MUSCULOSKELETAL I

MODULE
Study Guide

MBBS 1st YEAR

SESSION 2017

Islamic International Medical College

RIPHAH INTERNATIONAL UNIVERSITY, RAWALPINDI
 MUSCULOSKELETAL-I MODULE INTEGRATED CURRICULUM

MUSCULOSKELETAL-I MODULE
PLACEMENT IN CURRICULUM Module 02 in 1st Year
MODULE CODE
MODULE DURATION 10-Weeks
PRE-REQUISITE Foundation Module
MODULE TEAM
CHAIRMAN CURRICULUM COMMITTEE Maj. Gen. Masood Anwar

MODULE PLANNER Maj. Gen. Masood Anwar

ASSOCIATE DIRECTOR MEDICAL EDUCATION Dr. Rahila Yasmeen
ASSISTANT DEAN MEDICAL EDUCATION Prof. Rehan Ahmed Khan
MODULE COORDINATOR Dr. Shabana Ali
MODULE CO-COORDINATOR Dr. Asma Ali
CURRICULUM COMMITTEE Prof. Khalid Farooq Danish
Prof. Fareesa Waqar
Brig. Retd. Prof. Muhammad Farooq
Prof. Samina Iltaf
Dr. Komal Zulfiqar

ACADEMIC TEAM
ANATOMY Dr. Shabana Ali
BIOCHEMISTRY Dr. Amena Rahim
PHYSIOLOGY Dr. Rabia Azhar
PATHOLOGY Prof. Samina Iltaf

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TABLE OF CONTENTS

BLOCK NO TOPICS
I Upper limb and neuromuscular transmission
II Back ,lower limb and carbohydrate metabolism

TABLE OF CONTENT

SUBJECT CONTENT
ANATOMY Histology of bones
Histology of cartilage
Development of bones and cartilage in the limbs
Development of muscles
Histology of muscles
Classification Of joints
Scapula
scapular region
Clavicle
Humerus
shoulder region
Muscles of arm
Axilla
Ulna
Radius
Muscles of forearm and cubital fossa
Muscles of hand
Brachial plexus
Nerves of arm
Median nerve
Ulnar nerve
Radial nerve
Vessels in arm
Blood supply of hand and fascial spaces of palm

Veins of upper limb

Shoulder joint
Elbow joint
Wrist joint
Imaging of Upper limb
Hip bone
Gluteal region
Femur
Medial compartment Of thigh
Posterior and lateral Compartment of thigh
Anterior compartment Of thigh
Femoral triangle, Femoral canal, Femoral sheath

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Tibia
Fibula
Anterior Compartment of leg
Posterior Compartment of leg and Popliteal fossa
Articulated foot
Muscles of foot
Surface marking
Hip joint
Knee joint
Ankle joint
Arches of foot
Arteries of gluteal region and thigh
Arteries of leg
Lumbar plexus
Nerves of thigh
Superficial and deep peroneal nerve
Venous drainage of Lower limb
Cutaneous nerve supply Of upper and lower limb
Surface marking
Fascia of upper and lower limb
Lymphatic drainage of upper and lower limb
HISTOLOGY SKILL LAB Histology of bone
Histology of cartilage
Histology of muscle

PHYSIOLOGY Characteristics of skeletal muscle

Characteristics of smooth muscle
Characteristic of muscle during exercise
Resting membrane potential and action potential
Propagation of action potential
Action potential in muscles
Neuromuscular transmission
Molecular basis of skeletal muscle contraction
Smooth muscle contraction
Muscle energetics
Excitation contraction coupling
SKILL LAB Single muscle twitch
Two successive stimuli
Effect of temperature on muscle contraction
Tetanization
Fatigue
BIOCHEMISTRY Vitamin D
Calcium metabolism & associated metabolic Disorders
Bone as mineralized tissue
Synthesis of major fibrous proteins
Glycolysis
Citric acid cycle

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Glycogen metabolism
Gluconeogenesis
Fatty acid oxidation
Nucleotide metabolism-I
Nucleotide metabolism-II
Nucleotide metabolism-III
Uric acid estimation
Estimation of alkaline phosphatase
PATHOLOGY Pathologic calcification
Adaptive changes. atrophy and hypertrophy
Adaptive changes. Hyperplasia and metaplasia
RADIOLOGY Normal imaging attributes of the respiratory system

INTRODUCTION/ This module has been designed to unfold the structural organization,
RATIONALE functions, and congenital anomalies of musculoskeletal system. It
explains the mechanism of neuromuscular transmission, its
biochemical basis and the importance of Ca++ in the body. It also high
lights structure and function of joints in upper and lower limb.
It also highlights identification of common fractures of long bones on
radiograph. Teaching methodology includes lectures, PBL as a tool
where appropriate, SGD and demonstrations on models and dissection
of the limbs along with teaching in Histology labs to enable the
students to recognize different types of muscle and bone tissue under
microscope.
MODULE At the end of this module the student should be able to :
OUTCOMES KNOWLEDGE:
1. Explain the structure & development of MS.
2. Explain the physiological anatomy, biochemistry affecting the
functions of MS.
3. Apply the knowledge of the basic sciences to understand
pathophysiology of common fractures.
SKILL:
1. Dissect limbs to demonstrate their gross Anatomy and

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relationship to each other.

2. Identify histological features of parts of MS under microscope
3. Perform practicals on nerve and muscle preparation.
ATTITUTE:
1. Demonstrate effective communication skill strategies to
communicate with patients
2. Demonstrate a professional attitude, team building spirit and
good communication skills

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UNIT I. UPPER LIMB

PBL 1. Radial nerve injury
TOPIC DISCIPLINE LEARNING OBJECTIVES LEARNING
STRATEGY
BONE AS Biochemistry  Describe bone as a mineralized tissue.
Interactive
MINERALIZED  List the principal proteins found in bone.
TISSUE lecture
HISTOLOGY OF Anatomy  Describe the histological features of bone.
Interactive
BONES  Describe histological changes in bone in osteoporosis,
lecture
rickets and osteomalacia.
CLAVICLE Anatomy  Identify important bony land marks of clavicle
Skill lab
 Identify the attachment of clinically important muscles
 Identify the attachment of clinically important
ligaments
 Identify common sites of fracture of clavicle with the
help of radiographs
DEVELOPMENT OF Anatomy  Describe the development of bones and cartilage
BONES AND Interactive
in the limb.
CARTILAGE IN THE lecture
 Explain the difference between intramembranous
LIMBS
and endochondral ossification with examples
 Enlist common anomalies associated with
development.
CLASSIFICATION Anatomy  Classify joints giving examples according to
OF JOINTS Interactive
 Structure
 Function
lecture
 Movements
 Describe the components of joints along with their
clinical importance.
SCAPULA Anatomy  Identify important bony land marks of scapula
Skill lab
 Identify the attachment of clinically important muscles
 Identify the attachment of clinically important
ligaments
 Identify the common sites of fracture of scapula on
radiographs correlating its predisposition to fracture
VITAMIN D Biochemistry  Describe the metabolism and regulation of vitamin D Interactive
 Describe the biochemical functions of vitamin D and the Lecture
deficiency diseases associated with it.
SCAPULAR REGION Anatomy  Perform dissection to identify main muscles of scapular
Skill lab
region along with their nerve supply
CALCIUM Biochemistry  Describe the regulation, release and the functions of
METABOLISM & Interactive
parathormone
ASSOCIATED lecture
 Describe the release and the function of calcitonin
METABOLIC
 Describe the role of these in regulating the calcium
DISORDERS
metabolism
HISTOLOGY OF Anatomy  Describe the histological features of cartilage.
Interactive
CARTILAGE  Describe the histological changes in cartilage in
lecture
degenerative diseases

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SYNTHESIS OF Biochemistry  Describe the types, structure and steps of synthesis of

MAJOR collagen.
FIBROUS PROTEINS  Describe the structure of elastin. 2
 List the diseases that result from the defective Interactive
metabolism of collagen (Ehlers-Danlos syndrome, lectures
osteogenesis imperfect)
 Describe the role of α- antitrypsin in eslastin
degradation and defects in the Marfan’s syndrome.
 Enlist the major differences between collagen and
elastin.
HUMERUS Anatomy  Identify important bony land marks of humerus
Skill lab
 Identify the attachment of clinically important muscles
 Identify the attachment of clinically important
ligaments
 Identify common sites of fracture of humerus with the
help of radiographs
VIT D & VIT C Pathology  Effects of vit D and C deficiency on musculoskeletal SGD
DISORDERS system
HISTOLOGY OF Anatomy  Identify the type of bone on given slides under
BONES Skill lab
microscope.
 List two points of identification
 Draw labelled diagram of the identified structures on
the histology notebooks
DETERMINATION Biochemistry  Describe the principle of Serum ALP Skill lab
OF SERUM ALP  perform the procedure of Serum ALP
 calculate the serum alkaline phosphatase level
 Learn the clinical significance of ALP
PECTORAL AND Anatomy  Enumerate the muscles of pectoral region.
SGD
SHOULDER REGION  Explain the actions of pectoral muscles in relation to
their origin, insertion and nerve supply.
 Enumerate the arteries and veins of pectoral region.
 Describe the movements of
 Deltoid
 Pectoralis major
 Pectoralis minor
 Serratus anterior
 Trapezius
 Describe features of Paralysis of
 Serratus Anterior
 Deltoid
 rotator cuff muscles
BRACHIAL PLEXUS Anatomy  Describe formation of brachial plexus Interactive
 Enumerate nerves originating from lecture
 Cords
 Roots
 Trunks
 Describe injuries to inferior parts of the brachial
plexus (Klumpke paralysis)

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 Describe injuries to superior parts of the brachial

plexus (Erb-Duchenne palsy)
PATHOLOGIC Pathology  Define pathologic calcification Interactive
CALCIFICATION  Describe causes of pathologic calcification lecture
 Differentiate between metastatic and dystrophic
calcification
 Describe pathogenesis of pathologic calcification with
clinical relevance
MUSCLES OF ARM Anatomy  Perform dissection to identify main muscles of arm Skill lab
along with their nerve supply.
AXILLA Anatomy  Describe boundaries of axilla Skill lab
 Describe contents of axilla
 Describe Injury to the Axillary Vein and artery
 Describe enlargement of Axillary Lymph Nodes in
context of CA breast
NERVES OF ARM Anatomy  Describe formation of axillary and musculocutanous Interactive
nerve lecture
 Describe distribution of nerve
 Describe clinically important relations.
 Describe the anatomical sites of leison of nerve
correlating them to sensory and motor loss within area
of distribution.
ADAPTIVE Pathology  Define the terms Interactive
CHANGES.  Atrophy lecture
ATROPHY AND  Hypertrophy
HYPERTROPHY
 Enlist causes of atrophy with clinical examples
 Describe mechanisms of atrophy at cellular level
 Enlist types/ causes of hypertrophy with clinical
examples
 Describe mechanism of hypertrophy at cellular level
 Differentiate between physiologic and pathologic
hypertrophy.
SHOULDER JOINT Anatomy  Identify various muscles which help in scapular
Skill lab
movements.
 Identify clinically important ligaments of shoulder joint
 Identify the movements of shoulder joint
 Describe anatomical structures involved in dislocation
of shoulder joint
CHARACTERISTICS Physiology  Describe the following characteristics of
OF SKELETAL Interactive
 Skeletal muscle
MUSCLE  Muscle mass Lecture
 Muscle fiber
 Myofibril
 Define and explain sarcomere in skeletal muscle
 Describe the function of contractile element of muscle
 Describe the (Proteins) sarcotubular system
ADAPTIVE Pathology  Define the terms
CHANGES. Interactive
 Hyperplasia

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HYPERPLASIA AND  Metaplasia lecture

METAPLASIA  Enlist types of hyperplasia with clinical examples
 Differentiate between physiologic and pathologic
hyperplasia
 Describe mechanism of hyperplasia at cellular level
 Enlist causes of metaplasia with clinical examples
 Describe mechanism of metaplasia
 Describe clinical significance of metaplasia
RADIUS Anatomy  Identify important bony land marks of radius Skill lab
 Identify the attachment of clinically important
ligaments
CHARACTERISTICS Physiology  Describe the distribution of smooth muscle SGD
OF SMOOTH &  Discuss the characteristics of types of smooth muscles
CARDIAC MUSCLE
 Relate these characteristics to the functions of smooth
muscle
 Describe the characteristics of cardiac muscle
 Compare the characteristics of Skeletal, Smooth and
Cardiac muscles,
HISTOLOGY OF Anatomy  Explain the histological features of Interactive
MUSCLES  Skeletal muscle lecture
 Cardiac muscle
 Smooth muscle
HISTOLOGY OF Anatomy  Identify the type of cartilage on given slides under Skill lab
CARTILAGE microscope.
 List two points of identification
 Draw labelled diagram of the identified structures on
the histology notebooks
NERVE MUSCLE Physiology  To study kymograph and components of nerve muscle Skill Lab
PREPARATION preparation
MORPHOLOGY OF Pathology  Muscle atrophy Skill lab
ADAPTATIONS  Muscle hyper trophy
 Calcifications
ULNA Anatomy  Identify important bony land marks of ulna Skill lab
 Identify the attachment of clinically important muscles
 Identify the attachment of clinically important
ligaments
 Identify the common sites of fracture of ulna on
radiographs correlating its predisposition to fracture
DEVELOPMENT OF Anatomy  Describe the development of muscles. Interactive
MUSCLES  Enlist common anomalies lecture
RESTING Physiology  Define resting membrane potential (RMP) Interactive
MEMBRANE  Describe the physiological basis of RMP Lecture
POTENTIAL
ACTION POTENTIAL Physiology  Define action potential in a nerve fiber Interactive
IN NERVE FIBER  Describe the different phases of action potential in Lecture
nerve and muscles
PROPAGATION OF Physiology  Describe the features of propagation of action potential Interactive
ACTION POTENTIAL in myelinated and unmyelinated nerve fiber Lecture

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 Define saltatory conduction

 Describe the mechanism of saltatory conduction
VESSELS IN ARM Anatomy  Describe the extent of axillary artery ,ulnar and radial Interactive
arteries lecture
 Describe branches of arteries of arm.
 Describe the anatomical sites of lesion of artery
correlating them to ischemia within area of distribution.
MUSCLES OF Anatomy  Identify main muscles of anterior compartment of Skill lab
ANTERIOR forearm on given modal of upper limb
COMPARTMENT OF  Identify muscles forming boundaries of cubital fossa
FOREARM AND
 Identify contents of cubital fossa.
CUBITAL FOSSA
MUSCLES OF Anatomy  Perform dissection to Identify main muscles of Skill lab
POSTERIOR posterior compartment of forearm
COMPARTMENT OF  Identify the main blood vessels of posterior
FOREARM
compartment.
 Relate the location of radial artery with its clinical
significance.
ACTION POTENTIAL Physiology  Compare the different phases of action potential in: Interactive
IN MUSCLES  Skeletal muscle Lecture
 Smooth muscle
 Cardiac muscle
ELBOW JOINT Anatomy  Identify important ligaments of ankle joint on given Skill lab
model.
 Correlate the muscle attachment with various
movements of joint
 Enumerate nerve supply and blood supply of joint
 Explain the anatomical significance of carrying angle
 Discuss anatomical structures involved in Subluxation
and Dislocation of the Radial Head
NEUROMUSCULAR Physiology  Describe the components of neuromuscular junction Interactive
TRANSMISSION  Describe the mechanism involved in neuromuscular Lecture
transmission
 Describe the pathophysiological basis of Myasthenia
gravis
FASCIA OF UPPER Anatomy  Describe the fasciae in the upper limbs (including Interactive
LIMB retinacula) lecture
 Describe the fascial spaces of upper limbs.
 Enumerate the structures passing under and superficial
to each retinaculum.
 Describe their clinical relevance to compartment
syndrome
SIMPLE MUSCLE Physiology  Recording of Simple Muscle twitch in Gastrocnemius Skill lab
TWITCH sciatic nerve preparation.
HISTOLOGY OF Anatomy  Identify the skeletal, smooth and cardiac muscles under
MUSCLE the microscope
 Draw and label the diagrams along with two points of
identification for each.
RADIAL NERVE Anatomy  Describe formation and distribution of radial nerve SGD

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 Describe clinically important relations of radial nerve.

 Discuss sensory and motor loss associated with wrist-
drop
MOLECULAR BASIS Physiology  Describe the sequence of events of muscle contraction Interactive
OF SKELETAL  Describe the walk along theory (sliding filament) and Lecture
MUSCLE relate it to the molecular events during muscle
CONTRACTION
contraction
GLYCOLYSIS Biochemistry  Describe the metabolic sources of ATP in muscle Interactive
contraction lecture
 Describe the role of ATP in muscle contraction.
 Describe the pathway and the regulation of
aerobic/anaerobic glycolysis.
 Describe the process of lactic acidosis in exercising
muscle and ischemia.
ARTICULATED Anatomy  Enumerate the bones of hand. SGD
HAND AND  Describe functions of muscles in
MUSCLES OF HAND
 thenar compartment hypothenar compartment.
 Describe the fibrous of sheaths of the digits of the hand
 Discuss the anatomical structures involved in
Tenosynovitis
CITRIC ACID CYCLE Biochemistry  Describe the role of citric acid cycle in the provision of Interactive
energy in muscle contraction. Lecture
 Describe the Relation of pyruvatedehydrogenase
deficiency and congenital lactic acid
BLOOD SUPPLY OF Anatomy  Describe the formation of superficial and deep palmar Interactive
HAND arches in hand Lecture
 Compare the contribution of ulnar and radial arteries
for formation of arches
 Describe the structures involved in laceration of Palmar
Arches
 Describe boundaries and contents of fascial spaces of
palm
WRIST JOINT Anatomy  Enumerate the clinically important ligaments of wrist Skill lab
joint
 Enumerate the movements of joint
 Enumerate nerve supply and blood supply of joint
 Identify facial retinacula on anterior and posterior
surface of wrist joint.
 Enumerate the structures passing superficial and deep
to flexor and extensor retinaculum.
GLYCOGEN Biochemistry  Describe glycogenesis and glycogenolysis for the Interactive
METABOLISM synthesis of ATP during muscle contraction. Lecture
 Describe their regulation.
 Name the glycogen storage disorders along with their
enzymes.
MEDIAN NERVE Anatomy  Describe formation and distribution of median nerve SGD
 Describe clinically important relations of median nerve.
 Discuss the effects of lesion of nerve at forearm and

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wrist
 Disuss anatomical structures involved in carpal tunnel
syndrome
GLUCONEOGENESIS Biochemistry  Name the carbohydrate sources for gluconeogenesis. Interactive
 Describe the pathway of gluconeogenesis, its enzymes Lecture
and coenzymes.
 Describe the reversible steps of gluconeogenesis.
FATTY ACID Biochemistry  Describe the process of fatty acid β-oxidation for the Interactive
OXIDATION production of ATP and its clinical significance. Lecture
 Describe the energy yield from oxidation of fatty acids
VENOUS AND Anatomy  Describe the formation of basilic vein Interactive
LYMPHATIC  Describe the formation of cephalic vein lecture
DRAINAGE OF
 Describe the location of median cubital vein
UPPER LIMB
 Describe the areas of drainage of above veins
 Discuss the importance of median cubital vein for
venipuncture
ULNAR NERVE Anatomy  Describe formation and distribution of ulnar nerve SGD
 Describe clinically important relations of ulnar nerve.
 Discuss the sensory and motor loss associated with
lesion of nerve.

BLOCK II. BACK AND LOWER LIMB

PBL 2: BACKACH

PBL 3. KNEE JOINT INJURY

VERTEBRAE Anatomy  Identify bony features of all vertebrae forming 2 Skill lab
vertebral column.
 Distinguish between typical and atypical vertebrae
DEVELOPMENT OF Anatomy  Describe the development of vertebral column. Interactive
VERTEBRAL  Enumerate the developmental anomalies. lecture
COLUMN
EXCITATION Physiology  Describe the role of following in excitation Interactive
CONTRACTION  Contraction coupling Lecture
COUPLING  Sarcolemma
 Transverse tubules
 Sarcoplasmic reticulum
 Calcium ions
 Describe the phenomenon of rigor mortis
SMOOTH MUSCLE Physiology  Describe the physical basis of smooth muscle SGD
CONTRACTION contraction
VERTEBRAL Anatomy  Describe the gross anatomy of vertebral column. 2 Interactive
COLUMN  Describe various curves of vertebral column lectures
 Enumerate muscles of back.
 Describe the development of vertebral column
 Enlist anomalies of development

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MUSCLE Physiology  Describe the sources of energy for muscle Interactive

ENERGETICS contraction Lecture
 Describe the characteristics whole muscle
contraction
 Describe the following type of fibers:
 Fast fibers
 Slow fibers
HIP BONE Anatomy  Identify important bony land marks of hip bone Skill Lab
 Identify the attachment of clinically important
muscles
 Identify the attachment of clinically important
ligaments
 Identify the common sites of fracture of hip bone on
radiographs correlating its predisposition to fracture
TWO SUCCESSIVE Physiology  Compare the isomotic and isotonic contractor Skill lab
STIMULI ON NERVE  Recording the effect of two Successive stimuli on
MUSCLE nerve muscle preparation
PREPARATION
CHARACTERISTIC OF Physiology  Describe the strength, power and endurance of SGD
MUSCLE DURING muscle during exercise
EXERCISE  Describe the different types of muscle metabolic
system in exercise
 Describe the nutrients used during muscle activity
 Effect of athletetic training on muscle and muscle
performance
FEMUR Anatomy  Identify important bony land marks of femur Skill lab
 Identify the attachment of clinically important
muscles
 Identify the attachment of clinically important
ligaments
 Identify the common sites of fracture of femur on
radiographs correlating its predisposition to fracture
GLUTEAL REGION Anatomy  Identify Muscles of gluteal region on modal of lower Skill lab
limb.
 Identify the proper site for intramuscular injection
on modal.

LUMBOSACRAL Anatomy  Describe formation and distribution of lumbar Interactive

PLEXUS plexus. Lecture
 Describe formation and distribution of sacral plexus.
 Describe effects of lesion of branches of sacral
plexus.
NUCLEOTIDE Biochemistry  Describe the synthesis and regulation of purines. Interactive
METABOLISM-I  Describe how sulfonamide inhibits the bacterial Lecture
purine synthesis.
 Describe the importance of formyltransferase step in
the treatment of cancer
 Describe the role of purine salvage pathway in Lesch-
Nyhan syndrome.

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MEDIAL Anatomy  Identify muscles of the medial compartment of the Skill lab
COMPARTMENT thigh on given modal.
OF THIGH
ANTERIOR Anatomy  Identify muscles of the anterior fascial compartment Skill lab
COMPARTMENT of the thigh on given modal of lower limb.
OF THIGH
FEMORAL TRIANGLE Anatomy  Describe the boundaries of femoral canal and Interactive
FEMORAL CANAL femoral triangle. lecture
FEMORAL SHEATH  Describe the contents of femoral triangle and
femoral canal.
 Describe the course and distribution of femoral
artery.
 Describe the formation and importance of femoral
sheath
NUCLEOTIDE Biochemistry  Describe thepathway for Purine degradation Interactive
METABOLISM-II  Describe the involvement of adenine deaminase in Lecture
the production of Severe Combined Imunodeficiency
 Describe the mechanism involved in the production
of Gout
POSTERIOR AND Anatomy  Identify main muscles of the posterior facial Skill lab
LATERAL compartment of the thigh on given modal.
COMPARTMENT OF  Identify main muscles of the lateral fascial
THIGH
compartment of the thigh on given modal of lower
limb.
HIP JOINT Anatomy  Identify important ligaments of hip joint on given Skill lab
model.
 Correlate the muscle attachment with various
movements of joint
 Enumerate nerve supply and blood supply of joint
 Explain the importance of artery to the ligament of
the femoral head in Fractures of the Femoral Neck
 Explain the anatomical structures involved in
Dislocation of Hip Joint
NUCLEOTIDE Biochemistry  Describe the synthesis of pyrimidine. Interactive
METABOLISM-III  Describe oroticaciduria Lecture
 Describe the role of thymidylate synthase inhibitor in
treating tumors
 Describe the degradation of pyrimidine
FATIGUE Physiology  To study phenomenon of fatigue in a nerve muscle Skill lab
preparation.
NERVES OF THIGH Anatomy  Describe the origin, course and distribution of Interactive
 Sciatic nerve lecture
 Obturator nerve
 Femoral nerve
 Discuss anatomical structures damaged as a result of
improper technique of intragluteal injection
TIBIA Anatomy  Identify important bony land marks of tibia Skill lab
 Identify the attachment of clinically important
muscles

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 Identify the attachment of clinically important

ligaments
 Identify the common sites of fracture of tibia on
radiographs correlating its predisposition to fracture
URIC ACID Biochemistry  Describe the principle of uric acid estimation. Skill lab
ESTIMATION  Perform the procedure of uric acid estimation.
 Calculate the serum uric acid level
 Describe the clinical significance of serum uric acid
level in gout
FIBULA Anatomy  Identify important bony land marks of fibula Skill lab
 Identify the attachment of clinically important
muscles
 Identify the attachment of clinically important
ligaments
 Identify the common sites of fracture of fibula on
radiographs correlating its predisposition to fracture
KNEE JOINT Anatomy  Identify all intra and extra capsular ligaments of knee Skill lab
joint.
 Correlate the muscle attachment with various
movements of joint
 Enumerate nerve supply and blood supply of joint
 Explain the TCL and FCL injuries in atheletes.
TETANIZATION Physiology  To demonstrate the phenomenon of tetanization on Skill lab
nerve muscle preparation.
MUSCLES OF Anatomy  Identify main muscles in anterior and lateral Skill lab
ANTERIOR compartment of leg on given modal.
COMPARTMENT OF
LEG
MUSCLES OF Anatomy  Identify muscles of posterior compartment of the Skill lab
POSTERIOR leg on given modal.
COMPARTMENT OF
LEG
POPLITEAL FOSSA Anatomy  Describe the boundaries of popliteal fossa Interactive
 Enumerate contents of popliteal fossa lecture
 Describe the course and branches of popliteal artery.
 Describe the clinical significance of genicular
anastomosis
SUPERFICIAL AND Anatomy  Describe formation of peroneal nerve. SGD
DEEP PERONEAL  Describe distribution of peroneal nerve in the leg
NERVE and foot..
 Describe clinically important relations of peroneal
nerve.
 Discuss anatomical structures involved as a result of
injury to deep peroneal nerve
ARTICULATED FOOT Anatomy  Identify tarsal bones. Skill lab
AND MUSCLES OF  Identify Metatarsus.
FOOT
 Identify Phalanges.
 Identify articulations between individual tarsal bone.
 Perform dissection to identify main muscles of foot

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 MUSCULOSKELETAL-I MODULE INTEGRATED CURRICULUM

along with their nerve supply

ARCHES OF FOOT Anatomy  Enumerate arches of foot. Interactive
 Describe the components of arches of foot lecture
 Describe clinical importance of arches in walking.
ANKLE JOINT Anatomy  Identify important ligaments of ankle joint on given Skill lab
model.
 Correlate the muscle attachment with various
movements of joint
 Enumerate nerve supply and blood supply of joint.
 Identify the facial retinacula attached in the ankle
region
 Explain the anterior talofibular ligament injuries
NORMAL IMAGING Radiology  List the different types of medical imaging studies for Interactive
ATTRIBUTES OF THE examining the musculoskeletal system. lecture
MUSCULOSKELETAL  Describe commonly employed radiographic positions
SYSTEM
and imaging techniques used for examining the
musculoskeletal system structures.
 Recognize the radiological / imaging anatomy visible
on given diagnostic image, including common
normal variants and children of all ages.
IMAGING OF UPPER Anatomy  Identify the bony landmarks on AP and lateral view Skill lab
AND LOWER LIMB of X rays
FASCIA OF LOWER Anatomy  Describe the fasciae in the lower limbs (including Interactive
LIMB retinacula) lecture
 Describe the fascial spaces of lower limbs.
 Enumerate the structures passing under and
supercial to each retinaculum.
 Describe their clinical relevance to compartment
syndrome
SURFACE MARKING Anatomy  Mark the major vessels of upper and lower limb on Skill lab
the given subject
 Mark the major nerve of upper and lower limb on
the given subject
VENOUS AND Anatomy  Describe the formation of dorsal venous arch Interactive
LYMPHATIC lecture
 Great saphenous vein
DRAINAGE OF
LOWER LIMB  Small saphenous vein
 Describe the distribution of deep veins
 Describe the anatomical structures involved in
varicose veins,
 Thrombosis
 Thromboembolism
 Describe the use of saphenous vein in saphenous
vein grafts
 Describe the distribution of superficial lymphatic
vessels deep lymphatic vessels.
CUTANEOUS NERVE Anatomy  Describe the cutaneous nerve supply of upper limb SGD
SUPPLY  Describe the cutaneous nerve supply of lower limb
OF UPPER

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 MUSCULOSKELETAL-I MODULE INTEGRATED CURRICULUM

AND LOWER LIMB

EFFECT OF Physiology  Recording the effect of temperature on muscle Skill lab
TEMPERATURE ON contraction.
MUSCLE
CONTRACTION
TOTAL HOURS OF TEACHING:

Subjects Knowledge Skill Total in

subjects
Interactive SGD SGA PBL Skill Lab
lecture

Anatomy 24 12 - 6 (Hrs) 30 72

Physiology 9 3 - - 06 18

Biochemistry 11 - - - 2 13

Pathology 3 - - - - 03

TOTAL Hours 47 15 - 6 38 106

of Module
LEARNING RESOURCES

DECIPLINE Reference Book(s)

ANATOMY  Regional anatomy by Snell

 Snell Neuroanatomy
 Histology by Laiq Hussain
 Embryology by Langmans
PATHOLOGY  Pathologic Basis Of Disease 9th Edition by Robbins And Cotran

BIOCHEMISTRY  Review of Medical Microbiology and Immunology by Warren Levinson

(Microbiology) 12thedition.
 Lippincott’s Illustrated Review on Microbiology (2thedition).

th
PHYSIOLOGY Text book of Medical Physiology by Guyton & Hall 13 ed

th
Essentials of Medical Physiology, Jaypee, 6 Edition

th
Human Physiology, Author Sheerwood, 8 Edition
 Introduction to Psychology by Edward E. Smith

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