Syllabus · Current · V5 (2025) · Musculoskeletal System
I1 · Musculoskeletal System Anatomy and Physiology
I1.iii · Neuromuscular Junction
Describe the structure and physiology of the neuromuscular junction including receptors present.
Written examination
SAQ history
Neuromuscular Transmission
2 exam appearances
(a) Describe the structure of the neuromuscular junction (NMJ), including the location of receptors and enzymes (a diagram may assist in your answer but is not required to achieve full marks) (30% of marks). (b) Explain the events that occur at the NMJ that lead to the onset and offset of a muscle/motor end plate action potential (a description of excitation/contraction coupling is NOT required) (70% of marks).
76%
Oral examination
VIVA history
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2024A · Day 1 · VIVA 3
This VIVA will examine neuromuscular junction monitoring and neuromuscular blocking agents. Describe in detail the train of four (TOF)?
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2022A · Day 3 · VIVA 5
This viva will explore your understanding of physiology of the acetylcholine receptors. Describe the acetylcholine receptor at the neuromuscular junction.
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2017B · Day 3 · VIVA 5
This viva is on neuromuscular physiology and the pharmacology of neuromuscular blockade. Describe the structure of the neuromuscular junction and the events that lead to an action potential in the muscle plasma membrane.
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2017A · Day 2 · VIVA 7
This viva will test your knowledge of the neuromuscular junction and of assessment of neuromuscular blockade. Name the structures marked on the diagram at A, B, C and D. (Image removed.)
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2016A · Day 2 · VIVA 5
This viva tested knowledge of electrophysiology and neuromuscular blocking drugs. It discussed ion concentrations across cell membranes, Action potentials, pharmacology of atracurium and assessing neuromuscular blockade.
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2015B · VIVA 5
This Viva tested knowledge of the structure and function of the neuromuscular junction and the pharmacology of neuromuscular blocking drugs.
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2011B · VIVA 4
The candidates were shown a diagram of a neuromuscular junction and asked to label the various components. Subsequent questions sought knowledge of the processes occurring at the prejunctional / junctional / post junctional nerve terminal, to classify neuromuscular blockers, their mechanisms of action, and the pharmacokinetic properties that influence speed of onset and potency.
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2007B · VIVA 2
Brittle asthmatic requiring intubation; neuromuscular junction and neuromuscular blocking drug physiology/pharmacology.
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.