Course Content

Physiology First M.B.B.S. ( From August 2019)

(Based on Medical Council of India, Competency based Undergraduate curriculum for the
Indian Medical Graduate, 2018. Vol. 1; page no.91-118 )
Lectures(hours)-160 Self directed learning ( hours)-
Teaching hours 25
Small group teachings/tutorials/Integrated teaching/Practicals(hours)-310 Total(hours) -495
Early clinical exposure(hours)- 90 to be divided equally in all three subjects .
Competency No. Topics & subtopics
1 General Physiology
PY. 1.1 Structure and Functions of a Mammalian Cell
PY. 1.2 Principles of Homeostasis
PY. 1.3 Intercellular communication
PY. 1.4 Apoptosis – Programmed cell death
PY. 1.5 Transport mechanisms across cell membranes
PY. 1.6 Fluid compartment of the body, its ionic composition & measurements
PY. 1.7 Concept of pH & Buffer systems in the body
PY. 1.8 Molecular basis of resting membrane potential and action potential in excitable tissue
Methods used to demonstrate the functions of the cells and its products, its communication and their applications in
PY. 1.9
Clinical care and research.
2 Topic: Hematology
PY. 2.1 Composition & functions of blood components
PY. 2.2 Original, forms, variations and functions of plasma proteins
PY. 2.3 Synthesis and functions of Hemoglobin & explain its breakdown. Describe variants of hemoglobin
PY. 2.4 RBC formation (erythropoiesis & its regulation) and its functions
PY. 2.5 Types of anaemias & Jaundice
PY. 2.6 WBC formation (granulopoiesis) & its regulation
PY. 2.7 Formation of platelets, functions & variations
PY. 2.8 Physiological basis of hemostasis and anticoagulants. Describe bleeding & clotting disorders (Hemophilia, purpura)

PY. 2.9 Different blood groups and clinical importance of blood grouping, blood banking and transfusion
PY. 2.10 Types of immunity , development of immunity and its regulation
PY. 2.11 Estimation Hb, RBC, TLC, RBC indices, DLC, Blood group, BT/CT
PY. 2.12 Tests for ESR, Osmotic fragility, Hematocrit , findings and interpretion of test results etc.
PY. 2.13 Steps for reticulocyte and platelet count
3 Nerve and Muscle Physiology
PY. 3.1 Structure and functions of a neuron and neuroglia; Nerve Growth Factor & other growth factors/cytokines
PY. 3.2 Types, functions & properties of nerve fibers
PY. 3.3 Degeneration and regeneration in Peripheral nerves
PY. 3.4 Structure neuro-muscular junction and transmission of impulses
PY. 3.5 Action of neuro-muscular blocking agents
PY. 3.6 Pathophysiology of Myasthenia gravis
PY. 3.7 Types of muscle fibres and their structure
PY. 3.8 Action potential and its properties in different muscle types (skeletal & smooth)
PY. 3.9 Molecular basis of muscle contraction in skeletal and in smooth muscles
PY. 3.10 Mode of muscle contraction (isometric and isotonic)
PY. 3.11 Energy source and muscle metabolism
PY. 3.12 Gradation of muscular activity
PY. 3.13 Muscular dystrophy: myopathies
PY. 3.14 Ergography
PY. 3.15 Effect of mild, moderate and severe exercise and changes in cardiorespiratory parameters
PY. 3.16 Harvard Step test and impact on induced physiologic parameters in a simulated environment
PY. 3.17 Strength-duration curve
PY. 3.18 Computer assisted learning (i) amphibian nerve – muscle experiments (ii) amphibian cardiac experiments
4 Gastro-intestinal Physiology
PY. 4.1 Structure and functions of digestive system
Composition, mechanism of secretion, functions, and regulation of saliva, gastric, pancreatic, intestinal, juices and bile
PY. 4.2
secretion
PY. 4.3 GIT movements, regulation and functions ,defecation reflex. Role of dietary fibre.
PY. 4.4 Physiology of digestion and absorption of nutrients
PY. 4.5 Source of GIT hormones, their regulation and functions
PY. 4.6 Gut-Brain Axis
PY. 4.7 Structure and functions of liver and gall bladder
PY. 4.8 Gastric function tests, pancreatic exocrine function test & liver function tests
Physiology aspects of; peptic ulcer, gastro- oesophageal reflux disease, vomiting, diarrhea , constipation, Adynamic
PY. 4.9
ileus, Hirschsprung’s disease
PY. 4.10 Clinical examination of the abdomen in a normal volunteer or simulated environment
5 Cardiovascular Physiology (CVS)
PY. 5.1 Functional anatomy of heart including chambers sounds; and Pacemaker tissue and conducing system.
PY. 5.2 Properties of cardiac muscle including its morphology, electrical, mechanical and metabolic functions
PY. 5.3 Events occurring during the cardiac cycle
PY. 5.4 Generation, conduction of cardiac impulse
PY. 5.5 Physiology of electrocardiogram (E.C.G.), its applications and the cardiac axis
PY. 5.6 Abnormal ECG, arrhythmias, heart block and myocardial infarction.
PY. 5.7 Haemodynamics of circulatory system
PY. 5.8 Local and systemic cardiovascular regulatory mechanisms
PY. 5.9 Factors affecting heart rate, regulation of cardiac output & blood pressure
Regional circulation including microcirculation, lymphatic, coronary, cerebral, capillary, Skin, foetal, pulmonary and
PY. 5.10
splanchnic circulation
PY. 5.11 Patho-physiology of shock, syncope and heart failure
Blood pressure & pulse recording at rest and in different grades of exercise and postures in a volunteer or simulated
PY. 5.12
environment
PY. 5.13 Record and interpret normal ECG in a volunteer or simulated environment
PY. 5.14 Cardiovascular autonomic function tests in a volunteer or simulated environment
PY. 5.15 Clinical examination of the cardiovascular system in a normal volunteer or simulated environment
PY. 5.16 Recording Arterial pulse tracing using finger plethysmography in a volunteer or simulated environment
6 Respiratory Physiology
PY. 6.1 Functional anatomy of respiratory tract
Mechanics of normal respiration, pressure changes during ventilation, lung volume and capacities, alveolar surface
PY. 6.2
tension, compliance, airway resistance, ventilation, V/P ratio, diffusion capacity of lungs
PY. 6.3 Transport of respiratory gases: Oxygen and Carbon dioxide
Regulation of respiration -- Neural & chemical
PY. 6.4 Physiology of high altitude deep sea diving
PY. 6.5 Principles of artificial respiration oxygen therapy, acclimatization and decompression sickness
PY. 6.6 Pathophysiology of dyspnea, hypoxia, cyanosis asphyxia; drowning, periodic breathing
PY. 6.7 Lung function tests & their clinical significance
PY. 6.8 Technique to perform & interpret Spirometry
PY. 6.9 Examination of the respiratory system in a normal volunteer or simulated environment

PY. 6.10 Technique to perform measurement of peak expiratory flow rate in a normal volunteer or simulated environment

7 Renal Physiology
PY. 7.1 Structure and function of kidney
PY. 7.2 Structure and functions of juxta glomerular apparatus and role of renin-angiotensin system
PY. 7.3 Mechanism of urine formation and processes involved
PY. 7.4 Significance & implication of Renal clearance
PY. 7.5 Renal regulation of fluid and electrolytes & acid-base balance
PY. 7.6 Innervations of urinary bladder, physiology of micturition and its abnormalities
PY. 7.7 Artificial kidney, dialysis and renal transplantation
PY. 7.8 Renal Function Tests
PY. 7.9 Cystometry and discuss the normal cystometrogram
8 Endocrine Physiology
PY. 8.1 Physiology of bone and calcium metabolism
Synthesis, secretion, transport, physiological actions, regulation and effects of altered (hypo and hyper) secretion of
PY. 8.2
pituitary gland, thyroid gland, parathyroid gland, adrenal gland, pancreas and hypothalamus
PY. 8.3 Physiology of Thymus & Pineal Gland
PY. 8.4 Function tests: Thyroid gland; Adrenal cortex, Adrenal medulla and pancreas
Metabolic and endocrine consequences of obesity & metabolic syndrome, Stress response. Outline the psychiatry
PY. 8.5
component pertaining to metabolic syndrome
PY. 8.6 Mechanism of action of steroid, protein and amine hormones
9 Reproductive Physiology
Sex determination; sex differentiation and their abnormalities and outline psychiatry and practical implementation of
PY. 9.1
sex determination
Puberty: onset, progression, states; early and delayed puberty and outline adolescent clinical and psychological
PY. 9.2
association
Male reproductive system: functions of testis and control of spermatogenesis & factors modifying it and outline its
PY. 9.3
association with psychiatric illness
Female reproductive system: (a) functions of ovary and its control; (b) menstrual cycle – hormonal, uterine and
PY. 9.4
ovarian changes
PY. 9.5 Physiological effects of sex hormones
PY. 9.6 Contraceptive methods for male and female. Discuss their advantages & disadvantages
PY. 9.7 Effects of removal of gonads on physiological functions
Physiology of pregnancy, parturition & lactation and outline the psychology and psychiatry-disorders associated with
PY. 9.8
it
Interpret a normal semen analysis report including
PY. 9.9
(a) sperm court, (b) sperm morphology and (c) sperm motility, as per WHO guidelines and discuss the result
PY. 9.10 Physiological basis of various pregnancy tests
PY. 9.11 Hormonal changes and their effects during perimenopause and menopause
PY. 9.12 Common causes of infertility in a couple and role of IVF in managing a case of infertility
10 Neurophysiology
PY. 10.1 Organization of nervous system
PY. 10.2 Functions and properties of synapse, reflex, receptors
PY. 10.3 Somatic sensations & sensory tracts
Motor tracts, mechanism of maintenance of tone, control of body movements, posture and equilibrium & vestibular
PY. 10.4
apparatus
PY. 10.5 Structure and functions of reticular activating system, autonomic nervous system (ANS)
PY. 10.6 Spinal cord, its functions, lesion & sensory disturbances
Functions of cerebral cortex, basal ganglia thalamus, hypothalamus. Cerebellum and limbic system and their
PY. 10.7
abnormalities
PY. 10.8 Behavioural and EEG characteristics during sleep and mechanism responsible for its production
PY. 10.9 Physiological basis of memory, learning and speech
PY. 10.10 Chemical transmission in the nervous system. (Outline the psychiatry element)
Clinical examination of the nervous system: Higher functions, sensory system, motor system, reflexes, cranial nerves
PY. 10.11
in a normal volunteer or simulated environment
PY. 10.12 Normal EEG forms
PY. 10.13 Perception of smell and taste sensation
PY. 10.14 Patho-physiology of altered smell and taste sensation
PY. 10.15 Functional anatomy of ear and auditory pathways & physiology of hearing
PY. 10.16 Pathophysiology of deafness. Hearing tests
Functional anatomy of eye, physiology of image formation, physiology of vision including colour vision, refractive
PY. 10.17
errors, colour blindness, physiology of pupil and light reflex
PY. 10.18 Physiological basis of lesion in visual pathway
PY. 10.19 Auditory & visual evoke potentials
(i) Testing of visual acuity, colour and field of vision and (ii) hearing (iii) Testing for smell and (iv) taste sensation in
PY. 10.20
volunteer/ simulated environment
11 Integrated Physiology
PY. 11.1 Mechanism of temperature regulation
PY. 11.2 Adaptation to altered temperature (heat and cold)
PY. 11.3 Mechanism of fever, cold injuries and heat stroke
PY. 11.4 Cardio-respiratory and metabolic adjustment during exercise; physical training effects
PY. 11.5 Physiological consequences of sedentary lifestyle
PY. 11.6 Physiology of Infancy
PY. 11.7 Physiology of aging; free radicals and antioxidants
Cardio-respiratory changes in exercise (isometric and isotonic) with that in the resting state and under different
PY. 11.8
environmental conditions (heat and cold)
PY. 11.9 Interpretation of growth charts
PY. 11.10 Interpretation of anthropometric assessment of infants
PY. 11.11 Concept, criteria for diagnosis of Brain death and its implications
PY. 11.12 Physiological effects of meditation
PY. 11.13 History taking and general examination in the volunteer / simulated environment
PY. 11.14 Basic Life Support in a simulated environment
 Paper wise distribution of topics
Year: First MBBS Subject: Physiology

Paper Section Topics

I A MCQs on all topics of the paper I

B&C General Physiology
Blood
Respiratory System
Cardio Vascular System,
Cardio-respiratory and metabolic adjustment during exercise

Renal system
Gastro intestinal system
Life style, aging, Meditation
AETCOM module no. 1.2 & 1.3
Scenario based / application questions can be on any topic of the
paper I
For long answer question and scenario based / application
questions , topics will not be repeated
II A MCQs on all topics of the paper II
B&C Endocrine Physiology
Reproductive System, Physiology of Infancy
Special senses
Central nervous system including brain death
Temperature Regulation & applied
Nerve muscle physiology
Scenario based / application questions can be on any topic of the
paper II
For long answer question and scenario based / application
questions , topics will not be repeated
 Internal Assessment
Physiology
Applicable w.e.f August 2019 onwards examination for batches admitted from June 2019 onwards
Sr. I-Exam (December) II-Exam (March )
No
Practical Total Practical
(Including 05 Marks Including 05
Theory Marks for Theory Marks for Total Marks
Journal & Log Journal & Log
Book ) Book
1 100 50 150 100 50 150

Preliminary Examinations Remedial Examination (after University

III-Exam (July) Examination)
Sr. Practical Including Practical Including Total
No 10 Marks for 10 Marks for Marks
Theory Total Marks Theory
Journal & Log Journal & Log Book
Book
1 200 100 300 200 100 300
1. There will be 3 internal assessment examinations in the academic year. The structure of the internal assessment theory
examinations should be similar to the structure of University examination.
2. There will be only one additional examination for absent students (due to genuine reason) after approval by the
Institutional Grievances Committee. It should be taken after preliminary examination and before submission of internal
 assessment marks to the University. (It is mandatory for the students to appear for all the three internal assessment
examination. )
3. First internal assessment examination will be held in December, second internal assessment examination will be held in
March and third internal assessment examination will be held in July.

4. Internal assessment marks for theory and practical will be converted to out of 40. Internal assessment marks, after
conversion, should be submitted to university by 7th of August.
5. The student who scores 35% marks separately in theory & practical internal assessment examinations is eligible to
appear for university examinations
6. It is mandatory to secure at least 50% marks of the total marks (combined in theory & practical) assigned for internal
assessment in the particular subject in order to be declared successful at the final University Examination of that subject.
7. Remedial internal assessment examination for students:
a. Applicable for students who got individual theory or practical marks between 35% and 50% but did not score
aggregate 50% (combined in theory and practical) for the subject: Remedial internal assessment should be
organized by the college immediately after the completion of university examination of the affected students.
The revised internal assessment marks (converted out of 40 each) of such students should be sent to the
University within maximum of 15 days after university examination of these students. Such a remedial
examination shall be conducted by allocating only three days per subject without any gap (two days for theory
and one day for practical).
8. The internal assessment marks of the remedial examination alone shall be considered.
9. Conversion Formula for calculation of marks in internal assessment examinations
 First Second Third IA Total Internal Eligibility to appear for Minimum marks to be
IA IA (Prelim) assessment final University obtained to declare the final
marks: examination University examination
Conversion (after conversion out result (Out of 80 Combined
formula (out of of 40) in theory and practical)
40)
Theory 100 100 200 400 𝑇𝑜𝑡𝑎𝑙 𝑚𝑎𝑟𝑘𝑠 14 40
10

Practical 50 50 100 200 𝑇𝑜𝑡𝑎𝑙 𝑚𝑎𝑟𝑘𝑠 14

5

While preparing Final Marks of Internal Assessment, the rounding-off marks shall done as illustrated in following table
Internal Assessment Marks Final rounded marks
13.01 to 13.49 13
13.50 to 13.99 14

10. The result of the final University examination for students, who fail to secure 50% marks of the total marks (40 marks after
conversion - combined in theory & practical) in internal assessment, even after remedial examination, shall not be declared
by University and his / her performance in the final examination shall be annulled.
11.
a) Non eligible students having less than 35% internal assessment marks AND students who fail to secure 50 % combined in
theory and practical in remedial examination will have to appear for a remedial internal assessment examination which will
be held before supplementary examination. Eligible students (minimum 35 % separately in theory and practical) will be
permitted to appear for supplementary examination, but students have to undergo remedial examination after university
supplementary examination & score aggregate 50% marks for results to be declared (Same as described in point 8). The
result of the supplementary University examination for students, who fail to secure 50% marks of the total marks (40 marks
after conversion-combined in theory & practical) in internal assessment, even after remedial measures, shall not be declared
by University and his / her performance in the supplementary examination shall be annulled.
b) Students who score less than 35% separately in theory & practical AND the students who were unable to score aggregate
50% in remedial measures after supplementary examination will have to appear for III internal assessment examination (
Preliminary examination) along with next regular batch of students & marks obtained in this examination will be used to
calculate internal assessment marks. Further rules for these students will remain similar to the students admitted in next
regular batch.
13) Supplementary University examination shall be held within 45 – 90 days of declaration of results of first professional
University examinations.
 First Year MBBS Practical Mark’s Structure
Internal Assessment Examinations I & II
(Applicable for batch admitted in M.B.B.S Course from Academic Year 2019-20 & onwards)

Physiology
Journal/
Hematology Clinical Examination/Human Physiology expt. / Short exercises
Logbook
Oral Viva Total

A B C D E

Max.
15 20 5 10 50
Marks
First Year MBBS Physiology Practical Mark’s Structure (Prelim exam)
(Applicable for batch admitted in M.B.B.S Course from Academic Year 2019-20 & onwards)
Seat No. Exercise 1 Exercise 2 Exercise Exercise Practical Oral/Viva PR/Oral
3* 4** (Total) (Total) Total
Clinical Examination
C.V.S R.S C.N.S. & General Hematology Short Human Journal
Special Exam & exercise Physiology & Log
Senses Abdomen Experiment book

H
A B C D E F G I J K
Max. 10.0
10.0 10.0 10.0 10.0 10.0 15.0 15.0 90 10.0 100
Mark’s

*Short exercises 3 marks each(3X5)

1. Case based scenarios/ endocrine disorders photographs .2. Interpretation of function tests. 3. One skeletal graph

4. One cardiac graph 5. Calculation

** Exercise 4: Human Physiology Experiment 1. Basic Life Support in a simulated environment 2. ECG 3. Spirometry 4. PEFR 5. EEG Interpretation 6.
Ergography 7. Harward step test 8. Perimetry

* Suggested Methods of Assessment

Preclinical exam & OSPE

First Year MBBS Physiology Practical Mark’s Structure(MUHS)
(Applicable for batch admitted in M.B.B.S Course from Academic Year 2019-20 & onwards)
Exercise 1 Exercise 2 Exercise 3 Exercise Practical Oral/Viva PR/Oral
* 4** (Total) (Total) Total
Clinical Examination
C.V.S R.S C.N.S. & General Hematology Short Human
Special Exam & exercises Physiology
Senses Abdomen Experiment

A B C D E F G H I J
Max.
10.0 10.0 10.0 10.0 10.0 15.0 15.0 80 20.0 100
Mark’s

*Short exercises 3 marks each(3X5)

1. Case based scenarios/ endocrine disorders photographs .2. Interpretation of function tests. 3. One skeletal graph

4. One cardiac graph 5. Calculation

** Exercise 4: Human Physiology Experiment 1. Basic Life Support in a simulated environment 2. ECG 3. Spirometry 4. PEFR 5. EEG Interpretation 6.
Ergography 7. Harward step test 8. Perimetry

* Suggested Methods of Assessment

Clinical exam & OSPE

 MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
FORMAT / SKELETON OF QUESTION PAPER

1. Course and Year : First MBBS 2. Subject Code : Appendix - a

(applicable w.e.f. June 2020 & onwards examinations)
3. Subject (PSP) : Physiology
(TT) :
4. Paper : : I/II 5. Total Marks : 100 6. Total Time : 3 Hrs.

7. Web Pattern : [ ] 8. Web : [ ] 9. Web : [ ] 10. Web Old QP : [ ]

Skeleton Syllabus

Instructions: SECTION “A” MCQ

1) Put in the appropriate box below the question number once only.
2) Use blue ball point pen only.
3) Each question carries One mark.
4) Students will not be allotted mark if he/she overwrites strikes or put white ink on the cross once marked.

SECTION “A” MCQ (20 Marks)

1. Multiple Choice Questions (Total 20 MCQ of One mark each) ( 4 MCQ Should be CASE based ) (20x1=20)
a) b) c) d) e) f) g) h) i) j)
k) l) m) n) o) p) q) r) s) t)

SECTION “B” & “C”

Instructions: 1) Use blue/black ball point pen only.

2) Do not write anything on the blank portion of the question paper. If written anything, such type of act
will be considered as an attempt to resort to unfair means.
3) All questions are compulsory.
4) The number to the right indicates full marks.
5) Draw diagrams wherever necessary.
6) Distribution of syllabus in Question Paper is only meant to cover entire syllabus within the stipulated frame.
The Question paper pattern is a mere guideline. Questions can be asked from any paper’s syllabus into any
question paper. Students cannot claim that the Question is out of syllabus. As It is only for the placement
sake, the distribution has been done.
7) Use a common answerbook for all sections.

SECTION “B” ( 40 Marks )

2. Short Answer Questions (Any Four out of Five & two SAQs will be Clinical Application Based ) ( 4 x 5 = 20 )
a) b) c) d) e)
3. Long Answer Questions (Any Two out of Three) ( 2 x 10 = 20 )
a) b)

SECTION “C” ( 40 Marks)

4. Short answer questions (Any Four out of Five ) ( 1 Should be on AETCOM module 1.2/1.3 in
Paper I & two SAQs will be Clinical Application Based )
( 4 x 5 = 20 )
a) b) c) d) e)

5. Long Answer Questions (Any Two out of Three ) ( 2 x 10 =

20 )
a) b) c)
Books recommended:

1) Textbooks of Physiology :

Guyton - Textbook of Physiology

Ganong - Review of Medical Physiology
S. Wright - Applied Physiology

2) Reference Books :

Best and Taylor - Physiological basis of medical practice

Berne & levy. - Principles of Physiology
Dr. V.G. Ranade - Laboratory Manual and Journal of Physiology
Practicals
Ghai’s VP Varshney, Mona Bedi- Textbook of Physiology -9 th Edition2019.
G.K. Pal-Comprehensive Text Book of Medical Physiology.