《精神病学基础》教学大纲.docx

1、精神病学基础教学大纲精神病学基础教学大纲（供精神卫生专业本科使用）济宁医学院精神卫生学院（系、部）二00六年六月精神病学基础课程教学大纲课程主任：王克勤 开课单位：精神病学基础教研室 课程编码： 0310014 课程中文名称：精神病学基础 课程英文名称：The Foundation for Psychiatry精神病学基础课程是精神卫生专业本科高等教育的专业基础课程。其基本任务是为更好的预防和治疗精神疾病提供有效的理论基础。精神疾病是特殊复杂的，这主要在于人的精神活动既受生物、心理、社会和自然环境的多种影响，又反过来能影响到这其中的诸多因素。但人的精神活动的物质基础是大脑，不管是什么样的原因，

2、通过什么样的途径，最终都要作用于大脑，才能导致精神活动异常。精神病学基础以脑科学为基础，以与精神病学密切有关的功能神经解剖、神经生化、认知神经科学、神经心理学等领域的相关知识为主要讲授内容，是集理论性与应用性为一体的学科。设置本课程的目的是：使学习者全面了解与精神病学密切有关的神经生物学和心理社会科学内容，系统掌握有关的功能神经解剖、神经生化、神经发育、神经可塑性、认知神经科学、病因学、心理社会科学等方面的基础知识，具备在临床工作中全面、客观的认识、分析、判断精神疾病的实际技能，从而胜任精神科临床医疗和教学工作。学习本课程的要求是：学习者应认识到、生物-心理-社会这种医学模式在精神科尤为重要。

3、在学习中，要系统掌握：1、精神活动和行为的神经生物学基础，2、社会因素和心理活动及行为与大脑的相互作用、相互影响，3、人格和行为模式的形成和可变性。学会在临床工作中自觉地从生物、心理、社会三个方面全面、深刻地认识、分析、判断具体的疾病。提高诊断、治疗、预防精神疾病的水平，为成为一名高水平的精神科医生打下良好的基础。先修课程要求：神经解剖学、神经生化学、神经病理学、病理生理学、内分泌学和遗传学。本课程计划42学时，3.5学分。选用教材：自编英文版精神病学基础教学手段：课堂讲授考核方法：闭卷考试教学进程安排表：章节教学内容学时理论实践合计1Introduction of Brain and Beh

4、avior22Neural Signaling23Intraneuronal signaling pathways24Neurotransmitter45Limbic Structure and Basal Ganglia26Cerebral Cortex47Neuropsychological Development28Neural Plasticity29Memory210Emotion and Social Cognitive211Aetiology of psychiatry412Contributions of the Psychosocial Sciences to Human B

5、ehavior613Theories of Personality and Psychopathology414Psychology and Psychiatry: Psychometric and Neuropsychological Testing4合计42 第一章 脑与行为概述一、学习目的通过本章的学习，明确为什么研究脑和行为，理解脑和正常及异常精神活动的关系，掌握神经系统功能原则。本章计划2学时。二、课程内容1. Why Study Brain and Behavior?The human brain is the biological substrate for all of our

6、 emotions, cognitive abilities, and behaviorsthat is, everything we feel, think, and do. The accumulated research suggests three reasons for linking the study of brain and behavior: A growing list of behavioral disorders can be explained and possibly cured by understanding the brain. Indeed, more th

7、an 2000 disorders may in some way be related to brain abnormalities. The brain is the most complex living organ on Earth and is found in many different groups of animals. How the brain produces both behavior and human consciousness is a major unanswered scientific question. 2. Mental health and Brai

8、n We are defined by our brains more than any other organ in our body. The brain offers endless possibilities; when the brain malfunctions, however, an individual may face an unwelcome disorder, in many cases, a live-in guest for life. The number of people suffering from mental illnesses varies; wher

9、eas schizophrenia affects about 1% of the population, depression affects about 15%, as does Alzheimers disease in people over 65. Although exciting research is currently being conducted in neuroscience laboratories all over the world, a cure for mental illness is still elusive.3. Neuroscience in an

10、Evolutionary ContextEvolution results from the complex interplay of biology and environment, of genes and experience. This ongoing interplay influences how humans and other animals behave and learn from earliest infancy through old age. Experience can influence the messages that genes produce, and g

11、enes, in turn, can influence an organisms environment and experience.Predictable developmental stages are initiated by the genetic code, but the details of development can be influenced by chance, by experience, and by the environment.The dance of genetic and experiential influences continues throug

12、hout our lives just as it does in the continuing evolution of our species. Experiences can turn the genes in neurons on, and the way in which genes are turned on influences experience. The influence of genes and experience is not simply to form neurons and place them in appropriate relations with on

13、e another but also to eliminate excess or faulty neurons and connections, analogously to the sculpting of a statue from an unshaped block of marble.4. The Principles of Nervous System FunctionPrinciple 1: Information-Processing Sequence in the Brain Is “In Integrate Out”Principle 2: Sensory and Moto

14、r Functions throughout the Nervous System Are SeparatedPrinciple 3: Inputs and Outputs to the Brain Are CrossedPrinciple 4: Brain Anatomy and Function Display Both Symmetry and AsymmetryPrinciple 5: The Nervous System Works through Excitation and InhibitionPrinciple 6: The Nervous System Functions o

15、n Multiple LevelsPrinciple 7: Brain Components Operate Both Parallelly and HierarchicallyPrinciple 8: Functions in the Brain Are Both Localized in Specific Regions and DistributedPrinciple 9: Patterns of Neural Organization Are Plastic三、重点、难点提示和教学手段（一）重点：神经系统的功能原则及行为意义；精神卫生和脑的关系。（二）难点：神经系统的功能原则。（三）教

16、学手段：多媒体教学，尽量运用图片和录像增加学生的感性认识。双语教学，讲授法（结合提问、临床病例等进行启发式教学等）。（四）教具：多媒体电脑、多媒体投影仪、投影屏幕、多媒体课件、激光笔等 四、思考与练习 1精神卫生专业的工作者为什么要研究大脑 2脑的功能原则的行为意义 第二章 神经信号传递 一、学习目的通过本章的学习，理解神经细胞信息传递的电-化学转变过程，掌握神经细胞之间信息传递的步骤和涉及的结构，了解不同类型的神经细胞膜电位。本章计划2学时。 二、课程内容1. Nerve CellsIn general, neurons are composed of four morphologicall

17、y identified regions: (1) the cell body or soma, which contains the nucleus and can be considered the metabolic center of the neuron. (2) The dendrites, processes that arise from the cell body, branch extensively, and serve as the major recipient zones of input from other neurons. On some neurons, t

18、he shafts of the dendrites are smooth. On others, the shafts show numerous short spines. (3) the axon, a single process that arises from a specialized portion of the cell body (the axon hillock) and conveys information to other neurons; and (4) the axon terminals, fine branches near the end of the a

19、xon that form contacts (synapses) generally with the dendrites or the cell bodies of other neurons, release neurotransmitters, and thereby provide a mechanism for interneuronal communication.2. Electrical Potentials across Nerve Cell MembranesReceptor potentials are due to the activation of sensory

20、neurons by external stimuli, such as light, sound, or heat. Neurons have a means of generating a constant voltage across their membranes when at rest. This voltage, called the resting membrane potential. Activation of the synapses generates synaptic potentials, which allow transmission of informatio

21、n from one neuron to another. The electrical signals conducted along axons (or muscle fibers) by which information is conveyed from one place to another in the nervous system are called action potentials.3. Channels and Transporters3.1. Ion Channels Several channel categories are recognized. Passive

22、 (non-gated) channels are open at all times, permitting ions to move across the membrane. Voltage-gated channels contain a voltage-sensitive string of amino acids that cause the channel pore to open or close in response to changes in membrane voltage. Transmitter-gated channels abound in postsynapti

23、c membranes. Some are activated directly by transmitter molecules, others indirectly. Transduction channels are activated by peripheral sensory stimulation. 3.2. Active TransportersSeveral types of active transporter have now been identified. Although the specific jobs of these transporters differ,

24、all must translocate ions against their electrochemical gradients. Moving ions uphill requires the consumption of energy, and neuronal transporters fall into two classes based on their energy sources. Some transporters acquire energy directly from the hydrolysis of ATP and are called ATPase pumps. T

25、he second class of active transporter does not use ATP directly, but depends instead on the electrochemical gradients of other ions as an energy source. 3.3. Functional Properties of the Na+/K+ Pump This channel is capable of simultaneously extruding Na+ and importing K+. Three sodium ions are expor

26、ted for every two potassium ions imported. In both cases, the movement is against the existing concentration gradient. The required energy for this activity is provided by the ATPase enzyme that converts ATP to ADP. The greater the amount of Na+ in the cytosol, the greater is the activity of the enz

27、yme. The activity of the Na+-K+ pump is estimated to account for 2040% of the brains energy consumption, indicating its importance for brain function. 4. Synaptic Transmission The human brain contains at least 100 billion neurons, each with the ability to influence many other cells. Clearly, sophist

28、icated and highly efficient mechanisms are needed to enable communication among this astronomical number of elements. Such communication is made possible by synapses, the functional contacts between neurons. Two different types of synapseelectrical and chemicalcan be distinguished on the basis of th

29、eir mechanism of transmission. 4.1. Electrical SynapsesElectrical synapses are scarce in the mammalian nervous system. The structure of an electrical synapse consists of the presynaptic and the postsynaptic element. The membranes of the two communicating neurons come extremely close at the synapse a

30、nd are actually linked together by an intercellular specialization called a gap junction. Gap junctions contain precisely aligned, paired channels in the membrane of the pre- and postsynaptic neurons, such that each channel pair forms a pore. 4.2. Chemical SynapsesThe typical chemical synapse compri

31、ses a presynaptic membrane, a synaptic cleft, and a postsynaptic membrane. The presynaptic membrane belongs to the terminal bouton, the postsynaptic membrane to the target neuron. The bouton contains synaptic vesicles loaded with one or more neurotransmitters, together with numerous mitochondria. Ne

32、urotransmitter is released from the bouton by exocytosis, traverses the narrow synaptic cleft, and activates receptors in the postsynaptic membrane. Underlying the postsynaptic membrane is a subsynaptic web, in which numerous biochemical changes are initiated by receptor activation. 4.3. Signal Transmission at Chemical Syn