Musculoskeletal and Nervous System I (MSNSI) Block

Course Description

The Musculoskeletal and Nervous System I (MSNS I) Block deals with the structures of the upper and lower extremities, spine, cerebellum, brain stem and related structures using a multidisciplinary approach. It covers the fundamental tissues of the musculoskeletal system — bone, joint and ligament — along with the skin. It also covers the peripheral nervous system and part of the central nervous system that includes the motor and sensory neuron, spinal nerve root, brachial and lumbosacral plexus, peripheral nerve, neuromuscular junction and muscle. Bacterial, fungal, viral and parasitic skin disorders are also covered. Spinal cord pathways and disorders and cerebellum and brain stem and related structures are included to facilitate smooth transition into the Nervous System II block that deals with the central nervous system above the level of the brain stem. Sensory organs such as the ear, nose, throat and eye are covered, as well.

The goal is to understand normal and abnormal mechanisms of development of tissues and pathophysiological mechanisms of various disease processes — including trauma in the pediatric and adult patient population. Rehabilitative aspects of various disease processes will be discussed. Central and peripheral pain mechanisms and issues dealing with abuse of pain medications will be addressed. In conjunction with didactic lectures, case-based instruction, physician panel, ILMs and laboratory-based teaching sessions are used in order to help students apply information to clinical scenarios. The curriculum is further strengthened by inclusion of lectures on biostatistics, workers’ compensation and patient panels.

Learning Objectives

Educational Program Objectives are a subset of more broadly defined physician competencies, which represent general domains of performance for which the profession and the public hold physicians accountable.

Upon completing the Musculoskeletal and Nervous System I (MSNSI) Block, students should be able to:

• Describe the anatomical features and three-dimensional spatial relationships of the spine, as well as the upper and lower extremities — including the bone, ligament and vasculature.
• Describe the anatomical features of the peripheral nervous system — including the motor and sensory neuron, nerve root, plexus, peripheral nerve, neuromuscular junction and muscle.
• Describe the normal structure and function of cartilage, bone, ligaments, tendons, synovial tissue, skin and the peripheral nervous system.
• Describe the molecular, cellular and biochemical mechanisms involved in embryonic development, fetal maturation, perinatal changes, bone mineralization, exercise and physical conditioning, repair and regeneration of the musculoskeletal system.
• Describe the basic molecular, cellular and biochemical mechanisms involved in the healthy peripheral nervous system.
• Describe molecular, cellular and biochemical mechanisms of pain.
• Describe the altered structure (pathology) and function (pathophysiology) of the skin, musculoskeletal and peripheral nervous systems in inherited and acquired disease processes such as infectious, inflammatory, immune-mediated, traumatic and mechanical, neoplastic, metabolic, vascular, degenerative and idiopathic disorders.
• Explain radiological features of various bone and joint disorders.
• Describe the etiology, clinical features, prevention, treatment, outcomes and, where applicable, rehabilitation related to disorders of the skin, musculoskeletal and peripheral nervous systems.
• Explain how age, sex, socio-economic conditions, culture, race and ethnicity influence causation and clinical expression of skin, musculoskeletal and peripheral nerve disorders and its treatment.
• Describe the pathophysiology of pain, clinical pain syndromes and multi-disciplinary management strategies related to pain.
• Describe the spinal cord pathways and physiology including disease mechanisms.
• Explain the brain stem and related structures in terms of anatomy, physiology and disease process affecting them.
• Explain the pathology and clinical features of eye and ENT (ear, nose and throat) disorders.
• Describe the vestibular system and its disorders.
• Explain normal gait and gait disorders.
• Describe the neurological aspects of aging.
• Evaluate the usefulness of a screening test, the potential benefits and harms of prevention intervention, and the lead time bias and length bias and how they can affect observational data on screening tests.
• Analyze the patient-centric and population-centric data to link and/or aggregate data acquired from various sources and/or in different formats.
• Cooperate and collaborate with team members through verbal and non-verbal communication to document, present and discuss information in an organized, accurate, timely and understandable manner.
• Maintain professional behavior in interacting with faculty, staff and peers.
• Analyze, explain and discuss medical knowledge as it applies to effective patient care.
• (PC) Discuss diagnostic procedures, reason deductively and collaborate to arrive at provisional diagnoses during simulated patient care exercises.
• (ICS) Document simulated patient data and communicate them effectively and collaboratively with the team.
• (CAQI) Demonstrate awareness of ethical and social issues and assess information in educational resources during simulated patient exercises.
• (PRO) Show integrity in all interactions with peers and professional colleagues.