Neuroanatomy and circuits — structured clinical viva

Open with a framework. “I organise psychiatric neuroanatomy into five layers: prefrontal zones, limbic/Papez-plus, basal-ganglia loops, midbrain dopamine paths, and large-scale networks.” Avoid monologue without clinical anchors.[1][4]

Prefrontal. DLPFC — cognitive control/working memory; OFC/VMPFC — valuation and social-affective regulation; ACC/medial — motivation/conflict. Bedside syndromes: dysexecutive, disinhibited, abulic.[6]

Limbic. Teach Papez as historical closed loop (hippocampus–fornix–mammillary–anterior thalamus–cingulate) then immediately add amygdala and OFC as modern essentials.[7]

Loops. Alexander–DeLong: five parallel cortex–striatum–pallidum/SNr–thalamus–cortex circuits; psychiatric teaching emphasises DLPFC, lateral OFC, and ACC loops plus motor/oculomotor for movement-disorder interface.[1][6]

Dopamine. Four paths with clinical pairs; Howes–Kapur version III final common pathway and aberrant salience; Grace phasic vs tonic regulation as deeper viva polish.[2][3]

Networks. Raichle DMN; Seeley salience; Menon SN as switch between DMN and CEN. Explicitly say group imaging ≠ individual diagnosis.[4][5]

Clinical close. First-episode: organic screen + risk + MSE; circuit hypothesis guides differential and liaison, not prescription doses from memory of diagrams.[2][6]