Download KUHS (Kerala University of Health Sciences) MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st Year Human Physiology Syllabus
(I) GOAL
The broad goal of the teaching of undergraduate students in physiology aims in
providing the student, a comprehensive knowledge of the normal functions of the
organ systems of the body and their interactions to facilitate understanding of the
physiological basis of health and changes in disease.
(II) LEARNING
OBJECTIVES A.
Knowledge
At the end, a medical student in Physiology should be able to explain:
(a) Functions of organ systems in a normal subject.
(b) Contribution of organ systems and their integration in maintenance of homeostasis
(c) Altered physiology on exposure to stress, and during disease process
(d) Compare the normal and abnormal data; interpret the same to assess health status
(e) Physiological principles underlying pathogenesis and treatment of disease.
(f) Reproductive physiology as relevant to National Family Welfare programme
(g) Basic laboratory investigations relevant for a rural set up
(h) Concept of professionalism
(i) Approaches to the patient with humanity and compassion
B. Skills
At the end of the course the student shall be able to
(a) Conduct experiments designed for study of physiological phenomena
(b) Interpret experimental / investigative data
(c) Distinguish between normal and abnormal data derived as a result of tests which
he/she has performed and observed in the laboratory
C. Integration
At the end of the integrated teaching, the student shall acquire an integrated
knowledge of organ structure and function and its regulatory mechanisms.
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(III) DETAILED SYLLABUS
DETAILS OF THE COURSE
Duration of the course: 2 semesters
Total number of hours: 480
Lectures: 160 Practical: 120
Innovative session (Projects, seminars, structured discussion, integrated
teaching, formative evaluation and revision: 200
DETAILS OF CLASSES IN PHYSIOLOGY
GENERAL PHYSIOLOGY
3 hrs
Introduction to Physiology, Principles of Homeostasis, Transport Mechanism,
Intercellular communication. Body fluid compartments- divisions, composition,&
determination(mention Fick's Principle)Blood volume-normal value, abnormalities-
Hypervolemia & Hypovolemia.
HEMATOLOGY
21 hrs
Introduction
1hr
Blood - Functions, composition, Properties ? specific gravity, viscosity ? definition,
normal values & variations
Plasma proteins:
1hr
Types, Quantity, Functions, AG ratio- Importance to be given for functions -
Abnormal
proteins to be dealt in biochemistry
Red Blood Cells
1hr
Morphology, composition and functions, normal RBC count and variations-------
Properties ? to be dealt in practical's
Haemoglobin
1hr
outline only normal basic structure, normal content, functions, types (Hb A, Hb A2 and
Hb
F) abnormal Hbs (only two - Thalassemias & Haemoglobin S ? mention only
details in Biochemistry)
Erythropoiesis
1hr
Sites (intra and extra uterine) different stages, Factors influencing & regulating
Erythropoiesis Life Span of RBC and its destruction (outline), jaundice (mention ?
details in Biochemistry).
Anaemias
1hr
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definition, classifications (etiological, morphological), physiological basis of
anaemias (briefly), iron deficiency anaemia, Pernicious anaemia, aplastic
anaemia, Hemolytic anaemia (briefly), Polycythemia- primary and secondary
White Blood Cells:
4hrs
Classification, morphology (details in practical classes), lifespan Properties and
functions ? Neutrophil, Eosinophil, Basophil, Monocyte, Lymphocyte. Normal total
and differential count (methods in practicals), variations Leucocytosis, Leucopenia,
leukaemia (definition, mention difference from leucocytosis), agranulocytosis
Immunity
1hr
Definition, Types ? innate and acquired, Humoral and cellular Mechanisms of
immune response, plasma cell, immunoglobins, autoimmune disorders, AIDS
(mention).
Reticulo endothelial system
?hrs
Platelets:
1 hr
Morphology, properties and functions, normal count, variations,
thrombopoesis, and factors influencing this
Haemostasis
4 hrs
Primary (vasospasm, platelet plug formation) and Secondary (extrinsic and
intrinsic mechanisms of coagulation of blood) Clot retraction (mention)
Anticlotting mechanisms in vivo -factors that limit clot formation (Protein C, Protein
S and antithrombin III) and fibrinolytic system (all in brief).
Anticoagulants ? used in lab and in vivo. Bleeding disorders Purpura, Hemophilia,
Vitamin K deficiency Tests for bleeding disorders ? bleeding time, clotting time (in
practicals).
Prothrombin time and PTT (principles only) Thrombosis and Embolism ? mention
Blood volume - Normal volume, abnormalties, hypervolemia & hypovolemia (mention)
Blood groups
2 hrs
ABO and Rh systems, inheritance, differences, Bombay group, Landsteiner's laws I
and II Mention about Bombay blood group, no need of other minor blood groups
Blood grouping and cross matching (importance), concept of universal donor and
recipient
ABO and Rh incompatability ? important manifestations, erythroblastosis foetalis.
Management and preventive measures, Medicolegal and clinical importance (briefly)
Blood banking and transfusion
1 ?hrs
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Blood transfusion ? indications, precautions and complications
Blood Banking ?anticoagulants used, storage, changes during storage ? Lymph ?1 hr
formation, circulation, functions
Tissue fluid ? formation, circulation and functions Starling's hypothesis ? edema
formation
2 hrs
Seminars/tutorials
INTEGRATED TEACHING
6 hrs
1.Pathology dept
Anaemia blood smear ?Normal and abnormal -1hour
2. Transfusion medicine department
Transfusion of blood components ? with special reference to recent
advances, Modern trends in blood banking -1 hour
2. Microbiology department
Immune mechanisms -1hour
CARDIOVASCULAR SYSTEM
LECTURES
26 hrs
Functional anatomy of heart and blood vessels Chambers, valves, great
vessels, Systemic
and pulmonary circulations Properties of cardiac muscle, Excitability,
rhythmicity, conductivity, contractility, to review only as it is dealt in
NMP
1hr
Conducting system of heart, parts of conducing system, origin and spread of
cardiac
1hr
impulse, abnormal pacemakers, conduction defects
Cardiac cycle:
5hrs
Definition, phases, events of cardiac cycle Pressure changes ? Atria, Jugular
vein (mention clinical significance). Ventricles ? right and left, Aorta and
Pulmonary artery, Volume changes ? in different chambers. Heart sounds ?
causes, character, murmur (definition, physiological basis)
Arterial Pulse - genesis and characters of normal pulse
Common abnormalities? to be dealt in practical classes
Venous blood flow-Venous tone, valves
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ECG
2hrs
Definition, Principles of recording of ECG (details in practical) Leads ? unipolar and
bipolar, commonly used 12 Leads,Normal tracing in Lead II ? normal waves, intervals
and segments, how HR is determined, correlation with action potential and phases
of cardiac cycle,
Correlation between different events of cardiac cycle ? (diagrammatic representation)
Clinical uses of ECG ? (mention).
(Abnormal ECG pattern in myocardial infarction, cardiac arrhythmias . Effect of
changes in ECF K+, Ca++ and Na+ conduction defects to be dealt in practical)
Cardiac output:
5 hrs
Definition, normal values, variations Fick's principle ? mention (Methods & other
methods of measurement details not required) . Regulation of cardiac output ? heart
rate - Regulation of heart rate, stroke volume ? determinants, regulation
Hemodynamics:
2hrs
General principles including physical laws governing flow of blood in heart and
blood vessels not in detail)-Pressure ? resistance - flow relationship, Poiseuille-
Hagen formulae, law of Laplace Laminar flow, turbulent flow, Reynold's number,
critical closing volume Importance of peripheral resistance, venous circulation,
venous tone to be dealt with blood pressure. Regulation of blood flow
Structure & function of different segments of blood vessels. Correlate with
function, local regulation including autoregulation of blood flow, vasoconstrictors
and vasodilators,substances secreted by endothelium.
Arterial Blood pressure:
3hrs
Systolic and diastolic pressures? definition, normal values, variations Define end
pressure and lateral pressure, Bernoul i's principle (mention) Pulse pressure, Mean
arterial pressure
- definition, normal values Determinants of Systolic and diastolic
pressures Measurement? details in practical class
Regulation - neural and humoral.( short term, intermediate and long term)
Cardiovascular reflexes, Local regulation including auto regulation of blood flow,
vasoconstrictors and vasodilators, substances secreted by endothelium (important
ones)
Effects of gravity, Posture and Exercise on B.P Hypertension & hypotension in practicals
Regional circulation:
3hrs
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Coronary, cerebral, capillary, cutaneous, splanchnic circulation
Fetal, pulmonary, renal to be taught in respective system
Circulatory shock
1hr
Types pathophysiology, stages, compensatory mechanisms
Cardio-vascular & Respiratory adjustments in
1hr
health ?effect of gravity (+ve and ?ve),
weightlessness (brief)
Effect of exercise
2hrs
To be dealt after both Respiratory & CVS is over -Refer Respiratory system
Seminar/Tutorials
2hrs
Integrated teaching
2hrs
ECHO, Abnormal ECG and Cardiac catheterization
RESPIRATORY SYSTEM
LECTURES 16hrs
Introduction
1hr
Define respiration ,Organisation and functional anatomy of respiratory system
Tracheobronchial tree, Respiratory unit, Alveoli (structure and functions), Pleura,
pleural fluid Functions of different parts of respiratory system including non-
respiratory functions
Mechanics of respiration:
2hrs
Inspiration and expiration, muscles of inspiration and expiration and their actions,
Pump handle and bucket handle movements, expansion of thorax and lungs, Types
of breathing Pressure changes during normal respiratory cycle ? intra (alveolar)
pulmonary and intra thoracic (alveolar) pressure changes, development of negative
intra thoracic pressure
Surfactant ? functions (surface tension, alveolar stability, alveoli kept dry,
interdependence of alveoli), hyaline membrane disease, ARDS Law of laplace ?
application
Measurement of pulmonary ventilation
2hrs
Spirometry in practicals
Lung volumes (mention) static & dynamic lung volumes TV, IRV, ERV, RV, VC TLC, FEV,
FRC
? Residual volume (measurement not needed) RMV, MVV, breathing reserve,
closing volume (mention) to be dealt with practicals Ventilation ? pulmonary and
alveolar Dead space ? Anatomical & Physiological- definition, normal values,
variations (1-2 eg) (Measurement not needed)
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Pressure ? volume relationship -
1 hr
Elastic behaviour of lungs, total and lung compliance ? normal values Airway
resistance, work of breathing (brief outline ?it is to overcome elastic, nonelastic
and airway resistance), factors affecting bronchial tone, 1-2 conditions where
work of breathing is increased
Pulmonary blood flow: -
1 hr
Volume, pressure, factors influencing ? nervous and chemical factors, unique
features. Variations in regional pulmonary blood flow, ventilation ? perfusion
ratio and its importance
Pulmonary exchange of gas & Mechanism -
2hrs
Composition of inspired air, expired air, partial pressures gas composition of Arterial
& venous blood,. Structure of blood gas barrier, factors affecting diffusion across
respiratory Membrane diffusion capacity for O2 & CO2, O2 transport in
blood,oxygenation of Hb, O2 carrying capacity, O2 content, % saturation, coefficient
of O2 utilization, Properties of Hb that facilities O2 transport O2 dissociation curve,
factors shifting curve to right and left, P50 foetal Hb, Myoglobin, carboxy Hb?
CO2 transport in blood
1 hr
Different forms of transport, chemical reactions involved, changes occurring in
lungs Haldane and Bohr effect -
Regulation of respiration:
3 hrs
Neural control ? neural centers, genesis of respiratory rhythmicity, ramp signal
(experimental evidence not required), Voluntary control, Reflex control Breath
holding and braking point. Chemical control ? stimuli, chemoreceptors (peripheral
and central), ventilatory response to hypercapnea, hypoxia and change in H+ ion
concentration.
Hypoxia:
- 1hr
Definition, types, clinical features, Oxygen therapy - Cyanosis, asphyxia and dyspnea,
Definition, CO poisoning (mention),Periodic breathing Cheyne ? stokes and biots
breathing, voluntary hyperventilation
Environmental Physiology:
1hr
High altitude, rapid ascent, Mountain sickness, Acclimatization Effects of UV
rays, Dysbarism
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Effects of increased barometric pressure
1hr
Seminar/Tutorials
4hrs
Nitrogen narcosis, High pressure nervous syndrome, Oxygen toxicity
Decompression sickness (Caissons disease) Cardiovascular &Respiratory changes
during exercise - Space physiology ,effect of "G" forces on respiratory system
INTEGRATED TEACHING
4hrs
Artificial respiration( delete Holger Neilson method) CPR with Mannequien
Pulmonary function tests to be dealt in practicals & include in record .
GASTROINTESTINAL SYSTEM
LECTURES -12
Introduction to G.I. Physiology :
1 hr
General organization of G.I. tract Neural control of G.I function Enteric
nervous system, Autonomic control Mechanism of enzyme secretion by
glands in general.
Salivary Gland:-Saliva compositition, function, control of secretion.
1 hr
Conditioned and unconditioned reflexs disturbances in salivary secretion-in
anxiety and dehydration
Gastric Secretion:- Gastric ujice: Composition, functions. gastric
H
CL
3 hrs
secretion-mechanism and regulation of secretion. Gastric juice-functions,
phases of secretion and regulation. Gastrin-functions and regulation of
secretion. Mucosal barrier, pathophysiology of peptic ulcer in breif
Pancreas , Liver and gall bladder
2 hrs
Exocrine Pancreas; Pancreatic juice: Composition, function, and regulation
of secretion (neural and humoral ? CCK and secretin)-applied importance
(mention steatorrhoea)
. - Functions of Liver,Composition and functions of bile, control of secretion
Functions of gall bladder, filling and emptying of gall bladder Enterohepatic
circulation, Jaundice ? prehepatic, hepatic and post hepatic in brief
Small intestine.
1hr
Composition, regulation of secretion, and functions of intestinal juice Small
intestine Functions-
Large intestine
1 hr
Functions ? secretory, motor, absorptive, synthesis of short chain fatty acids.
Movements of G.I. tract. -
1hr
Movements to be taught in respective segments of GIT
Electrophysiology of smooth muscle in the GIT (revise) ? BER, MMC. Peristalsis ?
definition, basis, functions. Mastication ? definition, muscles involved, functions
Deglutition ? definition, muscles involved, stages functions & abnormalties 1hr
Gastric motility ? types, regulation, abnormal movements Gastric emptying ?dura tion,
factors affecting vomiting.
1hr
Movements of small intestine& Large intestine- Types with reference to BER
mixing, pendular, movements of villi and peristalsis.
Defecation reflex, Diarrhoea, Role of dietary fibre, bacterial flora
1hr
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Seminar/tutorials
4hrs
Gastro intestinal hormones
Assignment
4hrs
(Gastrin, CCK-PZ, Secretin, Villikinin, VIP, GIP)
INTEGRATED TEACHING
2hrs
Liver and biliary system (depts of physiology, anatomy,
biochemistry and internal medicine
RENAL SYSTEM
LECTURES 10 hrs
Introduction-
1hr
Functions of kidney ? homeostasis, as an endocrine organ Functional anatomy of
Kidney Nephron-structure, parts, function, types (in detail)
Renal circulation - Normal flow, regulation, peculiarities, and principle of measurement ?
Juxtaglomerular apparatus. Site, structure, function.
Glomerular filtration:
2hrs
Definition, rate, filtration membrane, forces governing filtration and permeability
of the membrane, measurement of GFR Clearance values ? definition, values for
glucose, insulin, and urea
Tubular functions:
1 hr
Tubular reabsorption ? define Sodium, glucose, water, urea, electrolytes - sites,
mechanisms involved Tubular maximum, Glomerulo tubular feedback, and Renal
threshold ,Water - reabsorption in different segments ? obligatory and facultative
Tubular secretion ? H+ (acidification), K+ Filtered load, -
Acidification of urine & Role of kidney in acid base balance
1hr
Mechanisms and sites of H+ secretion, pH changes along renal tubules, fate of H+ in
the renal tubule (buffer systems), non-ionic diffusion. ?
Concentration of urine
2hrs
Counter current system ? multiplier, exchanger Cortico medullary gradient ? factors
maintaining (ADH, permeability characteristics of renal tubule, role of urea and vasa
recta) Osmotic gradient along renal tubules Diuresis ? definition, osmotic and
pressure diuresis
Micturition:
2 hrs
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Functional anatomy of bladder -muscles and sphincters and innervation of bladder,
Filling and emptying of bladder, Cystometrogram Micturition reflex and its higher
control, voluntary control Abnormalities of micturition ? deafferented, decentralised
and automatic bladder ?
Urine ?Normal volume, constituents abnormal --dealt in biochemistry
Mention polyuria,oliguria,anuria
1hr
Basic principles of haemo & peritoneal
?Artificial kidney
dialysis
RFT dealt in biochemistry
Seminar /Tutorials
6hrs
SKIN AND TEMPERATURE REGULATION
2 hrs
Functions of skin, Methods of heat conservation and loss in human body
Regulation of body temperature ? role of skin, hypothalamus Hyperthermia,
Fever, hypothermia
NERVE MUSCLE PHYSIOLOGY
11hrs
Excitable tissue
1hr
Definition, properties. Neuron. Structure of a typical neuron, types, properties,
functions. Stimulus. Definition, types ? threshold, subthreshold, suprathreshold -
Nerve fibers Types, classification, and functions
Resting membrane potential.
1hr
Definition, ionic basis and genesis -
Nerve action potential. -
Definition, ionic basis and properties, Monophasic action potential
1hr
Transmission of nerve impulses. -
1hr
Types (myelinated and unmyelinated), differences in impulse transmission. Velocity
of conduction and factors affecting it
Peripheral nerve injury.
1hr
Wallerian degeneration, regeneration, denervation hypersensitivity
Neuromuscular junction.
1hr
Functional anatomy, transmission of impulses across neuromuscular junction, EPP.
Neuromuscular blocking drugs (important ones with clinical correlation).
Pathophysiology of Myesthenia Gravis
52
Muscles:
2hrs
Classification. Skeletal muscle Structure including molecular details, properties.
Action potential - Definition, ionic basis and properties, Comparison with nerve action
potential Molecular basis of muscle contraction - Excitation ? contraction coupling.
Types of muscle contraction ? isotonic and isometric with examples. Muscle types ?
fast and slow, differences. Fasiculation, fibrillation (briefly) --
Cardiac muscle:
2hrs
Structure, properties. Action potential- Definition, ionic basis and
properties, Comparison with nerve and muscle action potential.
Pacemaker potential - molecular basis, properties -
Smooth muscle:
1 hr
Types, Structure, innervation and neuromuscular junction.
Plasticity (cystometrogram to explain). ?
Seminar/tutorials
Comparison of structure & function of three types of muscle
INTEGRATED TEACHING in Practicals
1hr
EMG
NERVOUS SYSTEM
LECTURES -38 hrs
Organization of nervous system:
2hrs
General organization Functional anatomy of brain and spinal cord,
Coverings, white and grey mater ? review briefly. Brain ? lobes,
functions, Brodmann's areas ?important ones with functions Neuron,
neuroglia ? functions Spinal cord ? Functional anatomy -coverings,
structure, white and grey mater Cross section with location of sensory,
motor and autonomic neurons and tracts.
CSF:
2hrs
Formation, circulation, composition and functions ?Lumbar puncture.
Blood brain barrier
3hrs
Synapse:
Types. Functional anatomy of typical chemical synapse and synaptic transmission.
Synaptic potentials ? EPSP, IPSP ?ionic basis and comparison with action potential.
Properties of synapses (one way conduction, synaptic delay, synaptic inhibition,
convergence, divergence, summation, fatigue, after discharge and synaptic plasticity).
53
Synaptic inhibition ?types, mechanisms. Neurotransmitters ? facilitatory and
inhibitory with 2-3 eg and clinical applications Factors affecting signal transmission -
1hr
Reflex action.& Sensory receptors
Definition, reflex arc - components Classification with examples -Mono and
polysynaptic, Somatic and visceral, Superficial and deep with mention of examples
(details of reflexes in motor system)
Sensory receptors. Classification (recent view), types (phasic and tonic), properties -
adaptation Receptor potential, comparison with action potential.
Sensory tracts -
3hrs
Organisation of sensory pathways. Name all ascending pathways of spinal cord.
Tracing of pathways from body and face. Medial leminiscal system ? dorsal column
sensations. Spino thalamic system. Sensation of touch and pressure. Sensation of
pain and temperature. Synthetic sensation. Other ascending tracts ? salient features-
spinoreticular, spinocerebellar
Pain ?
1hr
Different types of pain. Slow and fast pain ? types of fibres, tracts and terminations.
Modulation of pain - Spinal level, supra spinal level. Visceral pain, referred pain,
radiating pain, - clinical correlates. Altered pain sensations Thalamus: connections in
relation to function only, Functions of thalamus Thalamic syndrome ?
Pain pathway ? across the DRGanglion, ST Tracts, Thalamus, PAGrey Matter,
Cortex, etc. Links with emotional centre. Pain appraisal ? primary and secondary,
subjectivity of pain experience.
3hrs
Sensory Cortex, Motor cortex & Cerebral
(not to be asked in
1hr
Cortex
exam)
Location ? primary area, secondary area, association areas. Salient histological
features. Body representation -sensory homunculus. Functions of primary, secondary
and association areas. : Brodmann's areas- Lesions -
Motor system ?
2hrs
Introduction, levels of motor control, review cross section of spinal cord.
Review cross section of spinal cord ? various ascending and descending Pathways
Stretch reflex ? details and function Inverse stretch reflex, Reciprocal innervation,
Other poly synaptic reflexes Pathological ? Babinski sign
Descending tracts.
3hrs
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Muscle spindle Structure -function-regulation
General organisation, Pyramidal and extra pyramidal tracts, their functions. Mention
as medial and lateral systems, Upper motor neurons and lower motor neurons. Upper
motor neuron and lower motor neuron lesions ? differences Effects of lesions at
various levels - hemiplegia, paraplegia, monoplegia
Cross section of spinal cord &Injuries of spinal cord
2hrs
- complete transection, incomplete transection, hemisection, section of anterior and
posterior roots, injury to motor nerve
Basal ganglia ?
2hrs
Organisation. Neuronal masses & Connections (brief). Functions. Disorders ?
Parkinsonism with explanation of the Physiological basis of the signs and symptoms.
Wilson's disease ? mention
Cerebellum-
2hrs
Evolutional divisions & functions. Deep cerebellar nuclei, connections in relation to
functions, Neuronal circuit (mention). Cerebellar lesion ? features and their
physiological basis -
Reticular formation:
1hr
ARAS, descending reticular system ?explain control of muscle tone
EEG and sleep.-
1hr
Define EEG, principle of recording, Normal waves (?, ?, ? and ?), alpha block, Clinical
uses
Sleep-Genesis, types,& stages of sleep-Differences between REM & NREM sleep
Limbic system & Prefrontal lobe
1hr
Organisation, connections (mention important ones) and functions -1hr
Vestibular apparatus:
2hrs
Functional anatomy - gross structure, receptors, receptor potential Functions &
abnormalities-
Muscle tone, posture, equilibrium.
1hr
Basis of maintenance ? stretch reflex, higher control, Postural reflexes ? mention
with levels of integration (details not required). Regulation of muscle tone and
posture (righting reflexes not included) -
Hypothalamus
1hr
Functional anatomy, Nuclei & functions
Higher functions of the brain:
2hrs
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Conditioned reflex ,Learning - Memory ? types& basis
Speech ? Types, Mechanisms of speech, Aphasia ? types ?
Autonomic nervous system:
2hrs
Organization and functions
SEMINAR / TUTORIAL -
8hrs
Autonomic nervous system, hypothalamus, Limbic system, cross section of Spinal cord,
CSF
SPECIAL SENSES
LECTURES ? 16 ? hrs
Olfaction
1hr
Receptor, pathway, lesions ? anosmia, parosmia -
Taste:
1hr
Taste buds, receptor, primary taste sensations, pathway -
Vision:
10 ?hrs
Introduction. Functional anatomy of eye ?
Review. Chambers of the eye, intraocular fluids - aquous humor, vitreous humor.
Lens - characteristics, changes with age, aphakia, cataract. Retina ? Histology to
be reviewed, Macula lutea, fovea centralis ? Explain - 11/2 hr
Basic optics. -2hrs
Optical system of the eye. Refractive media of eye -Refracting surfaces & refractive
indices. Concepts of reduced eye, Image formation on retina. Emmetropic eye. Far
and near points Errors of refraction ? chromatic and spherical aberrations,
hypermetropia, myopia, and Astigmatism presbyopia, ? causes (brief) features and
corrective lenses. Contact lenses (mention)
Visual receptors, adaptation, Muscles of eye - 3hrs
(cones and rods). Structure in detail. Visual pigments, role of vitamin A.
Phototransduction.(only nueral signaling) Adaptations of visual receptors -Dark
adaptation and light adaptation. Electrophysiology of receptors, receptor potential,
lateral inhibition. Electroretinogram (mention) Duplicity theory of vision, photopic
and scotopic vision ? Muscles of eye- Names, nerve supply and movements of eyeball
Corresponding points, double vision and squint (mention)Color vision
Primary, secondary and complementary colors (mention). Hue, brightness and
saturation (mention).Trichromatic and Opponent Process Theories. Color blobs ?
location and function. Color blindness. Afterimages, contrasts -
Visual Pathways. 2hrs
Monoocular and binocular vision. Visual signals -Processing in the Retina. Effects of
leision at different levels. Macular sparing (recent views) Visual cortex ? all areas and
functions
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Visual reflexes. Pupillary light reflex (direct and indirect) - pathway, lesion, Miosis &
mydriasis (mention).
Accommodation and accommodation reflex (Near response) ?3 components -
Pupillary constriction, convergence of eye balls, and increased anterior curvature of
lens.. ?
Accomodation reflex ? pathways, lesions. -
2hrs
Tests of Vision -Field of vision, Visual acuity, Color vision ? definition, details of tests
in practicals
AUDITION
4hrs
Acoustics ? frequency, amplitude of sound, pitch, intensity, and quality of sound.
Functional anatomy of the ear. Functions of external, middle and inner ear - 1hr
Cochlea ? structure, Organ of corti. Hair cell physiology- receptor potential. Mechano-
electrical transduction by hair cells. Endocochlear potential. Descrimination of pitch
(travelling wave theory) and intensity of sound -
2hr
Auditory pathway. Sound localization, pitch discrimination, masking of sounds. Deafness
(conduction and nerve deafness) ?
1hr
Audiometry (details in practicals) -
1hr
LECTURES -20 hrs
ENDOCRINOLOGY
General endocrinology&
-
-3hrs
Hypothalamus
Names and organisation of Endocrine glands in human body Hormone ? definition,
and classification ? on chemical nature. General hormones and local hormones ?
autocrine, paracrine and endocrine.hormones. Mechanism of action of hormones.
Hormone receptors ? cell membrane and intracellular, Mechanism of action via the
different receptors ? basics with 2 examples, Second messenger system ?brief.
Control of secretion of hormones in general ? the + ve and ?ve feed back with 2
examples. Abnormalities of hormone function ? decrease, increase, receptor
dysfunction, abnormal hormones or antibodies to be dealt with individual glands
Hypothalamus Functional anatomy, Hormones (Releasing and inhibiting), their
physiological actions Interrelationship between hypothalamus and pituitary glands ?
Infundibulum -hypothalmo ?pituitary tract and portal system.
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Pituitary gland
4 hrs
Hormones of anterior and posterior pituitary. Growth hormone - physiological
actions and regulation of secretion in detail. Hyper and hypofunction ? Acromegaly,
Gigantism and Dwarfism. Other hormones to be dealt with the target glands,
Mention intermediate lobe hormones - pro opiomelanocortin and MSH -
Thyriod gland:
4hrs
Hormones- names, biosynthesis (details in biochemistry), transport, physiological
actions and regulation of secretion (H-P-T axis). Thyroid function tests (details in
biochemistry). Hyper and hypofunction in children and adults ? Cretinism,
Myxedema, Hyperthyroidism -
Pancreas ? Endocrine.
2hrs
Hormones- physiological actions and regulation of secretion. Insulin - receptors and
insulin resistance (mention) Physiological actions Regulation of secretion Hyper and
hypofunction
? diabetes mellitus and hypoglycemia. Glucagon ? physiologic actions on
carbohydrate, proteins and fat metabolism, on heart. Regulation of secretion.
Somatostatin ? site of production, actions, stimuli for secretion, paracrine
regulations.Pancreatic polypeptide ? site of secretion, factors which increase
secretion, action
Adrenal gland:
4hrs
Adrenal Cortex: 3hrs
3 layers (briefly) Biosynthesis of adrenal cortical hormones (details in biochemistry).
Hormones of adrenal cortex - glucocorticoids, mineralocorticoids, sex steroids.
Transport, physiological actions and regulation of secretion glucocorticoids -
metabolic, permissive, anti inflammatory, anti allergic and in stress. Regulation of
secretion ? H-P-A axis mineralocorticoids ? role in salt and water balance, stress.
Regulation of secretion ? effects of K+, Na+, ACTH Hyper and hypofunction ? Cushings
syndrome. Primary and secondary hyperaldosteronism, Addison's disease ?
Adrenal
medulla:
Hormones
(catecholamine),
regulation
of
secretion,
Pheochromocytoma -1hr
Calcium homeostasis
-2hrs
Normal calcium metabolism (outline).Parathyroid hormone, calcitonin and vitaminD -
target organs and physiological actions. Hypocalcemia and tetany -
Other endocrine glands & Local Hormones-
1hr
Physiological actions and regulation of secretion ?Kidney, Pineal body (retino
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hypothalamic tract ? very brief). Thymus, Heart, Local hormones, Histamine, Sub P,
bradykinin, serotonin, prostaglandins, Sources and physiological actions -
SEMINARS / TUTORIALS -
Physiology of growth and development. Correlation of actions of different hormones
from childhood, puberty and adulthood (briefly) -1hr
PHYSIOLOGY OF REPRODUCTION
LECTURES -11hrs
Introduction
1hr
Briefly on hormonal factors influencing development of genitalia. Developmental
abnormalities-(adrenogenital, hermaphroditism). Puberty ? normal, precocious and
delayed puberty -
Male reproductive system.
2hrs
Functions of testis ? endocrine -testosterone (functions and regulation of secretion) -
Factors influencing Spermatogenesis and regulating it. Abnormalities of testicular
function
- cryptorchidism, male hypogonadism (mention) Erection, ejaculation, composition
of semen, sterility -
Female reproductive system:
2hrs
Ovarian hormones- estrogens, progesterone, relaxin. Control of ovarian functions by
H- P-Gonadal axis. Pituitary gonadotropins (FSH, LH), Prolactin ? physiologic actions,
regulation of secretion
Menstrual cycle:
2hrs
Menstrual, proliferative and secretary phases. Ovarian, uterine and vaginal changes
during menstrual cycle. Hormonal regulation. Abnormalities of ovarian function -
anovulatory cycle, infertility. Menarche, menopause. Castration before and after
puberty -
Pregnancy & Lactation ?
3hrs
Corpus luteum of pregnancy. Placenta ? functions, Placental hormones.
Foetoplacental unit. Parturition ? physiology of labour. Lactation Mention
Nueroendocrine reflex in Parturition & Lactation Pregnancy tests ? immunological
(currently done). Hormones influencing and their actions -
Contraception:
1hr
Temporary and permanent methods in males and females, and their physiological basis -
INTEGRATED TEACHING -
1hr
Induction of ovulation, in vitro fertilization, Infertility (with O &G dept)
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DETAILS OF PRACTICALS
Human Physiology
-76hr
1.Use and care of microscope and microscopic examination of blood
2.PCV, ESR, osmotic fragility
3.Haemoglobin estimation and blood indices
4.RBC count
5.WBC count
6.Examination of peripheral blood smear
7.Differential WBC count ? normal, abnormal, anaemias
8.ABO grouping, Rh typing
9.Bleeding time, clotting time
10.Recording of BP ? effects of posture and exercise
11.Recording of arterial pulse only
12.Respiratory movements demonstration
13.General examination
14.Examination of Respiratory system
15.Examination of CVS
16. Examination of higher functions and sensory system
17.Examination of Motor system
18.Examination reflexes
19.Examination of cranial nerves 1-6
20.Examination of cranial nerves 7-12
21. Revisions as required
Experimental physiology(Demonstration through e-modules /recorded graphs -28hr
1.Appliances in experimental physiology Laboratory including physiograph
2.Pithing, muscle nerve preparation, mounting, effects of different types of stimuli
3.Simple muscle twitch
4.Two successive stimuli, repetitive stimuli and fatigue
5.Genesis of tetanus and Starling's law of muscle
6.Effect of load and after load on muscle contraction
7.Effects of variations of temperature on muscle contraction
8.Velocity of nerve impulse
9.Normal cardiogram of frog's heart and effects of heat and cold.
10. Effect of temperature on frog's heart
11.Refractory period of frog's heart
12. Stannius ligatures. Properties of cardiac muscle ? all or none law, treppe,
summation of subminimal stimuli
13. Effect of vagal stimulation on frog's heart
14.Perfusion of frog's heart ? action of ions, action of drugs
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Demonstration Only
Electro encephalogram (EEG), Electro miogram (EMG),
Electro Cardio Gram (ECG), Audiometry, Perimetry,
Spirometry
Recommended Text Books
1. Text book of Physiology by Arthur C Guyton-13th edition
2. Review of Medical Physiology by Ganong.-24th edition
3. Text book of Physiology by G.K.Pal
4. Text book of Physiology by A.K.Jain (2volumes)
Reference Books
1. Text book of Human Physiology. Madhavan Kutty, Sarada
Subramaniam, HD Sing, S. Chand and Company
2.
Wintrobe's Hematology
3.
Williams text book of Endocrinology
4.
Snel 's neuroanatomy
5.
Samson Wright's applied physiology
6.
Best and Taylor's Physiological Basis of Medical Practice
7. Understanding Medical Physicology.R.I. Bajalani Jaypee Publishers
8. Best and Taylor's basis of Medical Practice by J B West-William and
Walkins
EVALUATION
M.C.I. Guidelines
1.
Problem solving exercises
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2.
OSPE (Objective Structured Practical Examination)
3.
Viva Voce ? with practicals
Pattern of questions in Theory paper
Paper 1: Blood, CVS, Respiration, Renal , Environmental Physiology,Digestion,
Regulation of Temperature,
Paper II: General Physiology, CNS, Special senses, Muscle and Nerve,
Endocrinology, Reproduction, Growth and development,
Structured Essay (preferably case scenario) - I no.(10 marks)
Short questions- 2 nos. (5mar
ks x 2 =10 marks)
Write briefly on-5 nos. (3 marks x 5 = 15 marks)
Draw labelled diagrams-2 nos. (2 ? marks x 2 =5)
Physiological basis/Give reasons- 5 nos. (2 marks x 5 =10)
Physiology Practical Exam
Max marks - 40(university) +20 (Internal)= 60 marks
Practical - I (20 marks)
Spotters -10 marks
Amphibian graph ? 5 marks
Short hematology ? 5 marks
Practical - II (20 marks)
Clinical Exam -10 marks
Long hematology (any one of the following - RBC count /
WBC count / Peripheral Smear) -10 marks
Mark distribution
Theory : (Total-140 marks)
? Theory Paper I + II = ( 50 + 50 ) =100 marks(University)
? Viva- 20 marks
? Internal asessment- 20 marks
Practicals : (Total-60 marks)
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? Practicals I& II-(20+20) =40 marks(University)
? Internal assessment - 20 marks
Aggregate : 200 marks
Internal Assessment
Based on day to day performance assessed by daily evaluation, short
examinations, tutorials, seminars, sessional examinations etc.
Theory ? Pattern of Question paper - Two papers of three hours duration (50 marks
each)
OBJECTIVE STRUCTURED PRACTICAL EXAMINATION (OSPE)
SPOTTERS : 10 Numbers-Based on calculations, ,instruments,charts, microscopic
slides ofblood cells, graphs,(including graphs from systems,amphibian expts-skeletal
muscle/cardiac muscle) clinical history,clinical skill)
Seminars :
Guide lines:
Allot 8 topics for a day.
Assign a single topic per student for presentation that lasts 10 minutes
All the students should learn all the 8 topics to participate in the post test
session (10 questions) after the presentation session
Marks: 10 marks for presentation & 10 marks for post test
Consider 10 % of this mark for internal assessment
List of Assignment topics and Seminar topics can be prepared by the department.
Records should be maintained with marks assigned during internal assessment
FORENSIC MEDICINE AND TOXICOLOGY
GOAL
The broad goal of the teaching of undergraduate students in Forensic
medicine is to produce a physician who is well informed about medico legal
responsibilities in practice of medicine. He/she acquire knowledge of law in
relation to medical practice, medical negligence and respect for codes of medical
ethics.
Learning objectives-
1. Be conversant with medical ethics, etiquette, duties rights and legal
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This post was last modified on 06 August 2021