anatomy

Dr Justin Adams
Email: Justin.Adams@monash.edu
Objectives:
describe the features of the bones of the thoracic cage
describe the anterior and posterior thoracic joints
describe the muscles of respiration and the mechanics of breathing
describe the vascular and nerve supply of the thoracic walls
name the surface anatomy features of the thoracic walls
understand clinical applications of thoracic wall anatomy
appreciate the underlying anatomical basis of procedures involving the thoraxic walls
Content synopsis:
The anatomical structures of the thoracic walls and their clinical applications.
Keywords:
thoracic walls, ribs, costal cartilages, sternum, respiratory muscles, intercostal space, intercostal
muscles, anterior and posterior thoracic joints, internal thoracic vessels, posterior/anterior intercostal
vessels, intercostal nerves, surface anatomy
Readings:
Prescribed
Moore, Dalley & Agur Ch 1 pg 71-105
Recommended
Anatomedia software Anterior & Posterior Thoracic Walls
Yes
140

Week 10
WEEK 10
Practical_ANAT_03/01-P17 & 18 to 16-P17 & 18 Cardiovascular system I
Theme:
III
Discipline:
Anatomy

Dr Justin Adams, Prof Paul McMenamin
Email: Justin.Adams@monash.edu
Objectives for each of the 2 (x1 hour) components of the practical class:
(The Tuesday class will be an Integrated Clinical Skills session).
After participating in the Specimen Workshop it is expected that students will be able to identify:
components of the thoracic cage (noting rib parts, articular surfaces and grooves)
boundaries of superior and inferior thoracic apertures
position, parts and attachments of the diaphragm
structures transmitted via (major and minor) openings in the diaphragm
contents of an intercostal space (noting layers and sites of neurovascular bundles)
course and branches of thoracic spinal nerves (noting associated dermatomes)
course of internal thoracic artery
position and structure of the breasts (noting their associated nerves and vessels)
After participating in the Applied Anatomy Tutorial, it is expected that students will be able to:
contrast the mechanisms involved with inspiration and expiration (noting the accessory muscles
of respiration and the significance of them being enlisted)
indicate the costal cartilages associated with each part of the sternum (noting the sternal
position in funnel chest and pigeon chest variants) and the site of the sternal angle
explain the diagnosis and significance of a fractured rib (noting the mechanism and effect of
flail chest in multiple rib fractures)
indicate the sites where thoracic wall vessels & nerves are endangered by a penetrating injury
explain the unique pattern of distribution of the pain and rash in shingles (reactivation of herpes
zoster) affecting a thoracic spinal nerve thorax (noting the jump in dermatomes from C:4 to T:2)
contrast the lymph drainage of lateral quadrants of the breasts with that of medial quadrants in
tumour spread (noting the significance of overlap across the nipple line vertical watershed)
Readings:
Content Synopsis and associated Readings are provided in the Anatomy practical manual.
141

Week 10
WEEK 10
Tutorial_04/01-P9 to 20-P9 - Cardiovascular system - history taking
Theme:
IV
Clinical Skills
Discipline:


Objectives:
demonstrate patient-centred communication skills
take a focused medical history of the cardiovascular system
explain the clinical significance of particular cardiovascular symptoms and their relevance to the
processes of diagnosis and clinical decision-making
discuss common cardiovascular risk factors
summarise the history to their peers
Content synopsis:
Tutors will discuss with students the common symptoms of cardiovascular disease and their clinical
significance (30 minutes)
Tutors will revise with students the format for taking a complete medical history, including a CVS
systems review and risk factors (10 minutes)
Students will practise taking a history from role-playing peers presenting with common cardiovascular
symptoms. (60 minutes)
Revision of the examination of the spine (15 minutes)
Key Words/Phrases:
Cardiovascular system, medical history, systems review, chest pain, dyspnoea, palpitations,
ischaemia, angina, orthopnoea, paroxysmal nocturnal dyspnoea, oedema, claudication, syncope,
hypertension, hypercholesterolemia, diabetes mellitus
Readings:
Prescribed
7th ed. Elsevier Australia pg 14 & 45-55
These extracts cover the most common presenting symptoms for cardiovascular disease, and
discuss their clinical significance.
Recommended
Epstein O, Perkin GD, de Bono DP & Cookson J 2008, Clinical Examination 4th ed. Mosby
Elsevier Limited Ch 1 Structure of the Interview & Ch 7 139-157
Cole SA & Bird J 2000, The Medical Interview: The Three-Function Approach 2nd ed. Mosby,
St Louis, Unit III
142

Week 10
WEEK 10
Lecture03/01-P59 - Cardiovascular system overview and basic haemodynamics
Theme:
III
Discipline:
Physiology

Dr Julia Choate
Email: julia.choate@monash.edu
Sub Discipline:
Cardiovascular

Dr Nik Asmah
Email: nik.asmah@monash.edu
Objectives:
explain the overall design of the human cardiovascular system and its functional components
(ie blood, blood vessels and heart)
appreciate that blood flows in series through the systemic and pulmonary circulations
appreciate that blood flows in parallel through many different vascular beds of the systemic
circulation
identify which regions of the cardiovascular system contain blood that is high in oxygen content
and which regions contain blood that is low in oxygen content
list factors that influence fluid to flow through a tube
explain the relationship between blood flow, pressure and resistance
appreciate what three factors influence the resistance to flow through a tube
Content synopsis:
transport function of the circulatory system
components of the circulatory system
basic properties of blood (incl. haematocrit) and total blood volume
arrangement of the cardiovascular system into right (pulmonary circulation) and left (systemic
circulation) sides
distribution of blood flow in the systemic circulation
the role of a pressure difference in determining flow
laminar flow and turbulent flow
the relationship between blood flow, pressure and resistance
factors that affect the resistance to blood flow
Keywords:
Cardiovascular system, systemic and pulmonary circulations, total blood volume, blood flow, pressure
difference, resistance to flow.
Readings:
Prescribed
Naish, Revest & Syndercombe Court, Medical Sciences Ch 11 The Cardiovascular System
Guyton & Hall, Textbook of Medical Physiology 12th ed. Elsevier Saunders Ch 14
Yes
143

Week 10
WEEK 10
Lecture03/01-P62 - The heart, cardiac muscle contraction and excitation-contraction
coupling
Theme:
III
Discipline:
Physiology

Dr Julia Choate
Sub Discipline:
Cardiovascular

Dr Nik Asmah
Objectives:
explain the basic anatomy of the heart and its arrangement into 4 chambers
describe the location and function of the heart valves
list in sequence the direction of blood flow through the four chambers of the heart
understand the basic mechanism of contraction of cardiac muscle
explain what enables excitation to spread from one cardiac muscle cell to the next
list the sequence of events in excitation-contraction coupling in cardiac muscle
appreciate the importance of changes in muscle cell length and intracellular calcium release in
determining the strength of cardiac muscle contraction
Content synopsis:
The four chambers and basic anatomy of the heart.
Location and function of heart valves.
Similarities and differences between cardiac and skeletal muscle.
The role of intercalated disks connecting cardiac cells to each other.
The relationship between the cardiac action potential and contraction of a cardiac muscle cell.
Steps in the excitation-contraction coupling sequence in cardiac muscle and the process of
calcium-induced calcium release from the sarcoplasmic reticulum.
Mechanisms by which the strength of contraction can be graded in cardiac muscle.
Oxygen dependence of the heart.
Keywords:
Myocardium, atria, ventricles, heart valves, intercalated disks, gap junctions, excitation-contraction
coupling, voltage-dependent calcium channels, calcium influx, calcium-induced calcium release,
coronary circulation and oxygen supply.
Readings:
Guyton & Hall, Textbook of Medical Physiology 12th ed. Elsevier Saunders Ch 9 The Heart as a
pump and Function of the Heart Valves pg 101-104
Yes
144

Week 10
WEEK 10
Lecture03/01-P56 Normal ageing
Theme:
III
Discipline:

Department of Medicine, Monash Medical Centre

Dr Paul Jambunathan
Objectives
After attending this lecture and completing the prescribed readings it is expected that students will be
able to understand the following developmental aspects of normal ageing:
concept of normal ageing
survival curve
squaring of the survival curve with ideal ageing
maximum lifespan potential
interaction between heritable and environmental factors
typical changes of normal ageing in each of the organ systems
Content synopsis
Introduction
Ageing can be considered as equivalent to development, embracing embryogenesis, maturation, a
period of adult vigour, and senescence. Ageing is a time dependent process which is progressive,
universal within a species, and intrinsic (ie not a result of disease or environmental influences).
Senescence is that part of the ageing process which is associated with an increasing probability of
dying as a function of time. In other words, survival curves should be rectangular in species which are
living under close to ideal conditions, and the onset of senescence in such species can be considered
the age at which survival begins to decrease rapidly.
Definition from Kirkland JL, The Biochemistry of mammalian senescence. Clin Biochem 1992 (25)
61-75
Normal ageing statistical definition
Normal or usual ageing is that series of events, which occur to the majority of the population as they
become older. By definition, it is the experience of the bulk of the population which lies within two
standard deviations of the mean for the item or process of interest. The problem with this definition of
ageing is that if most people experience a particular disease as they become older then it would be
considered mathematically normal to have that disease as a part of ageing. The ageing that most
people experience is a combination of senescence and the effects of disease (eg hypertension,
atherosclerosis) and the environment (eg ultraviolet light exposure, and exposure to cigarette smoke).
Normal ageing ideal ageing
Ideal ageing is the process that consists solely of changes that occur as a result of senescence
alone and that are not due to any disease or any deleterious environmental influences at all. In this
form of ageing most individuals in a species would live to close to the upper limit of the species
lifespan.
It must be obvious that the ideal ageing variant of normal ageing is extremely rare, and that the
ageing which the vast majority of the population experiences (the statistically normal ageing) is in
fact far from ideal or physiologically normal.
145

Week 10
Use of ageing
The concluding paragraphs of the section titles Humanitarian and Developmental aspects of ageing
in the 1982 International Action Plan on Ageing from the United Nations provide a stimulus for
thought:
The human race is characterized by a long childhood and by a long old age. Throughout history this
has enabled older persons to educate the younger and pass on values to them; this role has ensured
man's survival and progress. The presence of the elderly in the family home, the neighbourhood and
in all forms of social life still teaches an irreplaceable lesson of humanity. Not only by his life, but
indeed by his death, the older person teaches us all a lesson. Through grief the survivors come to
understand that the dead do continue to participate in the human community, by the results of their
labour, the works and institutions they leave behind them, and the memory of their words and deeds.
This may encourage us to regard our own death with greater serenity and to grow more fully aware of
the responsibilities toward future generations.
A longer life provides humans with an opportunity to examine their lives in retrospect, to correct some
of their mistakes, to get closer to the truth and to achieve a different understanding of the sense and
value of their actions. This may well be the more important contribution of older people to the human
community. Especially at this time, after the unprecedented changes that have affected humankind in
their lifetime, the reinterpretation of life-stories by the aged should help us all to achieve the urgently
needed reorientation of history.
Readings:
Publications at the United Nations web site: http://www.un.org/esa/socdev/ageing
The Merck Manual of Geriatrics 2nd ed. 1995 Merck Research Laboratories. Available online at
http://www.merck.com/pubs/mm_geriatrics/sec1/ch1.htm
146

Week 10
WEEK 10
Practical_HISTOLOGY_03/01 & 02 - Functional histology - heart, conduction and
vessels
Theme:
III
Discipline:
Anatomy
Sub Discipline:
Histology

Associate Professor Jeffrey Kerr
Email: jeff.kerr@monash.edu
Objectives:
state the function of the cardiovascular system and the lymph vascular system
describe the histology of the heart, blood vessels and lymph vessels
relate the histology of the heart, blood vessels and lymph vessels to their function
Content synopsis:
Function of the cardiovascular and lymph vascular systems.
Histological structure of the cardiovascular system.
Histology of the heart and histological features of cardiac muscle.
Function and components of the arterial system.
Histology of the aorta, arteries and arterioles.
Function and histological structure of capillaries.
Function and components of the venous system.
Histology of the large veins (vena cava, portal vein), medium veins and venules.
Composition of lymph.
Histology of large and small lymph vessels.
Key Words/Phrases:
Tunica intima, tunica media, tunica adventitia, endocardium, myocardium, epicardium, cardiac muscle,
smooth muscle, connective tissue, collagen, elastin, valves, diffusion
Readings:
Wheaters Functional Histology
Kerrs Functional Histology
147

Week 10
WEEK 10
Lecture03/01-P64 - Electrical activity of the heart
Theme:
III
Discipline:
Physiology

Dr Julia Choate
Sub Discipline:
Cardiovascular

Dr Nik Asmah
Objectives:
describe the conducting system of the heart and how electrical activity spreads from the
sino-atrial node to the rest of the heart
list the potential pacemaker cells in the heart
explain how sino-atrial node pacemaker cells spontaneously generate action potentials
and acts as the normal pacemaker of the heart
appreciate that action potentials in different regions of the heart have different shapes and the
reasons for this (eg SA node versus cardiac ventricular myocytes)
explain how sino-atrial node pacemaking (ie, heart rate) is regulated by the autonomic nervous
system
Content synopsis:
mechanisms underlying the spontaneous generation of action potentials in cardiac pacemaker
cells
initiation of the heart beat by the sino-atrial node pacemaker cells
spread of electrical activity from the sino-atrial node to the rest of the heart via specialised
conducting tissue (ie, the atrioventricular node, bundle of His, purkinje fibres)
primary, secondary and tertiary pacemaker regions of the heart
differences in the action potential between sino-atrial node cells and ventricular cardiac muscle
cells
mechanisms by which sympathetic nerve activity increases heart rate and parasympathetic
nerve activity decreases heart rate, through modulating the sino-atrial node pacemaker activity
concept of a maximum heart rate
Keywords:
Pacemaker cells, sino-atrial node, atrioventricular node, bundle of His, purkinje fibres, conducting
system, slow depolarisation (pacemaker potential), sino-atrial node action potentials, ventricular action
potentials, parasympathetic and sympathetic innervation of the heart.
Readings:
Guyton & Hall Textbook of Medical Physiology 12th ed. Elsevier Saunders pg 111 & 115-125
Yes
148

Week 10
WEEK 10
Lecture03/01-P65 The cardiac cycle and cardiac output
Theme:
III
Discipline:
Physiology

Dr Julia Choate
Sub Discipline:
Cardiovascular

Dr Nik Asmah
Objectives:
appreciate that each pumping cycle of the heart consists of 5 highly coordinated phases
explain in detail the events occurring in the different phases of cardiac cycle (eg opening and
closure of valves, timing of blood filling and blood ejection in consequent heart chambers)
describe the pressure and volume changes in the heart during each phase of the cardiac cycle
relate the phases of the cardiac cycle to the electrocardiogram (ECG)
appreciate the importance of the coordinated spread of excitation through the heart and the role
of the heart valves to the hearts pumping function
Content synopsis:
The cardiac cycle will be described as consisting of 5 phases. The pressure and volume changes in
the chambers of the heart, and the state of the heart valves, during each phase will be considered.
The phases of the cardiac cycle will be correlated with the ECG. The importance of the coordinated
spread of excitation through the heart and the ensuring of unidirectional flow of blood through the
heart chambers by the heart valves will be emphasised. Cardiac output will be defined and the role of
heart rate and stroke volume in determining cardiac output discussed. Control of heart rate by the
autonomic nervous system will be reviewed. The control of stroke volume through changes in
end-diastolic volume (Frank-Starling Law of the Heart) and changes in contractility will be described.
The concept of ejection fraction will be introduced. The importance of the Frank-Starling Law of the
Heart in ensuring that the outputs of the left and right sides of the heart are matched will be
emphasised.
Keywords:
Systole, diastole, passive ventricular filling, atrial contraction, isovolumetric ventricular contraction,
ventricular ejection, isovolumetric ventricular relaxation, heart sounds, cardiac output, heart rate,
stroke volume, end-diastolic volume, end-systolic volume, ejection fraction, contractility, Frank-Starling
Law of the Heart.
Readings:
Pre Reading
Guyton & Hall Textbook of Medical Physiology 12th ed. pg 104-107 (Cardiac Cycle)
Naish, Revest & Syndercombe Court, Medical Sciences pg 588-592 (Cardiac Cycle)
Recommended
Guyton & Hall Textbook of Medical Physiology 12th ed. Ch 9 The Heart as a pump and Function
of the Heart Valves pg 106-114
Yes
149

Week 10
WEEK 10
Lecture03/01-P60 Elderly, death and dying
Theme:
III
Discipline:

Department of Medicine, Monash Medical Centre

Dr Paul Jambunathan
Objectives
understand the changing perceptions, anxieties and feelings about death with age
describe Kbler-Ross' 5 stages of dying
define bereavement, grief, mourning, grief reactions
describe the experiences of death and bereavement across the lifespan
Content synopsis:
This module covers the major biopsychosocial factors in the transition from mid-to-late adulthood to
elderly and death, and includes death anxiety over the life span Kbler-Ross' 5 stages of dying,
end-of-life issues, palliative care, bereavement, grief and mourning, coping with grief, religiosity and
grief, childrens understanding of death, reactions to death across the lifespan.
Key words/Phrases:
Palliative Care, Bereavement, Mourning, Death, Death Anxiety
Readings:
Prescribed
Thomson/Wadsworth Ch 16 pg 582-585 & 591-607 (Thinking About Death, Surviving the Loss)
Recommended
Thomson/Wadsworth Ch 15 pg 558-564 (Friends and Family in Late Life)
Yes
150

Week 10
WEEK 10
Lecture03/01-P63 Pericardium and heart
Theme:
III
Discipline:
Anatomy

Dr Justin Adams
Sub Discipline:
Cardiovascular
Objectives:
describe the divisions of the mediastinum
describe the boundaries and contents of anterior and middle mediastina
describe the coronary arteries and conducting system of the heart
describe the chambers of the heart and specific features
describe pericardial structure and function
describe the proximal parts of the great vessels
Content synopsis:
The anatomical structures of the anterior and middle mediastina and their clinical applications.
Key Words/Phrases:
Anterior mediastinum, middle mediastinum, coronary arteries, cardiac conducting system, heart
chambers, pericardium, AV node, layers, foramen ovale, cardiac skeleton, ligamentum arteriosum,
heart valves, heart sounds, surface anatomy
Readings:
Moore & Dalley
Yes
151

Week 10
152
WEEK 11
153

Week 11
WEEK 11
outline the structural anatomy and function of the lymphatic system
outline the morphological and function properties of the lymphoid system
review and extend knowledge of the processes of immunity and responses to cell death
show how the heart and arteries develop and how the important malformations of this system
arise
gain a sophisticated insight into the haemodynamic regulation of the cardiovascular system as
revealed through mathematical modelling
recognize the histological and microanatomical composition of the heart and vessels and relate
these to the functions these structures perform
appreciate how knowledge of anatomy is central to successful heart surgery
review the anatomy of the heart from a clinical perspective
learn the risk factors, pathological mechanism of, and complications of atherosclerosis
describe the pathological significance of atherosclerosis
appreciate the pathological consequences of infarction
appreciate the actions and uses of drugs that affect the force of cardiac contraction
demonstrate and understand the main techniques of physical examination for the
cardiovascular system
perform and understand taking a focused medical history of the cardiovascular system,
including cardiovascular systems review and assessing for common cardiovascular risk factors,
whilst demonstrating appropriate communication skills
discuss or describe the clinical significance of particular cardiovascular symptoms and their
relevance to the processes of diagnosis and clinical decision making
154

Week 11
WEEK 11
Practical_CVS_03/01 to 04 Cardiovascular system
Theme:
III
Discipline:
Physiology
Sub Discipline:
Cardiovascular

Dr Julia Choate
Associate Professor Roger Evans
Associate Professor Yvonne Hodgson
Objectives:
have learnt:
describe the cardiovascular adjustments to changes in posture and/or blood volume
describe cardiovascular changes during exercise
explain the role of afferent (baroreceptors, somatic sensory receptors) and efferent (autonomic
nerves and hormones) mechanisms in control of the circulation
Content synopsis:
This practical is divided into two parts:
(1) the effects of postural changes on the cardiovascular system, and
(2) the effects of exercise on the cardiovascular system.
A finapres fingercuff will be used to record HR (beats/min), systolic (SAP, mmHg) and diastolic
(DAP, mmHg) arterial pressure and cardiac output (CO; l/min). Stroke volume (SV, ml) and total
peripheral resistance (TPR, mmHg/ml. min-1) will be calculated from the recorded variables.
Keywords:
Cardiac output, arterial pressure, stroke volume, total peripheral resistance
Readings:
Pre Reading
The practical notes in the Workbook.
155

Week 11
WEEK 11
Lecture03/01-P52 - Tissue infarction, tissue repair
Theme:
III
Discipline:
Pathology
Sub Discipline:
Cardiovascular

Associate Professor John Pedersen
Monash Institute of Medical Research
Email: John.Pedersen@tissuepath.com
Objectives:
After participating successfully in this session and related activities, you should be able to:
describe and explain the mechanisms and consequences of ischaemia
describe and explain the mechanisms and consequences of infarction
give an account of the cellular events, repair mechanisms and chronic outcome associated with
infarction
Content synopsis:
This lecture will cover the mechanisms and consequences of ischaemia and infarction. The
clinic-pathological correlation of infarction will be elaborated in terms of cellular events, repair
mechanisms and chronic outcome.
Keywords:
Ischaemia, infarction, organisation, resolution
Readings:
Recommended
Underwood JCE (ed.) 2009, General and Systematic Pathology 5th ed. Churchill Livingstone,
Edinburgh, Ch 13 pg 294-297 & Ch 8
156

Week 11
WEEK 11
Lecture03/01-P53 Pathology: when cells die
Theme:
III
Discipline:
Pathology
Sub Discipline:
Cardiovascular

Associate Professor Hans Schneider
Department of Immunology, Alfred Hospital
Email: Hans.Schneider@monash.edu
or
H.Schneider@alfred.org.au
Objectives:
list the principal protein markers used in the diagnosis of AMI
understand the use of cardiac marker testing in outcome prediction
assess the relative usefulness and sensitivity of different cardiac markers for the diagnosis of
AMI
understand the use of B-type natriuretic peptide (BNP) for the diagnosis of patients presenting
with shortness of breath
understand the value of BNP/NTproBNP for the management of patients with known heart
failure
understand the predictive use of C-reactive protein (CRP) for assessing risk of unstable angina
and AMI
Content synopsis:
This lecture will cover the detection and the use of markers of myocardial damage associated with
unstable angina and acute myocardial infarction (AMI). The use, sensitivity and specificity of these
markers will be discussed in relation to diagnosis and risk prediction.
Keywords:
Angina, AMI, infarction, creatine kinase (CK), troponin I and T, BNP, NTproBNP, C-reactive protein
(CRP)
Readings:
Recommended
Babuin L & Jaffe AS 2005, Troponin: the biomarker of choice for the detection of cardiac injury,
Canadian Medical Association Journal, vol 173, no 10, pg 1191-1202
Review. Errata in: (1) Canadian Medical Association Journal 2005, vol 173, no 12, pg 1490 and
(2) Canadian Medical Association Journal 2006, vol 174, no 3, pg 353
Rademaker MT & Richards AM 2005, Cardiac natriuretic peptides for cardiac health, Clinical
Science, vol 108, no 1, pg 23-36 Review
Omland T, New features of troponin testing in different clinical settings. J Intern Med. 2010, Sep
268 (3): 207-17 Epub 2010 Jun 8
Moe KT & Wong P, Current trends in diagnostic biomarkers of acute coronary syndrome. Ann
Acad Med Singapore 2010, Mar 39 (3) 210-5
Doust J, Lehman R & Glasziou P, The role of BNP testing in heart failure, Am Fam Physician
2006, Dec 1 74 (11): 1893-8
Yes
157

Week 11
WEEK 11
Lecture03/01-P66 Challenges in heart surgery
Theme:
III
Discipline:
Anatomy
Sub Discipline:
Cardiovascular

Professor Julian Smith
Head of Dept of Surgery, Monash Medical Centre
Email: julian.smith@monash.edu
Objectives:
At the end of this lecture students will be able to appreciate how knowledge of anatomy is central to
successful heart surgery.
This lecture is not core anatomy content but instead is meant to inspire you to appreciate how
anatomy is critical in surgery.
Key Words/Phrases:
Heart disease, chest wall and surgical access, by-pass, anatomy of the heart valves and major
vessels, coronary arteries
Readings:
Yes
158

Week 11
WEEK 11
Practical_INTEGRATED_ANAT_03_04/01-P1 and 02-P1
Cardiovascular system Integrated Anatomy and Clinical Skills
Theme:
III and IV
Anatomy and Clinical Skills
Discipline:
CMS Lecturers / Tutors

Professor Paul G McMenamin


Objectives:
perform a complete and thorough cardiovascular examination
competently take a patients blood pressure (revision from semester 1 week 8)
explain the significance of jugular venous pressure (JVP)
examine a patient for peripheral signs of cardiovascular disease
demonstrate patient-centred communication skills during the physical examination
summarise the physical findings to their peers
explain pathological processes that may affect the cardiovascular system, and related clinical
findings
make out on the chest of a colleague the bony landmarks important to painting in the heart
namely the sternum, clavicle and the ribs (will be covered in anatomy tutorial)
accurately paint boundaries or outline of the heart on the chest (sometimes known as the
surface projections) (will be covered in anatomy tutorial)
paint in the parts (atria and ventricles) of the heart and the major vessels (will be covered in
anatomy tutorial)
paint the position of the coronary arteries (will be covered in anatomy tutorial)
Content synopsis:
Students might start with either an anatomy or a clinical skills tutor with rotation after 2 hours
Clinical Skills:
Tutors will demonstrate a complete examination of the cardiovascular system (30 minutes)
Tutors will discuss with students the correlation of some physical signs and cardiovascular
disease (15 minutes)
Tutors will explain the significance of the JVP (10 minutes))
Students will practice the examination of the cardiovascular examination (60 minutes)
Key Words/Phrases:
Arterial pulses, blood pressure, systolic, diastolic, sphygmomanometer, jugular venous pressure
(JVP), cardiovascular system, precordium, heart sounds, patient centred, summary, intercostal space,
sternum, mid-clavicular line, pericardium, coronary arteries, ventricles, atria, ascending aorta,
pulmonary trunk
159

Week 11
Readings:
Prescribed
Thorax section of Moore and Dalley
Recommended
Epstein O, Perkin GD, de Bono DP & Cookson J 2008 Clinical Examination 4th ed Mosby,
Elsevier Limited 4th ed pg 157-173, General Observation pg 157, Palpating the peripheral
pulses pg 159, Measuring blood pressure pg 161, Examination of the jugular venous pulse
pg 164, Palpation of the precordium pg 166, Auscultation of the heart pg 167, cardiovascular
system and chest examination pg 173, cardiovascular system and abdominal examination
pg 173
Additional Resources
www.3m.com/us/healthcare/professionals/littmann/jhtml/littmann_heart_sounds.html
(this is a commercial site run by Littman stethoscopes, but has very good heart sound
recordings)
160

Week 11
WEEK 11
Tutorial_04/01-P11 to 20-P11 Cardiovascular system
Theme:
IV
Discipline:
Clinical Skills


*NB No content provided at the time of printing. Please check Workbook for material.
161

Week 11
WEEK 11
Tutorial_04 ECG - Online Tutorial (In Preparation for the ECG Interpretation Tutorial)
Theme:
IV
Discipline:
Clinical Skills

The ECG online tutorial will be uploaded on Moodle and is made up of three parts and it is
important that they be read in the order in which they are presented. Students need to study
the ECG online tutorial before attending the ECG tutorial session in week 12
Objectives:
At the end of the ECG online tutorial and its related activities, students are expected to be able to:
explain normal electrical conduction through the heart
describe the purpose and the function of the ECG
describe the indications for performing an ECG
describe the location of placement of electrodes for LI, II,III, aVR, aVL, aVF, V1 to V6
recognise which part of the heart each lead views
explain the graphing ECG paper
identify normal ECG waveforms and intervals
relate the phases of the cardiac cycle to the ECG
apply a systematic approach to interpret any ECG
determine the heart rate on an ECG
explain the normal sinus rhythm
identify ECG features of common heart blocks
visually identify different heart rhythms from an ECG strip
estimate the mean electrical axis and identify possible common causes of axis deviation
identify ECG hypertrophy patterns
explain the specific ECG changes associated with myocardial ischemia, injury and infarction
162

Week 11
WEEK 11
Lecture03/01-P67 - Arteries, arterioles and the distribution of blood flow
Theme:
III
Discipline:
Physiology

Email: roger.evans@monash.edu
Sub Discipline:
Cardiovascular

Dr Badariah Ahmad
Objectives:
appreciate that the wall of most blood vessels is composed of 3 layers
understand the importance of the elastic nature and low resistance of the large arteries
list the four main descriptive measures of arterial blood pressure and what they represent
understand the role of the arterioles in regulating the distribution of blood flow
appreciate the role of smooth muscle in the walls of arterioles in controlling their diameter
understand how arteriole diameter and blood flow can be controlled by local (intrinsic) factors
understand the role of the sympathetic nervous system in reflex (extrinsic) control of arteriole
diameter and blood flow distribution
Content synopsis:
The role of elastic arteries in facilitating continuous blood flow through the blood vessels will be
discussed. The arterial pressure profile will be described and descriptive measures of arterial blood
pressure defined. Constriction and dilation of arterioles through contraction and relaxation respectively
of the smooth muscle in their walls will be discussed. The relationship between arteriole diameter,
resistance, and blood flow through the arteriole will be explored in the context of how the arterioles are
able to regulate the distribution of blood flow through different organs and tissues. Factors that affect
arteriole diameter and blood flow at a local level, such as tissue metabolic activity and changes in
perfusion pressure, will be discussed. The role of the endothelium lining the lumen of arterioles in
controlling arteriole diameter will be considered. Reflex control of the arterioles and blood flow
distribution by the sympathetic nervous system will be considered and the importance of arterioles in
determining the level of mean arterial blood pressure will be introduced.
Key Words/Phrases:
Elastic arteries, systolic pressure, diastolic pressure, pulse pressure, mean arterial pressure,
arterioles, constriction, dilation, resistance and flow, vascular smooth muscle, vascular endothelium,
metabolic regulation of blood flow, autoregulation of blood flow, reflex control of blood flow.
Readings:
Prescribed
Naish, Revest & Syndercombe Court, Medical Sciences Ch 11 The Cardiovascular System. It is
expected that students will read Ch 11 in its entirety in association with the lectures on the
cardiovascular system pg 571-572 & 596-608, 2009 ed. should be read before the lecture.
Recommended
Guyton & Hall, 2006, Textbook of Medical Physiology 12th ed. Ch 15
Widmaier, Raff & Strang 2008, Vanders Human Physiology 12th ed. Ch 12 pg 377-385
Yes
163

Week 11
WEEK 11
Lecture03/01-P68 - Vasodilator agents
Theme:
III
Discipline:
Pharmacology

Professor Robert Widdop
Email: robert.widdop@monash.edu
Sub Discipline:
Cardiovascular

Objectives:
describe the mechanism of action of some vasodilator drugs (eg nitrites/nitrates, hydralazine,
alpha-adrenoceptor antagonists)
discuss the basis for their use in the treatment of angina and/or heart failure
describe their pharmacokinetics and their adverse effects
Content synopsis:
Strategies for the medical treatment of heart failure (eg reducing cardiac work load, increasing
contractility).
Definition of angina pectoris, and strategies for non-surgical treatment.
Mechanism of action of some vasodilator drugs (eg nitrites/nitrates, hydralazine,
alpha-adrenoceptor antagonists), their uses in the treatment of heart failure and/or angina (the
use of some of these drugs in the treatment of hypertension is considered in the lectures on
Treatment of Hypertension), their pharmacokinetics and their adverse effects.
Keywords:
Heart failure, vasodilator agents, angina pectoris, nitrites, nitrates, hydralazine, alpha-adrenoceptor
antagonists
Readings:
Prescribed
Antihypertensive agents Ch 11 pg 169-191; Vasodilators & the treatment of angina pectoris Ch
12 pg 193-210
Recommended
Livingstone, Edinburgh, The heart Ch 21 pg 246-264
Yes
164

Week 11
WEEK 11 & 12
Practical_ANAT_03/01-P19 & P20 to 16-P19 & P20 Cardiovascular system II
Theme:
III
Discipline:
Anatomy

Email: justin.adams@monash.ed
Objectives for each of the 4 (x1 hour) components of the practical class:
After participating in the Specimen Workshop it is expected that students will be able to identify:
components of the pericardium
contents of pericardial sac
pericardial cavities and their sinuses
position of apex, base and borders of heart
features of right and left atria
features of right and left ventricles
major valves and their position (noting relationship to auscultation sites)
impulse conducting system (noting relationship to fibrous ring)
course and branches of coronary arteries (noting right or left dominance)
major veins of the heart (noting entry of coronary sinus into right atrium)
After participating in the Imaging Workshop, it is expected that students will be able to:
identify each component of right and left cardiomediastinal contour on a normal Chest X-Ray
(PA view)
identify the cardiomediastinal contour on a normal Chest X-Ray (lateral view)
comprehend the appearance of arteries on a normal coronary angiogram (contrasting a right
dominant pattern with a left dominant pattern)
comprehend the appearance of chambers and their associated valves on a normal
echocardiogram (contrasting diastole with systole)
165

Week 11
WEEK 11
Lecture03/01-P73 - Microcirculation and the lymphatic system
Theme:
III
Discipline:
Physiology

Sub Discipline:
Cardiovascular

Dr Badariah Ahmad
Objectives:
understand the nature of lymph, the structure of the bodys lymphatic system, and how this
relates to other body fluid compartments
explore the specific anatomy and physiology of the lymphatic system
understand capillary dynamics and particularly Starling forces
be able to link an understanding of capillary dynamics to oedema production
understand the role that lymphatic disorder may play in disease states
Content synopsis:
A powerpoint presentation will describe the structural anatomy and function of the lymphatic system,
giving important vital statistics, and showing how this system links to other body fluid compartments
and the lymph glands. Capillary haemodynamics will be described in detail and the functional
implications of Starling forces will be illustrated.
Key Words/Phrases:
Lymphatics, lymph nodes, body fluid compartments, capillary dynamics, Starling forces
Readings:
Prescribed
cardiovascular system pg 611-618, 2009 ed. should be read before the lecture.
Recommended
Yes
166

Week 11
WEEK 11
Lecture03/01-P70 - Atherosclerosis and its complications
Theme:
III
Discipline:
Pathology
Sub Discipline:
Cardiovascular

Dr Anthony Longano
Department of Anatomical Pathology
Email: Anthony.Longano@southernhealth.org.au
Objectives:
Learn the risk factors, pathological mechanism of, and complications of atherosclerosis.
Content synopsis:
Risk factors for atherosclerosis.
Mechanism of atherosclerosis.
Microscopic and macroscopic appearance of atherosclerosis and its complications.
Key Words/Phrases:
Atherosclerosis
Readings:
Prescribed
JC Underwood, General and Systematic Pathology 5th ed. Ch 13 pg 272-278
Yes
167

Week 11
WEEK 11
Lecture03/01- P71 Adulthood and health behaviour
Theme:
III
Discipline:

Dr Glenn Melvin

Dr Paul Jambunathan
Objectives:
At the end of this session, students should be able to demonstrate:
an understanding of the change in health behaviour over the lifespan
the ability to contrast health behaviour across the lifespan
the ability to explore social learning of health behaviour within families
an understanding of health behaviour in old age
Content synopsis
Health behaviours change over the lifespan. This lecture will discuss some examples of health
behaviour during adulthood and into old age and consider their consequences on biopsychosocial
wellbeing. Theoretical mechanisms of intergenerational transmission or learning of health behaviours
will be explored.
Key words/Phrases
Health behavior, modelling, compliance, caring, health belief model
Readings:
Prescribed
Australia 2nd ed. Sydney, Pearson pg 508-521 (Caring) & pg 152-154 (Health Belief Model)
168
Yes

Week 11
WEEK 11
Lecture03/01-P72 - Inotropic agents
Theme:
III
Discipline:
Pharmacology

Sub Discipline:
Cardiovascular

Dr Amudha Kadirvelu
Objectives:
discuss the mechanism of action of drugs used to increase cardiac contractility
list the uses of positive inotropic agents in the treatment of heart failure
describe the pharmacokinetics of positive inotropic agents
describe the adverse effects of positive inotropic agents
Content synopsis:
Strategies for the medical treatment of heart failure (eg reducing cardiac work load, increasing
cardiac contractility).
Mechanism of action of drugs used to increase cardiac contractility (positive inotropic agents,
eg digoxin), their uses in the treatment of heart failure, their pharmacokinetics and their adverse
effects.
Keywords:
Positive inotropic agents, digoxin, heart failure.
Readings:
Prescribed
Ch 13 Drugs used in heart failure pg 211-226
Recommended
Yes
169

Week 11
170
WEEK 12
171

Week 12
WEEK 12
describe developmental difference and developmental disability
describe the development of the heart and the common congenital heart abnormalities
give an overview of the main infectious diseases affecting the cardiovascular systems
explain the functions of the vascular endothelium, the microcirculation and the vascular supply
system of the heart in health and disease
show how veins contribute to the regulation of blood pressure and how arterial pressure is
regulated in the short term including responses to disturbances such as blood loss and exercise
describe common infectious diseases affecting the cardiovascular systems
outline the use of drugs and non-pharmacological options for the treatment of hyperlipaemia
appreciate the actions and uses of drugs that affect the rhythm of cardiac contraction
recognise and describe the components of a normal electrocardiogram (ECG) and interpret
basic ECGs
review and practice history taking and physical examination techniques
discuss or describe the clinical significance of particular cardiovascular symptoms and their
relevance to the processes of diagnosis and clinical decision making
172

Week 12
WEEK 12
Tutorial_ECG_04/01 to 12 ECG
Theme:
IV
Clinical Skills
Discipline:


Objectives:
After participating in this activity, it is expected that students will be able to:
recognise and describe the components of a normal electrocardiogram (ECG)
interpret basic ECGs
identify some clinical situations in which ECG may be used
Content synopsis:
Review the features of a normal ECG and analyse some ECG tracings (1 hour)
Students should come prepared for this session. They need to study the ECG online tutorial before
attending this session
Keywords:
Electrocardiogram, limb leads, chest leads, sino-atrial node (SA node), atrioventricular node (AV
node), electrocardiogram, arrhythmia, bradycardia, tachycardia, ectopic beat
Readings:
Prescribed
Hampton J 2003 ECGs made easy, Churchill Livingstone Ch 1
or
Meek S & Morris F 2002 ABC of Clinical Electrocardiography Introduction I Leads, rate,
rhythm & cardiac axis, BMJ;324 (16th Feb) 415-418 at www.bmj.com/cgi/reprint/324/7334/415
173

Week 12
WEEK 12
Lecture03/01-P69 The vascular endothelium
Theme:
III
Discipline:
Physiology

Dr Marianne Tare
Email: marianne.tare@monash.edu
Sub Discipline:
Cardiovascular

Dr Amudha Kadirvelu
Objectives:
explore the factors released by the endothelium and their potential effects
examine the physiological effects of the endothelial NO system
understand how disorder of endothelial function may lead to common disease states
Content synopsis:
A powerpoint presentation will describe the structure and function of the endothelium, giving important
vital statistics, an overview of its activities and its various balancing acts:
vasoconstriction and vasodilation
cell growth promotion and inhibition
blood cell adhesion and anti-adhesion
clot promotion and lysis
inflammation and anti-inflammation
The ways in which the endothelial NO system participates in these physiological effects will be
explored in some detail, leading to a preliminary look at disease states where this system is altered.
Keywords:
Endothelial structure
pathophysiology
and
function,
hormonal
systems,
Readings:
Yes
174
balancing
activities,
NO
system,

Week 12
WEEK 12
Lecture03/01-P74 Lipid lowering drugs
Theme:
III
Discipline:
Pharmacology

Sub Discipline:
Cardiovascular

Dr Amudha Kadirvelu
Objectives:
describe the processes involved in the development of atherosclerosis
list the classes of lipid lowering drugs
discuss the basic mechanism of action and common adverse effects of lipid-lowering drugs
Content synopsis:
lipoproteins and atherosclerosis
lipid transport in the blood and hyperlipidaemia
lipid lowering agents statins, fibrates and bile acid-binding resins
non-pharmacological options for treatment of hyperlipaemia
choice of drug treatment
Keywords:
lipoproteins, hyperlipidaemia, dyslipidaemia cholesterol, lipid lowering agents
Readings:
Prescribed
Agents used in dyslipidemia Ch 35 pg 619-633
Recommended
Livingstone, Edinburgh; Atherosclerosis and lipoprotein metabolism Ch 23 pg 285-293
Yes
175

Week 12
WEEK 12
Theme:

Professor Ben Canny
Deputy Dean, MBBS
Objectives:
No
176

Week 12
WEEK 12
Tutorial_04/01-P10 to 20-P10 Clinical reasoning skills
Theme:
IV
Clinical Skills
Discipline:


Objectives:
After participating in this class, it is expected that students will be able to:
demonstrate appropriate communication skills when interviewing a patient with cardiovascular
disease
perform a competent and thorough history of the cardiovascular system including a focused
system review
perform a competent and thorough basic examination of the cardiovascular system
describe the clinical significance of particular cardiovascular symptoms and signs found on
examination of the cardiovascular system and their relevance to the processes of diagnosis and
clinical decision-making
Content synopsis:
Review communication skills; medical history taking and common symptoms; examination and
important findings/clinical signs in relation to the cardiovascular system.
Practise collecting and synthesising key findings from cardiovascular history and examination;
and applying clinical reasoning skills to reflect on possible clinical significance and
interpretation.
Glossary:
Clinical reasoning, Comprehensive-exhaustive, Hypothetico-deductive
Key Words/Phrases:
Review cardiovascular system: medical history, systems review and examination, clinical reasoning
Readings:
Recommended
Epstein O, Perkin GD, de Bono DP & Cookson J 2008 Clinical Examination 4th ed Mosby
Elsevier Limited pg 139-185
177

Week 12
WEEK 12
Lecture03/01-P75 - Coronary circulation in health and disease
Theme:
III
Discipline:
Physiology

Professor Karlheinz Peter
Department of Medicine, Alfred Hospital
Sub Discipline:
Cardiovascular

Dr Nik Asmah
Objectives:
understand the gross anatomy of the coronary circulation
appreciate the high reliance of the heart on an adequate oxygen supply and the role of the
coronary circulation in providing this
describe the unique features of the regulation of the coronary circulation
describe the outcomes of atherosclerosis involving the major coronary arteries
state the major determinants and risk factors for coronary atherosclerosis
explain various treatment modalities available
Content synopsis:
The left main coronary branches into the left anterior descending and circumflex coronary arteries
supplying the left ventricle. The right coronary artery supplies the atria, right ventricle and left to a
varying degree. Coronary veins feed into the right atrium mainly through the coronary sinus.
Coronary blood flow mostly occurs in diastole. The large coronary arteries are the epicardial surface
and with reduced flow it is endocardial supply that is most at risk. The major determinant for coronary
blood flow is myocardial oxygen consumption. The major determinants of the latter are heart rate and
cardiac afterload. The product of heart rate x blood pressure (double product) provides a reasonable
approximation. Other regulators of the coronary circulation include the endothelium, the sympathetic
nervous system and a range of autocrine factors.
The major risk factors for the development of atherosclerotic plaques in the coronaries include lipid
disorders, high blood pressure and smoking. Lesions develop early in life and do not cause symptoms
unless there is haemodynamically significant narrowing (>70% stenosis) leading to exertional angina.
Plaque disruption is the other major mechanism of acute coronary syndromes causing thrombosis and
partial (unstable angina) or complete (myocardial infarction - heart attack) occlusions.
Keywords:
Coronary blood flow, atherosclerosis, endothelium, angina, myocardial infarction, risk factors.
Readings:
Recommended
Davies A, Blakeley AGH & Kidd C 2001 Human Physiology, Churchill Livingstone, Edinburgh,
pg 524-533 & 571-584
Kumar P & Clark M 2002 Clinical Medicine: A Textbook for Medical Students and Doctors,
5th ed. Saunders, Philadelphia Ch 13 Cardiovascular Disease pg 701-706 & pg 766-782
Sherwood 3rd ed. Fundamentals of Physiology Ch 9 Cardiac Physiology pg 265-269
Silverthorn 5th ed. Human Physiology - An Integrated Approach Ch 15 Cardiovascular Disease
pg 535-540
Guyton & Hall 2006 Textbook of Medical Physiology 11th ed. Ch 21 Muscle Blood Flow and
Cardiac Output During Exercise; the Coronary Circulation and Ischaemic Heart Disease
pg 252-256
Cardiac Output During Exercise; the Coronary Circulation and Ischaemic Heart Disease,
pg 252-256
Yes
178

Week 12
WEEK 12
Lecture03/01-P76 - Veins and venous return
Theme:
III
Discipline:
Physiology

Sub Discipline:
Cardiovascular

Dr Badariah Ahmad
Objectives:
understand the importance of the veins in returning blood to the heart (venous return)
appreciate the characteristics of veins that allow them to be able to hold large volumes of blood
and to have low resistance to flow
appreciate that cardiac output and venous return are closely associated
understand the importance of venous pressure, and appreciate the factors that determine
venous pressure
appreciate that venous return can be increased by increasing the contractile tone of smooth
muscle in the vein walls
recognise that veins have one-way valves and appreciate that factors such as muscular activity
and respiratory activity can influence venous return
Content synopsis:
The characteristics of veins will be discussed including the consequences of their high distensibility
(compliance) and relatively large diameters. The close association between venous return and cardiac
output will be discussed, noting that over any appreciable time interval venous return must equal
cardiac output. The importance of venous pressure in the return of blood to the heart will be
emphasised. The importance of smooth muscle in the walls of veins in determining the stiffness of the
vein walls, and thus the distensibility, will be considered together with the role of the sympathetic
nervous system in controlling the contractile state of the venous smooth muscle (venomotor tone).
How changes in venomotor tone affect venous return and consequently cardiac output will be covered.
Ancillary factors that influence venous return will be described, with emphasis on skeletal muscle
activity and alternating pressure changes in the abdomen and thorax resulting from respiratory activity.
The importance of venous valves will be highlighted.
Key Words/Phrases:
Distensibility of veins, volume reservoir, venous return, venous pressure, venomotor tone, venous
valves, skeletal muscle pump, respiratory pump.
Readings:
Prescribed
Recommended
Yes
179

Week 12
WEEK 12
Lecture03/01-P77 - Short-term regulation of mean arterial blood pressure
Theme:
III
Discipline:
Physiology

Sub Discipline:
Cardiovascular

Dr Nik Asmah
Objectives:
understand that mean arterial blood pressure depends upon the cardiac output and the total
peripheral resistance
appreciate the importance of maintaining the mean arterial pressure at an appropriate level
describe the role of baroreceptors in monitoring arterial blood pressure and in the regulation of
mean arterial pressure
understand the role of the medullary cardiovascular centre in the regulation of mean arterial
blood pressure
describe the physiological mechanisms by which adjustments to the mean arterial pressure can
be made
describe the baroreceptor reflex and its involvement in short-term regulation of mean arterial
pressure
appreciate that the long-term control of mean arterial pressure involves the kidneys and
regulation of body water and hence blood volume
Content synopsis:
The basis for the dependence of mean arterial pressure on cardiac output and total peripheral
resistance will be discussed and physiological mechanisms by which adjustments to the mean arterial
pressure can be made will be highlighted. The cardiovascular system will be considered as a control
system in the context of the regulation of mean arterial pressure. The response of arterial
baroreceptors to changes in arterial blood pressure will be described. Consideration will be given to
the role of the medullary cardiovascular centre in receiving and integrating information received from
the baroreceptors and initiating reflex actions to adjust mean arterial pressure. Short-term regulation of
mean arterial pressure through the baroreceptor reflex will be illustrated by considering the response
to a sudden fall in arterial pressure. The concept of long-term regulation of mean arterial pressure
through regulation of blood volume will be introduced.
Key Words/Phrases:
Mean arterial pressure, cardiac output, total peripheral resistance, arterial baroreceptors, medullary
cardiovascular centre, baroreceptor reflex, blood volume.
Readings:
Prescribed
Recommended
Yes
180

Week 12
WEEK 12
Practical_ANAT_03/01-P21 to 16-P21 Revision
Theme:
III
Discipline:
Anatomy

Objective:
Students will have the opportunity to revise the chest anatomy and the anatomy of the heart,
medistim, coronary arteries and major vessels in the mediastinum.
181

Week 12
WEEK 12
Lecture03/01-P78 Congenital abnormalities of the heart and great vessels
Theme:
III
Discipline:
Anatomy
Sub Discipline:
Cardiovascular

Prof Paul McMenamin
Objectives:
At the end of this lecture, students will be able to:
describe the development of the heart
describe the fetal circulation and the transition at birth
discuss the common congenital heart and aortic arch abnormalities
Content synopsis:
Development of endcardial heart tubes and fusion to form tubular heart.
Development of S shaped heart, septa, endocardial cushions and AV valves.
Head fold and position of the heart.
Fetal circulation and transition at birth.
Atrial and ventricular septal defects, presentation, development and management.
Description of tetralogy of Fallot, patent ductus arteriosus and coarctation of the aorta.
Key Words/Phrases:
Heart, development, congenital anomalies, septal defect, tetralogy of Fallot, patent ductus, coarctation
of aorta
Readings:
Prescribed
Recommended
Harvey & Rosenthal 1998, Heart Development, Academic Press
Kirby 2007, Cardiac Development, Oxford University Press
Yes
182

Week 12
WEEK 12
Lecture03/01-P79 - Infectious diseases of the cardiovascular system
Theme:
III
Discipline:
Microbiology
Sub Discipline:
Cardiovascular

Dr Iain Abbott
Department of Infectious Diseases
Objectives:
After participating successfully in this session and related activities, you should be able to describe the
aetiology, clinical features, diagnosis and management of infections of the heart (endocarditis,
myocarditis and pericarditis) and fevers of unknown origin (FUO).
Content synopsis:
This lecture describes the common types of infections seen in the cardiovascular system,
distinguishing between infections of the heart (endocarditis, myocarditis and pericarditis) and those
classified as septicaemias and fevers of unknown origin (FUO). A detailed account of endocarditis
(including aetiology and mechanisms of infection, clinical features, diagnosis, therapy and prophylaxis)
will be followed by briefer treatments of myocarditis and pericarditis. The lecture will conclude with a
discussion of FUOs, detailing the most common infective and non-infective causes, the categories of
the infective FUOs (nosocomial, neutropenic and HIV-associated), and the approaches to
investigations and management.
Keywords:
endocarditis, myocarditis, pericarditis, septicaemia, fever, fever of unknown origin (FUO)
Readings:
Prescribed
Goering et al, Mims Medical Microbiology 5th ed Ch 29
Recommended
PowerPoint presentation on Moodle
183

Week 12
WEEK 12
Lecture03/01-P80 Developmental difference
Theme:
III
Discipline:

Dr Jane Tracy
Centre for Developmental Disability Health Victoria
Email: jane.tracy@monash.edu

Dr Paul Jambunathan
Objectives:
describe the concepts of developmental difference and developmental disability and list the
major categories
identify possible pre, peri and postnatal causes of developmental difference and disability
describe the challenges for a child with disabilities making the transition to adulthood
discuss the ways developmental disabilities can impact on development across the lifespan
contrast the family lifecycle of a family with and without a child with developmental disability
Content synopsis:
This module comprises an introduction to Developmental Psychopathology and Developmental
Difference and explores some of the implications for developmental disability across the lifespan:
the spectrum of developmentally based functions
the broad categories of developmental disabilities
developmental disabilities: intellectual disability, autism spectrum disorders, cerebral palsy and
sensory impairment
an exploration of the impact of Down syndrome through the lifespan
Key words/Phrases:
Developmental delay, developmental deviance, developmental disability, intellectual disability, autism
spectrum disorders, cerebral palsy, sensory impairment, Down syndrome, depression, anxiety,
Alzheimers disorder, dementia, family lifecycle
Readings:
Prescribed
Management of an adolescent with developmental disability in Lennox N & McDowell J 2005
Management Guidelines: Developmental Disability V2 Melbourne, Australia: Therapeutic
Guidelines Ch 8 pg 53-62
Thomson/Wadsworth Ch 2 pg 45-47 (Genetic Disorders) & Ch 6 pg 223-226 (Children with
Intellectual Disability, Learning Disabilities)
Online learning module
Jacqui in Health and Disability: Partnerships in Action
184
Yes

Week 12
WEEK 12
Lecture03/01-P81 - Arrhythmias and their pharmacological treatment
Theme:
III
Discipline:
Pharmacology

Sub Discipline:
Cardiovascular

Objectives:
list the phases and major ionic currents in the action potential in cardiac muscle, conduction and
pacemaker tissues
describe common heart arrhythmias including bradyarrhythmias and tachyarrhythmias and their
pharmacological treatment
describe the mechanisms of action of the commonly used anti-arrhythmic drugs, their uses, and
the adverse effects and adverse drug interactions of these drugs
Content synopsis:
The lecture will consider:
major types of bradyarrhythmias and tachyarrhythmias
treatment options for arrhythmias
mechanisms of tachyarrhythmias (atrial/supraventricular and ventricular)
drug-induced arrhythmias
classification of antiarrhythmic drugs
Class 1: local-anaesthetic or membrane stabilising, eg quinidine, procainamide,
disopyramide, flecainide, lignocaine, mexiletine, etc
Class 2: beta-adrenoceptor antagonists ( -blockers)
Class 3: drugs that prolong action potential and effective refractory period, eg sotalol,
amiodarone
Class 4: cardiac Ca2+ channel blockers, eg verapamil
others eg adenosine, digoxin
mechanism of action of antiarrhythmic drugs, and adverse effects and adverse drug interactions
pharmacological treatment of some common arrhythmias, including: atrial fibrillation,
paroxysmal supraventricular tachycardia, non-sustained ventricular tachycardia
Keywords:
Heart arrhythmias, local anaesthetics, betaadrenoceptor blocking drugs, sotalol, amiodarone,
calcium channel blocking drugs, verapamil, diltiazem
Readings:
Prescribed
Basic and Clinical Pharmacology, ed BG Katzung 12th ed. Lange, Medical Books/McGraw Hill
Ch 14 Agents used in cardiac arrhythmias pg 227-250
Recommended
Livingstone, Edinburgh; The heart Ch 21 pg 246-264
Yes
185

Week 12
186
READINGS
187
188

Readings
WEEK 1
Lecture04/01-P1 - Introduction to clinical examination
Prescribed
Clinical Skills Student Participation Information Sheet on Moodle
Lecture04/01-P2 - Introduction to clinical reasoning

Prescribed
Epstein O, Perkin GD, de Bono DP & Cookson J 2004 Clinical Examination 4th ed Mosby Ch 1
Cole SA & Bird J 2000 The Medical Interview 2nd ed Mosby, Unit 1 Ch 1-5
Recommended
The powerpoint presentation of this lecture will be available on Moodle at least one week prior
to the lecture.
Lecture03/01-P1 Embryology of the limbs

Larsons Human Embryology
Practical_ANAT_03/01-P1 & P2 to 16-P1 & P2 - Upper limb I

Tutorial_04/01-P1 to 20-P1 Introduction to musculoskeletal history taking and

examination
Prescribed
7th ed. Elsevier Australia Ch 23 & 24 pg 291-296 & 297-300
Recommended
Limited pg 267-272
Lecture03/01-P1 Musculoskeletal system of the upper limb

Moore & Dalley, Upper Limbs chapter introduction
Lecture03/01-P3 - Introduction to human lifespan development

Prescribed
Thomson/Wadsworth Ch 1 pg 5-22 (Thinking About Development)
Go to the following link http://www.learner.org/discoveringpsychology/development/ (Human
Lifespan Development: our amazing capacity for change), click on start flash activity and
explore each of the three domains (bio/psycho/social) across the lifespan (click on each
photograph from newborn to elderly).
189

Readings
Lecture02/01-P1 Introduction to population health

Prescribed
Twitter Feed
Please follow @PennyRobaus and @RobinBellAus and the #SPHPM twitter feed imbedded into
Moodle. Information page about Twitter will be placed on Moodle.
Tutorial_02/01-P1 to 20-P1 - Introduction to epidemiology and causation

Lecture03/01-P4 - Introduction to motor systems

Recommended
Neuroscience Exploring the Brain 3rd ed. Bear, Connors & Paradiso Ch 14
Lecture03/01-P5 Principles of medical imaging I

Prescribed
Ch 24 Radiographic Anatomy and Imaging in Eizenberg N 2008, General Anatomy principles
and applications Sydney: McGraw-Hill
Recommended
anatomy St Louis: Elsevier
Lecture01/01-P1 Mental health enhancement

Prescribed
WEEK 2
Lecture03/01-P6 Anatomy of the breast and axilla
Moore & Dalley, Upper Limbs chapter
Lecture03/01-P7 - Neural integration connections and pathways

Prescribed
Moodle notes on Neural integration.
Recommended
Siegel & Sapuru Ch 5
Siegel & Sapuru Ch 25 & 28
190

Readings
Lecture03/01-P8 - Pharmacokinetics I - Absorption and distribution

Prescribed
Basic and Clinical Pharmacology, ed BG Katzung, 12th ed. Lange Medical Books/McGraw Hill
pg 37-51
Livingstone, Edinburgh; Drug absorption and distribution Ch 8 pg 99-114
Recommended
Birkett DJ Pharmacokinetics Made Easy 2nd ed. Ch 2 pg 8-14, Ch3 pg 15-22, Ch 5 pg 31-40,
Ch 8 pg 60-66, Ch 12 pg 97-106
Practical_ANAT_03/01-P3 & P4 to 16-P3 & P4 - Upper limb II

Tutorial_04/01-P2 to 20-P2 Musculoskeletal examination of the shoulder

Prescribed
7th ed Elsevier Australia Ch 24 pg 308-312 & 337-338
Limited pg 279-281
Lecture03/01-P9 The peripheral nervous system and vasculature of the upper limb
Moore & Dalley
Lecture03/01-P10 - Pharmacokinetics 2: Metabolism and excretion

Prescribed
pg 37-51; Drug biotransformation Ch 4 pg 53-68
Livingstone, Edinburgh; Drug metabolism and elimination Ch 9 pg 115-122; Pharmacokinetics
Ch 10 pg 123-131
Recommended
Birkett DJ Pharmacokinetics Made Easy 2nd ed. Ch 1 pg 1-7, Ch 4 pg 23-30, Ch 6 pg 41-50,
Ch 7 pg 51-59, Ch 9 pg 67-75
Lecture03/01-P11 - Introduction to sensory systems ONLINE

Recommended
Guyton 11th ed. Textbook of Medical Physiology Ch 46 Sensory Receptors and neuronal
Circuits for processing pg 572-584
Sherwood 3rd ed. Fundamentals of Physiology Ch 5 The Central Nervous System pg 109-143
Marieb 8th ed. Human Anatomy & Physiology Ch 12 The Central Nervous System pg 467-476
Tutorial_02/01-P2 to 20-P2 - Measuring disease-descriptive epidemiology

Prescribed
Ch 3 Types of studies: Odds ratio pg 46
191

Readings

Lecture03/01-P12 - Newborn and Infant Development

Prescribed
Thomson/Wadsworth Ch 3 pg 82-93 (The Newborn, Early Motor Skills), Ch 2 pg 59-69
(Influences on Prenatal Development)
Recommended
Thomson/Wadsworth Ch 2 pg 42-58 (Heredity and From Conception to Birth) pg 70-77 (Labour
& Delivery)

Lecture03/01-P13 - Early cognitive development

Prescribed
Thomson/Wadsworth Ch 4 pg 124136 (Piaget), 137-141 (Information Processing),
144-146 (Vgotsky) & 146-151 (Language Development)
Recommended
Australia 2nd ed Sydney, Pearson Ch 1 Lifespan, ageing and beliefs about health pg 14-17
Thomson/Wadsworth Ch 3 pg 114-118 (Becoming self aware)
WEEK 3
Lecture03/01-P14 Anatomy of the hand
Moore & Dalley, upper limb section, text dealing with wrist and hand
Lecture03/01-P15 Pharmacogenomics
Recommended
Livingstone, Edinburgh Pharmacogenetics, pharmacogenomics & personalised medicine
Ch 11 pg 132-138
Lecture03/01-P16 - Muscle function - mechanism of contraction and cross bridge

function
Practical_ANAT_03/01-P5 & P6 to 16-P5 & P6 - Upper limb III

192

Readings
Tutorial_04/01-P3 to 20-P3 Musculoskeletal examination of the elbow, wrist, hand

and fingers
Prescribed
7th ed. Elsevier Australia pg 300-308 & 339
Recommended
Limited pg 283-290
Recommended viewing
Talley & OConnor DVD Examination 7
Lecture03/01-P17 - Muscle function - EC coupling and mechanics of contraction

Silverthorn Human Physiology An Integrated Approach, 5th ed. Ch 12 Muscles pg 407-464
Lecture03/01-P18 - Muscle function - grading the strength of contraction


Tutorial_02/01-P3 to 20-P3 - Exposure assessment, error, validity, reliability and

confounding
Prescribed
Ch 3 Types of studies: potential errors in epidemiologic studies pg 51-58
Lecture03/01-P19 Muscle function - energy supply, fibre types and adaptability

Lecture_INDIGENOUS/01 Indigenous Health

Recommended
Taylor K & Guerin P 2010, Health Care and Indigenous Australians: Cultural Safety in Practice,
Palgrave McMillian, South Yarra
193

Readings
Lecture02/01-P2 Study design

Prescribed
Lecture04/01-P3 - Clinical examination of the motor system

See clinical skills tutorial readings Week 6.
WEEK 4
Lecture03/01-P20 - Early and middle childhood development
Prescribed
Thomson/Wadsworth Ch 5 pg 168-175 (attachment) & 183-190 (social development)
Recommended
Kail RV & Cavanaugh JC 2013 Human Development: A Lifespan View. 6th ed. Belmont CA:
Thomson/Wadsworth Ch 7 pg 266-272 (peers)
Lecture03/01-P22 Lower limb overview

Prescribed

Recommended
Goering et al 2013 Mims Medical Microbiology, Mosby 5th ed.
Washington, DC
Washington, DC
Tutorial_INTEGRATED_03_04/01 to 20 Upper limb revision Integrated Anatomy and

Clinical Skills
All prescribed and recommended readings from anatomy and clinical skills weeks 1, 2 & 3.
Lecture_Rural/01-P1 Rural Health: Setting the Scene

Lecture_Rural/01-P2 Dealing with chronic illness in a rural area

Tutorial_Rural/01-P1 to 20-P1 Rural health understandings

194

Readings
Tutorial_Rural/01-P2 to 20-P2 Indigenous cultural safety

Tutorial_Rural/01-P3 to 20-P3 Rural assignment group tutorial

Websites
Echidna health services profiles
www.med.monash.edu.au/srh/resources/echidna/index.html
Lecture_Rural/01-P3 Rural Health: Voices of the region

Lecture_Rural/01-P4 Rural Health Q&A - Panel discussion and debrief

WEEK 5
Lecture03/01-P24 - Overview of autonomic nervous system
Pre Reading
Moodle notes on Neurotransmission
Recommended
Bear MF, Connors BW & Paradiso MA 2007, Neuroscience: exploring the brain Ch 15
Wilson-Pauwels, Stewart, Akesson, Autonomic Nerves. BC Decker (had really useful clinical
examples, and basic explanations)

Lecture03/01-P31 Discriminative somatic sensation

Siegel & Sapru Ch 9 & 15
Moodle notes on Discriminative somatic sensation
Practical_ANAT_03/01-P9 & P10 to 16-P9 & P10 - Lower limb I

Lab book and Moore & Dalley, Lower Limb chapter
Tutorial_04/01-P4 to 20-P4 - Peripheral nervous system history taking

Prescribed
7th ed Elsevier Australia pg 393-399 & 436-437
Recommended
Limited pg 362-369 & 373-380
195

Readings

Recommended
Washington, DC
Washington, DC
Lecture03/01-P33 - Pain and temperature sensations

Recommended
Lecture03/01-P21 - Adolescent development

Prescribed
Thomson/Wadsworth Ch 8 pg 286-300 (Pubertal Changes, Health), Ch 10 pg 261-265 (Physical
Development & Health) & Ch 9 pg 324-328 (Romantic Relationships and Sexuality)
Recommended
Thomson/Wadsworth Ch 9 pg 316-323 (Identity & Self Esteem) & Ch 10 pg 362-367 (Cognition)
Tutorial_02/01-P4 to 20-P4 Study design

Prescribed
Acad_Briefing_SITE_VISIT_04/01 - Geriatric site visit academic briefing

Prescribed
Epstein O, Perkin GD, de Bono DP & Cookson J 2000 Clinical Examination 2nd ed. Mosby
Ch 10 pg 255-295
Tutorial notes for musculoskeletal examination will be in your workbook
Tutorial notes for neurological examination will be in your workbook
Lecture03/01-P35 Pain
Lecture02/01-P3 Sampling
Prescribed
196

Readings
Lecture03/01-P29 Autonomic nervous system - central system

Bear MF, Connors BW & Paradiso MA 2007 Neuroscience: exploring the brain Ch 15
Davies A, Blakeley AGH & Kidd C 2001 Cardiovascular control pg 600-601 & 606-607 Human
Physiology 1st ed. Churchill Livingstone
Berne RM & Levy MN 1998 Central control Ch 15 pg 241-246 Cardiovascular reflexes
Ch 28 pg 450-454 Physiology 4th ed. Mosby, St Louis
Wilson-Pauwels, Stewart, Akesson, Autonomic Nerves. BC Decker
WEEK 6
Practical_PHYSIOLOGY_03/01 to 04 - Nerve conduction
Pre Reading
Moodle notes on Ulnar nerve conduction
Lecture03/01-P30 Principles of medical imaging II

Prescribed
Ch 25 Sectional Anatomy, CT and MRI in Eizenberg N, Briggs C, Adams C & Ahern G 2008,
General Anatomy principles and applications Sydney: McGraw-Hill
Ch 26 Ultrasound Imaging in Eizenberg N 2008, General Anatomy principles and applications
Sydney: McGraw-Hill
Recommended
anatomy, St Louis: Elsevier

Prescribed

Recommended
Washington, DC
Washington, DC
SiteVisit_04/01-P1 to 06-P1 - Site visit 1 - Geriatric medicine facility (focusing on

musculoskeletal examination)
Revise tutorial notes for musculoskeletal examination from your clinical skills workbook and
textbook.
Tutorial_04/01-P5 to 20-P5 - Peripheral nervous system upper limb examination

Prescribed
to physical diagnosis pg 437-448 & 340-341 7th ed Elsevier Australia
Further Recommended
Limited pg 362-366, 373 & 376-380
197

Readings
Practical_ANAT_03/01-P9 & 10 to 16-P9 & 10 - Lower limb II

Lecture03/01-P32 Anatomy of the hip and thigh region


Prescribed
Lecture03/01-P34 - Epidemiology and emerging infections

Prescribed
Tutorial_02/01-P5 to 20-P5 Biostatistics

Prescribed
This is a long tutorial, so there are no extra readings on Moodle.
Lecture03/01-P28 - Youth and health behaviour

Prescribed
Australia 2nd ed Sydney, Pearson
Ch 4 Immunization Behaviour pg 122-126
Ch 10 The Medical Consultation pg 323-327
Ch 7 School-based Interventions, Out-of-School Activities & Peer Education pg 238-242
Recommended
Australia 2nd ed Sydney, Pearson Ch 15 Illness a Family Affair pg 506-508
Anderson & Wild 2006, Little Children are Sacred Report Summary
www.inquirysaac.nt.gov.au/report_summary.html
Lecture03/01- P36 - Gender identity formation, gender issues in health

Prescribed
Thomson/Wadsworth Ch 5 pg 191-199 (Gender Roles and identity)
Recommended
Kail RV & Cavanaugh JC 2013, Human Development: A Lifespan View 6th ed. Belmont CA,
Thomson/Wadsworth Ch 12 pg 431-437 (Discrimination)
Papers of interest
Minto C, Alderson J, Balen A & Creighton S 2001 Management of intersex (letter) The Lancet,
358, 2085-2086
Reiner WG 2005 Gender identity and sex-of-rearing in children with disorders of sexual
differentiation, Journal of Pediatric Endocrinology & Metabolism 18 (6) 549-553
Warne G, Grover S, Hutson J, Sinclair A, Metcalfe S, Northam E & Freeman J 2005 A long-term
outcome study of intersex conditions, Journal of Pediatric Endocrinology & Metabolism 18 (6)
555-567
198

Readings
For information on intersex conditions, visit The Intersex Society of North America (ISNA)
http://www.isna.org/
For a perspective on womens health, visit following website of Womens Health Victoria
http://www.whv.org.au/health_policy/gender.htm
For perspectives on womens and mens health conditions, visit the following websites of the
Australian Federal Government
http://www.healthinsite.gov.au/topics/Men_s_Health and
http://www.healthinsite.gov.au/topics/Women_s_Health
Lecture02/01-P4 - Outbreak investigation

Prescribed
Lecture04/01-P4 - Clinical examination of gait and sensory system

See clinical skills tutorial readings Week 6
WEEK 7
Lecture03/01-P38 Clinical oriented anatomy of knee and leg
Moore & Dalley, Lower Limb/Knee chapter
Lecture03/01-P37 - Modulation of conduction and nerve signalling local anaesthetics

Prescribed
Local anaesthetics Ch 26 pg 449-464
Tutorial_04/01-P6 to 20-P6 - Musculoskeletal examination of the hip and lower limb

(knee, ankle and foot)
Prescribed
7th ed Elsevier Australia pg 448-461, 380-384 & 464
Recommended
Limited pg 293, 305-306, 362-363, 366-368, 373-374 & 377-379
Practical_ANAT_03/01-P11 & P12 to 16-P11 & P12 - Lower limb III

199

Readings

Prescribed
Recommended
Press, Philadelphia
Publishers, Oxford

Prescribed
Recommended
Press, Philadelphia
Publishers, Oxford
Lecture03/01-P42 - DMARDs and treatment of gout

Prescribed
Tutorial_02/01-P6 to 20-P6 - Outbreak investigation

Prescribed
Basic Epidemiology by R Bonita, R Beaglehole & T Kjellstrom WHO 2nd ed 2006.
Lecture03/01-P43 Ankle and foot

Moore & Dalley
Lecture03/01-P45 Bipedalism and walking

Prescribed
Moore & Dalley has a section on walking
Recommended
Students would be advised to look at the last episode of David Attenboroughs Planet Earth
DVD and the new series The Human Planet. The new BBC Series Origins of Us is also
interesting.
Lecture03/01-P39 - Analgesics, aspirin and NSAIDs

Prescribed
200

Readings
Lecture02/01-P6 Social and environmental determinants of health

Prescribed
Ch 1 What is epidemiology? pg 1-12
WEEK 8
Tutorial_04/01-P7 to 20-P7 Examination of the PNS in the lower limb
Prescribed
to physical diagnosis pg 448-461, 380-384 & 464 7th ed Elsevier Australia
Recommended
Limited pg 293, 305-306, 362-363, 366-368, 373-374 & 377-379
Practical_ANAT_03/01-P13 & P14 to 16-P13 & P14 Lower limb revision

Lecture03/01-P46 - Centrally acting analgesics opioids

Prescribed
Opioid analgesics and antagonists Ch 31 pg 543-564

Lecture03/01-P44 - Developmental psychopathology 1: childhood and adolescence

Prescribed
pg 438-442 Developmental Psychopathology & pg 444-452 ADHD & Schizophrenia
Recommended
Thomson/Wadsworth Ch 9 pg 334-339 (The Dark Side)
Tutorial_02/01-P7 to 20-P7 Health promotion

Prescribed
Ch 6 Epidemiology and prevention: chronic non-communicable diseases pg 99-113
Ch 10 Epidemiology, health policy and planning pg 165-175
Lecture03/01-P47 - Infectious diseases of the skin and musculoskeletal system

Prescribed
Mims Medical Microbiology 5th ed. Elsevier Mosby, Ch 26 Infections of the skin, soft tissue,
muscle and associated systems
201

Readings
Lecture03/01- P48 Developmental psychopathology 2: adulthood and later life

Prescribed
pg 458-461 Personality Disorder, 462-465 Major Depression & 468-472 Contexts and
Psychological Problems
Lecture02/01-P7 - Diagnosis and screening

Prescribed
Ch 8 Clinical epidemiology pg 133-143
Ch 6 Epidemiology and prevention: chronic non-communicable disease pg110-114
WEEK 9
Lecture03/01-P49 Thoracic and lumbar spine
Moore & Dalley, Lower Limb chapter on vertebral column
Lecture03/01-P50 - Steroidal anti-inflammatory drugs

Prescribed
Ch 39 Adrenocorticosteroids & adrenocortical antagonists, pg 697-713
Lecture03/01-P51 Review of nerves and vessels of lower limb

Moore & Dalley
Practical_ANAT_03/01-P15 & P16 to 16-P15 & P16 - Back I

Moore & Dalley, chapter on vertebral column
Tutorial_04/01-P8 to 20-P8 Examination of the back and spine

Prescribed
Further Recommended
Limited pg 274-276
SiteVisit_04/01-P2 to 06-P2 - Site visit 2 - Geriatric medicine (neurological)

Revise tutorial notes for neurological examination from your clinical skills workbook and
textbook.
Lecture03/01-P55 - Nerve signalling in the ANS

Prescribed
Introduction to autonomic pharmacology Ch 6 pg 79-96
202

Readings
Lecture02/01-P8 - Cancer prevention

Prescribed
Ch 6 Epidemiology and prevention: chronic non-communicable diseases
Ch 10 Epidemiology health policy and planning pg 165-176
Lecture03/01-P54 Spinal canal and contents

Moore & Dalley
Tutorial_02/01-P8 to 20-P8 Screening and diagnosis and revision


Prescribed
Cholinoceptor-activating & cholinesterase-inhibiting drugs Ch 7 pg 97-113; Cholinoceptorblocking drugs Ch 8 pg 115-128

Prescribed
Adrenoceptor agonists & sympathomimetic drugs Ch 9 pg 129-149; Adrenoceptor antagonist
drugs Ch 10 pg 151-168
Lecture02/01-P5 Life and death in the world

Prescribed
WEEK 10
Lecture04/01-P5 - Cardiovascular system - history and examination
Prescribed
Epstein O, Perkin GD, de Bono DP & Cookson J 2008 Clinical Examination 4th ed Mosby pg 7
Systems review: cardiovascular system Ch 6 provides an overview of important features of the
CVS and of history and examination technique
or
7th ed MacLennan & Petty Sydney pg 14 Systems review and Ch 3, 4 & 5 provide an overview
of important features of the CVS and of history and examination technique
Recommended
7th ed MacLennan & Petty Sydney Ch 1 to 5
Cole SA & Bird J 2000 The Medical Interview: the three-function approach 2nd ed Mosby
St Louis, MO, USA Ch 13 Review of Systems pg 101-3 this chapter provides a brief overview of
this part of the medical history
Refer to clinical skills tutorial notes on CVS history and examination.
203

Readings
Lecture03/01-P57 Chest wall and diaphragm

Prescribed
Moore, Dalley & Agur Ch 1 pg 71-105
Recommended
Anatomedia software Anterior & Posterior Thoracic Walls
Practical_ANAT_03/01-P17 & 18 to 16-P17 & 18 Cardiovascular system I

Content Synopsis and associated Readings are provided in the Anatomy practical manual.
Tutorial_04/01-P9 to 20-P9 - Cardiovascular system - history taking

Prescribed
7th ed. Elsevier Australia pg 14 & 45-55
These extracts cover the most common presenting symptoms for cardiovascular disease, and
discuss their clinical significance.
Recommended
Epstein O, Perkin GD, de Bono DP & Cookson J 2008, Clinical Examination 4th ed. Mosby
Elsevier Limited Ch 1 Structure of the Interview & Ch 7 139-157
Cole SA & Bird J 2000, The Medical Interview: The Three-Function Approach 2nd ed. Mosby,
St Louis, Unit III
Lecture03/01-P59 - Cardiovascular system overview and basic haemodynamics

Prescribed
Guyton & Hall, Textbook of Medical Physiology 12th ed. Elsevier Saunders Ch 14
Lecture03/01-P62 - The heart, cardiac muscle contraction and excitation-contraction

coupling
Guyton & Hall, Textbook of Medical Physiology 12th ed. Elsevier Saunders Ch 9 The Heart as a
pump and Function of the Heart Valves pg 101-104
Lecture03/01-P56 Normal ageing

Publications at the United Nations web site: http://www.un.org/esa/socdev/ageing
The Merck Manual of Geriatrics 2nd ed. 1995 Merck Research Laboratories. Available online at
http://www.merck.com/pubs/mm_geriatrics/sec1/ch1.htm
Practical_HISTOLOGY_03/01 & 02 - Functional histology - heart, conduction and

vessels
Wheaters Functional Histology
Kerrs Functional Histology
Lecture03/01-P64 - Electrical activity of the heart

Guyton & Hall Textbook of Medical Physiology 12th ed. Elsevier Saunders pg 111 & 115-125
204

Readings
Lecture03/01-P65 The cardiac cycle and cardiac output

Pre Reading
Guyton & Hall Textbook of Medical Physiology 12th ed. pg 104-107 (Cardiac Cycle)
Naish, Revest & Syndercombe Court, Medical Sciences pg 588-592 (Cardiac Cycle)
Recommended
Guyton & Hall Textbook of Medical Physiology 12th ed. Ch 9 The Heart as a pump and Function
of the Heart Valves pg 106-114
Lecture03/01-P60 Elderly, death and dying

Prescribed
Thomson/Wadsworth Ch 16 pg 582-585 & 591-607 (Thinking About Death, Surviving the Loss)
Recommended
Thomson/Wadsworth Ch 15 pg 558-564 (Friends and Family in Late Life)
Lecture03/01-P63 Pericardium and heart

Moore & Dalley
WEEK 11
Practical_CVS_03/01 to 04 Cardiovascular system
Pre Reading
The practical notes in the Workbook.
Lecture03/01-P52 - Tissue infarction, tissue repair

Recommended
Underwood JCE (ed.) 2009, General and Systematic Pathology 5th ed. Churchill Livingstone,
Edinburgh, Ch 13 pg 294-297 & Ch 8
Lecture03/01-P53 Pathology: when cells die

Recommended
Babuin L & Jaffe AS 2005, Troponin: the biomarker of choice for the detection of cardiac injury,
Canadian Medical Association Journal, vol 173, no 10, pg 1191-1202
Review. Errata in: (1) Canadian Medical Association Journal 2005, vol 173, no 12, pg 1490 and
(2) Canadian Medical Association Journal 2006, vol 174, no 3, pg 353
Rademaker MT & Richards AM 2005, Cardiac natriuretic peptides for cardiac health, Clinical
Science, vol 108, no 1, pg 23-36 Review
Omland T, New features of troponin testing in different clinical settings. J Intern Med. 2010, Sep
268 (3): 207-17 Epub 2010 Jun 8
Moe KT & Wong P, Current trends in diagnostic biomarkers of acute coronary syndrome. Ann
Acad Med Singapore 2010, Mar 39 (3) 210-5
Doust J, Lehman R & Glasziou P, The role of BNP testing in heart failure, Am Fam Physician
2006, Dec 1 74 (11): 1893-8
Lecture03/01-P66 Challenges in heart surgery

205

Readings
Practical_INTEGRATED_ANAT_03_04/01-P1 and 02-P1

Cardiovascular system Integrated Anatomy and Clinical Skills
Prescribed
Thorax section of Moore and Dalley
Recommended
Epstein O, Perkin GD, de Bono DP & Cookson J 2008 Clinical Examination 4th ed Mosby,
Elsevier Limited 4th ed pg 157-173, General Observation pg 157, Palpating the peripheral
pulses pg 159, Measuring blood pressure pg 161, Examination of the jugular venous pulse
pg 164, Palpation of the precordium pg 166, Auscultation of the heart pg 167, cardiovascular
system and chest examination pg 173, cardiovascular system and abdominal examination
pg 173
Additional Resources
www.3m.com/us/healthcare/professionals/littmann/jhtml/littmann_heart_sounds.html
(this is a commercial site run by Littman stethoscopes, but has very good heart sound
recordings)
Tutorial_04/01-P11 to 20-P11 Cardiovascular system

Tutorial_04 ECG - Online Tutorial (In Preparation for the ECG Interpretation Tutorial)
Lecture03/01-P67 - Arteries, arterioles and the distribution of blood flow

Prescribed
cardiovascular system pg 571-572 & 596-608, 2009 ed. should be read before the lecture.
Recommended
Lecture03/01-P68 - Vasodilator agents

Prescribed
Antihypertensive agents Ch 11 pg 169-191; Vasodilators & the treatment of angina pectoris Ch
12 pg 193-210
Recommended
Practical_ANAT_03/01-P19 & P20 to 16-P19 & P20 Cardiovascular system II

206

Readings
Lecture03/01-P73 - Microcirculation and the lymphatic system

Prescribed
Recommended
Lecture03/01-P70 - Atherosclerosis and its complications

Prescribed
JC Underwood, General and Systematic Pathology 5th ed. Ch 13 pg 272-278
Lecture03/01- P71 Adulthood and health behaviour

Prescribed
Australia 2nd ed. Sydney, Pearson pg 508-521 (Caring) & pg 152-154 (Health Belief Model)
Lecture03/01-P72 - Inotropic agents

Prescribed
Ch 13 Drugs used in heart failure pg 211-226
Recommended
WEEK 12
Tutorial_ECG_04/01 to 12 ECG
Prescribed
Hampton J 2003 ECGs made easy, Churchill Livingstone Ch 1
or
Meek S & Morris F 2002 ABC of Clinical Electrocardiography Introduction I Leads, rate,
rhythm & cardiac axis, BMJ;324 (16th Feb) 415-418 at www.bmj.com/cgi/reprint/324/7334/415
Lecture03/01-P69 The vascular endothelium

Lecture03/01-P74 Lipid lowering drugs

Prescribed
Agents used in dyslipidemia Ch 35 pg 619-633
Recommended
Livingstone, Edinburgh; Atherosclerosis and lipoprotein metabolism Ch 23 pg 285-293

207

Readings
Tutorial_04/01-P10 to 20-P10 Clinical reasoning skills

Recommended
Epstein O, Perkin GD, de Bono DP & Cookson J 2008 Clinical Examination 4th ed Mosby
Elsevier Limited pg 139-185
Lecture03/01-P75 - Coronary circulation in health and disease

Recommended
Davies A, Blakeley AGH & Kidd C 2001 Human Physiology, Churchill Livingstone, Edinburgh,
pg 524-533 & 571-584
Kumar P & Clark M 2002 Clinical Medicine: A Textbook for Medical Students and Doctors,
5th ed. Saunders, Philadelphia Ch 13 Cardiovascular Disease pg 701-706 & pg 766-782
Sherwood 3rd ed. Fundamentals of Physiology Ch 9 Cardiac Physiology pg 265-269
Silverthorn 5th ed. Human Physiology - An Integrated Approach Ch 15 Cardiovascular Disease
pg 535-540
Cardiac Output During Exercise; the Coronary Circulation and Ischaemic Heart Disease
pg 252-256
Cardiac Output During Exercise; the Coronary Circulation and Ischaemic Heart Disease,
pg 252-256
Lecture03/01-P76 - Veins and venous return

Prescribed
Recommended
Lecture03/01-P77 - Short-term regulation of mean arterial blood pressure

Prescribed
Recommended
Practical_ANAT_03/01-P21 to 16-P21 Revision

208

Readings
Lecture03/01-P78 Congenital abnormalities of the heart and great vessels

Prescribed
Recommended
Harvey & Rosenthal 1998, Heart Development, Academic Press
Kirby 2007, Cardiac Development, Oxford University Press
Lecture03/01-P79 - Infectious diseases of the cardiovascular system

Prescribed
Goering et al, Mims Medical Microbiology 5th ed Ch 29
Recommended
PowerPoint presentation on Moodle
Lecture03/01-P80 Developmental difference

Prescribed
Management of an adolescent with developmental disability in Lennox N & McDowell J 2005
Management Guidelines: Developmental Disability V2 Melbourne, Australia: Therapeutic
Guidelines Ch 8 pg 53-62
Thomson/Wadsworth Ch 2 pg 45-47 (Genetic Disorders) & Ch 6 pg 223-226 (Children with
Intellectual Disability, Learning Disabilities)
Online learning module
Jacqui in Health and Disability: Partnerships in Action
Lecture03/01-P81 - Arrhythmias and their pharmacological treatment

Prescribed
Basic and Clinical Pharmacology, ed BG Katzung 12th ed. Lange, Medical Books/McGraw Hill
Ch 14 Agents used in cardiac arrhythmias pg 227-250
Recommended
Livingstone, Edinburgh; The heart Ch 21 pg 246-264
209

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