THE LOCOMOTOR MODULE

Assalam u Alaikum D’25. Hope you all would be fine in your homes. The situation is really going
away from our hands. COVID-19 is causing devastations but our people aren’t being serious about
that... but In Sha Allah this will get a downward trend soon & we will again be united at our beloved
Dow soon by God’s Will. Do follow the guidelines of hygiene & social distancing and pray that the
world recovers from this pandemic.
Now this is your Locomotor Module. I am sorry to be late in sending the guidelines because of the
strict routine. But In Sha Allah this will help.
Locomotor is an easy module and among my favorites. Trust me. All it needs is proper attention
and settling of priorities.

REMOVAL OF MYTHS:
First, I would like to eradicate the myths related to this module.

• Locomotor is easy but much lengthy and needs explanations.

• Give an optimum of 2 hours to study each day. Then do whatever you want, play, sleep,
read, listen etc.
• In the start don’t study much in the weekends. But when the Module is going towards its
end, give only 2 to 4 hours to study in the weekend as well. There is no need to spend the
whole weekend in studying.
• This Module isn’t a score-breaker. Many students from my batch (Areesha Bano, Huzaifa
Soomro, Javeria Jawaid are to name a few) have accomplished distinction in this module by
following some novel techniques which I will elaborate in the subsequent headings.

SUBJECTS:
The subjects in Locomotor Module are:

MAJORS/IMPORTANTS MINORS CLINICAL SUBJECTS

ANATOMY Biochemistry Forensic Medicine
Physiology Pharmacology Radiology
Histology Pathology Neurology
Embryology Community Medicine Orthopedics
Behavioral Sciences
Clinical Skills (Skill’s Lab)
Study Skills

SYLLABUS:
The Specific Topics & Syllabus is given in the D.U.H.S. Locomotor Module Guide. Click on the link
below for it;
https://www.duhs.edu.pk/curriculum/downloads/LOCOMOTOR%20MODULE%20GUIDE%202019-
20190804.pdf.

I will discuss it here in a nutshell;

1. Anatomy:
Introduction:
Anatomy is the main subject in this Module. You will be revolving around anatomy only in
this module. It is further divided into 5 categories:
i. Osteology: It is the detailed anatomy of Bones. You must do Osteology of Upper
Limb (Clavicle, Scapula, Humerus, Radius, Ulna, Carpals, Metacarpals & Phalanges)
and Lower Limb (Hip Bone, Femur, Tibia, Fibula, Tarsals, Metatarsals & Phalanges).
Do not rely on books for Osteology. You must have the specific bone in your hand
while studying so that you can see all the related features. You can study with
Synthetic bones from the Library or Anatomy Museum, but it will not be much
productive. So, try to have Real Bones for studying. S.A.P. and S.A.S. have their bone
banks for this purpose.
{But since there is lockdown, it is impossible to have bones now. For the time being
you can see the images of Netter’s or some other Atlases like Mc Minn’s, Thieme’s
etc.}
Many of us might be of using BD Chaurasia’s Anatomy for Osteology. BD is good in
Osteology, but I advise precaution while using it as it goes a bit controversial. So, if
you are doing BD then always be careful that it doesn’t goes contrary to mainstream
books i.e. KLM & Gray’s; and when it goes, follow these textbooks, not BD Anatomy
because Dow always follows these.
ii. Myology: It is the anatomy of attachments of muscles on skeleton, their
neurovasculature and functions.
iii. Angiology: It is the anatomy of Blood Vessels; here of the two limbs.
iv. Arthrology: It is the anatomy of joints. You will study the Shoulder, Hip, Elbow,
Forearm, Knee, Leg, Wrist, Ankle Joints and the Joints of Hand & Foot.
v. Neurology: It is the anatomy of Nervous Supply of the two limbs. This will make the
main bulk of assessments; both theory and viva. Brachial & Lumbosacral Plexuses
should be on the fingertips.
Apart from all this you will have to cover Breast also. I wonder why it is added.

Clinicals of KLM Anatomy are very important. Nerve Supply & Clinicals will make 90%
of your assessment.

Books to follow:
All the textbooks are good and have mere pros & cons.
KLM Anatomy will have best description, but it lacks on illustrations.
Gray’s Anatomy for Students has good illustrations, but it is observed that it is not as
eloquent as KLM in explaining.
I recommend doing KLM Anatomy + Netter’s Atlas. KLM will explain you and Netter will
make a clean picture of the scenario in your mind. But it’s just a recommendation, I agree
with Dr. Khizer of D’19 a.k.a. Khizer Bhai i.e. to do the book which suits you.
You can do Essence Anatomy Review for Revision and Internal Evaluation. It’s very helpful,
otherwise BRS Anatomy can also be followed. Do not rely on long books for revision. These
short books are made for this purpose only.
Practical: There will be Model Studies on the Limbs & Bones.
2. Physiology:
Introduction:
Physiology is also an important subject in this Module. Here in Locomotor we will revolve
around Membrane, Nerve, Muscle and Bone Physiologies.
Books to follow:
The only book is Guyton & Hall textbook of Medical Physiology (a.k.a. Guyton Physiology).
Dow Papers always have lines from it. Rattafy the mechanism & propagation of Action
Potentials, Definitions of RMP, AP, Hyperpolarization, Neuron, Sarcomere, EPSP, IPSP,
Excitable & Non-Excitable Cells, Absolute and Relative Refractory Periods etc. They are
worth asking in Vivas.
Unit 2: Chapters 5, 6, 7.
Unit 9: Chapter 49 (overview is needed in this Module)
Unit 14: Chapter 80 (Pages 1003 to 1007)
Practical:
Power Lab Experiments will start from this module;
i. Nerve Conduction Velocity
ii. Electromyography
iii. Simple Muscle Twitch
iv. Summation
v. Muscle Fatigue
3. Biochemistry:
Introduction:
Biochemistry is very conceptual and easy. Extracellular Matrix is to be covered. Vitamin D &
Parathyroid hormone are to be done. Rattafy the Collagen types.
Books to follow:
You can do Lippincott or Harper. It is your choice. I personally went with Lippincott &
Lecture Slides.
Lippincott Chapters: 4, 14 (leave Glycoproteins), 28 (only Vitamin D)
Harper Chapter: The Extracellular Matrix.
Tutorials: Practical:
i. ECM i. Detection of Proteins by Uristix
ii. Bone Markers ii. Detection of normal constituents of Urine
iii. Parathyroid Hormone (Chloride, Sulphate, Urea, Uric Acid)
4. Histology:
Introduction:
Histology is very easy. It will comprise:
• Bone Histology • Cartilage Histology
• Muscle Histology • Breast Histology
Books to follow:
Medical Histology by Laiq Hussain Siddiqui has an easy approach. But do see the pictures
and slides from Wheater’s Functional Histology.
Chapters: 7, 8, 10 & 21
5. Embryology:
Introduction:
Embryology has is a bit conceptual. It will comprise:
• Bone Development • Cartilage Development
 • Muscle Development • Breast Development
• Limb Development
Books to follow:
You can follow anyone; KLM Embryology or Langman Embryology. I did KLM. Must do
Clinicals from it. They are frequently asked in Viva.
6. Pharmacology:
Introduction:
Being a Clinical Subject, Pharmacology isn’t much lengthy in this module. In Locomotor
Module you will be studying the NSAID Aspirin and Paracetamol only.
Books to follow:
I prefer Katzung & Trevor’s Review of Basic & Clinical Pharmacology. Lippincott’s Illustrated
Reviews on Pharmacology can also be followed.
7. Pathology:
Introduction:
Pathology is very less in this Module. You will only have to do the Developmental &
Acquired disorders of Bone, Vitamin D disorders, PTH disorders, Fractures and Bone
Infections.
Robbin’s & Cotran Pathologic Basis of disease is the Standard book for studying Pathology.
Don’t go anywhere else for Pathology. The blue boxes & orange blocks of Basis are very
essential to excel in the exam. Revision can be done from Pathoma.
Chapters: 9 (only Vitamin D) and 26 (Pgs. 1180-1194, 1195-1196)
8. Community Medicine:
Introduction:
Community Medicine is very easy in this Module. Disease transition, Elderly Health, Snake
Bite & Disaster Management will be taught.
Do learn the last two topics from slides. Questions are made from them.
Books to follow:
Lecture Slides are more than enough.
9. Behavioral Sciences:
Introduction:
Locomotor BS topics will revolve around Medical Ethics.
Books to follow:
Slides are more than enough.
10. Clinical Subjects: [cover all the Clinical Subjects from Lecture Slides]
i. Radiology:
For this module you must only have an idea on how to differentiate the normal X-
Rays. Rest just have a bird’s eye view on MRIs of Limbs.
ii. Neurology:
For this Module just focus on the Anatomical aspects i.e. Brachial & Lumbosacral
Plexuses & respective nerves.
iii. Orthopedics:
Just have a brief idea on types of Fractures & Soft Tissue injuries and fracture
management.
iv. Forensic Medicine: It will be introduced from this Module
 11. Medical Skills:
Locomotor Module will comprise of Vital Signs i.e. Temperature, Blood Pressure, Pulse
Pressure & Pain scaling. Handouts will be provided to you prior to every session.
Pakistan Studies, Islamiat & Study Skills:
Although not confirmed, but these subjects might be a part of Curriculum now. Ask Dr.
Sabahat or Madam Zohra for this from Admin Block.

USE OF SMART APPLICATIONS & VIDEOS:

There are some fantastic Android & iOS applications which will help in studying Anatomy;
1. Teach Me Anatomy by TeachMeSeries Ltd.
2. Anatomy 3D Atlas by Catfish Animation Studio
3. Anatomy Learning – 3D Anatomy Atlas by Anatomy Learning LLC
4. Anatomyka – 3D Human Anatomy Atlas by Woodoo Art s.r.o.
Moreover, there are some YouTube channels as well which have a good content for Locomotor;
1. Selfless Medicose
2. Anatomy Zone
3. The Charsi of Medical Literature
4. Nabil Ebrahim
5. Human Anatomy Education
6. Sanjoy Sanyal

ASSESSMENT PLAN:
As you know there are four phases of assessment:

Internal Evaluation
Modular Test
Annual Exam
Structured Viva
Internal Evaluation:
As you know the Internal Evaluation will be done prior to end of the module. It will probably
comprise of 3 subjects: Anatomy, Physiology & Biochemistry.
Anatomy:
Anatomy will be composed of 5 spots (bone, muscle, nerve, artery, joint & histological slide) and 2
Viva Stations i.e. one of each Limb.
The Spots questions are very easy i.e. identification with reasoning points, Muscle attachment, Bone
markings, Nerve or Arterial Supply and Course.
The Viva questions are also very easy i.e. they can ask you to take any bone from the models
provided and mark its Osteology, they can ask the function and nerve supply of muscles etc. They
can also ask the Clinical aspects like Carpal Tunnel Syndrome, Hip dislocation etc.
Physiology:
Physiology usually comprises of Spots & Practical.
There will be about 10 spots coming from the Textbook & Practical apparatus. Power Lab is
introduced so it will make the main bulk of spots. All practicals are essential. Learn the techniques
form the Senior Technician Mr. Ali Sher he is very helpful.
Biochemistry:
There will be a practical, one or two Clinical Cases & at least two Viva Stations. Viva will again be
very simple for e.g. Define ECM. What are the components of ECM? Define the Collagen. What are
Bone markers? etc.
Modular Test:
The Modular test will be conducted at the end of each Module at the Digital Library on Moodle. It
will probably comprise of 100 Multiple Choice Questions (M.C.Qs.). We can grossly divide the
questions into 4 Categories;
Best Choice Questions (B.C.Qs.): Basic concepts and clinical case-based M.C.Qs.
Objective Structured Practical Questions (O.S.P.E.): Pictorial Questions. The Pictures usually
come from the prescribed textbooks.
Case Based Learning (C.B.L.): A Clinical Case is provided, and few questions are asked.
Extended Matching Questions (E.M.Qs.): Although discontinued, they comprise of some questions
with same options.
Annual Exam:
The Annual Exam will be conducted for every taught module at the end of each academic year. It
will comprise of 100 Multiple Choice Questions (M.C.Qs.). We can grossly divide the questions into 4
Categories. (See above)
Structured Viva:
At the end of the Examinations there would be a Structured Viva. There are Viva Stations alternated
with Rest Stations. Each station lasts 5 minutes & the schedules + timings are uploaded on the
D.U.H.S. website at least one day earlier.

SOME IMPORTANT TOPICS FOR ASSSESSMENT:

Important O.S.P.Es.:
1. Osteon (https://i.pinimg.com/originals/26/d5/67/26d567eff5c9e6d3d83ed07f93500508.jpg)
 2. Scapular Anastomosis (From KLM Anatomy {7th Ed. Pg. 727 Fig. B6.11 A & B})
3. Axillary Artery (From Netter’s Atlas {7th Ed. Plate # 418})
4. Femoral Triangle (From Netter’s Atlas {7th Ed. Plate # 490})
5. Osteoporosis (From Robbin’s Basis {9th Ed. Pg. 1189 Fig. 26.10})
6. Flexor Retinaculum (From Netter’s Atlas {7th Ed. Plate # 444})
7. Cubital Fossa (From KLM Anatomy {7th Ed. Pg. 747 Fig. 6.58})
8. Axillary Lymph Nodes (From KLM Anatomy {7th Ed. Pg. 720 Fig. 6.42 A})
9. Rotator Cuff Muscles (From KLM Anatomy {7th Ed. Pg. 798 Fig. 6.94 C})
10. Sarcomere (From Junqueira’s Histology {14th Ed. Pg. 199 Fig. 10.8 C})
11. Brachial Plexus (From Netter’s Atlas {7th Ed. Plate # 420})
12. Lumbar Plexus (From Netter’s Atlas {7th Ed. Plate # 488})
13. Sacral Plexus (From Netter’s Atlas {7th Ed. Plate # 489})
14. Anatomical Snuff Box (From KLM Anatomy {7th Ed. Pg. 757 Fig. 6.65})
15. Carpal Bones (From Netter’s Atlas {7th Ed. Plate # 442})
16. Carpal Tunnel (From Netter’s Atlas {7th Ed. Plate # 452})
17. Tarsal Bones (From Netter’s Atlas {7th Ed. Plate # 515})
18. Graphs of EMG, Muscle Twitch, Summation (from the Practicals)
Important C.B.Ls.:
1. Osteomalacia
2. Axillary Lymphadenopathy
3. Knife Wound Injury
4. Gun Shot Injury
5. Carpal Tunnel Syndrome
6. Sacral Dermatome Palsy
7. Elbow Fracture
8. Knee Bursitis
9. Osteoporosis
10. Varicose Veins
Expected Viva Stations:
1. Anatomy [Upper Limb]
2. Anatomy [Lower Limb]
3. Physiology
4. Biochemistry
5. Histology + Embryology

ONE LAST ADVICE:

Due to the imposed lockdown because of the Global COVID-19 Pandemic, the Assessment
plan and schedule might be altered. Stay in touch with the website nowadays for it.

So, this sums up the discussion for now. At the end I would wish you all the best for this Module. Do
remember me in your prayers.
I would like to quote Sirius Black at the end;

Feel free to ask if you have any queries.

Regards,
Moeez Tariq
D’24