Mbbs Yr1 Syllab 02032017
Mbbs Yr1 Syllab 02032017
Mbbs Yr1 Syllab 02032017
AND
CURRICULUM
PREFACE
The MBBS students coming out of this prestigious Medical University should be
competent in diagnosis and management of common health problems of the individual
and the community at primary, secondary, tertiary levels using the clinical skills based
on history, physical examination and relevant investigations.
The Graduate Medical Curriculum has been prepared to fulfill the vision of this
University and it is oriented towards training students in an unique environment
preparing them to undertake the duties and responsibilities of a physician of first
contact who is capable of looking after the preventive, promotive, curative and
rehabilitative aspects of medicine. The students pursuing Graduate Medical curriculum
will have the necessary competencies (knowledge, skills & attitudes) to assume the role
of a quality health care provider to the people of India and across the world.
The Introduction of teaching elements, OSCE / OSPE have also been incorporated
which are proven to be an important, innovative, reliable and objective modality of
assessment for clinical / practical skills in the changing scenario of Medical Sciences.
Record Book / Log Book becomes a reflective record of student's learning and
achievements and faculty contribution towards learning. Every student will be motivated
to document what he/she has learnt in the respective department / specialty in the log
book and make it as a permanent record. The revised Record Book/Log Book should
be followed by all the affiliated Medical colleges of this University to bring uniformity in
teaching and training of students.
I want to thank the Academic Officer and the team of Academic, Experimental
Medicine & Examination wing and the team of experts from their relevant Medical
Specialties of various Medical Colleges in the State for their enthusiastic and
energetic efforts to bring this revised syllabus & curriculum.
Dr.S.GEETHALAKSHMI,M.D.,Ph.D.,
VICE-CHANCELLOR.
The broad goal of the teaching of undergraduate students in Anatomy aims at providing comprehensive knowledge of the gross and microscopic
structure and development of the human body to provide a basis for understanding the clinical correlation of organs or structures involved and the
anatomical basis for the disease presentations.
2A. KNOWLEDGE:
(a) describe the normal disposition, clinically relevant interrelationships, functional and cross sectional anatomy of the various structures in the body;
(b) identify and describe the microscopic structure and correlate elementary ultrastructure of various organs and tissues and correlate the structure
with the functions as a prerequisite for understanding the altered state in various disease processes;
(c) describe the basic structure and connections of the central nervous system to analyse the integrative and regulative functions of the organs and
systems. The student shall be able to identify the site of gross lesions according to the deficits encountered.
(d) demonstrate knowledge of the basic principles and sequential development of the organs and systems, recognise the clinical stages of
development and the effects of common teratogens. The student shall be able to explain the developmental basis of the major variations and
abnormalities.
2B. SKILLS:
(a) identify and locate describe all the structures of the body and mark the topography of the living anatomy.
(b) Identify and locate structures in gross Anatomy Sections.
(c) identify describe, depict normal appearance of the organs and tissues under the microscope;
(d) Describe the principles of karyotyping and identify the gross congenital anomalies;
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(e) Describe the principles of newer imaging techniques like Ultra sound, MRI, Computerised Tomography Scan, Interpretation of plain and contrast
X-rays.
(f) Describe the clinical basis of some common clinical procedures i.e. intra-muscular and intravenous injection, lumbar puncture, kidney biopsy etc.
2C. INTEGRATION:
From the integrated teaching of other basic sciences, student shall be able to describe the regulation and integration of the functions of the organs and
systems in the body and interpret the anatomical basis of disease processes.
Horizontal integration can be done in common with basic science departments, and vertical integration can be done with clinical departments. For
example, horizontal integration can be the study of liver along with Physiology and Biochemistry; and vertical integration can be the study of
anatomical basis of varicose veins along with General Surgery.
3. A.TEACHING HOURS - One example of the duration for each of the Teaching-Learning Methods
For example: Embryology Lectures: Duration = 2 hours per week, each class lasting 45 - 60 minutes.
Neuroanatomy-20
Genetics-3
Total-259 hours Total -299 hours Total -36 hours Total 43 hours Total 8 Total 5
hours hours
3B.TEACHING METHODOLOGY
Theory (Teaching-Learning methods)
1. Interactive Lecture (include buzz groups, self-assessment questions, quizzes, MCQs. One minute paper)
2. Didactic Lecture- with a problem solving approach, with discussions of relevant clinical problems.
3. Seminar
4. Symposium
5. Role play and discussion on medical ethics topics
6. Self-directed learning
Practicals
1. Dissection
2. Small Group Discussion - Osteology, Surface marking, OSPE-Genetics, Radiology
3. Demonstrations - Histology slides, Embryology models
4. Case Discussion - Nerve Lesions, e.g. Facial Palsy, Radial Nerve Palsy
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4.THEORY SYLLABUS & 5.PRACTICAL SYLLABUS
Introduction to anatomy
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For the following regions (2) Upper limb and (3) Lower limb, (4) Thorax, (5) Abdomen and (6) Head & Neck- General concept of the parts of the bones to which each
muscle is attached, and the relation of the fibres to the axes of the joints they cross in order to understand how a muscle causes a particular movement must be taught.
Muscles may be discussed as muscle groups.
Wherever clinical conditions are mentioned only the relevant anatomical basis is required.
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o Breast abscess
o Breast cancer
o Developmental anomalies
Axilla Boundaries, contents
Axillary Artery:
o Origin, extent, course, parts,
relations, branches
Axillary Vein: Brachial plexus:
o Formation, extent, course, - Variations - Prefixed and
relations, tributaries postfixed plexuses
Brachial plexus: - Injuries – Erb palsy
o formation, branches, relations, and Klumpke paralysis
area of supply of branches, - Anaesthetic block
course and relations of terminal
branches Enlargement of axillary lymph
Axillary lymph nodes: nodes
o Anatomical groups and their
areas of drainage
Back - Concept of layers of muscles of the back Specific attachments of Triangle of
with emphasis on trapezius and latissimus trapezius and latissimus dorsi auscultation
dorsi muscles
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Origin, course, relations, branches (or
tributaries), termination of nerves and
vessels
Wrist drop
- Compartments deep to extensor retinaculum
and contents of each one
Dorsum of hand Extensor expansion - formation and Anatomical “snuff box”
muscles attached
Joints of upper limb Description of type, articular surfaces, Description of type, articular Carrying angle
capsule, synovial membrane, ligaments, surfaces, capsule, synovial
relations movements, blood and nerve supply membrane, ligaments, Intercarpal joints
of: relations movements, blood intermatacarpal
Elbow joint (including muscles involved and nerve supply of: joints
in movements of the joint) Sternoclavicular joint Carpometacarpal
Proximal and distal radio-ulnar joints Acromioclavicular joint joints,except first
(including muscles involved in carpometacarpal
movements of the joint) Dislocation of radial head joint
Wrist joint (including muscles involved in Metacarpophalan
movements of the joint) geal joint
First carpometacarpal joint (including Interphalangeal
muscles involved in movements of the joint
joint)
Radiology Anteroposterior and lateral views of
bones and joints of upper limb
Surface anatomy Bony landmarks:
Jugular notch, sternal angle, acromial
angle,
spine of the scapula - vertebral level of
the medial end
Inferior angle of the scapula – vertebral
level
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(10) GENERAL HISTOLOGY – SYLLABUS (40 hours)
Epithelium
Cartilage
Bone
Muscle
Lymphoid tissue
Nervous tissue
Gametogenesis Oogenesis
Spermatogenesis
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Uterine and ovarian cycles Uterine and ovarian cycles
Ovulation
Fertilization and Blastocyst Definition, Phases of fertilization, Results Assisted reproductive technology – IVF,
of fertilization, Contraceptive methods- GIFT, ZIFT, ICSI
barrier techniques, contraceptive pills,
IUD, vasectomy and tubectomy,
Infertility
Embryonic and adult stem cells
Embryonic period Definition, Neurulation – neural pores External appearance during 2nd month
and the time of closure, Derivatives of Induction and organogenesis
each of the 3 germ layers, Somites
Foetal membranes and Placenta Structure, Placental circulation, Function, Erythroblastosis
Placental barrier fetalis and fetal
hydrops
Amnion and umbilical cord Structure and function Amniotic fluid- hydramnios and Umbilical cord
oligohydramnios anomalies, Amniotic
bands
Birth defects Types of abnormalities – malformation,
disruption, deformation, syndrome,
Teratogens
Overview Regions
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Bones Hip bone Neck-shaft
Side determination (one Femur - ossification of lower end angle
feature for each of the
opposite directions) Patella
Anatomical position Tibia -Ossification of upper end
Identification and
description of features of Fibula
each part
Articulations Articulated foot
Fascia, veins, lymphatics Fascia lata Enlarged inguinal lymph nodes
cutaneous nerves of lower Intermuscular septa Flexor, extensor and peroneal
limb Venous drainage of lower limb retinacula
Varicose veins and deep vein thrombosis
Musculovenous pump
Lymphatic drainage of lower limb including
areas draining into inguinal lymph nodes
Dermatomes of lower limb
Cutaneous nerves of lower limb
Front of thigh Muscle groups with their attachment, nerve Psoas abscess
supply and actions Femoral hernia
Insertion of psoas major, and quadriceps Palpation of femoral artery
femoris Knee jerk
Origin, course, relations, branches (or
tributaries), termination of nerves and
vessels
Boundaries, floor, roof and contents of
femoral triangle
Medial side of thigh Muscle groups with their attachment, nerve
supply and actions
Adductor canal
Gluteal region Muscle groups with their attachment, nerve - Trendelenburg sign
supply and actions - Pudendal block
Insertion of gluteus maximus, medius and
minimus
Relations of piriformis and ischial spine
Origin, course, relations, branches (or
tributaries), termination of nerves and
vessels
- Liability of sciatic nerve to injury during
gluteal intramuscular injections
Back of thigh Muscle groups with their attachment, nerve
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supply and actions
Position, name of bones to which attached,
nerve supply and actions of hamstrings,
Origin, course, relations, branches (or
tributaries), termination of nerves and
vessels
Hip joint • Description of type, articular surfaces, Dislocation of hip joint
capsule, synovial membrane, ligaments, Surgical hip replacement
relations, movements and muscles involved,
blood and nerve supply, bursae around the
joint,
• Fracture neck of femur
Popliteal fossa Boundaries, roof, floor, contents and
relations of contents
•
• Popliteal pulse
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Sole of foot Basic organization Flat foot,
Club foot
Factors maintaining and importance of Plantar fasciitis
arches of the foot
Joints of lower limb • Description of type, articular surfaces, Subtalar and transverse tarsal joints
capsule, synovial membrane, ligaments,
relations, movements and muscles involved,
blood and nerve supply, bursae around the:
Tibiofibular joints
Ankle joint
Radiology • AP and Lateral views of bones and joints of Shenton’s line
lower limb:
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Anterior abdominal wall Transpyloric, Transtubercular, Subcostal
Lateral vertical
Linea alba, Linea semilunaris
Fascia of anterior abdominal wall Abdominal incisions
Regions and quadrants of abdomen
Nerves & blood vessels of abdominal wall
Muscles Collateral routes for
Name of the muscles, direction of fibers, their abdominopelvic venous blood
actions and nerve supply, neurovascular plane
Rectus sheath formation, its contents
Inguinal canal Superficial inguinal ring, Deep inguinal ring Attachments of muscles of
Inguinal ligament anterior abdominal wall
Attachment & modifications
Extent, boundaries, contents
Greater sac
Boundaries of subdiaphragmatic spaces Duodenal recesses
Definition of ligaments, omentum and mesentery Caecal recesses
The mesentery Clinical anatomy
Attachment and contents, Rectouterine pouch, Ascitis, Peritonitis
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Uterovesical pouch Subphrenic abscess
Rectovesical pouch
Viscera Name, position, external and internal features, Clinical anatomy:
important peritoneal and other relations, blood Importance of splenic notch
supply, nerve supply, lymphatic drainage and during palpation of spleen
applied aspects of: Accessory spleens
Spleen, Abdominal part of oesophagus Anatomical basis of
Stomach, Liver & its vascular segments o Kehr’s sign (Referred pain in
Gall bladder, Pancreas, Small intestines the left shoulder during
Caecum, Appendix, Colon, Kidneys, Ureter splenic infarction)
Suprarenals, o different types of vagotomy in
Extrahepatic bilary apparatus gastric ulcer
o Liver biopsy – site of needle
puncture
o Referred pain in cholecystitis
o obstructive jaundice in biliary
tract obstruction
o Referred pain around
umbilicus in acute
appendicitis
o Radiating pain of kidney to
groin
Lymphatic spread in carcinoma
stomach – special emphasis on
Trosier’s sign
Clinical importance of Calot’s
triangle
Blood vessels & nerves Veins: Formation, course relations and
tributaries of- Portal vein, portosystemic
anastomosis
o haemetemesis, malena, caput medusae in
portal hypertension
Inferior vena cava, Renal vein Concept of superior mesenteric
Arteries plexus, inferior mesenteric
Origin, course, important relations and branches plexus, renal plexus, superior
of abdominal aorta, coeliac artery, superior hypogastric plexus, inferior
mesenteric artery, inferior mesenteric artery, hypogastric plexus
common iliac artery, external iliac artery
Reason for preserving 1st lumbar
Autonomic nervous system sympathetic ganglion in lumbar
Coeliac ganglion sympathectomy
Diaphragm Attachments, openings, nerve supply & action Abnormal openings and
diaphragmatic hernia
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Pelvis Muscles: Levator ani & coccygeus (pelvic Clinical anatomy
diaphragm), Obturator internus, Piriformis Anatomical basis of :
o suprapubic cystotomy
Viscera: Position, features, important peritoneal o Urinary obstruction in benign
and other relations, blood supply, nerve supply, prostatic hypertrophy
lymphatic drainage and o Retroverted uterus
Clinical aspects of-Urinary bladder & pelvic part o Prolapse uterus
of ureter, Rectum, Anal canal Neurological lesions of the
Prostate, age changes bladder
Seminal vesicle, Vas deferens, Ejaculatory o Autonomous neurogenic
ducts, Male urethra bladder
Uterus & its supports, Fallopian tube o Atonic bladder
Ovary, Vagina, Female urethra o Automatic bladder
Blood vessels: Origin, course, important Lobes involved in benign
relations and branches of - Internal iliac artery prostatic hypertrophy & prostatic
Nerves: cancer, Vasectomy
Structures palpable during Tubal pregnancy, Tubal ligation
o Vaginal examination Sacral plexus
o Rectal examination Branches
Internal and external haemorrhoids Pelvic splanchnic nerve
Anal fistula
Perineum Extent and Subdivisions of perineum Clinical anatomy
Superficial perineal pouch - boundaries and
contents Perineal tear / episiotomy
Deep perineal pouch – boundaries and contents
Perineal body, Perineal membrane
Ischiorectal / ischioanal fossa, Perianal abscess
and anal fissure
Joints Curvatures of the vertebral column Scoliosis, lordosis, prolapsed
Type, articular ends, ligaments and movements disc, spondylolisthesis, spina
of: Intervertebral joints, Sacroiliac joints, Pubic bifida
symphysis
Lumbar puncture: Site, direction of the needle,
structures pierced during the lumbar puncture
Cross-sectional anatomy Cross-section at the level of L1 (transpyloric Cross-sectional anatomy of
plane) abdomen and pelvis
Microanatomy Gastro-intestinal system: Oesophagus, Fundus of Cardio-oesophageal junction
stomach, Pylorus of stomach, Duodenum,
Jejunum, Ileum, Large intestine, Appendix,
Liver, Gall bladder, Pancreas, Suprarenal gland
Urinary system: Kidney, Ureter, Urinary bladder
Male Reproductive System: Testis, vas deferens,
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Prostate
Female reproductive system:
Ovary, uterus, Uterine tube, cervix, Placenta, Epididymis, seminal vesicle,
umbilical cord
Uterus - Proliferative and
secretory phases of Corpus
luteum
Embryology Anterior abdominal wall Abdominal aorta Inferior vena cava
Diaphragm Portal vein
Development and congenital anomalies of: Embryological basis and
Foregut & spleen, midgut and hindgut clinical presentation of
Derivatives of dorsal and ventral mesenteries congenital anomalies
Urinary system Achalasia cardia, Congenital
Male reproductive system hypertrophic pyloric stenosis,
Female reproductive system Annular pancreas, Errors of
rotation of the gut, Errors of
fixation, Exomphalos,
Gastroschisis, Umbilical hernia,
Situs inversus
Congenital obstruction: Atresia,
Stenosis
Meckel’s diverticulum,
Imperforate anus, Hirchsprung
disease (Congenital megacolon),
Horseshoe kidney
Congenital polycystic kidney,
Aberrant renal arteries, Ectopia
vesicae, Epispadias
Hypospadias, Rectovaginal
fistula
Osteology Features of typical and atypical lumbar vertebra, Coccyx
Sacrum
Bony pelvis: Anatomical position Bony Pelvis
Types
Define true pelvis and false pelvis Clinical Anatomy
Boundaries of pelvic inlet, pelvic cavity, pelvic Sacralization of lumbar vertebra,
outlet, Sex determination Lumbarization of 1st sacral
vertebra
Radiological anatomy Plain x-ray abdomen Principles of USG, ERCP, CT
Contrast X-rays: Barium swallow, Barium meal, abdomen,
Barium enema, Cholecystography MRI
Intravenous pyelography,
Hysterosalphingography, Arteriography
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Surface anatomy Regions and planes of abdomen, Stomach Spleen,
Liver, Fundus of gall bladder, Kidneys, Duodenum
Abdominal aorta , Inferior vena cava, Superficial Pancreas
inguinal ring, Deep inguinal ring, Ileocaecal junction
McBurney’s point Root of the mesentery
Osteology Sternum
Features of 2nd, 11th
Ribs and 12th ribs
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Internal thoracic artery
Lungs
Trachea
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drainage and nerve supply
Applied anatomy
∙ Bronchitis
Phrenic nerves
Coronary arteries
Origin, course and branches
Applied anatomy
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Embryology Development of pleura
Development of respiratory system
Development of heart
Development of the chambers,
interatrial and interventricular septa
Development of oesophagus
Living Anatomy ∙ Internal thoracic artery
∙ Parietal pleura
∙ Lungs, root of lungs and fissures
∙ Trachea
∙ Heart
∙ Apex beat
∙ Arch of aorta
∙ Oesophagus
Surface projection of valves of heart
Radiology ∙ Plain X-ray chest – PA view CT and MRI of Thorax
Cranial Cavity Cranial fossae: structures related and Clinical importance of Pituitary tumours
major foramina and structures passing dural venous sinuses
through
Pituitary gland
Dural venous sinuses
Orbit Attachments, nerve supply and actions of Strabissmus Testing of extraocular
muscles of eyeball muscles
Nerves and vessels in the orbit
Ciliary ganglion
Horner’s Syndrome
Anterior Triangle Boundaries and subdivisions of the
anterior triangle
Boundaries and contents of the muscular,
carotid, digastric and submental triangles
Temporal and Infratemporal Extent, boundaries and contents of Clinical significance of
regions temporal and infratemporal fossae pterygoid venous plexus
Attachments, direction of fibres, nerve Dislocation of
supply and actions of muscles of temporomandibular joint
mastication
Temporomandibular joint
Submandibular region Parts, borders, surfaces, relations, nerve Submandibular stones
supply of submandibular gland Bidigital palpability of
Course and relations of submandibular submandibular swellings
duct
Submandibular ganglion
Position, relations and nerve supply of
sublingual gland
Deep structures in the neck Thyroid gland- location, parts, borders, Thyroid swellings-
surfaces, relations, blood supply anatomically relevant
Parathyroid glands- location, blood clinical features
supply Awareness of liability of
Trachea, Tracheostomy- structures injury to external and
encountered recurrent laryngeal nerves
Subclavian artery- Origin, parts, course, during thyroidectomy
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branches Compression of
Vagus Nerve in the neck- Course and subclavian artery by
branches cervical rib
Accessory Nerve- Course and supply Fascial spaces of neck
Cervical Sympathetic chain- Thymus
Components, branches, area of supply
Deep cervical fascia- parts, extent,
attachments, modifications
Deep cervical lymph nodes
Mouth, Pharynx, Palate Subdivisions and contents Tonsillitis and Killian’s dehiscence
Names, position, actions and nerve tonsillectomy
supply of muscles of palate and pharynx Adenoids
Palatine tonsil- Position, relations, blood Paratonsillar abscess
supply
Waldeyer’s lymphatic ring- Components
and their function
Boundaries and clinical significance of
pyriform fossa
Cavity of Nose Nasal septum Maxillary sinus tumours
Epistaxis- significance of Little’s area Sinusitis
Lateral wall of nasal cavity
Paranasal sinuses concept of referred
pain
Larynx Cartilages and ligaments Laryngitis
Names, nerve supply and actions of Recurrent laryngeal nerve
intrinsic and extrinsic muscles of larynx injury
Sensory innervation and blood supply of
larynx
Tongue Names, nerve supply and actions of Hypoglossal nerve palsy
extrinsic and intrinsic muscles of tongue
Nerve supply and lymphatic drainage of
tongue
Organs of hearing and equilibrium Parts, boundaries, contents, relations, Internal ear, Mastoid Antrum,
blood supply and nerve supply of Otitis externa, Otitis media,
external ear, middle ear and Auditory McEwan’s triangle-Approach
tube to mastoid antrum,
Myringotomy
Eyeball Parts and layers of eyeball Cataract, Glaucoma, Central
retinal artery occlusion,
Intraocular muscles- position,
nerve supply and actions
Prevertebral region and Joints of Concept of prevertebral muscles
Head and neck Atlanto-occipital joint
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Atlantoaxial joint
Microanatomy Pituitary gland Olfactory epithelium, Eyelid, Adult Tooth
Thyroid and Parathyroid gland Lip, Salivary glands, Cornea,
Tongue Retina, Sclero-corneal
Tonsil junction, Optic Nerve, Crista
Epiglottis ampullaris, Macula, Cochlea-
organ of Corti, Pineal gland
Embryology Face Facial clefts, First Arch
Palate Anomalies, Developmental
Tongue anomalies of tongue,
Branchial apparatus Branchial cysts and fistulae,
Pituitary gland Ectopic thymic, parathyroid or
Thyroid gland thyroid tissue, Thyroglossal
Eye cyst, Coloboma iridis
Surface Anatomy Vertebral levels of: Hyoid bone, Thyroid Accessory nerve
cartilage, Cricoid cartilage
Surface Projection of Thyroid gland, Parotid
gland and duct, Pterion, Common carotid
artery, Internal jugular vein, Subclavian vein,
External jugular vein, Facial artery
Radiology Plain X ray skull: AP view, Lateral view CT and MRI of Head and
Plain X ray cervical spine lateral view Neck
Plain X ray of paranasal sinuses
Carotid angiogram
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e) Upper and lower motor neurons
f) Spinal segment and dermatome
g) Blood supply
h) Modifications of piamater
Brainstem External and interrnal features of
Ventricles of the brain Features of lateral, third and fourth ventricle. Subarachnoid cisterns, blood- CSF
Choroid plexus, Circulation of Cerebro-Spinal barrier.
Fluid (CSF).
Limbic system Limbic system –
parts and function
Connections of
limbic system
Reticular formation and ARAS Reticular formation
and ARAS-General
arrangement, zones,
basic connections
and functions
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Cranial nerve nuclei Cranial nerve nuclei - location Functional columns
Optic and auditory pathways
Optic and auditory pathways
Blood supply of brain and Blood supply of brain and spinal cord Clinical importance of blood supply of
spinal cord brain and spinal cord, Lateral medullary
syndrome, Medial medullary syndrome,
pontine hemorrhage, Weber’s syndrome,
posterior circulation stroke, Middle
cerebral artery stroke.
Microanatomy Transverse sections of spinal cord at cervical,
thoracic, lumbar and sacral levels
Cerebral cortex Differentiation
Cerebellar cortex between motor and
Nerve endings Neuromuscular junction- Motor end plate sensory cortex
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numerical / structural
Gene mutation
Gametogenesis Oogenesis
Spermatogenesis
Embryonic period Definition, Neurulation – neural pores and External appearance during
the time of closure, Derivatives of each of 2nd month
the 3 germ layers, Somites Induction and organogenesis
Foetal membranes and Placenta Structure, Placental circulation, Function, Erythroblastosis fetalis and fetal
Placental barrier hydrops
Amnion and umbilical cord Structure and function Amniotic fluid- hydramnios Umbilical cord anomalies,
and oligohydramnios Amniotic bands
Birth defects Types of abnormalities – malformation,
disruption, deformation, syndrome,
Teratogens
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6.REFERENCES FOR LEARNING (BOOKS)
Gross Anatomy
3. Clinical Oriented Anatomy 7th edition by Moore KL, Agur AMR and Dalley AF
Neuroanatomy
Histology
1. Inderbir Singh's Textbook of Human Histology with Colour Atlas and Practical Guide 7th edition, 2014 by Vasudeva Neelam
2. Wheater's Functional Histology: A Text and Colour Atlas, 6th Edition by Barbara Young, Geraldine O'Dowd, Phillip Woodford
Embryology
2. Larsen’s Human Embryology 5th Edition 2014 by Schoenwolf, Bleyl, Brauer and Francis-West
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3. The Developing Human: Clinically Oriented Embryology 9th edition, 2012 by Keith L. Moore
Genetics
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7.THEORY EXAMINATION
Paper 1: General Anatomy, General Histology, General Embryology, and Genetics Gross Anatomy of Upper Limb, Lower Limb, Abdomen, Pelvis
and Perineum and special histology and special embryology relevant to these regions;
Paper 2: Gross Anatomy of Thorax, Head, Neck, Brain and Spinal Cord and special histology and special embryology relevant to these regions;
Histology and Embryology may be included in theory as a part of the essay, short notes and short answers
Marks will be allotted for relevant diagrams which may be part of the essay, short notes and short answers.
8.PRACTICAL EXAMINATION
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Lower Limb 4. Heart- chambers
1. Femoral triangle 5. Heart – blood supply
2. Gluteal region 6. Lungs
3. Front of thigh 7. Posterior mediastinum
4. Posterior and adductor compartment of thigh 8. Pericardium
5. Anterior and lateral compartments of leg
6. Back of leg Head and Neck
7. Sole of foot 1. Scalp
8. Dorsum of foot 2. Face and parotid region
9. Knee joint 3. Posterior triangle
10 Ankle joint 4. Cranial cavity
5. Orbit
Abdomen, Pelvis and Perineum 6. Anterior triangle
1. Anterior abdominal wall 7. Temporal and infratemporal regions
2. Posterior abdominal wall 8. Deep structures of the neck
3. Male external genitalia 9. Mouth, pharynx and palate
4. Inguinal canal 10. Larynx
5. Liver and extrahepatic biliary apparatus 11. Nasal cavity
6. Stomach 12. Dural venous sinuses
7. Duodenum and pancreas
8. Small intestine and large intestine Nervous system
9. Blood vessels of abdomen and pelvis 1. External surfaces of the cerebral hemisphere
10. Diaphragm 2. Base of the brain
11. Female reproductive system 3. White fibres of the cerebrum
4. Ventricles of the brain
Thorax 5. Coronal section of the cerebrum
1. Thoracic cage 6. Horizontal section of the cerebrum
2. Superior mediastinum 7. Cerebellum
3. Heart- external features 8. Brain stem
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List of Slides for Histology Practical *=Nice to Know
Part 1 9. Nerve - CS
General Histology
1. Hyaline cartilage 10. Spinal ganglion
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Systemic Histology
1. Cardio-oesophageal junction 10. Liver
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Part 2
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Practical Examination
Anatomy:
Spotters
Gross anatomy ---12 x1= 12 marks
Histology ---12x1= 12 marks
Discussion
Gross anatomy- --2 x 3 = 6 marks
Histology --2 x 3 = 6 marks
SPOTTERS
Gross anatomy-
Upperlimb - 2
Lowerlimb -2
Abdomen -2
Pelvis -1
Thorax -2
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Head and neck -2
Brain -1
Histology
General –3
Paper 1 ---5
Paper -2 ---4
Discussion
Gross anatomy
Paper -1 ----1 specimen
Paper –2- ----1 specimen
Histology
General ----1 slide
Systemic ---1 slide.
VIVA
Osteology – 5marks
Embryology- 5marks
Radiology- 5 marks
Surface anatomy- 5marks.
(For Clinical Anatomy and Genetics charts - the anatomical relevance to common clinical conditions should be asked. The number of charts to be
made available should be at least 70:
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Paper I - 30 charts
Paper II - 30 charts
Genetics - 10 charts
The clinical anatomy charts should include relevant Gross Anatomy, Embryology and Radiology
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List of Surface Markings learnt o Brachial pulsations
Upper limb:
Student must be able to demonstrate o Radial pulsations
• Relevant bony and soft surface landmarks
o Ulnar pulsations
• Arteries:
o Ulnar nerve
o Axillary
o Anatomical snuff box/ scaphoid
o Brachial
• Locate the common sites for venipuncture in the upper limb:
o Radial
o Median cubital vein
o Ulnar
o Cephalic vein at the wrist
o Superficial palmar arch
o Dorsal venous network
o Deep palmar arch
Lower limb:
• Nerves: Student must be able to demonstrate
• Relevant bony and soft surface landmarks
o Median
• Arteries:
o Ulnar
o Femoral
o Radial
o Popliteal
o Axillary
o Anterior tibial
• Others:
o Posterior tibial
o Flexor retinaculum
o Dorsalis pedis
o Extensor retinaculum
• Veins:
• Surface landmarks to palpate the following on the surface:
o Great saphenous
42
o Femoral o Trachea
o Femoral • Organs:
• Others: o Pleura
Thorax: o Stomach
Student must be able to demonstrate
o Liver
• Relevant bony and soft surface landmarks
o Spleen
• Superior Mediastinum:
o Fundus of Gall bladder
o Right and left brachiocephalic veins
o Base of the appendix
o Superior Vena Cava
o Arch of aorta
43
o Morrison’s parallelogram for posterior marking of the o Facial artery
kidneys
o Common, internal and external carotid arteries
• Blood vessels: Abdominal aorta and Inferior Vena Cava
o Internal and external jugular veins
• Others:
o Subclavian artery and vein
o Superficial and deep inguinal rings
• Nerves:
o Mc Burney’s point
o Spinal accessory nerve
o Vertebral levels of main events occurring in the
o Vagus
abdomen
44
10.FORMATIVE ASSESSMENT - Quarterly (marks need to be submitted three times to the university)
Students should be given feedback on their performance after each of the following eight units.
Each student should be shown as having a mark for each of the eight units mentioned above. These marks should be grouped together and sent to the
university on three occasions in one academic year. Based on all these marks the total internal assessment will be finally calculated as Theory and
Practical marks which will be the average of the 8 Internal Assessment unit tests:
Theory 20 marks
Practical 15 marks
12.MEDICAL ETHICS -
1) Respect of the cadaver
2) Privacy and confidentiality
3) Cultural sensitivity
45
4) Consent
5) Autonomy
6) Source of cadavers
7) Eugenics
8) Genetic counselling
13.INTEGRATED TEACHING
1) Vertical Integration- with the help of clinicians and hospital visits wherever possible
2) Horizontal Integration- may be considered for topics such as peptic ulcer, diseases of liver and biliary tract, diseases of the kidney, diseases of
the central nervous system, myocardial infarction
Superior mediastinum –thoracic inlet syndrome, scalenus anterior syndrome General surgery
Pleural effusion, Pneumothorax, Pleural tapping Medicine / Respiratory Medicine
Pericardial pain, referred pain from heart Medicine
Tracheo-oesophageal fistula Paediatric surgery
Appearance of thorax in CT and MRI Radiology
47
Clinical Integration for Nervous System
Prenatal diagnosis OG
14.RECORDS
Gross Anatomy Record and Histology Record
49
List of Histology slides to drawn by I MBBS students
General Histology
Epithelial Tissue Blood vessels
- Simple squamous epithelium - Elastic artery
- Simple cuboidal epithelium - Medium sized artery and vein
- Simple columnar epithelium - Large vein
- Pseudostratified cil. columnar epithelium Glands
- Stratified squamous epithelium - Unicellular gland (Goblet cell)
- Transitional epithelium - Simple tubular gland
Connective Tissue - Serous gland
- Areolar tissue - Mucous gland
- Adipose tissue - Mixed gland
- Tendon L.S -Sebaceous and sweat gland
Cartilage -Mammary gland
- Hyaline cartilage Lymphoid Tissue
- Elastic cartilage - Lymph node
- Fibro cartilage - Spleen
Bone - Thymus
- Compact bone L.S. - Tonsil
- Compact bone C.S. Nervous Tissue
- Spongy bone - Nerve C.S
- Developing bone - Nerve L.S (Osmicatted )
Muscle - Spinal ganglion
-Skeletal muscle L.S. - Sympathetic ganglion
-Skeletal muscle C.S. Integumentary System
50
- Smooth muscle - Hairy skin
- Cardiac muscle - Nonhairy skin
- Nail
Special Histology
Gastrointestinal system - Cornea
- Oesophagus - Iridio-corneal junction
- Cardio-oesophageal junction - Retina
- Stomach - fundus - Optic nerve
- Stomach - pylorus - Macula
- Duodenum - Crista
- Jejunum - Organ of Corti
- Ileum - Pituitary gland
- Large intestine - Pineal gland
- Appendix - Thyroid gland
- Liver - Parathyroid gland
- Gall bladder - Tongue – fungiform and filiform papillae
- Pancreas - Tongue – circumvallate papilla
Genitourinary system - Epiglottis
- Kidney - Olfactory epithelium
- Ureter CNS
- Urinary bladder Nerve Endings
-Adrenal gland - Motor end plate
-Testis - Muscle spindle
-Epididymis - Meissner’s corpuscle and Pacinian corpuscle
-Vas deferens
-Seminal vesicle -Spinal cord - cervical
-Prostate -Spinal cord - Thoracic
51
-Ovary -Spinal cord - Lumbar
-Fallopian tube -Spinal cord - Sacral
-Uterus - Medulla - Motor Decussation
-Cervix - Medulla - Sensory Decussation
-Placenta - Medulla - Mid Olivary Level
-Umbilical cord -Pons – lower pons
Respiratory System - Pons - upper Pons
-Trachea - Midbrain – inferior colliculus
- Lung - Midbrain - Superior Colliculus
Head & Neck - Cerebrum – Typical Cortex
- Eyelid - Cerebellum
- Lip
- Adult tooth
- Developing tooth –Bell stage
52
PHYSIOLOGY
1
The goal of learning Physiology is to enable an undergraduate student to have a comprehensive knowledge of the normal functions of the organ systems which
HUMAN PHYSIOLOGY
COMPETENCIES:
- Have an understanding of the functioning of the different organ systems of the human body and their interactions towards maintenance of
homeostasis or a constant internal environment.
- Be able to apply the knowledge of physiological processes to comprehend mechanisms of disease and basis of treatment.
- Be able to perform some basic laboratory tests and interpret their results
ii) OBJECTIVES
a) KNOWLEDGE
(1) Explain the normal functioning of all the organ systems and their interactions for maintenance of a constant internal environment.
(2 ) Describe physiological responses and adaptations to changes in internal and external environment.
2
(3) Describe the physiological principles underlying pathogenesis and treatment of disease.
(4) List normal values and acceptable ranges for relevant physiological parameters
(6) Diagnose conditions from symptoms and signs and investigative data provided in case scenarios dealing with common disorders of:
hematological, musculoskeletal, alimentary, endocrine, reproductive, renal, cardiovascular, respiratory, and neurological systems.
b) SKILLS
At the end of the course the student should have developed skills in/to:
(2) Distinguish between normal and abnormal data derived from the tests mentioned above.
(3) Perform the following tests and clinical examinations in a normal subject with an understanding of the physiological basis of the examination and
the clinical need to do so. The student should be able to:
(i) Measure blood pressure, record ECG and perform clinical examination of the cardiovascular system.
(ii) perform tests of ventilatory function using spirometer and peak flow meter and perform clinical examination of the respiratory system
(iii) do experiments towards understanding the effect of posture and various grades of exercise on cardiorespiratory function.
3
(iv) perform clinical examination of the abdomen
(v) perform clinical examination of the nervous system including special senses
c) ATTITUDE:
INTEGRATION
The teaching-learning program should be integrated horizontally and vertically, as much as possible, to enable students to understand the physiological
processes in health, derangements in disease and rationale of treatment.
Number of hours:
4
TOTAL HOURS ALLOCATED FOR PHYSIOLOGY AS PER MCI NORMS
5
The teaching learning methods employed will include
Theory
• Lectures
• Tutorials
• Small group discussion
• Case based learning
• Problem based learning
• Integrated teaching module
• Early Clinical Exposure
Practical
• Demonstration of Hematology Experiments
• System wise Clinical Examination
• OSPE
• OSCE
• Case Discussion
• Charts and calculation
6
THEORY AND PRACTICAL SYLLABUS
7
GENERAL PHYSIOLOGY AND BODY FLUIDS (Lectures + Tutorials 20 hours; Practicals + OSPE 5 hours; ECE: 3 hours)
SPECIFIC LEARNING OBJECTIVES TEACH
ING CLINICAL
NO TOPIC
HOURS INTEGRATION
MUST KNOW DESIRE TO KNOW NICE TO KNOW
1
Cell • Will be discussed in Biochemistry and
Organelles Anatomy
2 • Describe the concept of maintenance • State and describe
Homeostasis of internal environment examples of negative
and • Recognize that negative feedback is feedback 1 Hour
Feedback
the most common type of • State and describe
System
physiological control instances of positive
feedback in human
physiology
3 Body Fluids • List the different body fluid • Difference between Changes in electrolyte with clinical
compartments, - state the volume, tonicity and osmolarity concentration in departments to
osmolarity and electrolyte • Edema and its causes Vomiting, Diarrhoea, 2 hours enable a student to
composition of each of the following • The dilution principle for severe dehydration and understand the
compartments measurement of body burns principles of
• Total body water, extracellular, fluid compartments Cause for oedema in intravenous fluid
intracellular, plasma, intravascular • Methods of measurement Kwashiorkor, Liver therapy
• Describe the term transcellular fluid of body fluid failure, learn the
• Measurement of volumes of compartments glomerulonephritis and presentations and
compartments filariasis management of
• Describe the Starling's forces that electrolyte disorders
govern fluid exchange across the (the causes of fluid
membranes separating the various and electrolyte
compartments disorders may be
• Define Donnan effect and discussed later in
equilibrium the course)
• Use the Concept of electro neutrality see patients
in the fluid compartments to calculate presenting with
‘Anion gap’ different types of
edema
• Define anion gap as the term referring
8
to unmeasured anions in plasma.
9
• Exocytosis
6 Membrane • Describe the mechanisms • Patch Clamp Technique • Describe the term With Pharmacology
Potential involved in genesis of resting • Cathode Ray Oscilloscope ‘Depolarizationblock and Anaesthesia to
membrane potential (RMP) in a ’ in terms of 2 Hours understand
prototype cell inactivation of (i)The use of drugs
• Recognise the RMP in a nerve or voltage –gated causing
cardiac cell sodium channels depolarization
• Nernst or equilibrium potential during sustained blockade
‘Equilibrium potential’ partial depolarization (ii))Long QT
• Action potentials in neuron, and therefore the syndrome as an
skeletal muscle cell, Sino atrial inability of the tisse adverse effect of a
node and cardiac ventricular cell to develop new number of drugs
action potential causing blockade of
a K channel called
HERG channel
10
Blood (Lectures + Tutorials 30 hours; Practical + OSPE 40 hours; ECE: 6 hours)
3 Erythrocyte • Define and state normal values for • Estimate ESR by • See evidences
Sedimentation ESR in men and women Wintrobe/Westergren’s Practical for ESR serving
Rate (ESR): • Describe the factors influencing ESR method of a provided 3 Hours as an index of
(fibrinogen particularly) sample of blood and acute phase
• Discuss the significance of ESR in interpret the result reaction
disease states
13
the pathways of coagulation and clotting factor Intravascular
• Explain various causes for abnormal assays. Coagulation
hemostasis • Discuss the use of anti- • Explain reason for
• Perform and interpret simple tests of platelet agents in thrombosis and
hemostasis like bleeding time by therapeutics embolism in
Duke’s method and clotting time by atherosclerotic
capillary method of Wright on oneself vascular disease and
by collecting blood using finger prick venous stasis
method using aseptic method
• Explain Lee and White’s method for
determining clotting time
10 Blood groups • Describe the importance of blood • Discuss the minor blood • Bombay Blood • Visit to Blood
& Blood groups group systems. Group Bank Storage
banking • Explain the genetic determination of • Perform and interpret 1 Hour and Cross
blood groups blood grouping/typing on Theory matching
• Describe the ABO system of blood oneself by collecting
grouping blood using finger prick • With clinical
• State the frequency of different blood method under aseptic pathology for a
groups conditions (or on a visit to the blood
• Describe the Rh system of blood provided blood sample) 3 Hours bank to observe
grouping • Explain the process and Practical and discuss
• Explain the mechanism and interpretation of blood procedures done
consequence of ABO and Rh cross match to separate
incompatibility components of
• Explain the condition Erythroblastosis blood for clinical
Fetalis, state preventive measure and use and
treatment option for the same. procedures done
in the blood bank
for safe blood
transfusion.
• Teaching may be
integrated with
clinical
pathology to
discuss
transfusion
reaction
14
11 WBC • State the normal Total and • Make a peripheral blood • With medicine -
• Monocyte‐
Differential count smear on their own blood macrophage system altered total and
• Classify types of WBC as / provided blood and state their 2 Hours differential
granulocytes, agranulocytes • Perform and interpret the function theory counts
• Describe the morphology and differential leucocyte • Brief
functions of neutrophils, eosinophils, count using aseptic introduction to
basophils, mast cells; Lymphocytes , precautions hematological
monocytes. 6 Hours malignancies
• Perform and interpret total leucocyte Practical • Bone marrow
on their own blood / provided blood transplantation
using aseptic precautions
• List Conditions in which total
leucocyte counts is increased or
decreased.
• List conditions in which counts of
each type of WBC are increased or
decreased
• Describe the various cells that
constitute the monocyte- macrophage
system and state their function
12 Leucopoiesis • Outline the process of maturation
of white blood cells 1 Hour
13 Immunity • Classify immunity and state the • Classify • Name important • To integrate with
differences between innate and immunoglobulins and cytokines. medicine to
acquired immunity state their functions • State their source 5 Hours discuss and
• Discuss the cells and mechanisms • Explain primary and and functions observe patients
involved in innate secondary immune with
• immunity response • Auto Immune Immunodeficien
• Name the lymphoid organs in the • Illustrate the role of Disease cy syndromes,
body and outline the development of Complement system in Immunodeficiency • Autoimmune
T and B cells immunity Syndrome diseases
• Classify acquired immunity and • Organ transplant • To integrate with
mention the cells involved in and dermatology to
acquired immunity • Immunosuppresio discuss and
• Describe the cells and mechanisms n observe patients
involved in cell mediated immunity with
• Describe the cells and mechanisms • Allergy and
15
involved in humoral immunity Hypersensitivity
• To integrate with
nephrology to
discuss immune
response related
to
• Organ
Transplantation
and
immunosuppress
ive therapy
14 Lymph • Describe the formation and Discuss the • Integrate with
composition of lymph pathophysiology of surgery to
• Illustrate the lymphatic circulation. lymphedema 1 Hour discuss and
• Discuss functions of lymph. observe patients
with
lymphedema
(filariasis, Ca
Breast with
upper arm
edema)
16
Autonomic nervous system (Lecture 2 Hours)
TEACH
SPECIFIC LEARNING OBJECTIVES CLINICAL
No Topic ING
INTEGRATION
HOURS
MUST KNOW DESIRE TO KNOW NICE TO KNOW
1 Organization • Sympathetic and • B type nerve fibres
parasympathetic divisions • Unmyelinated C fibres
• Pre-ganglionic neuron
• Post-ganglionic neuron
8 Eye • Parasympathetic –
Accommodation, miosis –
• Sympatheticac-cm
om
ydmrioadsaistion, miosis
- mydriasis
9 Heart • SA node
• Parasympathetic - decreases
heart rate – muscarinic
receptor
• Sympathetic - Increases
heart rate - beta 1 receptors
• Atria & Ventricle
• Parasympathetic - decreases
18
force of contraction
• Sympathetic - increases
force of contraction - beta 1
& 2 receptors
• AV node and Purkinje fibers
• Parasympathetic - decreases
conduction velocity
• Sympathetic - increases
conduction velocity - beta 1
& 2 receptors
10 Lungs • Parasympathetic –
bronchoconstriction
• Sympathetic -Dilation -
beta 2
11 Vessels • Arterioles
• Sympathetic -
vasoconstriction - α 1 & 2
• Veins
• Sympathetic - constriction -
α1&2
12 Stomach and Parasympathetic
Intestine o Increases motility &
secretion
o Relaxes sphincters
14 Urinary • Detrusor
Bladder • Parasympathetic –
contraction
• Sympathetic – relaxation
19
• Sphincter \
• Parasympathetic –
relaxation
• Sympathetic – contraction
15 Male Organ • Erection – parasympathetic
• –
Sympathetic
16 Skin • Pilomotor - Sympathetic –
contraction
• Sweat glands
• Parasympathetic -
generalized dilute secretion
17 Liver • Sympathetic -
glycogenolysis
18 Pancreas • Exocrine • Endocrine
• Parasympathetic increases • Sympathetic - decreases
secretion
• Sympathetic –decreases
20
Muscle (Lectures + Tutorials 15 hours; Practicals + OSPE 5 hours; ECE: 3 hours)
1 Skeletal • Describe and draw the structure of • Describe the functions of • Role of Dystrophin • Muscular
Muscle sarcomere marking actin filament, other structural proteins in muscle dystrophy
Morphology myosin filament, I band, A band, H like Titin, Desmin etc Dystrophies 2 Hours (Neurology/P
band, Z line and sarcomere MR)
• Describe the functions of contractile
and regulatory proteins involved in
muscle contraction
• Draw and describe the structure of the
sarco-tubular system
2 Neuromuscul • Draw and Describe the structure of • Pseudocholinesterase • Neuromuscular Succinyl choline
ar junction the neuromuscular junction Lambert-Eaton Blockers and
• Describe the events involved in Syndrome 2 Hours depolarization
neuromuscular transmission • Organophosphorus block –
• Describe the pathophysiology of poisoning (Anaesthesia)
diseases affecting the neuromuscular • EMG. Therapeutic use
junction like myasthenia gravis of Botox
• Describe the mechanism of action Myesthenia
cholinesterase inhibitors Gravis –
• Motor Unit (Neurology)
Organophosphor
us Poisoning
Factors affecting force of (Medicine)
3 Muscle • Describe the molecular Basis of contraction: pre‐load, • Types of Muscle
Contraction after load, beneficial
muscle contraction, events involved fibres Rigor Mortis
effect.
in excitation contraction coupling. • Energy sources in (Forensic
• Describe the
• Explain the types of Muscle muscle 2 Hours Medicine)
physiological basis of the
contraction
length-tension • Denervation
• Describe the sliding filament theory hypersensitivity
of muscle contraction • Describe the
21
• Role of ATP and calcium pumps in relationship. concept of oxygen
the mechanism of relaxation of the debt
muscle
• Describe the Factors affecting the
force of contraction
4 Smooth • Structure, distribution, types, • Comparison between
Muscle molecular mechanism of contraction smooth, skeletal and 1 Hour
cardiac muscle
5 Factors • List the various factors that modulate •
modulating smooth muscle contraction like Cystometrogram
smooth stretch, sympathetic nerveous system, 1 Hour (PMR, Urology)
muscle circulating substances etc.
contraction
And • Describe the special properties of
Properties smooth muscle like latch-bridge
mechanism and plasticity
22
Gastrointestinal System (Lectures + Tutorials 15 hours; Practicals + OSPE 12 hours; ECE: 3 hours)
5 Liver and • Explain the portal system • Explain the • Explain the Integrated teaching
gall bladder • Describe the functions of liver pathophysiology of consequences of with Anatomy to
23
(Horizontal • Describe the composition and functions • Portal Hypertension liver Failure understand the
Integration) of Bile • Ascites functional Anatomy
• Explain Micelle formation and its • Gall Stone 1 Hour of Liver
functions • Jaundice With Biochemistry
• Explain what is emulsification of fat to discuss LFT
• Explain the process of Entero-hepatic With Medicine –
circulation Liver Failure
With Surgery –
Jaundice
6 Gall Bladder • State the factors regulating bile • State the composition of • State what is ERCP Integrated with
secretion gall stones and factors and when it is Surgery to discuss
• Explain the function of Gall Bladder involved in the formation performed 1 Hour about Gall Stones
• Explain how concentration of Bile of gall stones • State what is
Cholecystectomy
and what are the
indication of the
same
7 Pancreatic • List the Enzymes present in pancreatic • Reason for the alkaline • what is pancreatitis
secretion juice and explain their functions pH of pancreatic • Explain
• Explain the regulation of secretion the secretion and its Steatorrhoea
role of enterokinase importance 1 Hour
25
Endocrinology (Lectures + Tutorials 30 hours; Practicals + OSPE 15 hours; ECE: 3 hours)
• Panhypopituitarism
• Shehan’s Syndrome
• Postpartum Pituitary
Necrosis
4 Thyroid Gland • Explain the functional Anatomy of • Explain the • Describe the Cases of Hypo and
(Horizontal Thyroid Gland physiological basis for important thyroid Hyperthyroidism
and Vertical • List the steps involved in the synthesis Simple Goitre function tests and its can be shown
Integration)
of thyroid hormones • List the differences clinical use
• Explain the mechanism of release of between dwarfism and
Thyroid Hormone cretinism
• Explain the transport actions of thyroid
hormone 3 Hours
• Describe the regulation of thyroid
hormone secretion
• List the causes and features of Hypo
secretion of thyroid hormones -
Myxedema and Cretinism, Goitre and
features of Hypothyroidism
• List the causes and features
Hypersecretion of thyroid hormones –
Gigantism and Acromegaly
• Calcitonin
• Secretion and action of Calcitonin
27
5 Parathyroid • Parathormone • List the different types • List the causes of Case of Tetany can
Gland • Discuss the actions of parathyroid of cells present in the secondary be shown
hormone Parathyroid Gland hyperparathyroidism
• Describe the causes and features of • Describe the secretion • Recognize its 2 Hours
hyper/hypoparathyroidism of parathyroid hormone emerging role as an
• Descibe Calcium Homeostasis • Explain he regulation immunomodulator.
• Vitamin D (Calcitriol) of secretion of
• Mention the sources, synthesis parathyroid hormone
mechanism of action and • Differences between
• List the features of vitamin D Tetanus and Tetany
deficiency in children and in adults – Cases of Rickets
Rickets and Osteomalacia and Osteomalacia
can be shown
• Calcitonin
• Actions of calcitonin
6 Adrenal Gland • List the hormones secreted by the • Disorders produced by • Discuss the causes of Indications for
different layers of Adrenal Cortex the deficiency of • Cushing’s steroid therapy,
• Describe the Functional Anatomy of enzymes involved in Syndrome adverse effects 0f
Adrenal Cortex adrenocortical hormone • Adrenal Tumour steroid therapy and
• Describe the mechanism of action, synthesis • Adrenal tapering of steroid
functions and regulation of action of • Diseases related to Hyperplasia, therapy( Integration
Mineralocorticoids, Glucocorticoids Mineralococorticoids • Secondary 3 Hours with Medicine)
and sex steroids • Conn’s Syndrome Hyperaldosteroni
• Discuss the causes and features of • Aldosterone Escape sm Cases of Cushing’s
Cushing’s Syndrome and Addison’s • Atrial Natriuretric Disease and
Disease Peptide (ANP) Addison’s Disease
•• Synthesis
Adrenal medulla: ca be shown
and physiological effects of
epinephrine and nor‐epinephrine on
various systems of the body 1 Hour Medical uses of
• Factors that regulate the secretion of
• List the features of
Phaeochromocytoma adrenaline and
adrenal medullary hormones dopamine
7 Endocrine • Name the different cells present in the • Describe the steps in • Compare and contrast Glucose tolerance
Pancreas Islets of Langerhans biosynthesis of Insulin Type I and Type II test and role of
• Physiological stimulus for Insulin and the origin of the C‐ Diabetes Mellitus and HbA1C
secretion peptide (Connecting their complications (Biochemistry)
• List the target cells of Insulin and the peptide) • Mention the clinical
cells that do not require insulin action • Diabetes Mellitus: feature of Diabetes 2 Hours Mechanism of
Mellitus action of insulin
28
for glucose uptake • Discuss the • List the features of and oral
• Mention the mechanism of action of Pathophysiology of hypoglycemia and the hypoglycemic
Insulin on its receptor Diabetes mellitus counter regulatory agents
• List the important actions of insulin • List the hormones that hormones (pharmacology)
• List the various factors that regulate raise blood sugar level • Diabetic Ketoacidosis
insulin secretion Diabetic
• Describe the features of hypersecretion ketoacidosis and
of Insulin and Hypoglycemia 1 Hour principles of
• Glucagon treatment of
• List the important actions of glucagon Diabetes Mellitus
(medicine)
8 Other • Pineal gland
Endocrine • Mention the role of hypothalamus and
Glands melatonin on circadian rhythm
• Thymus
• Local Hormones 1 Hour
9 Atrial • List the important actions of ANP
Natriuretic
Peptide (ANP)
31
Reproductive Physiology (Lectures + Tutorials 20 hours; Practicals + OSPE 5 hours; ECE: 3 hours)
TEACHING CLINICAL
SPECIFIC LEARNING OBJECTIVE INTEGRATION
HOURS
TOPIC
NO
3 Puberty • Describe the mechanism of action • Discuss causes of • Discuss the problems
functions and regulation of precocious and associated with
Menopause secretion of pituitary gonadotropins delayed puberty Menopause 1 Hour
and prolactin
Pituitary
Gonadotropins
• Explain the changes that occur 1Hour
(FSH,LH) and during puberty and describe the
Prolactin mechanism of onset of puberty
• Define menopause and describe
the physiological changes
during menopause
33
4 Female • Describe the Functional anatomy of • Differences Define: • Investigatio
reproductive the female reproductive system between • Menorrhagia, n for male
system • Outline the stages of Oogenesis oogenesis and • Dysmenorrhea, and female
• State differences between spermatogenes • Amenorrhea, and infertility
oogenesis and spermatogenesis is • Premenstrual •
• Describe the development of • Discuss the syndrome
ovarian follicles (Stages of follicle physiological basis • Discuss role of
development, ovulation, of use of synthetic selective estrogen
luteinisation, luteal regression ) estrogens and receptor modulators
• Describe the control of follicular progestins as oral • List important causes of
development, ovulation and contraceptives male and female
luteinisation (role of FSH, • Describe the infertility
estrogen and LH) mechanism of • Assisted Reproductive
• Describe the process of ovulation Techniques (IVF)
• 3 Hours
follicle attrition State the • Abnormalities
• List the hormones produced by tests for leading to infertility
the ovary ovulation • Assisted
• Illustrate the synergistic role of and their Reproductive
thecal and granulosa cells in physiological Technics (IVF)
steroidogenesis basis (Gynaecology)
• Discuss the mechanism of action • Common causes
and functions of estrogen and of anovulatory
progesterone cycles
• Describe the feedback regulation (physiological,
of ovarian function PCOD)
• Describe the physiological • Protein hormones
changes occurring in ovaries, produced by the
uterus, cervix , vagina and breast ovary and state
during a menstrual cycle their source and
• Discuss and illustrate the functions
hormonal changes during the • Identify common
menstrual cycle (changes in FSH, causes of
LH, estrogen and progesterone) anovulatory cycles
(physiological,
PCOD)
34
7 Physiology of • Outline the process of • Physiological basis 1Hour •
Pregnancy fertilization, implantation and of immunological
placental formation tests for pregnancy
• Discuss the importance of based on hCG
corpus luteum of pregnancy • Parturition
• Discuss the functions of placenta. • Source and
• Discuss the secretion and function functions of
of hCG from the placenta. relaxin
• Describe the role of hormonal • Describe the
and mechanical factors influencing fetoplacental unit
labor
• Describe the changes that occur in
the various organ systems in the
mother during pregnancy
35
Excretory system (Lectures + Tutorials 25 hours; Practicals + OSPE 10 hours; ECE: 3 hours)
39
Respiratory system (Lectures + Tutorials 25 hours; Practicals + OSPE 20 hours; ECE: 6 hours)
40
chest wall
• State the values of intra alveolar
pressure, Intra pleural pressure
• Discuss the changes in alveolar and
intra pleural pressures during
respiration
• Identify the sites of air way resistance
• Indicate changes in airway resistance
with inspiration and expiration
• Explain the action of autonomic
nervous system on bronchial tone
• List histamine as a bronchoconstrictor
• Recognise that airway resistance is
increased in obstructive lung diseases
• Define lung compliance and relate it to
clinical conditions in which it is altered
• State clinical conditions in which work
of breathing is increased
5 Lung Volumes • Define the lung volumes and capacities; • List the common causes • Methods of
and Capacities state the normal values and discuss their Pathology & clinical determining FRC
physiological variations features of obstructive and and RV 3 Hours
• Explain the recording of the Spirogram restrictive lung diseases. • Artificial ventilation Theory
with a diagram and recognize the • Asthma
volumes and capacities which cannot be • COPD
measured by spirometry • Emphysema
• Record the lung volumes and capacities • Chronic bronchitis
of a normal subject using a spirometer • State the physiological
• Discuss the physiological significance basis of tests to
of the Residual volume & functional differentiate them. 3 Hours
residual capacity Practical
• Describe the forced expiratory For
spirogram and describe FEV1, FVC and Spirome
the FEV1/FVC ratio and its variations in -try
obstructive and restrictive lung diseases.
• Define peak expiratory flow & state its • Recognize the flow-volume
normal value curves
• Record peak expiratory flow in a • Methods of determining
FRC and RV
41
normal subject • Helium dilution method
• Record FEV1, FVC and calculate the • Whole body
FEV1/FVC ratio in a normal subject plethysmography
• Interpret altered values of absolute lung • Measurement of dead space
volumes, peak expiratory flow and
FEV1/FVC ratio in restrictive and
obstructive lung diseases
• Define minute ventilation, anatomical
dead space, physiological dead space &
alveolar ventilation
• Discuss the effect of changes in
respiratory rate and tidal volume on
alveolar ventilation
6 Alveolar • Total ventilation = Tidal Volume x • Measurement of Dead
Ventilation Respiratory Rate Space
• Dead Space and Classification 1 Hour
• Alveolar Ventilation
• Factors affecting alveolar ventilation
7 Pulmonary • State the normal rate of pulmonary
Circulation blood flow & normal range of
pulmonary blood pressures 1 Hour
• Discuss the special features of
pulmonary circulation, pulmonary
veins, pulmonary vascular resistance,
its response to hypoxia
8 Ventilation • Explain the regional differences in • Type I respiratory failure • State the
perfusion Ratio perfusion, ventilation & V/Q ratio in the physiological
(V/Q Ratio) lungs mechanisms 1 Hour
• State normal values of V/Q ratio and operating to keep
recognize that physiological dead space the lungs dry
is associated with high V/Q and • Pulmonary
‘physiological shunt’ is associated with hypertension
low V/Q. • Pulmonary
embolism
• Cor-pulmonale
9 Gas Exchange • Discuss the factors that affect rate of • Define Type I respiratory
gas exchange at lung & tissue level, failure and state the
with application to clinical conditions common causes
42
• State Fick’s law of diffusion • Explain Type I respiratory
• Discuss normal composition of failure due to unequal V/Q
atmospheric, tracheal and alveolar air distribution even when
and recognize the conditions which can total ventilation and 1 Hour
affect it perfusion may be normal
• Discuss the normal partial pressures of • State the Alveolar gas
gases in blood entering and leaving equation and discuss its
lung application
• Explain oxygen uptake and carbon- • Recognize that arterial
dioxide elimination by lungs & tissues PCO2 is equal to alveolar
and state the normal rates of the same PCO2 and that arterial
• Define respiratory exchange ratio and PCO2 can be used in the
state its normal values alveolar gas equation
• State normal time taken for gas • State the causes for
equilibration & its application in abnormal Alveolar –
exercise arterial oxygen difference
• State the physiological causes for • Distinguish between
normal alveolar-arterial oxygen intrapulmonary and
difference extrapulmonary right to
• Explain the dependence of carbon left shunts.
dioxide elimination on ventilation
• Define physiological shunt
10 Transport of • State the physiological • State what pulse
Oxygen • Explain the forms of oxygen transport basis of oxygen therapy oximetry measures
in blood as treatment for the
• Discuss hemoglobin affinity for different types of 2 Hours
oxygen hypoxias
• Explain & illustrate oxygen-
hemoglobin dissociation curve and
discuss the factors affecting it and the
physiological advantages of the curve
• Explain Bohr effect
• Discuss oxygen carrying capacity of
blood
• Differentiate between oxygen content
of blood & % oxygen saturation of
hemoglobin
• Define hypoxemia and hypoxia;
explain the physiological basis of
40
types of hypoxia with examples
• Define cyanosis and differentiate
between conditions in which it occurs
and may not occur
11 Transport of • Explain the forms of carbon dioxide
Carbon dioxide transport in blood 1 Hour
• Explain the role of chloride shift and
Haldane effect
12 Regulation of • Express the concept of the sensors, • State the normal values of • State the causes of
Respiration central controller in brain & effectors in arterial blood gases (ABG) respiratory acidosis
the respiratory control system and interpret altered values and alkalosis
• Describe the location and functions of • Define hypercapnoea and • Define Type II
the respiratory centres in brain; describe hypocapnoea respiratory failure
the current explanation for the basic • State the causes of and mention its 3Hours
rhythm of respiration asphysxia causes
• Describe the effects of neural inputs on
respiration in terms of the voluntary
cortical control, motor cortical input,
limbic input, peripheral afferent inputs
(Hering breuer reflexes, J receptor
input, proprioceptor input, and other
peripheral inputs)
• Express the aim of chemical control of
respiration; explain the role of
peripheral and central chemoreceptors;
explain the feedback control of
ventilation to regulate gas exchange &
maintain normal levels of arterial blood
gases and pH 3 hours
• Discuss and compare the influence of practicals
arterial carbon dioxide and oxygen on for expts
ventilation in health and in disease on
• Describe Cheyne-stokes breathing, state stethogra-
its causes, explain the physiological and phy
pathophysiological mechanisms that
produce it; state the abnormality in
Biot’s breathing
• Demonstrate the effect of apnoea &
41
hyperventilation on respiration;
demonstrate the effect of breathing
through a tube and the effect of speech
& cough on respiration
13 Physiological • State the physiological effects of zero
adaptations in gravity
special • State the physiological basis of
environments Caisson's disease & Nitrogen narcosis 1 Hour
(High Altitude, • State the physiological adaptations
Deep Sea occurring at high altitude Physiological
Diving and effects of zero gravity
Gravity) • Aviation Physiology
14 Exercise • Describe the effects of exercise on the
respiratory system and explain the
physiological basis of these effects; 1 Hour
explain the physiological need for these
changes
• Define VO2 max and oxygen debt
15 Pulmonary • Spirometry
Function Tests • Arterial Blood Gas Analysis
• Peak Flow Meter 1 Hour
• Pulseoxymetry
16 Miscellaneous • List the Non-Respiratory functions of
lung
• State the physiological mechanism of 1 Hour
cough, sneeze and gag reflexes
17 Clinical • Demonstrate the methods of Clinical • Pathology & clinical
examination of examination of the respiratory system features of
respiratory • Recognize normal Clinical findings of • Pleural effusion
system respiratory system examination • Pneumothorax 3 Hours
• State the abnormal findings that may be • Pneumonia, Practical
present in a patient and list the common consolidation
clinical conditions in which these • Fibrosis
abnormalities occur and the • Collapse
physiological explanations for these • Bronchiectasis
abnormalities if any
42
Cardiovascular system (Lectures + Tutorials 35 hours; Practicals + OSPE 20 hours; ECE: 6 hours)
44
potential. • Hyperkalemia
• Describe the 12 Leads in which ECG is • Ventricular tachycardia
recorded. • State the causes for PR
• State the rationale of recording from prolongation
multiple leads. • Describe the types of Heart
• Identify the lead which is commonly block as represented by
used to monitor patients continuously. ECG changes 1Hour
• Describe the P, QRS, T and U waves of • Arrhythmias ECG
an ECG in lead II configuration and • Vector cardiogram recordin
describe the electrical events • Calculation of axis g to be
shown
responsible for these waves • His bundle electrogram
• Describe PR and QT intervals and state
what they represent
• Describe the significance of ST segment
being on the isoelectric line in a normal
ECG
• Record an ECG in a human subject in all
12 leads
• Calculate rate from a normal ECG
tracing
• Identify if every QRS complex is
preceded by a P wave and if every P
wave is followed by a QRS complex
• State in what conditions the above will
not happen
10 Properties of • Describe the function of the sinoatrial • Understand that there is
cardiac muscle: node as the pace-maker of the heart redundancy in pace-maker 1 Hour
• Describe the determinants of heart rate function – if the sinus node
and the neural and chemical regulation fails, there are alternate
Automaticity of heart rate sites of rhythm generation
• Describe the ionic currents • Arrhythmias
responsible for rhythm-generation in
the SA node
Excitability • Define refractory period, describe its • Describe refractory period
and relation to the duration of the ventricular in terms of properties of
Refractoriness action potential, and state its voltage-gated sodium
physiological significance. channels
• State factors which cause
45
prolongation of action
potential duration
• Define Long QT syndrome
Conductivity • Describe the normal mode of • Alternate conducting
conduction of the cardiac impulse pathways
• Define the causes of
arrhythmias in terms of
abnormal site of rhythm-
generation or re-entry
Contractility • Describe the determinants of force of • Discuss Ejection fraction
contraction of the ventricle in terms of (EF) as a measure of
o Preload (Starling's law) cardiac contractility
o Afterload (inotropic status).
o Inotropic status (contractility) • State the different modes of
o Frequency (or heart rate), and indications for Cardiac
(Bowditch phenomenon or Force- catheterization
frequency relation) • State how
• Discuss the clinically measurable echocardiography may be
parameters reflecting preload, afterload used as a non-invasive
and force of contraction of the heart means to assess cardiac
• Describe Starling curves or ventricular function
function curves
11 Cardiac • Definition of Stroke Volume, Cardiac • Methods of Measuring • Discuss high output
Output Index, EDV, ESV, and EF Cardiac Output and low output
• Discuss the determinants of cardiac states 2 Hours
output
• Describe the regulation of cardiac
output
• Discuss high output and low output
states
12 Heart Rate • Innervation of Heart – Parasympathetic
and Sympathetic
• Normal Values 1 Hour
• Regulation of Heart Rate
• Factors affecting Heart Rate
13 Vascular • Describe the function of Aorta and large • Discuss the role of • State what would
Physiology Arteries as elastic, windkessel vessels capillaries as exchange happen to pulse
• Describe what would happen to pulse vessels volume (as assessed
46
pressure in case of thickening and loss • Describe the Starling's by taking the radial
of elasticity of aorta forces determining fluid pulse) in case of
• Describe the role of arterioles as movement across the thickened arteries 2 Hours
resistance vessels capillary membrane • Discuss the
• Describe the term Total Peripheral • Describe the function of physiological/pathop
resistance (TPR) Veins as capacitance hysiological role of
• Discuss the determinants of TPR and vessels the following
the relationship of TPR to blood • Define the term Venous vasoactive
pressure and cardiac output. return (VR) and discuss its substances:
• Discuss the role of arteriolar resistance role as preload Histamine,
as a determinant of blood flow to a • Describe the determinants bradykinin,
specific organ of VR serotonin,
• Discuss the determinants of arteriolar • Discuss the significance of thromboxane A2,
resistance in terms of Poiseulle’s assessing jugular venous prostacyclin, Endoth
equation pulse elin
• Identify that the arteriolar diameter is • Discuss the interactions • Describe Venous
the major determinant of arteriolar between Right atrial return curves
resistance pressure, VR and Cardiac • Describe the
• Discuss the global and local factors output (CO) interaction of
affecting arteriolar diameter and Venous return and
therefore the TPR, blood pressure and Cardiac output
blood flow – vasodilator and curves
vasoconstrictor mechanisms • Discuss the clinical
• Discuss the physiological role of significance of
endothelium-derived relaxing factor monitoring of CVP
(EDRF) or Nitric oxide (NO)
14 Blood Pressure • Define the following terms: • Hypertension
• Mean arterial blood pressure, Systolic • Hypotension
pressure, Diastolic pressure, pulse
pressure
• Describe the determinants of blood 1 Hour
pressure Theory
• Discuss the short-term (neural and
hormonal) and long term (renal)
mechanisms regulating blood pressure
(with special reference to shock and
exercise).
• Demonstrate the method of
47
measurement of blood pressure using a
sphygmomanometer. 1 Hour
• Describe the principle of measuring Practical
blood pressure by sphygmomanometry
• Discuss other methods of measuring
blood pressureby sphygmomanometer
48
sympathetic regulation versus local
metabolic factors in the regulation of
the regional circulations mentioned
above.
18 Hypertension • State the normal ranges for systolic and • Discuss the risk factors for
diastolic blood pressures in the various essential hypertension and
age groups causes of secondary
• Define hypertension hypertension
19 Hypotension • Define the term ‘Shock’ or Describe the term Vasovagal 1 Hour
(Shock) Cardiovascular shock syncope
• State the different types of shock
• Discuss the pathophysiology of the
following types of shock: Hypovolemic,
cardiogenic, Distributive (septic,
anaphylactic, neurogenic) Obstructive
20 Heart Failure • Define the term cardiac failure or heart • State some causes of heart
failure. failure
• State the clinical features of left heart • Discuss the physiological
failure and right heart failure. basis of treatment of heart
• Define the term congestive cardiac failure
failure
21 Myocardial • Define the following terms:
infarction or • Angina
heart attack • Ischemia
1 Hour
• Myocardial infarction or heart attack
• Discuss the major ECG changes in:
• Myocardial ischemia
• Myocardial infarction
Valvular • State the causes for
22 diseases stenosis and regurgitation
of the valves
• State the murmurs
associated with the various
valvular defects
23 Congenital • State the hemodynamic
heart diseases abnormalities and murmurs
in ASD, VSD, PDA
49
Central nervous system (Lectures + Tutorials 45 hours; Practicals + OSPE 22 hours; ECE: 6 hours)
SPECIFIC LEARNING OBJECTIVE TEACHIN CLINICAL
NO TOPIC G HOURS INTEGRATION
50
• ‘excitatory or inhibitory post-synaptic junction block in terms of the
potentials (EPSP and IPSP)’ in a post- properties of
synaptic neuron voltage-gated
• ‘end-plate potential’ at the sodium channels.
neuromuscular junction • Define the
• Define the term ‘Action potential’ and mechanism of
describe the currents responsible for the action of local
different phases of the action potential anaesthetics.
in the neuron.
• Describe the process of transmission of
action potential in unmyelinated and
myelinated neurons
• Describe the phenomenon of saltatory
conduction in a myelinated neuron.
• List the factors affecting conduction
velocity in a nerve.
5 Synapses Define the terms electrical & chemical • Define the following • Define synaptic
synapse properties of synapse: fatigue
Describe the morphological features of a • One-way conduction • Define the
chemical synapse – pre and post synaptic • Synaptic delay following synaptic
neurons • Convergence and phenomena
List the morphological types of chemical Divergence of synapses Occlusion &
synapse – axosomatic, axodendritic and • Spatial summation subliminal fringe
axoaxonic • Temporal summation effects 2 Hours
Describe the process of synaptic • Define the term synaptic
transmission. plasticity
List the events in the pre-synaptic neuron, • Describe the differences
culminating in release of neurotransmitter. between Pre-synaptic and
Describe the events in the post-synaptic post-synaptic inhibition.
neuron – Excitatory and inhibitory post- • Define the term Pre-
synaptic potentials, Summation (spatial synaptic facilitation
and temporal) of synaptic inputs at the
axon hillock, formation of action
potential.
6 Neurotransmitt • List the important small molecule • State whether the action of • Glutamate-induced
ers neurotransmitters in the CNS and their each of the above excitotoxicity 1 Hour
receptors: neurotransmitters on the Organic brain
• Glutamate and its ionotropic various receptors is syndromes –
receptors: excitatory or inhibitory. Schizophrenia,
51
NMDA, and non-NMDA • State the major excitatory Depression
• GABA neurotransmitter in the (Psychiatry)
• Glycine CNS
• Dopamine • State the inhibitory
• Serotonin or 5-HT neurotransmitters of the
• Acetylcholine CNS.
• Noradrenalin • State the mechanism of
inhibition.
• Denervation
hypersensitivity
• Criteria for a substance to
be called a
neurotransmitter
Introduction to • Anatomical parts of CNS
7 CNS • Functional divisions
8 Sensations • Classify the types of sensations (sensory • Describe the common
modalities attributes of sensory
information – modality, 1 Hour
location, intensity and
duration
52
9 Ascending Ascending sensory pathways • State the mechanism
sensory • Sensory Cortex – Primary sensory proposed by
pathways area SI and SII V.S.Ramachandran
• Sensory Homenculus to explain the
• Cortical Sensations phantom limb
• Cortical Plasticity phenomenon.
3 Hours
Three neuron pathway of sensory Theory
Pathway for systems
fine touch • I order neurons, dorsal root • Medial to lateral
(Posterior ganglia, Fasciculi gracilis and arrangement of fibres in
Column) cuneatus in posterior column and posterior column
termination in medulla • Lateral to medial
• II order neurons (cross over) : arrangement of fibres in
Medial lemniscus from medulla to spinothalamic tract
contralateral thalamus
• III order neurons: 1Practical
session
Thalamocortical neurons
(3 hrs for
• Cortical termination of pathway:
examinatio
Post-central gyrus.
n of the
• Sensory Cortex-Primary sensory
sensory
area SI & SII
system)
Pathway for
proprioception Important receptors for Proprioception
(other than touch and pressure
(Dorsal and receptors):
Ventral • Muscle spindle (muscle length
Spinocerebellar detectors)
Tract) • Golgi tendon organ
• Joint receptors (Pacinian
corpuscles)
• Fate of proprioceptive input:
• Posterior column pathway – same
as fine touch
• Spinocerebellar tracts – dorsal
and ventral; Clarke‟s column
• Spinal reflex arcs – stretch and
53
Pathway for inverse stretch reflex arcs
crude touch Receptors for crude touch, pain and
(Anterior temperature : Mechanoreceptors,
Spinothalamic Nociceptors and Thermoreceptors
tract) Major pain pathway:
Pain and • I order neurons – end in spinal
Temperature cord; Lissauer's tract; substantia
(Lateral gelatinosa
Spinothalamic • Fast pain through Aδ fibres and
Tract) slow pain through C fibres
• II order neurons cross over –
forming lateral spinothalamic
tract
• III order neurons –
Sensations thalamocortical, end in Post-
from face central gyrus.
• Pathway for sensations from face
Physiology of Briefly describe receptors for pain. • Describe the gate control • List a few opiates
Pain • Describe the pathway for transmission theory of pain used to treat pain.
of pain from receptors to the cortex. • Discuss the principle of
• Define the following terms: Substantia using pain balms and
gelatinosa, Lissauer’s tract, fast pain, Acupuncture for pain
slow pain. relief.
• State the type of peripheral nerve fibres • List the endogenous 2 Hours
carrying fast pain and slow pain opioids and the types of
respectively. Opiate receptors.
• Describe the following phenomena: • Describe the role of
• Referred pain endogenous opioids in pain
• Peripheral sensitization of pain transmission
• Central sensitization of pain –
(wind-up) – role of glutamate
and NMDA receptors
• Dissociated anaesthesia
• Phantom limb pain
• Describe descending pain control
pathways: from Periaqueductal grey,
Locus ceruleus and Nucleus Raphae
magnus
54
10 Motor system • Describe the features of organization of • Arrangement of LMNs in
the motor system. the anterior horn
• Define UMN & LMN • ‘Motor homunculus’
Descending • List the descending tracts involved in • Describe the physiological
Motor Tracts motor control. basis and the clinical
• Describe origin, course, termination and significance of
functional role of the Pyramidal tracts. • Decerebrate posture
State why the pyramidal tracts are called • Decorticate rigidity 3 Hours
so. Theory
• Describe the role of corticobulbar tracts.
• List the extrapyramidal descending
tracts.
• State the origin, termination and
physiological role of the following 1 Practical
extrapyramidal tracts: session
• Rubrospinal (3 hrs for
• Pontine reticulospinal examinatio
• Medullary reticulospinal n of the
• Lateral vestibulospinal motor
• Describe the influence of the system)
extrapyramidal tracts on spinal motor
neurons & spinal reflexes
• Describe the effects of lesion of the
pyramidal and extrapyramidal tracts
respectively on spinal motor neurons,
spinal reflexes & muscle tone
11 UMN and • Describe the features and Physiological • Define the following terms: • Definition of Clinical cases can
LMN Lesions basis of Upper motor neuron & lower Hemiplegia, quadriplegia, terminology: be shown
motor neuron lesion. paraplegia o Transient ischemic
• Describe the features of: • Hemiparesis, attacks
• Hemisection of spinal cord at a quadriparesis & o Stroke
given level (e.g. T8, L3 etc) paraparesis o Cerebrovascular
• Brown Sequard syndrome accidents
• Complete transaction of spinal • Neurogenic bladders
cord at a given level.
55
12 Reflexes • Define the term ‘reflex’. • Alpha-gamma co- Tonic neck reflexes Pediatrics
• Describe the components of a reflex arc activation (upper cervical cord)
with a diagram. • Physiological basis for • Symmetrical Neurology
• Classify reflexes: Jendrassik's maneuver tonic neck
• based on the location of receptors • Crossed extensor reflex reflex (STNR) Medicine
(deep and superficial) • Importance of using a • Other
• Based on number of synapses in painless stimulus to elicit Primitive PMR
the reflex arc (mono, di or plantar response reflexes:
polysynaptic) • Central excitatory state & - Sucking reflex Study of patients
• Describe in detail, the stretch reflex and irradiation of stimulus in - Rooting reflex with postural
its physiological significance. spinal cord - Grasp reflex - 6 abnormalities as a
• List the other terms which are • Mass reflex & its use in months 2 Hours result of primitive
commonly used to refer to the stretch spinal cord injury patients - Plantar – Babinski – Theory reflexes being
reflex. 1 year expressed.
• Identify that the clinically tested deep o Postural reflexes other than Should not remain
reflexes (or tendon jerks) are stretch stretch reflex and crossed active beyond 6-12
reflexes. extensor reflex: months of life.
• Differentiate between alpha and gamma o Brain stem reflexes:
motor neurons. Righting reflexes If they do, and they are
• Name the receptor for the stretch reflex (Midbrain) not integrated, they
and describe its basic structure with a oLabyrinthine righting can interfere with
diagram. State the functional role of oNeck righting voluntary control of
gamma motor neurons. oBody on head righting specific movements
• State the effects of supraspinal oBody on body righting and result in immature
influences on the stretch reflex patterns of movement
• Describe the effects of UMN lesions. • Vestibular or (eg. Cerebral palsy)
• Describe the effects of LMN lesions. Labyrinthine reflexes • The primitive 1 Practical
• Describe the inverse stretch reflex arc. (Medulla) reflexes may session
State the stimulus and response for the o Vestibulospinal or tonic re-emerge in (3 hrs for
inverse stretch reflex. labyrinthine reflex (TLR) examinatio
an adult after
• Describe the functional role of Golgi Vestibulocollic reflex brain injury
n of
tendon organ. Vestibuloocular reflex reflexes)
• Describe the physiological basis of (VOR)
“Clasp-knife” rigidity oVestibular placing
• Describe the flexion withdrawal reflex. reaction
State its functional role?
• Describe the afferent, efferent pathways • Tonic neck reflexes (upper
and the centre of integration for the cervical cord)
56
following superficial reflexes: Corneal,
conjunctival, Abdominal, cremasteric
• State the rationale in assessing
superficial reflexes, while examining the
nervous system.
• Describe flexor and extensor plantar
reflexes.
• Recognize the importance of using a
painless stimulus to elicit plantar
response
• Describe Babinski’s sign and state its
clinical significance.
• List the physiological conditions, where
plantar response is extensor.
• Demonstrate how to elicit the clinically
significant superficial and deep reflexes
in normal subject.
13 Cerebellum • Describe the structure of cerebellum, its • Describe the features of • Cerebellar lesions Anatomy:
somatotopic organization, deep cerebellar lesions Structure,
cerebellar nuclei, afferent pathways, • Describe cerebellar 3 Hours connections and
internal connections, efferent pathways. function tests. blood supply to
• Name the afferent and efferent fibres of cerebellum
cerebellum 1 Hour
• Describe the functions of cerebellum. Practical Medicine
Neurology
14 Basal ganglia • Define the term basal ganglia. • Describe the features of
• List the nuclei forming the basal Parkinson’s disease.
ganglia. • Describe the
• List the following: pathophysiological basis
• Input nuclei – which receive of Parkinson’s disease. 2Hours
afferents from cortex
• Output nuclei – which send
output to thalamus and spinal
cord
• Describe the internal connections
between input and output nuclei – give
details of the direct pathway and
indirect pathway.
57
• Describe the origin and termination of
the nigro-striatal pathway. State the
neurotransmitter in this pathway.
• Describe the physiological role and
clinical significance of the nigrostriatal
pathway.
15 Reticular • Describe the organization of the • List the neurotransmitters
formation reticular formation and its physiological of various nuclei of RF.
role. • Give an outline of 1 Hour
• Describe the ascending Reticular afferent & efferent
Activation System connections
16 Thalamus • List the groups of thalamic nuclei • List the important
• Give an outline of connections of features of thalamic 1 Hour
thalamus syndrome
• List the functions of thalamus.
17 Hypothalamus • List the major regions and functions Hypothalamic Obesity
of hypothalamus.
• Connections of hypothalamus 1 Hour
• Describe the functions of the
hypothalamus
18 Limbic system • State the components of Limbic system • New concept of the Limbic • Recognize
• Describe the physiological role of the System – Emphasis on differences between
limbic system Recognize the importance amygdala. the new concept of 1 Hour
of Papez’s contributions • Kluverbucy Syndrome Limbic circuit and
• Recognize the central role of amygdala. • Shamrage Papez’s circuit.
• Identify nuclei
involved in addiction
19 Cortex • Identify the major somatic and special Define the role of corpus • Sperry’s Split Brain
sensory, motor & association areas in callosum – inter- Experiments
the cortex. hemispheric transfer of • Dyslexia
• Recognize the somatotopy of the motor information • Prefrontral 1 Hour
and somatic sensory areas (homunculi) Lobotomy
• Recognize the phenomena of • Define the
hemispheric specialization following terms:
(dominance), handedness. • hemi-neglect
syndrome
• cortical
58
blindness
• synaesthesia
20 EEG • State the physiological basis of EEG,
types of EEG waves,
• Uses of EEG 1 Hour
21 Sleep • Define the various stages of a sleep Sleep Disorders • Theories of sleep –
cycle. • Hypersomnolence Wakw Cycle
• Distinguish between NREM and REM • Obstructive sleep 1 Hour
sleep. apnea
• Insomnia
22 Language & • Define the role of Wernicke’s &
speech Broca’s areas in language & speech 1 Hour
• Define aphasia and state the site of
lesion in motor and sensory aphasia
23 Learning and • Describe the classification of learning • List Alzheimer’s
memory and memory disease and
• Describe the following phenomena of Korsakoff’s
implicit or Non-declarative learning: psychosis as
o Non-associative – Habituation disorders of learning 1 Hour
Sensitization and memory
o Associative – Classical
conditioning
Operant
conditioning
60
Special Senses (Lectures + Tutorials 20 hours; Practicals + OSPE 6 hours; ECE: 3 hours)
Observe perimetry
3 Retina • List the retinal cells contributing to the • Cone & rod density
visual pathway. (photoreceptors, distribution in retina
61
bipolar cells and ganglion cells) • Convergence of synapses Ophthalmology:
• Describe optic disc, macula lutea and 1 Hour
fovea as important structural features in To observe testing
the retina of visual acuity
• Classify photoreceptors – Rods and
cones
• List major structural and functional
differences between rods and cones
• Demonstrate visual acuity on a subject
using Snellen’s chart
4 Photo • Visual pigments • Decomposition of
transduction • "Dark current" – at rest in the rhodopsin - biochemical
photoreceptors steps involved 1 Hour
• Hyperpolarizing receptor potential in Neurotransmitters involved
rods & cones in response to light • Wavelengths of light best
• Transmission of Action potential to the absorbed by pigments
optic nerve.
5 Light & Dark • Describe the changes that happen • Nyctalopia
adaptation during dark and light adaptation
6 Colour vision • Name the types of photoreceptors • Color constancy and
responsible for colour vision Purkinje shift
• Classify cones based on their spectral • Theories of color vision 1 Hour
sensitivity
• List the types of colour blindness
• Describe theories of colour vision
• Demonstrate the use of Ishihara’s chart
to check for colour blindness
7 Optic Pathway • Draw and describe the optic pathway • List the conditions
from the photoreceptors to the visual producing pupillary
cortex constriction & pupillary 1 Hour
• Describe the visual field defects dilatation
produced by lesions at various levels of
the pathway
8 Pupillary • Describe the pupillary light reflex • Describe the • Conditions
Reflexes pathway accommodation reflex producing pupillary
• Differentiate between direct and pathway constriction & 1 Hour
consensual pupillary light reflexes • List the features of pupillary dilatation
62
• Demonstrate direct and consensual light Horner’s syndrome
reflexes on a subject provided Explain Argyll-Robertson
pupil
9 Eye • List the extraocular muscles and • Saccadic & smooth pursuit
Movements describe their actions movements
• Name the cranial nerves innervating the • Opto-kinetic reflexes 1 Hour
extraocular muscles
• List the types of eye movements
(saccadic, smooth pursuit, vergences
EAR
1 Functional • List different parts of the ear.
anatomy of the • Mention functions of outer ear
ear • Describe the role of middle ear in
impedance matching 1 Hour
• List structures within the inner ear and
specify their functions
• Describe the importance of attenuation
reflex
2 Inner Ear • Draw the cross-section of cochlea with • Volley effect or Frequency
Function of all 3 three scalae. principle of hearing
cochlea • Describe the ‘travelling wave theory’ of
hearing 1 Hour
• Describe the function of basilar
membrane in frequency discrimination -
'Place principle' of hearing
3 Sound • Physics of sound • Noise - as an occupational
• Concept of the Decibel scale hazard
Sensory • Recognize the importance of 1 Hour
transduction in endocochlear potential and sensory
4 cochlea transduction in the cochlea.
5 Processing of • Describe the auditory pathway • Describe the mechanisms • Describe the
auditory underlying sound concept of tonotopic 1 Hour
signals localization and masking maps
effect of sounds
6 Assessment of • Define an audiogram • Principle of hearing
hearing • Identify a normal air-conduction and aids
bone-conduction tracing 1 Hour
63
• Identify conductive hearing loss and
sensory neural hearing loss using
audiogram
• Describe the principle of Rinne’s and
Weber’s test
7 Deafness • Types of deafness - Conductive & • Audiogram • Speech Audiometry
Neural • Distinguish between
conductive hearing loss and 1 Hour
sensory neural hearing loss
based on audiogram
VESTIBULAR APPARATUS
1 Functional • List the structures which make up
anatomy of vestibular apparatus and their functions 1 Hour
vestibular
apparatus
2 Mechanism of • Describe the mechanism of stimulation
stimulation of otolith organs - deflection of hair
vestibular hair cells using gravitational force/inertial
cell force of otolith membrane 1 Hour
• Describe the mechanism of stimulation
of semicircular canals - deflection of
hair cells using inertial force of
endolymph
3 Vestibular • Describe the connections of vestibular • Connections to cranial
pathway nucleus to the cortex and cerebellum nerve nucleii controlling
• Describe the projections through • Eye movements -
vestibulospinal tracts Vestibulo-ocular reflex 1 Hour
• Describe the functions of Vestibular • Head & neck movements
system - Maintenance of balance,
equilibrium and posture
4 Tests of • Identify nystagmus in a • Meniere's disease
Vestibular patient
function • Caloric test 1 Hour
• Rotation in a Barany chair
SMELL
Microscopic • Describe the arrangement of olfactory • List the types of cells • Pheromones
1 anatomy of sensory neuron within the olfactory within the olfactory bulb
64
olfactory epithelium • Describe the connections of
epithelium and olfactory sensory neurons 1 Hour
olfactory bulb with cells in the olfactory
bulb
65
REFERENCE LEARNING BOOKS
Text Book of Medical Physiology by Guyton and Hall – A South Asian Edition
Understanding Medical Physiology – A Text Book for Medical Students by RL Bijlani and S Manjunath Best &
66
THEORY EXAMINATION
Minor
experiment
1.Hemoglobin
Estimation
2.Blood Grouping
3.Bleeding Time and Clotting Time
4.ESR or PCV
67
Suggestion:
(To avoid mouth sucking in doing hematology experiments with RBC and WBC pipettes instead, automated
micro pipettes can be used)
III OSPE (2 Skilled stations): 2x2=4 marks (1 station in Hematology and one in clinical examination)
68
INTERNAL ASSESSMENT (40 marks) (Theory 20 & Practical 15 + Record 5)
Theory to asses knowledge - Periodic Test in the first week of Oct, Dec, Jan, Mar and May (5 test totally)
and Model Exam Paper I & II in June last week.
Practical to asses skill - One Practical Exam in Hematology and one in clinical examination.
Model Practical in June.
MEDICAL ETHICS
Privacy and confidentiality of Students
Ethical Issues
INTEGRATED TEACHING
2 vertical and 3 horizontal integration to be done in each Academic Year
e.g. Horizontal – Gastric secretion, Liver, Kidney
Vertical – Anemia, Jaundice and Hemiplegia
RECORD
Record should be followed as recommended by this university
*********
69
BIOCHEMISTRY
Goals and objectives given below are as per the Medical Council of India Regulations on Graduate
Medical Education, 1997.
GOAL
The broad goal of the teaching of undergraduate students in biochemistry is to make them understand the
scientific basis of the life processes at the molecular level and to orient them towards the application of
the knowledge acquired in solving clinical problems.
b. SKILLS:
At the end of the course, the student should be able to :
(1) make use of conventional techniques/instruments to perform biochemical analysis relevant to clinical
screening and diagnosis;
(2) analyze and interpret investigative data;
(3) demonstrate the skills of solving scientific and clinical problems and decision making;
c.INTEGRATION
The knowledge acquired in biochemistry should help the students to integrate molecular events with
structure and function of the human body in health and disease.
TEACHING HOURS:
Theory classes: Total: 115 hours
TEACHING METHODOLOGY
Lectures, tutorials, small group discussions, integrated teaching modules, use of charts (paper-based
clinical scenarios) for case discussions, practical exercises and demonstrations
THEORY SYLLABUS FOR FIRST YEAR M.B.B.S.
Note: The syllabus has been prepared keeping in mind the requirements of a doctor at the end of the
MBBS course. It is also to emphasize that the teaching of Biochemistry needs to continue throughout the
clinical phase of training of the MBBS students, when they will be in a better position to make correlations
between derangements in biochemical processes and disease conditions. The content of the syllabus has
been divided into 3 categories: “must know”, “desirable to know” and “nice to know”.
TEACHING
DESIRABLE TO NICE TO
TOPIC MUST KNOW HOURS
KNOW KNOW
RECOMMENDED
1 2 hours
CELL
.
Cell and cellular Basics of structure of a Functions of
organelles eukaryotic cell. peroxisomes.
Specificity of enzymes:
reaction and substrate
specificity, with an example
for each.
Effect of substrate
concentration (Michaelis-
Menten equation [no
derivation of equation
required], concept of Km and
Vmax).
Examples of non-
competitive enzyme
inhibition –
organophosphorus/cyanide
poisoning
Isoenzymes Definition and examples Isoenzymes of lactate
dehydrogenase (LDH)
Clinical significance of and ALP
elevated plasma levels of
isoenzymes of creatine kinase
(CK)
Diagnostic Aspartate aminotransferase Clinical utility of 5-
and (AST), alanine nucleotidase and
therapeutic aminotransferase (ALT), gamma-glutamyl
enzymes alkaline phosphatase (ALP), transferase
(clinically lactate dehydrogenase
useful (LDH), creatine kinase (CK)
enzymes) and amylase as markers of
various disease conditions.
Plasma markers of
myocardial infarction and
liver damage.
Enzymes involved in
digestion of
carbohydrates.
Sources, sites and actions
of the enzymes that digest
carbohydrates.
End products of
digestion and their
absorption.
Lactose intolerance.
Importance of dietary
fibre.
Glucose Types, functions, tissue
transporters specificity and
physiological relevance
Glycolysis Definition, importance,
cellular site and pathway
involved (with emphasis
on the importance of the
pathway, sites of
utilization and generation
of energy and irreversible
reactions involved).
Importance of aerobic
and anaerobic forms of
glycolysis.
Energetics.
Overview of regulation of
glycolysis.
Rapaport- Leubering
shunt and its
physiological importance.
Importance of inhibition
of enolase by fluoride in
blood samples collected
for glucose estimation.
Citric acid cycle/ Pyruvate dehydrogenase Overview of
Krebs’ cycle / as a link between regulation of
tricarboxylic acid glycolysis and pathway (no
(TCA) cycle Krebs’ cycle (no details of details
reaction mechanism required).
required).
Definition, importance,
cellular site, pathway
(including intermediates
and enzymes involved,
but excluding details of
reactions involved).
Concept of anaplerosis,
amphibolic nature of
Krebs’ cycle.
Energetics.
Pentose Importance of pathway - Definition, cellular site
phosphate ribose for nucleic acid and overview of
pathway (PPP) synthesis and NADPH pathway, showing
for synthesis of various starting material and
lipids, maintenance of products (intermediates
reduced form of iron in not required).
haemoglobin, reduced
glutathione and its
importance in
maintaining red cell
membrane integrity.
Overview of pathway of
synthesis (starting
material, action of
glycogen synthase and
branching enzyme and
the end product).
Glycogenolysis Physiological importance Role of insulin and
of glycogen breakdown in glucagon in reciprocal
the body. regulation of
glycogenesis and
Overview of pathway of glycogenolysis (details
breakdown in the liver of reactions involved in
and muscle (starting regulation not
material, action of required).
glycogen phosphorylase
and debranching enzyme Examples of glycogen
and products obtained). storage diseases (Von
Gierke’s disease and
McArdle’s disease) may
be used to illustrate
functions of glycogen
in the liver and muscle
and the reasons for
different manifestations
of the diseases.
Gluconeogenesis Definition, substrates Concept of reciprocal
used, physiological regulation of glycolysis
importance, sites in the and gluconeogenesis
body and in cell where (no details required).
the pathway occurs.
Role of insulin and
Overview of pathway glucagon in regulation.
with key intermediates
and enzymes.
Importance of Cori’s
cycle and glucose-alanine
cycle.
Uronic acid Overview of
pathway pathway
showing
starting
material
(glucose)
and product
(glucuronic
acid).
Importance
of
glucuronic
acid in
conjugation
of bilirubin
and drugs
and
synthesis of
heteropolysa
ccharides.
Essential
pentosuria
Metabolism of Dietary sources of
galactose galactose.
Overview of pathway by
which galactose is
metabolized (showing the
sites of 3 main enzymes
involved).
Galactosemia (definition,
causes, biochemical basis
of clinical manifestations
and rationale of
treatment).
Metabolism of Dietary sources of Disorders of
fructose fructose. fructose
metabolism
Overview of pathway by
which fructose is
metabolized (showing
entry into glycolysis and
formation of
triacylglycerol).
Importance of fructose in
seminal fluid.
Minor pathways Polyol pathway and its
of carbohydrate importance in
metabolism pathogenesis of
complications of diabetes
mellitus.
Regulation of Factors maintaining
blood glucose blood glucose levels - role
levels of dietary carbohydrates,
role of hormones (insulin,
glucagon, glucocorticoids
and catecholamines) and
roles of liver and kidney.
Diabetes Types and pathogenesis Pathogene-
mellitus of diabetes mellitus. sis of
chronic
Concept of insulin complicati-
resistance. ons of
diabetes
Metabolic derangements mellitus.
and clinical features.
Concept of impaired
fasting glucose and
impaired glucose
tolerance.
Gestational diabetes –
definition and diagnosis
Pathogenesis of diabetic
ketoacidosis.
Laboratory Blood glucose estimations
investigations in (fasting and post-
diabetes prandial).
mellitus
Glycated haemoglobin
(HbA1c).
Detection and
importance of
microalbuminuria.
Important functions of
General lipids in the human body.
featuresof lipids
Concept of importance of
lipids in causation of
disease (atherosclerosis
with subsequent
myocardial infarction and
stroke; obesity,
cholelithiasis, etc).
Classification of Major types of lipids in
lipids the body (classification
into simple, complex and
precursor or derived
lipids).
Classification system
based on chain length,
degree of
saturation (saturated and
mono- and
polyunsaturated fatty
acids), and nutritional
requirement.
Importance of ω3 and ω6
fatty acids (dietary sources
and their health benefits).
Simple lipids Concept of importance of
(fats) saturated and unsaturated
fats in one’s diet
(including hydrogenation
of oils).
End-products of lipid
digestion.
Process of absorption of
lipids.
Steatorrhoea.
Salient features of
formation, metabolism
and physiological
importance of
chylomicrons.
Fate of fatty
acids
Fatty acid Importance of oxidation End-products of Conditions
oxidation of fatty acids in the body. beta- oxidation of where fatty
odd chain fatty acids. acid oxidation
Types of oxidation of fatty is impaired.
acids. Alpha oxidation of
fatty acids.
Beta-oxidation of even
chain fatty acids (site,
activation of a fatty acid,
the role of carnitine, steps
involved and energetics of
the process).
Importance of NADPH in
the pathway and its
sources.
Pathway of ketogenesis
and utilization of ketone
bodies and sites where
these occur.
Enterohepatic circulation
of bile acids.
Metabolism of Association of high levels Brief overview of
lipoproteins of LDL with metabolism of
atherosclerosis. VLDL, LDL and
HDL (including
Anti-atherogenic effect of reference values).
HDL
Lipoprotein (a)
Dyslipidemias –
causes (with
emphasis on
secondary causes of
dyslipidemia and
familial
hypercholesterol-
emia) and
consequences.
Denaturation of proteins
– definition, agents
causing denaturation and
consequences (loss of
biological activity of
protein).
Overview of structure-
function relationship of
haemoglobin, myoglobin
and collagen.
Hemoglobinopathies:
sickle cell anaemia and
thalassemia
Digestion and Mechanism of activation Disorders associated
absorption of enzymes involved in with amino acid
the digestion of proteins absorption
in the stomach and small (cystinuria/
intestine (conversion of Hartnup’s disease).
zymogens to active
proteases) – proteolytic
enzymes of the gastric and
pancreatic secretions.
Role of glutamine in
detoxification of ammonia
in the brain.
Disorders of
pyrimidine
metabolism:
orotic aciduria
8. INTEGRATED METABOLISM 3 hours
Overview of metabolism in the Overview of
fed and fasting states metabolism in liver,
brain and adipose
tissue
9 BIOENERGETICS 3 hours
Role of ATP Role of ATP as the “energy Role of high
currency” of the cell. energy
phosphates in
energy capture
and transfer
e.g., role of
creatine
phosphate in
muscle.
The respiratory Sources of reducing equivalents Transport of
chain and in the cell (NADH and cytosolic
oxidative FADH2). NADH into the
phosphorylation mitochondria
Role of mitochondria as the (mitochondrial
“power house” of the cell. shuttle systems).
Overview of
complex V
(ATP synthase).
10 HOMEOSTATIC MECHANISMS IN THE BODY 4 hours
Acid base balance Definitions of acid, base and
buffer.
Mechanisms involved in
regulation of pH
Compensatory mechanisms in
metabolic/respiratory
acidosis/alkalosis.
Fluid and Distribution of water in various Regulation of
electrolyte body compartments. osmolality– role of
balance anti-diuretic hormone
Intra- and extracellular fluid (ADH).
composition (sodium and
potassium)
Sodium:
Normal levels in the blood.
Physiological functions.
Regulation of sodium
homeostasis (including the role
of renin-angiotensin-aldosterone
system).
Major causes, clinical features of
hyponatremia and hypernatremia
Potassium:
Normal levels in the blood.
Physiological functions.
Regulation of potassium
homeostasis.
Major causes and clinical features
of hypokalemiaandhyperkalemia.
11 IMMUNOLOGY 2 hours
Immunology Introduction to
immunoglobulins
Differential diagnosis of
jaundice, based on liver function
tests.
Measurement of
total and free
thyroxine levels.
Role of TSH
and free
thyroxine in
laboratory
diagnosis of
hypothyroidism
and
hyperthyroidism
Adrenal function Hormones
tests produced by the
adrenal cortex
and medulla.
Regulation of
secretion of
adrenocortical
hormones.
Overview of organization of
DNA in a chromosome.
DNA replication Overview of the process of Inhibitors of DNA Importance of
and repair DNA replication in eukaryotes replication as anti- telomeres and
cancer drugs. telomerase
Roles of DNA polymerase,
helicase, primase, topoisomerase Overview of role of
and DNA ligase major DNA repair
mechanisms –
Diagrammatic representation of mismatch repair, base
the events at the replication fork excision repair,
Okazaki fragments and its nucleotide excision
importance in replication. repair and double
strand break repair.
Diseases associated
with abnormalities of
DNA repair systems
– xeroderma
Pigmentosa and
hereditary non-
polyposis colon
cancer (HNPCC).
Transcription Structure of a gene - concepts of
exons and introns, promoter,
enhancers/repressors and
response elements.
Post-transcriptional processing –
capping, tailing and splicing.
Translation and Genetic code - definition. Overview of the
genetic code: process of translation
Characteristics of the genetic – initiation,
code – universal, unambiguous, elongation and
degenerate, without punctuation termination
(continuous/commaless).
Inhibition of
Basis of degeneracy of the prokaryotic
genetic code (wobble translation by
hypothesis). antibiotics.
Gene therapy
Diagnosis of genetic
diseases and genetic
counseling
Forensic investigation
Mechanisms of
generation of
reactive oxygen
species (ROS)
in cells.
Role of
antioxidants –
vitamin E and
glutathione.
Role of
antioxidant
enzymes –
glutathione
peroxidase,
superoxide
dismutase
18. NUTRITION 3 hours
Importance of various macro Calorific value of Dietary protein
and micro-nutrients in diet. various quality –
Components and importance of macronutrients. biological value
each type in diet. and net protein
Principles of utilization.
Concept of balanced diet and calculation of energy
glycemic index of food. requirements of a Concept of
person. nitrogen
Importance of dietary fibre. balance.
Protein-energy malnutrition
(PEM): marasmus and
kwashiorkor - causes and main
differences.
PRACTICAL SYLLABUS
Estimation of important biochemical analytes in blood (glucose, creatinine, urea, uric acid and total protein)
Identification of abnormal constituents in urine; interpretation of the findings and correlation of the
findings with pathological states
Tests (including dipstick tests) to detect abnormal constituents in urine include heat coagulation test,
sulphosalicylic acid test and Heller’s test for proteins, Benedict’s test for reducing sugar, benzidine test for
blood, Rothera’s test for ketone bodies, Hay’s test for bile salts and Fouchet’s test for bile pigments
Interpretation of laboratory results in the context of a patient’s presenting complaints.
Principles of spectrophotometry (including the Beer-Lambert Law)
Principles of electrophoresis (with specific reference to separation of serum proteins) and paper
chromatography
Unit II - October
Unit IV - January
Metabolism of lipids
Unit V - February
Organ function tests, acid–base homeostasis and associated disorders, water and electrolyte balance and associated
disorders
RECOMMENDED TEXTBOOKS
The most recent editions of the following books are suggested.
1. Text book of Biochemistry for Medical Students by DM Vasudevan, SreeKumari S and Kannan
Vaidyanathan
2. Medical Biochemistry by AR Aroor
3. Principles and Applications of Biochemistry in Medicine by Rafi
4. Biochemistry – Lippincott’s Illustrated Reviews
5. Harpers Illustrated Biochemistry
The topics in Biochemistry will be divided into 4, as detailed below, for the viva voce. Each examiner will
assess the students in one of these areas and will award marks out of 5.
RECORD BOOKS
It is suggested that students be issued a printed Biochemistry Record Notebook in which they are
expected to write only the observations, inferences and calculations of experiments they do in the practical
classes conducted.
INTEGRATED TEACHING:
Suggested topics that may be used for integrated teaching:
Clinically important enzymes, plasma markers of myocardial, infarction and liver and renal damage,
rationale of oral rehydration solutions, lactose intolerance, galactosemia, diabetes mellitus, ketoacidosis,
dyslipidemias, atherosclerosis and coronary artery disease, liver disease, haemoglobinopathies,
phenylketonuria, hyperuricemia and gout, deficiencies of vitamins A, D, K, B12, thiamine, pyridoxine and
folic acid, acid-base and electrolyte disorders, disorders of calcium homeostasis, iron deficiency anemia,
iodine deficiency, disorders of bilirubin metabolism, renal and thyroid function tests, protein-energy
malnutrition.
RECORD