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[ STUDY GUIDE 1ST YEAR MBBS ]

2019WAH MEDICAL COLLEGEWAH CANTTDepartment of Medical Education

WAH MEDICAL COLLEGE MODUL CODE: Y1M3

Study Guide for Y1M3 ModuleCourse Code :Y1M3

1 Over view 3

2 Introduction to the study Guide. 4

3 Teaching and learning methodologies (MITs). 5

4 Assessment strategies 6

5 Structured summary of foundation Module 7

6 Course content 8

Anatomy 8

Broad outline of topics

Los

MIT

ETA

Reference books

Physiology 19

Los

MITs

ETA

Reference Books

Biochemistry 24

Los

MITs

ETAs

Reference Books

7 Time Table 27

2


Over view.

Module name Foundation module 3

Year 1

Duration 6 &1/2 weeks course work +2 weeks end of module exam )

Module development committee

Chairperson Prof. Dr. S.T. Abbas

Module In charge Dr. Zahid Mehmood

Members/ Resource persons Anatomy: Dr. Uzma Shahid

Physiology : Dr. Sumera Gul

Biochemistry : Dr. Zahid Mehmood

Study guide developed By Department of Medical Education

Wah Medical College

under Supervision of

Prof. Dr. Musarat Ramzan

Resource person for Study Guide Dr. Ayesha Younas

3

In case of any query: regarding your course work. Feel free to contact concerned resource persons for each department.


Commonly used abbreviations in the study guide

1. MIT Modes of Information Transfer.

These are the methodologies through which you will be taught by your instructors. These can

include.

LGIS: Long class interactive session

CBL: Case based learning.

Practicals

Demonstrations

Dissection

SGDs: Small group discussions format.

2. LOs :

Learning objectives are statements that define the expected goal of your course, lesson or activity

in terms of demonstrable skills or knowledge that will be acquired by you as a result of

instruction. In simple words, these are the things that you must know after learning a particular

topic.

3. ETA: Expected time allocation (ETA) for any learning activity.

2. INTRODUCTION: Dear Students, we at the Department of Medical Education, Wah Medical College, have developed

this study guide specially for you. This study guide is an aid to

Inform students how their learning programs have been organized in this module

Help students organize and manage their studies throughout the module

Guide students on assessment methods, rules and regulations.

Communicates information on organization and management of the module. This will

help the student to contact the right person in case of any difficulty.

Defining the objectives which are expected to be achieved at the end of the module.

Identifying the learning strategies such as lectures, small group teachings, clinical skills,

demonstration, tutorial and case based learning that will be implemented to achieve the

module objectives.

Providing a list of learning resources such as books, and journals for students to consult

in order to maximize their learning.

Providing information on the assessment methods that will be held to determine every

student’s achievement of objectives.

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3. TEACHING AND LEARNING METHODOLOGIES In this module, the following teaching/ learning methods are used to promote better

understanding:

Large group Interactive sessions

Small Group Discussion

Case-Based Learning

Practicals

Self-Directed Study

Large Group Interactive Sessions

In large group , the lecture introduction a topic or common clinical conditions and

explains the underlying phenomena through questions , pictures, videos of patients

interviews, exercises, etc. Students are actively involved in the learning process.

Small Group Discussion

This format helps students to clarify concepts acquired skills or attitudes. Sessions are

structured with the help of specific exercises such as patient case, interviews or

discussion topics. Students exchange opinions and apply knowledge gained from

lectures, tutorials and self-study. The facilitator’s role is to ask probing questions,

summarize, or rephrase to help clarify concepts.

Case-Based Learning

This is a small group discussion format where learning is focused around a series of

question based on a clinical scenario. Students’ discuss an answer the questions applying

relevant knowledge gained in clinical and basic health science during the module.

Practical

Basic science practical related to Anatomy, Biochemistry, Pathology, Pharmacology and

Physiology are scheduled for student learning.

Self-Directed Study

5


Students’ assume responsibilities of their own learning through individual study, sharing

and discussing with peers, seeking information from learning Resource Center, teachers

and resource persons with and outside the college. Students can utilize the time within the

college schedule hours for self-study.

4. Assessment strategies During the module the students shall be continually formatively assessed.

The weightage of internal assessment shall be 30% in 1st professional MBBS

Examination.

There shall be three modular and one pre-annual examination.

The scores of tests at the end of each modular assessment and pre-annual

examination shall be used for calculation of the internal assessment.

Module and Pre-Annual Examination:

There will be three module examinations, one at the end of each module.

There will be only one pre-annual examination.

The structure of the paper of all the module examination and pre-annual will be

same as that for annual examination though syllabus will be different.

The syllabus for modular examination will be announced by the department at

least 02 weeks prior to examination.

Pre-annual examination will be from whole syllabus.

The date sheet for module and pre-annual examinations will be published by

examination branch of college while the examinations will be conducted by the

respective department.

The result will be submitted to NUMS examination branch for incorporation in

internal assessment before annual examination.

Annual Professional Examination:

The university shall take the 1st professional Examination as per PM&DC

guidelines at the end of the academic year.

Each subject section has table of specification of module. Pre-annual and annual

examination.

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Annual theory and practical Examination shall be of 200 marks each in: Anatomy,

Physiology and Biochemistry.

The pass score shall be 50% in theory and practical separately.

5. Structure Summary of Y1M3 Module- 1 st year

Y1M3 Lower LimbRespiratory System

Gross anatomyLower LimbGeneral AnatomySkin FasciaVertebral columnNervous system-IIEmbryologyBirth defectsBody cavitiesRespiratory systemMuscular SystemSkeletal system except head and neckDevelopment of limbsHistologyRespiratory system

Physiology of respirationDeep sea physiologyAviation/space physiologyHigh altitude physiologyExercise physiology

NutritionWater soluble vitaminsFat Soluble vitamins

7


1. Course content

Curriculum (Anatomy) 3rd module, 1st year MBBS (Y1M3); 2019 onwards

LEARNING OUTCOMES (GROSS ANATOMY OF LOWER LIMB):By the end of this course, the student should be able to:

Appraise the concepts of gross anatomy of bones, muscles & joints of lower limb to deal with the common musculoskeletal diseases (e.g. fractures, sprains, dislocations) in future.

Appraise the concepts of topographic anatomy of neurovascular components of lower limb to deal with the common neurovascular diseases/injuries in clinical practice.

Apply the knowledge and skill gained through dissection of cadavers & study of prosected specimens of lower limb to learn the surgical procedures, important from clinical standpoint.

Understand the topographic anatomy of blood vessels of lower limb to learn the common diagnostic & therapeutic procedures (e.g. Femoral vessels catheterization, saphenous cut-down), in future.

Appraise the knowledge of lymphatic drainage of lower limb to locate the site of sepsis or malignancy. Correlate the topographic plan of the foot with mechanism of walking and running. Identify normal radiographic anatomy, so as to recognize common abnormalities (dislocations, fractures,

tumors) in future.

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TOPIC LEARNING OBJECTIVES

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1 Arrang-ement of lower limb bones

Identify the basic topographic anatomy of six major regions of lower limb

MK √ SGD 1 Viva voce/OSCE

GM: 510-514

Justify the arrangement of lower limb bones for support of erect bipedal posture of humans

MK √

2 Hip bone & Femur

Define pelvic girdle. Justify its clinical importance

MK √ 4 GM: 512

Demonstrate the anatomical position of hip bone and determine its side

MK GS: 555-561,GM: 514-520,GG: 526-531, 535-537, 556-57

Identify important bony land marks of hip bone, on gross inspection as well as on radiographs.

MK

Identify the site of attachments of muscles & ligaments on the given bone

NK

Identify the gender of hip bone. NKDemonstrate the articulation of hip bone MK

8


with other bones.Demonstrate the anatomical position of femur and determine its side.

NK

Identify important bony land marks of femur, on gross inspection as well as on radiographs.

NK

Identify the site of attachments of muscles & ligaments on the given bone

NK

Demonstrate the articulation of femur with other bones.

MK

Describe different fractures of femur mentioning the presentation of limb in each type of fracture.

NK

Describe the four major ways by which structures pass from the abdomen and pelvis into and out of lower limb. Describe the boundaries of each gateway and enumerate contents of each.

MK

Apply the anatomical knowledge of blood supply to the femoral head so as to explain avascular necrosis of femoral head after fractures of femoral neck.

MK Theory/ viva voce

GS: 561

Define the terms coxa valga & coxa vara ; Justify their clinical importance.

MK

3 Subcutaneous tissue & Fascia

Describe the composition and continuity of subcutaneous tissue (superficial fascia) of lower limb with that of abdomen and buttocks

MK √ 1 Viva voce

GM: 532

Trace the lining of fascia lata on the skeleton. Describe its modifications & Justify its importance.

MK √ GG: 544-45, GS: 562

Demonstrate the saphenous opening on the cadaver.

NK

4 Gluteal region

Trace the origin and insertion of muscles of gluteal region after performing dissection

NK √ 4 Viva voce/ OSCE

GG: 547-554, 566

Demonstrate the major functions of muscles of gluteal region.

MK √

Enumerate the nerves entering into gluteal region and comprehend the origin, important relations, & muscles innervated by each

NK √ Theory/ viva voce

GS: 566

Demonstrate the effects of injury to superior gluteal, inferior gluteal and sciatic nerves

MK √ GS: 659, GM: 581-82,

Enlist vessels of gluteal region and trace origin, relations & supply of each artery on the model/ prosected specimen.

NK √ GS: 566-67

Enumerate structures deep to gluteus maximus. Correlate this knowledge with

MK √ GM: 565

9


method of giving intragluteal injections without injuring neurovascular structuresDefine the term ‘positive tredelenberg sign’. Enlist its causes and describe various gaits for its compensation.

MK √ GM: 582

5 Compart-ments of thigh

Enumerate the contents of three fascial compartments of thigh. Describe the three routes by which structures enter and leave the top of thigh

NK √ 6 Theory/ viva voce

GG: 555, GS:573

Describe the boundaries, compartments, contents and importance of femoral sheath

MK √ GG: 547, GS: 579

Comprehend the inguinal lymph nodes regarding their location, arrangement and area of drainage

MK √ GS: 573

Demonstrate the femoral canal & mark the boundaries of femoral ring on the prosected specimen. Justify its clinical importance.

MK √ GS: 553-54

Describe in tabulated form the origin, insertion, blood supply, nerve supply and actions of muscles of anterior facial compartments of thigh.

MK √ GS: 578

Describe the functions of muscles of thigh to understand the displacement of fragments of a fractured femur.

NK √ GS: 561

Identify the boundaries of femoral triangle and interrelationship of its contents in the given prosected specimen.

MK √ GS: 575, 580, 654, GM:551, 556,GG: 567

Describe the extent, boundaries, & contents of adductor canal. Justify the importance of Adductor hiatus.

NK √

Differentiate among different swellings in front of thigh.

MK √ GS: 580, GM: 212-13,

Enlist the nerves forming patellar plexus NK √ GS: 570Describe the origin, insertion, nerve supply and actions of muscles of medial facial compartments of thigh in tabulated form.

MK √ GS: 584

Describe the origin, insertion, nerve supply and actions of muscles of posterior facial compartments of thigh in tabulated form.

MK √ GS: 589

Identify the muscles, and neurovascular structures (important from clinical standpoint) of thigh in the prosected specimens/ models.

MK √ GS: 573-587

Mark the femoral artery, femoral nerve, & sciatic nerve on the given subject/ mannequin

MK √ OSCE GG: 630, GS: 650

Mark the superficial & deep inguinal rings on the surface of mannequin. Demonstrate the boundaries of these rings & Justify their clinical importance.

MK √ GS: 203

10


Correlate the signs and symptoms of sensory and motor loss with the level of injury of femoral, sciatic, and obturator nerve.

MK GS: 659, 660

6 Hip joint Demonstrate the articulation, line of capsule attachment, synovial membrane & ligaments of hip joint.

MK √ 2 Theory/ viva voce

GS: 587-592

Describe the type, nerve supply, blood supply and important relations of hip joint.

MK √

Demonstrate the movements of hip joint in an articulated skeleton with special reference to their axes.

MK √

Explain the congenital & traumatic dislocation of hip joint.

NK √

Explain the referred pain of hip joint with anatomical reasoning.

MK √

Demonstrate the positive Trendelenburg’s sign, explaining the factors responsible for stability of hip joint

MK √

7 Bones of leg

Identify important bony land marks of tibia, fibula and patella on gross inspection as well as on radiographs.

MK √ 4 Viva voce

GG: 558-560,586-587, GS: 592-596Identify the site of attachments of muscles &

ligaments on the Tibia and FibulaNK √

Demonstrate the articulation of bones of leg with the help of given bones.

MK √

Demonstrate the anatomical position of tibia & fibula and determine their side.

MK √

Describe patellar dislocations & patellar fractures

NK √

Describe the common sites of fractures of tibia and fibula and correlate them with their clinical presentation with special emphasis on the fracture of neck of fibula and foot drop.

MK √

Illustrate the tibial plateau. NK √8 Popliteal

fossaEnlist the structures forming various boundaries of popliteal fossa


GS: 600-604.GG: 584-85

Identify the contents of popliteal fossa and inter-relationships of its contents in a prosected specimen/model.

MK √

9 Fascial compartments of leg

Demonstrate division of leg into various compartments on the given model, enumerating contents of each compartment.

NK √ 4 GS: 606, GS: 609, 614-615

Describe in tabulated form, the origin, insertion, nerve supply and actions of muscles contained within anterior, lateral and posterior compartments of leg.

MK √ GS: 613, 614, 617

Mark the common peroneal & tibial nerve on MK √ OSCE GS: 660

11


the surface of given subject.10 Knee

jointDescribe the articulation, type, capsule, ligaments (extra and intra articular), synovial membrane, nerve supply, blood supply, important relations, and movements related to the knee joint.


GS: 629-632,GG: 575-583

Enlist the structures responsible for stability of knee joint

MK √

Demonstrate the mechanism of locking and unlocking of the knee joint

MK √

Describe the functions of ligaments in various movements of knee joint.

MK √

Enlist the bursae related to knee joint and point out those which communicate with the joint cavity.

MK √

Illustrate genicular anastomosis and justify its clinical significance

MK √

Enlist the commonly injured ligaments of knee joints. Correlate the effects of injury of each ligament with its topographic anatomy.

MK √

11 Tibio-fibular joints

Describe the type, ligaments, nerve supply, blood supply, and movements related to these joints.

NK √ 1 Theory/ Viva voce

GS: 632, 634

Demonstrate the articulation, line of capsular attachment & synovial membrane of proximal and distal tibiofibular joints, with the help of given bones and model.

NK √

Describe the interosseous membrane and the structures passing through it

MK √

12 Foot &Region of ankle

Describe the foot as a functional unit. Demonstrate the propulsive action of foot

NK √ 8 Theory/ viva voce

GS: 638, GS: 642-43

Identify the three groups of bones of foot (enlisting bones in each group) in the given skeleton as well as on radiograph

MK √ GG: 600-605

Demonstrate the articulation among various bones of foot for the formation of Tarsal joints of foot

MK √

Demonstrate anatomical position and determine the side of calcaneus and talus

NK √

Recognize important bony landmarks, muscular & ligamentous attachments on calcaneus & talus.

NK √

Explain the arches of foot regarding the bones forming the arches, & the mechanism of arch support

MK √ GS: 639-642

12


Explain the clinical problems associated with arches of foot (pes planus and pes cavus).

MK √ GS: 642

Explain the bursae and bursitis in the lower limb.

NK √ GS: 643

Describe the articulation, type, and movements of subtalar, talocalcaneonavicular, & calcaneocuboid joints

NK √ GS: 637-38

Explain the hallux valgus, hallux rigidus, & hammer toe

MK √ GS: 638,GM: 667

Demonstrate the articulation, line of capsular attachment & synovial membrane of ankle joint, with the help of given bones and model.

MK √ GS: 634-37

Describe the type, ligaments, nerve supply, blood supply, movements and important relations of ankle joint.

MK √

Differentiate between acute sprains of lateral ankle and medial ankle.

MK √

Describe the sequence of events occurring in tri-malleolar fracture.

NK √

Explain the sensory and motor loss associated with tibial nerve entrapment in tarsal tunnel syndrome.

MK √

Correlate patellar and Achilles tendon reflex with the segmental innervations of muscles

MK √

Perform the Planter flexion, Dorsiflexion, inversion & eversion of foot mentioning the Muscles producing these movements and joints at which these movements occur.

MK √

Identify the arrangement of tendons, arteries, and nerves in the region of ankle joint (in relation to the retinaculae of ankle) in the given model/ prosected specimen.

MK √

Explain the fracture dislocations of the ankle joint addressing the causative factors and involvement of bones participating in ankle joint.

MK √

Describe the origin, insertion, nerve supply and action of extensor digitorum brevis

NK √

Describe arteries and nerves of dorsum of foot

NK √

Identify the structures in each layer of sole of foot in the prosected specimen/ model.

MK √

Describe the attachments and relations of plantar aponeurosis and

NK √

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plantar fasciitis.Describe in tabulated form the origin, insertion, nerve supply and action of muscles of sole of foot

NK √

Describe arteries and nerves of sole of foot

NK √

13 Cutaneous innervation of lower limb

Illustrate the cutaneous nerves of lower limb MK √ 1 Theory/ viva voce

Describe in tabulated form the origin (including contributing spinal nerves) and distribution of cutaneous nerves of lower limb.

MK √

Define the terms : axial line, dermatome, myotome

MK √

Illustrate the dermatomes of lower limb MK √Correlate the development of lower limb with its location of dermatomes

MK

14 Blood supply of lower limb.

Describe the origin, relations and main branches of arteries of lower limb.

MK √ 4 Theory/ viva voceEnlist the vessels participating in trochanteric

& cruciate anastomosis.NK √

Enlist the superficial and deep veins of lower limb.

MK √ GM: 535

Describe the formation, course, & tributaries of great and small saphenous veins.

MK √

Describe deep veins of lower limb. MK √Mark the great and small saphenous vein on the given subject.

MK √

Define the term ‘varicose veins’. Enlist its causes. Describe their formation with anatomical reasoning.

MK √ GM: 540

Define deep venous thrombosis. Enlist the causes of venous stasis.

NK √

Justify the role of great saphenous vein in coronary arterial bypasses with anatomical reasoning.

MK √

Define the term ‘saphenous cutdown’. Demonstrate the site of saphenous cut down Justify its clinical importance.

MK √

Palpate Pulse points of arterial tree of lower limb in the given subject

MK √ GS: 658

Explain the collateral circulation for femoral artery. Discuss its clinical importance

MK √

Describe the mechanism of intermittent claudication emphasizing the relevant anatomical knowledge.

NK √

Mark the precise position of main arteries of lower limb to arrest a severe hemorrhage.

MK √ OSCE

15 Lymphatic drainage

Describe the lymphatic drainage of lower limb. Correlate this knowledge to locate the site of sepsis or malignancy.


GM: 535-36, 541, GS:

14


of lower limb

554, 573,

Define the term ‘lymphadenopathy’. Describe its causes. Discuss its clinical importance.

MK √

16 Radiographic anatomy of lower limb

Differentiate between radiopaque and radiolucent structures

MK √ 1 OSCE GS: 644-652

Identify different bony structures on radiographs of different regions of lower limb

MK √

Enlist various imaging techniques mentioning the basic principle of each technique

MK √

Determine the age and gender of person based on radiographic anatomy

MK √

Identify important bony land marks and articulating bones forming each joint of lower limb, in different views of radiographs.

MK √

Mark the shenton’s line on anteroposterior radiograph of hip joint.

MK √

LEARNING OUTCOMES (GENERAL ANATOMY):By the end of this course, the student should be able to: Apply the general concept of anatomical organization of nervous system in the regional anatomy. Correlate the topographic anatomy of vertebral column with relevant presentations encountered in

clinical practice.

S.N

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TOPIC LEARNING OBJECTIVESIm

port

ance

of

cont

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Domain MIT

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1 Skin & Fascia

Enumerate the components of integumentary system

MK √ SGD 1 Theory/ Viva Voce

GAL: 111-116Enlist the functions of integumentary system

Enlist the two main parts of skin. Enumerate their layers with general features.

Enumerate appendages of skin & describe their general features.

Define cleavage lines & describe their clinical importance.

2 Verteb-ral column

Describe the anatomy of vertebral column with reference to number of vertebrae in different regions & curvatures of vertebral column

1 GS: 852, 860-863

Describe the movements of vertebral column

Explain the abnormal curves of vertebral column

3 Nervous System-II

Describe division of nervous system on gross anatomical basis

1 GAL: 117-132Enumerate components of central and

peripheral nervous system. Describe their

15


general featuresDefine autonomic nervous system (ANS). Enlist the differences between autonomic and somatic nervous systemEnlist the main divisions of ANS. Describe differences of its two main divisions in tabulated form.Enumerate cranial parasympathetic ganglia. Describe their general featuresDefine enteric nervous system. Describe its general features.

LEARNING OUTCOMES (EMBRYOLOGY):By the end of this course, the student should be able to:

Correlate the developmental events of respiratory system with relevant congenital anomalies Identify the basic principles behind the occurrence of birth defects and correlate them with various

relevant clinical presentations. Apply the knowledge of development of limbs with relevant congenital anomalies and their clinical

presentations. Appraise the embryological basis of common congenital anomalies related with development of axial

skeleton. Correlate the developmental events of body cavities with relevant congenital anomalies Appraise the development of muscles to explain the common relevant congenital anomalies

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Define birth defects. Enlist their causes & types, giving one example each.

MK √ LGIS 5 Theory/ viva voce

EL: 17-25, 126-140, EM: 471-499

Define the terms: Euploid, Aneuploid, Polypoid, Diploid, Monosomy, Trisomy, Microdeletion, Microduplication, Inversion, Isochromosomes.

MK √

Define nondisjunction & explain its consequences.

MK √

Enlist birth defects caused by genetic and environmental factors.

MK √

Define the term mosaic. Explain the embryological basis of mosaicism and compare it with aneuploidy.

NK √

Define teratology & teratogenesis. Comprehend the principles of teratology

MK √

Classify teratogens. Give important congenital malformations associated with each teratogen in tabulated form.

MK √

Explain numerical & structural chromosomal MK √

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anomalies regarding their incidence, embryological basis, characteristics & prognosisEnumerate diagnostic techniques for identifying genetic abnormalities & enlist indications for the usage of each technique.

MK√√

Describe the remedies to prevent birth defects. MKExplain the invasive and noninvasive approaches for assessing growth & development of fetus.

MK √

2

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Describe the limb growth and development MK √ 4 Theory/ viva voce

EL: 163-174

Define apical ectodermal ridge and describe its role in limb development including digits

MK √

Describe the process of rotation of limbs during development.

MK √

Correlate the rotation of limbs with their cutaneous nerve supply

MK √

Compare the development of upper and lower limbs

NK √

Describe development of limb musculature MK √

Describe the various types of limb defects. Discuss their embryological basis

MK √

3

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Identify the sources of muscular tissue MK √ 4 Theory/ viva voce

EL: 156-162

Describe the histogenesis of skeletal, cardiac & smooth muscles

NK √

Describe the process of somitogenesis. MK √

Identify different regions of early somite and further differentiation & contribution of its each region

MK √

Enumerate the muscles which are derived from Primaxial & Abaxial precursors.

MK √

Define lateral somitic frontier. Enlist the structures whose borders are defined by it

MK √

Describe the innervation of axial skeletal muscles.

MK √

Explain the patterning of muscle formation & determination of their final shape.

NK √

Enlist the derivatives of Myotome MK √

Correlate developmental origin of muscles with their nerve supply

MK √

Explain the embryological basis of congenital anomalies related with development of muscular

MK √

17


system.Differentiate between three types of muscles & explain the process of development of each type of muscle

NK √

Enlist the developmental source of Head muscles, Limb muscles, Cardiac muscles, & Smooth muscles

MK √

4

Deve

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Describe the development of trachea MK √

Comprehend the embryological basis of various types of tracheoesophageal fistulas

√ 3 Theory/ viva voce

EL: 218-224

Justify the relationship of tracheoesophageal fistula with polyhydramnios

√

Describe the development of larynx with special reference to sources of origin of its different components

√

Explain Different stages of lungs maturation √

Comprehend the role of surfactant in the normal functioning of lungs and in initiation of labor

√

Justify the importance of fetal breathing movements before birth.

√

Enumerate factors important for normal lung development.

√

Describe routes for the clearance of fluid from lungs after birth.

√

Enumerate congenital anomalies of lungs & comprehend the embryological basis of these anomalies.

√

5

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Explain the formation of tube on top of a tube 3 EL: 95-104

Describe the formation of intraembryonic coelom and its divisions and correlate the effects of folding with relocation of different parts of intraembryonic coelomEnumerate the structures involved in partitioning of intraembryonic coelom into definitive body cavitiesEnumerate the developmental sources of Diaphragm and explain the contribution of each sourceCorrelate the positional changes of diaphragm with the age of the fetus

Correlate the nerve supply of diaphragm with its developmental sources

Explain the anomalies of ventral body wall and

18


diaphragm on the basis of your knowledge of Embryology

6De

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Differentiate between the appendicular and axial skeleton and enlist the sources of each type of skeleton

3 Theory/ viva voce

EL: 143-155 (excluding skull)

Correlate the development of vertebrae with definitive positioning of their nerves and vessels

Define spina bifida, enlist its different types and describe embryological basis of each alongwith methods of prenatal assessment in this anomalyDescribe the development of ribs & sternum and explain the embryological basis of relevant clinical conditionsComprehend the development of joints

LEARNING OUTCOMES (HISTOLOGY):By the end of this course, the student should be able to:

Correlate the location and histomorphological characteristics of various cell types of respiratory epithelium with their functions.

Correlate the progressive microstructural modifications of respiratory tract from nasal cavity down to alveoli with their functions.

Predict functional outcome that result from altered structure & function of tracheobronchial tree, alveolar cells & septa.

Differentiate between H&E stained slides of different parts of tracheobronchial tree and appreciate their characteristic histological features to distinguish them from common pathological conditions in future

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1

Hist

olog

y O

f Res

pira

tory

Sys

tem

Enumerate cells comprising respiratory & olfactory epithelium; describe their light & electron microscopic structure with the help of diagram.

MK √ LGIS 3 hrs

Theory/ viva voce

HL: 183-190

Differentiate various parts of bronchial tree on the basis of lining epithelium, presence of cilia, glands, cartilage, smooth muscles, and elastic fibers

√

Explain the progressive microstructural modifications of respiratory tract from nasal cavity down to alveoli, correlating with their functions

√

Explain the histological structure of blood air barrier

√

Describe the histological structure of pleura √

Explain the Immotile cilia syndrome & Respiratory distress syndrome on the basis of your knowledge of histology

√

19


Illustrate & differentiate the slides of different components of respiratory system

4 hrs

OSCE

Curriculum (Physiology) 3 rd module 1st year MBBS (Y1M3) 2018- 2019

S. No LEARNING OUTCOMES LEARNING OBJECTIVES

DOMAINMIT

Tim

e al

loca

ted

(hrs

)

Nam

e of

inst

ruct

or

Mod

e of

ass

essm

ent

The

ory/

OSC

E/ V

iva

Voc

e

By the end of this module, the student should be able to:

By the end of session, the student should be able to:

RE

CA

LL

APP

LIC

AT

ION

SKIL

L

AFF

EC

TIV

E

LG

IS/ S

GD

/ C

BL

/ Pra

ctic

al/

Tut

oria

l

1. Appraise the physiological processes governing the mechanics of breathing, perfusion and ventilation in the respiratory system.

Discuss the functional anatomy of respiratory tract

√ √ LGIS Theory/Viva Voce

2. Explain the functions of various parts of respiratory system


3. Appraise the non-respiratory functions of respiratory tract

√ LGIS Theory/Viva Voce

4. Discuss the functions of respiratory muscles


5. Explain various pressures acting on lungs and chest wall


6. Explain the change in pressures during each phase of respiration


7. Discuss the normal lung volumes and capacities

√ √ LGIS/CBL/ Lab

Theory/Viva Voce

20


8. Explain the concept of static v/s dynamic lung volumes/capacities

√ LGIS/CBL/ Lab

Theory/Viva Voce

9. Explain the concept of lung and chest wall compliance


10. Appraise the composition & role of surfactant in alveolar surface tension


11. Explain the concept of work of breathing

√ √ √ LGIS Theory/Viva Voce

12. Explain the layers of respiratory membrane


13. Discuss the concept of diffusing capacity through respiratory membrane


14. Explain the factors affecting gas diffusion through respiratory membrane


15. Appraise the mechanics of oxygen diffusion from alveoli to blood


16. Explain the mechanism of oxygen transport in the arterial blood


17. Appraise the mechanics of oxygen diffusion from blood to tissue fluid

√ √ LGIS/ CBL

Theory/Viva Voce

18. Discuss the mechanics of oxygen diffusion from tissue fluid in to cell

√ √ LGIS/ CBL

Theory/Viva Voce

19. Explain the role of Hb in oxygen transport

√ √ LGIS/ CBL

Theory/Viva Voce

20. Explain the normal oxygen-hemoglobin dissociation curve

√ LGIS/ CBL

Theory/Viva Voce

21. Explain the factors that shift oxygen-hemoglobin dissociation curve

√ LGIS/ CBL

Theory/Viva Voce

21


22. Discuss the various chemical form in which CO2 is transported in blood

√ LGIS/ CBL

Theory/Viva Voce

23. Explain the normal CO2 dissociation curve

√ LGIS/ CBL

Theory/Viva Voce

24. Explain the concept of haldane effect √ √ LGIS/CBL

Theory/Viva Voce

25. Explain the composite effects of PCO2, pH, & PO2 on alveolar ventilation


26. Explain pressure differences b/w pulmonary & systemic circulation


27. Discuss the pulmonary blood flow and effect of hydrostatic pressure on it


28. Explain the concept ventilation perfusion ratio


29. Interpret the physiological mechanisms involved in the regulation of respiration.

Discuss different group of neurons composing respiratory center


30. Explain the control of inspiration and respiratory rhythm


31. Appraise the role of pneumotaxic center in respiration


32. Explain the regulatory mechanism of hering- breuer inflation reflex


33. Explain the central chemosensitive area & its stimulation by CO2 and H+


34. Discuss the role of peripheral chemoreceptors for control of respiration


35. Relate the processes altering the normal

Explain various causes of hypoxia √ LGIS Theory/Viva Voce

22


physiological principles of respiratory system.

36. Discuss the effects of hypoxia on the body


37. Explain the role of oxygen therapy in different types of hypoxia


38. Explain the causes of cyanosis and asphyxia


39. Discuss the hypercapnia & its association with various forms of hypoxia


40. Explain the effects of very high blood CO2 levels on respiratory center


41. Discuss the signs, symptoms, pathophysiology of various restrictive and obstructive lung diseases

√ √ √ LGIS/CBL

Theory/Viva Voce

42. Explain the physiological mechanisms controlling the response of body in unique environments including deep sea, high altitude and space.

Explain the change in composition of air at high altitude

√ LGIS/CBL

Theory/Viva Voce

43. Explain the effects of low oxygen pressure on the body

√ LGIS/ CBL

Theory/Viva Voce

44. Discuss the change of alveolar PO2 at different elevations

√ LGIS/ CBL

Theory/Viva Voce

45. Explain the mechanism of acclimatization of the body to low O2

√ LGIS/ CBL

Theory/Viva Voce

46. Explain the cause of natural acclimatization in natives of H.A

√ LGIS/ CBL

Theory/Viva Voce

47. Explain the principles of acclimatization

√ LGIS/ CBL

Theory/Viva Voce

48. Discuss the process of oxygen consumption and pulmonary ventilation during exercise


49. Explain the respiratory changes during exercise


23


50. Appraise the body’s regulation of respiration during exercise


51. Discuss the causes & clinical features of AMS/HAPE/HACE

√ √ LGIS/ CBL

Theory/Viva Voce

52. Explain the pathophysiological mechanism of development of AMS

√ LGIS/ CBL

Theory/Viva Voce

53. Explain the various treatment modalities for AMS/HAPE/HACE

√ LGIS/ CBL

Theory/Viva Voce

54. Discuss the effects of weightlessness on the body.


55. Explain the effects of high partial pressures of gases on the body.


56. Explain the causes, symptoms, prevention and management of decompression sickness


57. Discuss the importance of hyperbaric oxygen therapy


24


Curriculum (Biochemistry) 3rd module 1st year MBBS (Y1M3) 2019

S.No

LEARNING OBJECTIVES LEARNING OUTCOMES MIT

Tim

e al

loca

ted

(hrs

)

Nam

e of

inst

ruct

or

Mod

e of

as

sess

-m

ent

By end of the session, the student should be able to:

By end of the session, the student should be able to:

LGIS/ SGD/ CBL/ Practical/ Tutorial Th

eory

/ O

SCE/

Vi

va V

oce

Refe

renc

e

1. To understand the structure, function and biochemical/ clinical significance of water soluble vitamins

Classify water soluble vitamins. LGIS 1 hr Prof. Tauqer

Theory MBC/LB

Describe the chemistry of water soluble vitamins.

LGIS 1 hr Prof. Tauqer

Theory MBC/LB

Explain the Biochemical Functions of water soluble vitamins.


Theory MBC/LB

Describe the deficiency manifestations of water soluble vitamins

LGIS/CBL 1 hr Prof. Tauqer

Theory MBC/LB

Describe the hypervitaminosis of water soluble vitamins and its clinical fall outs


Theory MBC/LB

Differentiate the deficiency manifestations of water soluble vitamins and hypervitaminosis


Theory MBC/LB

Enlist the daily allowances and sources of water soluble vitamins.


Theory MBC/LB

2. To understand the structure, function and biochemical/ clinical significance of fat soluble vitamins

Explain general features of fat soluble vitamins.


Theory MBC/LB

Explain the structure and biochemical functions of fat soluble vitamins.


Theory MBC/LB

Explain the deficiency manifestations of fat soluble vitamins.


Theory MBC/LB

Describe causes and manifestations of Hypervitaminosis and toxicity.


Theory MBC/LB

Differentiate the deficiency manifestations of fat soluble vitamins and hypervitaminosis


Theory MBC/LB

25


Enlist the daily allowances and sources of fat soluble vitamins.


Theory MBC/LB

3. To understand the biochemical aspects of food, diet and nutrition

Describe the concept of food, nutrition, Diet and Balanced Diet.

LGIS/ Tutorial

1 hr Dr. ZahidMehmood

Theory LB

Define different parameters regarding food and nutrition like RDA.

LGIS 1 hr Dr. ZahidMehmood

Theory LB

Illustrate concepts of BMR, RMR, Caloric requirements of the body, Energy Balance.

LGIS/ Tutorial


Theory LB

Appreciate carbohydrates, fats and proteins as major food sources and their nutritional requirements.


Theory LB

Understand the nutritional quality of a protein, essential amino acids their nutritional importance and nitrogen balance.

LGIS/ Tutorial


Theory LB

Elaborate the sources of carbohydrates, their glycemic index.

LGIS/ Tutorial


Theory LB

Recall the nutritional importance of fats and fatty acids, essential fatty acids, saturated, unsaturated and poly unsaturated fatty acids.

LGIS/ Tutorial


Theory LB

Understand and estimate caloric requirements of the body.

LGIS/ Tutorial


Theory LB

4. To know about the requirements of balanced diet in different conditions and diseases related to nutrition

Describe the detailed concept of Balanced Diet


Theory LB

Explain nutritional requirements in: - pregnancy, lactation, of the new born and in nutritional disorders.

LGIS/ Tutorial


Theory LB

Explain Protein Energy Malnutrition. LGIS/ Tutorial


Theory LB

Explain the concept of Obesity and its biochemical/ clinical significance


Theory LB

Differentiate between Marasmus and Kwashiorkor.

LGIS/ Tutorial


Theory LB

26


2. Time Table

27

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