Department of Medicine and Surgery

SECTION 2

INTEGRATED BASIC MEDICAL SCIENCES

1. Anatomy
2. Biochemistry
3. Physiology

 

1.0 DEPARTMENT OF ANATOMY

Philosophy

To provide the fundamental basis for understanding of the structure of the human body through an integrated multidisciplinary approach.

 

Objective

Broad objective: To equip medical students with the knowledge of developmental processes and understanding the structure of the human body in health and disease.

 

200 level 1^st semester

Specific objectives:

At the end of the posting, the student should be able to demonstrate sufficient knowledge and understanding of the:

1. General and gross anatomy through dissection of the human body
2. Developmental processes in humans and congenital malformations

• Microscopic structures of the human body

 

200 level second semester

Specific objectives:

At the end of the posting, the student should be able to:

1. Describe and identify the macroscopic and microscopic anatomy of various systems of the body.
2. Relate the structures of the human body to functions in health and disease.

 

 

300 level 1^st semester- Clinical application of basic medical sciences

Specific objective:

At the end of the posting, the student should be able to:

1. Apply the knowledge of anatomy to the pathogenesis and principles of management of health and disease.

 

Revision sessions in anatomy

Specific objective:

At the end of the revision exercise, the student should be able to:

1. Apply, analyse and evaluate the competences in anatomy as they relate to structures and function of the human body.

Learning methods

• Lectures, Tutorials, Dissections, Histology and Problem-based questions

Measurements of outcomes of rotation

• MCQs, SAQs, Viva Voce, OSPE

 

Anatomy (ANA)

24 Units Lectures

9 Units Practicals

ANA 201	General Anatomy, Gross Anatomy, Abdomen, Pelvis and Perineum, General Embryology and General Microscopic Anatomy	8	3
ANA 211	Gross Anatomy, Systemic Embryology (including genetics) and Systemic Microscopic Anatomy	8	3
ANA 301	Neuroanatomy and Clinical Correlates	8	3

 

FIRST SEMESTER, 200 LEVEL

COURSE CODE: ANA 201 (8 units, Lectures; 3 units, Practicals)

COURSE CONTENTS: General Anatomy, Gross Anatomy, Abdomen, Pelvis and Perineum, General Embryology and General Microscopic Anatomy

Course Contents

General Anatomy

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain the role of anatomy in medicine
2. Classify various tissues and joints

• State the importance of anatomy in radiology

Outline: Definition of anatomy, The place of Anatomy in Medicine, Methods of the study of Anatomy, Cadaver and Dissection; the ethics, Application of Basic Anatomy to Clinical Medicine, Vertebrates and Man, Anatomy of the cell and cellular function, Classification of tissues, Joints, Classification of joints, Bone and Radiological Anatomy, Dentition, Nervous System, Muscles and Glandular Tissues.

Gross Anatomy (lower limb)

Learning Outcomes

At the end of the lectures, students should be able to:

1. Describe femoral triangle and list its contents
2. Draw the following bones: the femur, tibia and fibula and state their primary and secondary centres of ossifications

• Explain the blood supply, lymphatic drainage and innervation of the lower limb

1. Describe inguinal canal and its role in the pathophysiology of congenital hernia
2. Differentiate between the inguinal canal, femoral canal and adductor canal
3. Discuss the course of the sciatic nerve and its distributions

Outline: Osteology of Lower Limb, front of the thigh I (femoral triangles, femoral canal and hernia, sub-sartorial canal). Front of thigh II, medial side of the thigh, gluteal region, back of the thigh, popliteal fossa, front of the leg and the dorsum of the foot, lateral side of the leg, back of the leg, sole of the foot (aches of the foot), Hip joint and the knee joint, tibio-fibula joints and ankle joints.

Abdomen, Pelvis and Perineum

Learning Outcomes

At the end of the lectures, students should be able to:

1. Discuss the topographic anatomy of the anterior abdominal wall
2. List the contents of the spermatic cord

• State the visceral contents of the pelvis and their blood supply

1. Describe the anatomy of the liver, its blood supply, lymphatic drainage and innervation
2. Distinguish between the true and the false pelvis.
3. Draw the structure of kidney and state its functions

Outline: Spermatic cord, inguinal canal and hernia, arteries, veins, lymphatic, abdominal alimentary tract, liver, spleen, pancreas and kidney. Anatomy of pelvis and perineum (including genital organs), with emphasis on Clinical application.

Microscopic Anatomy

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain cell structure, cell function and state the different types of tissue
2. Draw a typical cell structure and state the functions of various cell organelles

• Identify and list the various types of tissues

1. Distinguish between smooth muscles, cardiac and skeletal muscles

Microscopic Anatomy: Cell structure and division, epithelial tissues, connective tissues, bone and cartilage, muscular tissue, nervous tissues I and II, peripheral blood, circulatory (blood vascular) system and lymphatic (lymphoid) organs.

 

General Embryology

Learning Outcomes

At the end of the lectures, students should be able to:

1. List the three germ layers and their derivatives
2. Describe the mechanisms of morphogenesis, foetal membranes, growth, estimation of embryonic age

• Explain the development of placental and state its functions

1. Draw and state the major events in second week of development (week of two)
2. Explain the principles of teratology and list ten environmental causes of teratology.

Outline: The importance of Embryology in Medicine, subdivision of embryology. Origin of germ cells, spermatogenesis and oogenesis, sex determination, events leading of fertilization, oestrus and menstruation, ovarian cycle and ovulation, fertilisation, cleavage and gastrulation. The origin of germ layers, mechanisms of morphogenesis, foetal membranes, classification of the placenta, physiology of the placenta, growth, estimation of embryonic age. Factors affecting embryogenesis. Introduction to experimental embryology. Twins and twinning. Teratology.

 

SECOND SEMESTER, 200 LEVEL

COURSE CODE: ANA 211 (8 units, Lectures; 3 units, Practicals)

COURSE TITLE: Gross Anatomy, Systemic Embryology (including genetics), Systemic Microscopic Anatomy and Neuroanatomy

Course Contents

Upper Limb

Learning Outcomes

At the end of the lectures, each student should be able to:

1. Describe the osteology of the humerus, radius, ulnar and thoracic cage
2. Explain blood supply of the upper limb, the pathophysiology of Erb’s pals and State the functional adaptability of the upper limb

• Draw the brachial plexus and dermatome of the upper limb

1. Differentiate between the shoulder and elbow joints

Outline: Osteology of the upper limb, pectoral region and the breast, brachial plexus, scapular region and the axilla, shoulder joint, arm, cubital fossa and elbow. Forearm, wrist joint and hand. Vessels and lymphatic drainage of the upper limb.

Thorax

Learning Outcomes

At the end of the lectures, each student should be able to:

1. Describe the arrangement of neurovascular bundle and the blood supply of the thorax
2. Discuss the blood supply, innervation of the diaphragm and State the division of mediastinum and their respective contents

• Distinguish between the true and false rib bones, typical and atypical ribs

Outline: Osteology of the thoracic cage, intercostal space (intercostal muscles, vessels and nerves), pleura and lungs, mediastinum, cardiac plexus and thoracic diaphragm.

Systemic Microscopic Anatomy

Learning Outcomes

At the end of the lectures, students should be able to:

1. Describe the microanatomy of the digestive system
2. Distinguish between the microanatomy of the glands and the urinary bladder

• Draw the microanatomy of the skin and list the various types of cells that are found in the skin

1. Identify the microanatomy of the nervous system under microscope

Outline: Digestive System I and II, glands of the digestive system, cardiovascular system, respiratory system, urinary system, male reproductive system, female reproductive system, endocrine system I and II. Skin (integumentary system), nervous system (CNS and PNS). Eye and ear.

Systemic Embryology

Learning Outcomes

At the end of the lectures, each student should be able to:

1. State the anomalies of the derivatives of the pharyngeal arches and pouches
2. Describe the development of urogenital system and their abnormalities

• Mention the various centres of haematospoesis

1. Discuss the development of the gastrointestinal tract and its accessory organs
2. List the various types of anomalies of the heart, the kidney and vertebral column.
3. Explain the following terms: malformation, deformation, disruption

Outline: Derivatives of the pharyngeal arches, pouches (Development of Tonsils, Thymus, Thyroid, Parathyroid) and cleft. Anomalies of the derivatives. Development of the respiratory system, Development of the stomach, pancreas, liver, gall bladder and bile duct, rotation of the stomach and the formation of the lesser sac, Development of the intestine, rotation, withdrawal and fixation of the gut, The peritoneum, its reflections and the bare areas of viscera. Development of the urinary bladder and rectum. Development of the spleen. Hematopoietic system. Development of the kidneys. Development of the gonads, uterus and prostate. Development of the external genitalia, descent of the testes, Anomalies of the urogenital system. Development of the vertebral column and skull. Development of the cardiovascular system, foetal circulation and circulatory changes at birth. Development of the musculoskeletal system, integuments-skins, hair mammary gland and teeth. Development of the head and neck. Development of the central nervous system. Mechanism of Development of the Nervous system. Development of the special senses- eye, ear, nose, and tongue.

Genetics

Learning Outcomes

At the end of the lectures each student should be able to:

1. State the significance of oogenesis and spermatogenesis in human development
2. Describe the mechanism of inheritance

• Differentiate between gene and chromosome

1. Explain the following terms: duplication, deletion, mutation, reduction.

Outline: Mechanism of inheritance: Mendel’s laws. Significance of oogenesis and spermatogenesis in man. Sex linkage. Effects of radiation and in-breeding in man. Genes in development and differentiation; causes of abnormal developments; Sex ratio, twinning, congenital malformations. Nature of genes. Genetic control of inherited diseases; genetic counseling.

 

FIRST SEMESTER, 300 LEVEL

COURSE CODE: ANA 301 (8 units, Lectures; 3 units, Practicals)

COURSE CONTENTS: Neuroanatomy and Clinical Correlates

Course Contents

Head and Neck

Learning Outcomes

At the end of the lectures, each student should be able to:

1. List the derivatives of the pharyngeal arches and pouches
2. Explain the course of carotid artery and its distributions

• List the muscles of facial expressions, muscles of mastication and state their innervation

1. Describe the anatomy of the anterior and posterior triangles of the neck
2. Draw the structure of eye, list the extra ocular muscles and their innervation

Outline: Osteology of head and neck, scalp, temple and face. Deep cervical fascia, triangles of the neck. Deep structures of the neck. Cranial cavity and venous sinuses. Orbit and the eye. Parotid, temporal, infra-temporal, pterygoid, submandibular region, and temporo-mandibular joint. Oral cavity nasal cavity and paranasal air sinuses. Pharynx and larynx. Ear. Angiology of the neck and lymphatic drainage of head and neck.

Neuroanatomy and Clinical Correlates, General Revision

Learning Outcomes

At the end of the lectures each student should be able to:

1. Mention the twelve cranial nerves and their functions
2. Describe the anatomy of the cerebrum and its blood supply

• Differentiate between the medulla, pons and the mid brain

1. State the nuclei within the basal ganglia
2. Draw the structure of the brain, list the components of the meninges and describe the cerebrospinal fluid circulation.
3. Explain the ascending and descending pathways

Outline: Methods of study of neuroanatomy. Neurulation: brain vesicles, neurohistogenesis. Phylogeny of the nervous System in vertebrates. Coverings of the CNS. The neuron, axon and its sheaths. Sensory receptors. Blood supply of the spinal cord. Development of the spinal cord. Internal organisation of the spinal cord, (a) ascending pathways, descending pathways, functional components Cranial Nerves. Applied anatomy. Development of brain stem and cerebellum. Cross sectional anatomy of the medulla, pons and midbrain. Cerebellum in posture and balance. Brainstem: cranial nerve nuclei, long tracts and connections, applied anatomy. Development of the Ear, auditory system and vestibular system, physiology of hearing. Cerebellum: gross features, cortex, white matter, circuitry, connections and functional consideration. Thalamus: connections, sensory and motor functions. Hypothalamic connection and functions. Basal ganglia: connections and functions. Cerebrum: gross features, Microanatomy, functional area and development. Development of the eye and visual System, physiology of vision. Limbic system and control of posture and movement.

 

 

2.0 DEPARTMENT OF BIOCHEMISTRY

DEPARTMENTAL CURRICULUM FOR MB;BS PROGRAMME

Departmental Philosophy for MB;BS Programme

To provide the fundamental basis for medical biochemistry and molecular biology for medical education and basic research methodologies.

Objectives

1. To equip medical students with the knowledge of developmental processes and understanding the structure of the human body in health and disease.
2. To equip medical students with sufficient knowledge of medical biochemistry and molecular biology to understand the processes of health and disease
3. Produce medical graduates who are able to apply the knowledge of biochemistry to the pathogenesis and principles of management of clinical entities.

First Semester, 200 Level - Integrated Core Basic Medical Sciences

Specific objectives:

At the end of the semester, the student should be able to demonstrate knowledge and practical understanding of:

1. Basic biochemical processes in humans.
2. Metabolism of macromolecules, blood, immunoglobulins, hormones and overview of disorders associated with distorted metabolism. Biochemical importance of lipoproteins

Second Semester 200 Level – Integrated Core Basic Medical Sciences II

Specific Objectives

At the end of the semester, the student should be able to:

1. Build on previous knowledge of normal biochemical processes.
2. Acquire adequate knowledge of the biochemical basis of human diseases.

First Semester, 300 Level– Clinical Application of Basic Medical Sciences and Revision of Core Basic Medical Sciences

Specific Objectives

At the end of the semester, the student should be:

1. Proficient in the application of the knowledge of biochemical processes to the understanding of disease states in clinical practice.
2. Show knowledge and skills of core basic medical sciences.
3. Show a good understanding of biochemistry prior to proceeding to clinical school.
4. Apply, analyse and evaluate knowledge and skills of Biochemistry as they relate to normal biochemical processes in health and disease of the human body.

Learning methods

• Lectures, Tutorials, Practical, and personal studies

Measurements of Outcomes:

• MCQs, SAQs, and long essays

 

 

Biochemistry (BCH)

12 Units Lectures

3 Units Practicals

		Teaching	Practicals
BCH 201	Introductory Biochemistry I	4	1
BCH 211	Introductory Biochemistry II	4	1
BCH 301	Biochemistry and Clinical Correlates	4	1

 

FIRST SEMESTER, 200 LEVEL

COURSE CODE: BCH 201 (4 units, Lectures; 1 unit, Practicals)

COURSE TITLE: INTRODUCTORY BIOCHEMISTRY I

Course Contents

Structure, Chemistry and Functions of the Living Cell

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain the cellular structure, chemical composition and cellular metabolism of a living cell.
2. Describe how a particular cellular structure and its organelles allow the cell perform function associated with the structure.
3. Discuss the effect of pH and buffers on cellular functions.
4. Demonstrate critical thinking skills on diseases that could arise from alteration in cellular structure and chemical composition of the cell.

Outline: Structure, Chemistry and Functions of living cell including oxygen transportation. pH and Buffers.

Metabolism of proteins I, II & III

Learning Outcomes

At the end of the lectures, students should be able to:

1. Demonstrate an understanding of the chemistry and structure of the amino acids as well as protein classification, structure and functions.
2. Discuss the metabolism of proteins
3. Relate derangement in the metabolism of proteins to pathological conditions such as haemoglobinopathies etc.
4. Relate metabolism of protein to the human defence system
5. Describe the therapeutic use of antibodies for diseases

Outline for Metabolism of Protein I: Chemistry and structure of the amino acids, essential and non–essential amino acids. Peptides, Proteins classification, structure and functions. Introduction to the metabolism of amino acids; transamination, oxidative deamination, decarboxylation etc. The Urea cycle and its Biochemical importance. Metabolism of leucine, isoleucine and valine (the branched-chain amino acids).

Outline for Metabolism of Proteins II: Metabolism of phenylalanine and tyrosine. Metabolism and interconversion of threonine. Metabolism of the sulphur–containing amino acids; methionine, cysteine and cysteine inborn error. Metabolism of some amino acid: phenylketonuria, tyrosinosis, alkaptonuria, albinism, and cystinuria. Blood, Porphyrins, Haemoglobinopathies I: Blood, General properties and functions; the red cell and its metabolism. Blood, plasma, the plasma proteins; separation and functions, blood clotting mechanisms. The haemoglobin: Its structure, properties and biochemical functions. Blood, Porphyrins and Haemoglobinopathies II: Metabolism of porphyrins and porphyrinurias. Formation of bile pigments, jaundice. Haemoglobinopathies, thalassemia, haemophilia.

Outline for Metabolism of Protein III: Immunoglobulins: Types, structure, functions. Estimation of immunoglobulins; antigens and antigenic determinants, Immunotherapy. Hybridoma technology and monoclonal antibodies in Medicine and Biological research.

Metabolism of carbohydrates I, II & III

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain what carbohydrates are and their sources
2. Describe the major and minor metabolic pathways of carbohydrate metabolism
3. Demonstrate the knowledge of carbohydrate metabolism in the detection and prevention of metabolic diseases including diabetes mellitus
4. Discuss the role of carbohydrate in blood grouping

Outline for Metabolism of Carbohydrate I: Classification and chemistry of carbohydrates, Chemistry and biochemistry of the polysaccharides including the amino sugars, mucopolysaccharides, blood group substances, etc.

Outline for Metabolism of Carbohydrates II: Glycolysis (Embden–Meyerhof) pathway, aerobic and anaerobic phases. Control mechanisms and substrate–level phosphorylation. The Kreb’s cycle/Citric acid cycle. Metabolism of galactose and fructose; the uronic acid pathway. Definition and inter–relationships of glycolysis, gluconeogenesis, glycogenesis and glycogenolysis. The Hexose Monophosphate Shunt and its biochemical importance; Glucose-6-phosphate dehydrogenase deficiency.

Outline for Metabolism of Carbohydrates III: Diseases of the carbohydrate metabolism.

The Biochemical functions of hormones and clinical features of abnormalities

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain the characteristics, molecular mechanisms of action and regulation of secretion of hormones
2. Discuss diseases associated over- and-under production of hormones
3. Demonstrate proficiency in techniques of hormone assay

Outline: Characteristics of hormones. Molecular mechanism of hormone action. The parathyroid hormones: Chemistry, functions, and regulation of secretion, abnormalities. The pancreatic hormones: Insulin Chemistry, secretion, metabolism, function, assay; diabetes. Glucagon Chemistry and function of hormones of the adrenal cortex; glucocorticoids and the mineralocorticoids, biosynthesis regulation of biosynthesis and metabolic functions Hormones of the adrenal cortex, adrenocortical insufficiency; Addison’s disease; hyperaldosteronism. The biochemical functions of the gastrointestinal hormones; gastrin etc. Assay of hormones. Techniques– Biological, Chemical and Radio–displacement assays. Hormones of the testis, the ovary and the placenta, testosterone, the androgens, oestrogens, progesterone.

Metabolism of Nucleic Acids I & II

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain the chemistry and structure of nucleic acids components
2. Discuss the de novo and salvage pathways of purine and pyrimidine synthesis
3. Explain the significance of uric acid
4. Describe the diseases associated with nucleic acid metabolism
5. Discuss the roles of purines and pyrimidines in molecular biology
6. Demonstrate the application of components of molecular biology in the diagnosis of both communicable and non-communicable diseases

Outline for Metabolism of Nucleic Acids I: Chemistry and structure of the nucleic acids: RNA and DNA, Purine nucleosides and nucleotides, Pyrimidine nucleosides and nucleotides. Roles of purine and pyrimidine nucleotides in intermediary metabolism. Synthesis and catabolism of purine nucleotides. Synthesis and catabolism of pyrimidine nucleotides

Outline for Metabolism of Nucleic Acids II: Disorders of purine and pyrimidine metabolism. Overview of Molecular Biology and Genetic Engineering: Terminology and basic concepts including polymerase chain reaction (PCR).

Lipid metabolism I

Learning Outcomes

At the end of the lectures, students should be able to:

1. Describe the chemistry, classification and functions of lipids
2. Differentiate between different forms of lipids
3. Explain the digestion and absorption of lipids
4. Discuss the biochemical significance of lipoproteins
5. Relate lipid metabolism to disease conditions

Outline: Introduction to lipids; classification, chemistry and functions of lipids, digestion and absorption of lipids. Formation of chylomicrons; transport of lipids in the blood; the lipoproteins, biochemical importance of lipoproteins. Structure and functions of biological membranes, membrane transport and disease.

 

SECOND SEMESTER, 200 LEVEL

COURSE CODE: BCH 211 (4 units, Lectures; 1 unit, Practicals)

Lipid Metabolism II

Learning Outcomes

At the end of the lectures, students should be able to:

1. Describe the biosynthesis and degradation of fatty triacylglycerol, cholesterol, phospholipids and sphingolipids
2. Discuss oxidation of fatty acids and the associated control mechanisms
3. Demonstrate a clear understanding of the association between ketosis and certain diseases e.g. diabetes mellitus

 

Outline: Biosynthesis of fatty acids and of the triacylglycerol. Metabolism of cholesterol: Biosynthesis, degradation into bile acids and bile salts. Biosynthesis and degradation of triacylglycerol, phospholipids and sphingolipids. β–oxidation of fatty acids and the control mechanisms. Ketone bodies and ketosis. Biochemistry of the prostaglandins.

Genetics and diseases

Learning Outcomes

At the end of the lectures, students should be able to:

1. Discuss the organisation of a gene and the mechanism of transcription
2. Explain how translation of proteins occurs
3. Demonstrate a clear understanding of how environmental factors influence gene expression and its subsequent effect on disease phenotypes
4. Describe available therapies for the control and cure of genetic diseases

Outline: Translocation and gene rearrangement in disease state. Gene rearrangement in Burkitt’s lymphoma and other diseases. Sickle cell anaemia. Inborn errors of metabolism. Introduction to genomics, proteomics and metabolomics.

Biochemical Functions of the Nervous System

Learning Outcomes

At the end of the lectures, students should be able to:

1. Describe the metabolism of neurotransmitters
2. Relate the interplay between diseases of the nervous system and neurotransmitters

Outline: Neurotransmitters: Biosynthesis and breakdown, Diseases affecting the nervous tissues.

 

Biochemistry of Communicable and Non-Communicable Diseases

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain how diseases can interfere with human genetic expression
2. Relate the role of certain diseases in the process of carcinogenesis
3. Discuss the biochemical mechanisms involved in drug resistance

Outline: Retroviruses: Molecular structure and involvement in cancer, Cancer: Proto–oncogenes and oncogenes, AIDS: Biochemistry of the virus, spread, detection, drug treatments and drug resistance, Biochemical features of Tropical Diseases.

Biochemical functions of selected organs

Learning Outcomes

At the end of the lectures, students should be able to:

1. Discuss the biochemical functions of the kidney and the liver
2. Describe disease conditions of these key organs

Outline: Biochemical functions of the kidney, renal function tests (RFTs) etc. Biochemical functions of the liver, liver function tests, jaundice, hepatitis

Bioenergetics

Learning Outcomes

At the end of the lectures, students should be able to:

1. Discuss the need for energy generation in the body
2. Explain the mechanisms of energy generation in the electron transport chain and by oxidative phosphorylation
3. Discuss the role of inhibitors on energy generation in the electron transport chain

Outline: Electron transport chain (ETC) and oxidative phosphorylation, Theories and models proposed for ATP generation, inhibitors of ETC etc.

Muscle action

Learning Outcome

At the end of the lecture, students should be able to:

1. Describe the biochemical and molecular mechanisms of muscle action

Outline: Biochemical and molecular concepts of muscle action.

 

Vitamins and Nutritional Biochemistry

Learning Outcome

At the end of this lecture, students should be able to:

1. Classify vitamins based on solubility in water or lipid
2. Explain the functions of vitamins including their role as coenzymes
3. Discuss diseases associated with excess or deficient intake of vitamins

Outline: The water–soluble vitamins: The B-group and Vitamin C. Biochemical importance of water–soluble vitamins in the body. The fat–soluble vitamins A, D, E and K and their biochemical functions.

Principles of human nutrition and biochemical basis for nutritional diseases and remedies.

Enzymology

Learning Outcomes

At the end of the lectures, students should be able to:

1. Classify enzymes
2. Demonstrate an understanding of enzymes and coenzymes activities in biochemical processes
3. Discuss the role of enzymes in clinical diagnosis

Outline: Enzyme classification. Catalysis and Kinetics of enzyme action. Factors affecting enzyme activity, allosteric effects etc. Coenzymes: Structure and role in cellular metabolism. Clinical importance of enzymes, Enzyme inhibition, Enzyme assay in clinical medicine; Immobilized enzymes.

FIRST SEMESTER, 300 LEVEL

COURSE CODE: BCH 301 (4 units, Lectures; 1 unit, Practicals)

COURSE TITLE: Biochemistry and Clinical Correlates and Revision of Core Basic Medical Sciences prior to the MBBS Part I Examination

Course Contents

Introduction to fluid and electrolytes

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain water distribution in the body
2. Discuss the reasons for effective water regulation in the body
3. Describe measures for correcting dehydration
4. Explain the functions of ions (electrolytes) of clinical importance in the body

Outline: Water and the major ions: H⁺, Na⁺, K⁺, Ca²⁺, HCO₃^-,Fluid intake and output. Total body water distribution; intercellular, intracellular and extracellular fluids. Regulation of water balance in the body. Functions of electrolytes; dehydration and its correction

Ageing

Learning Outcomes

At the end of this lecture, students should be able to:

1. Explain the biochemical changes in elderly
2. Discuss the role of oxidative stress in ageing

Outline: Ageing and signaling pathways, ageing and apoptosis, metabolic processes and oxidative stress in ageing

Introduction to Xenobiochemistry

Learning Outcomes

At the end of the lectures, students should be able to:

1. Describe Phase 1 and Phase 2 reactions
2. Explain the role of cytochrome P450 in relation to drug oxidation/metabolism
3. Discuss biochemical mechanisms of drug toxicity and its effect on human system

Outline: Phases 1 and 2 reactions, Cytochrome P450 and drug oxidation, Mechanism of drug toxicity.

 

 

DEPARTMENT OF PHYSIOLOGY

Philosophy of the Department

This is centred on developing a thorough understanding of the normal functions of the human body by providing students with adequate knowledge of theoretical, practical and applied physiology, to make such graduates suitable to utilize this knowledge for future problem solving and other applications like the practice of medicine, pharmacy, nursing and other allied professions.

Objective of the Department

The objectives of physiology training include training the students to acquire basic knowledge of physiological principles and ability to apply the knowledge of physiology to life situation, provide sufficient knowledge and skills in experimental physiology.

 

Learning Methods

Knowledge on physiology will be derived through lectures, tutorials, laboratory practical sessions and personal studies        

 

Assessment of Learning Outcomes

• MCQs, SAQs, and long essays

 

Integrated Core Basic Medical Sciences Postings

During Integrated Core Basic Medical Sciences Postings medical students will be prepared with adequate knowledge of human physiology especially in understanding the normal functions from cellular to systemic level, and how these processes are affected by pathological conditions

200 LEVEL FIRST SEMESTER                

Integrated Core Basic Medical Sciences I

Following the end of this semester, the medical student should be able to demonstrate and show proof of proper understanding of components of a typical cell, blood and body fluids. The student should have good grasp on functions of the cardiopulmonary system, autonomic nervous system, nerves and muscles.

 

200 LEVEL SECOND SEMESTER           

Integrated Core Basic Medical Sciences II

At the end of the semester, the students should be able to build on previous knowledge of normal physiological mechanism on endocrinology, reproduction, renal, gastrointestinal activities and metabolism.

300 LEVEL FIRST SEMESTER

Clinical Application of Basic Medical Sciences and Revision of Core Basic Medical Sciences.

At the conclusion of this semester, the student should be able to:

1. Demonstrate better understanding of previously taught courses
2. Apply the basic understanding of basic physiology to clinical correlate
3. Demonstrate a good understanding of neurophysiology, special senses and general physiology prior to proceeding to clinical school.

Physiology (PIO)

12 Units Lectures

6 Units Practicals

		Teaching	Practicals
PIO 201	Introductory Physiology I	4	2
PIO 211	Introductory Physiology II	4	2
PIO 301	Neurophysiology and Clinical Correlates	4	2

 

FIRST SEMESTER, 200 LEVEL

COURSE CODE: PIO 201 (4 units, Lectures; 2 unit, Practicals)

COURSE TITLE: INTRODUCTORY PHYSIOLOGY I

 

Course Contents

Cell and Introduction to Physiology

Learning Outcomes

At the end of the lectures, students should be able to:

1. Explain the cellular structure, functions of different organelles and haemostatic mechanisms.
2. Explain the different process involved in transportation through cellular or organellar membranes

• Demonstrate intercellular and intracellular communications, how and why cells communicate with each other

Outline: Introduction and history of physiology. Structure and functions of cell membranes. Membrane permeability barriers. Transport process across membranes. Homeostasis, control systems and Biological rhythms. Mechanism of intercellular communication; Roles of ion and ionic movements in cellular function. Introduction of the concept of the body as a whole organism in balance involving both inter and intracellular communication

 

Blood and Body Fluids Physiology

Learning Outcomes

At the end of the lectures, students should be able to:

1. Know the different body fluids compartments
2. Understand the components/classification of blood and their functions
3. Explain the genesis of haematopoiesis and blood disorders
4. Fully understand haemoglobin and its disorders and the role of iron metabolism
5. Explain inflammation and role of leucocytes in disease conditions
6. Understand the concept of Immunity, Hypersensitivity and Blood typing
7. Explain platelets aggregation and coagulation

 

Outline: Introduction and definition of body fluids and body fluid compartments. Regulation of body fluid volumes. Physiological variation of body fluid volumes. Techniques for quantifying various body fluid volumes. Blood: Functions of blood and classification of blood cells. Erythropoiesis. Haematological indices. Haemoglobin genotype and Blood groups. Immunology and cell defence. Haemostasis

 

Excitable Tissues (Nerves and Muscle Physiology)

Learning Outcomes

At the end of the lectures, students should be able to:

1. Define the following properties of ion channels: gating, activation, and inactivation.
2. Differentiate between the properties of electrotonic conduction, conduction of an action potential, and saltatory conduction.

• Identify the differences between cardiac, smooth and skeletal muscles.

1. Explain the excitation-contraction coupling of skeletal and smooth muscles
2. Understand that at the chemical synapse, contrast the terms temporal summation and spatial summation.
3. Define, and identify on a diagram of a motor neuron, the following regions: dendrites, axon, axon hillock, soma, and an axodendritic synapse.

• on the Nernst equation, and explain the effects of altering the intracellular or extracellular Na+, K+, Cl-, or Ca2+ concentration on the equilibrium potential for that ion.
• Describe the ionic basis of each of the following local graded potentials: excitatory post synaptic potential (EPSP), inhibitory post synaptic potential (IPSP), end plate potential (EPP) and a receptor (generator) potential.

Outline: Deals on the nerve, synapse, transport mechanisms across cell membrane, muscle types and structure, muscle contraction and Physiology of glands. Ionic equations, resting membrane potential. Action potential. Synaptic transmission. Membrane receptors. Some emphasis also on the neuromuscular junction and various drugs and agents acting on it, including some common anaesthetic agents.

 

Autonomic Nervous System

Learning Outcomes

At the end of the lectures, students should be able to:

1. Define the sympathetic and parasympathetic systems and differentiate their components
2. Compare and contrast terms and concepts related to the sympathetic and parasympathetic systems, including: the central location of cell body of origin, number of synapses between CNS and effector organs, degree of myelination, and general effects on target tissues.

• Describe the sensory input and roles for visceral afferent fibres of the ANS.

1. Describe the synaptic characteristics, receptors, and neurotransmitters for the parasympathetic and sympathetic division of the ANS.
2. Describe the function of non-adrenergic, non-cholinergic fibres in the ANS.

Outline: Physiologic anatomy of the ANS. Functions of the ANS. Difference and similarities between ANS and somatic nervous system. Divisions of the ANS. Characteristics of the sympathetic and parasympathetic system. Similarities and differences. ANS effects on major organs of the body. Pharmacology if the ANS, ANS reflexes and control centres.

 

Cardiovascular System

Learning Outcomes

At the end of the lectures, students should be able to:

1. Understand the steps in excitation-contraction coupling in cardiac muscle and outline the sequence of events that occurs in action potential in a cardiac muscle.
2. Explain the role of conducting fibres and pace maker cells in cardiac muscle activities

• Contrast the sympathetic and parasympathetic nervous system influence on heart rate and cardiac excitation in general.

1. Differentiate between stroke volume and stroke work, and define ejection fraction and be able to calculate it from end diastolic volume, end systolic volume, and/or stroke volume. Predict the change in ejection fraction that would result from a change in a) preload, b) afterload, and c) contractility.
2. Understand the basic functional anatomy of the atrioventricular and semilunar valves, and explain how they operate.
3. Draw, in correct temporal relationship, the pressure, volume, heart sound, and ECG changes in the cardiac cycle. Identify the intervals of isovolumic contraction, rapid ejection, reduced ejection, isovolumic relaxation, rapid ventricle filling, reduced ventricular filling and atrial contraction.

• Know the various phases of ventricular systole and ventricular diastole.
• Know the factors that contribute to the formation of turbulent flow.

1. Describe the timing and causes of the four heart sounds.
2. Describe the expected auscultation sounds that define mitral stenosis, mitral insufficiency, aortic stenosis, and aortic insufficiency. Explain how these pathologic changes would affect cardiac mechanics and blood pressure.
3. Define the term dipole, the characteristics that define a vector, and how dipoles generated by the heart produce the waveforms of the ECG.

• Know the electrode placements and polarities for the 12 leads of a 12-lead electrocardiogram and the standard values for pen amplitude calibration and paper speed.
• Explain why the ECG tracing looks different in each of the 12 leads.
• Define mean electrical vector (axis) of the heart and give the normal range. Determine the mean electrical axis from knowledge of the magnitude of the QRS complex in the standard limb leads.

1. Understand the principles underlying cardiac output measurements using the Fick principle, dye dilution, and thermodilution methods.

• Define venous return. Understand the concept of “resistance to venous return” and know what factors determine its value theoretically, what factors are most important in practice, and how various interventions would change the resistance to venous return.
• Describe how arterial systolic, diastolic, mean, and pulse pressure are affected by changes in a) stroke volume, b) heart rate, c) arterial compliance, and d) total peripheral resistance.
• Identify the cell membrane receptors and second messenger systems mediating the contraction of vascular smooth muscle by norepinephrine, angiotensin II, and vasopressin.
• Identify the cell membrane receptors and second messenger systems mediating the relaxation of vascular smooth muscle by nitric oxide, bradykinin, prostaglandins, and histamine.

1. Explain the sequence of events in the baroreflex that occur after an acute increase or decrease in arterial blood pressure. Include receptor response, afferent nerve activity, CNS integration, efferent nerve activity to the SA node, ventricles, arterioles, venules, and hypothalamus.

• Contrast the sympathetic and parasympathetic nervous system control of heart rate, contractility, total peripheral resistance, and venous capacitance. Predict the cardiovascular consequence of altering sympathetic nerve activity and parasympathetic nerve activity.
• Contrast the relative contribution of neural and renal mechanisms in blood pressure and blood volume regulation.

Outline: Definition and functions of the cardiovascular system; Cardiac muscle, Cardiac myoelectrophysiology; Cardiac cycle; Electrocardiogram (ECG) and the ECG in Cardiac Arrhythmias and Myopathies; Cardiovascular reflexes; Excitation contraction coupling in cardiac muscle; Circulation of blood: Cardiac output and regulation; Blood pressure; Heart sounds and murmurs. Haemodynamics and microcirculation. Pulmonary, Cerebral, Coronary, Splanchnic and muscle circulation, Shock and cardiovascular changes in exercise. Structure of the heart and blood vessels.

 

Respiratory Physiology

Learning Outcomes

At the end of the lectures, students should be able to:

1. Demonstrate by diagrams the changes of pleural pressure, alveolar pressure, airflow, and lung volume change during a normal quiet breathing cycle.
2. Draw a normal spirogram, labelling the four lung volumes and four capacities.
3. Identify which volume and capacities cannot be measured by spirometry.
4. Describe the principal components of pulmonary surfactant and explain the roles of each.
5. Describe the regional differences in alveolar ventilation in healthy and diseased lungs and explain the basis for these differences.
6. List the normal airway, alveolar, arterial, and mixed venous PO2 and PCO2 values.
7. Define and contrast the following terms: anatomic dead space, physiologic dead space, wasted (dead space) ventilation, total minute ventilation and alveolar minute ventilation.
8. Define the following terms: hypoventilation, hyperventilation, hypercapnoea, eupnoea, hypopnoea, and hyperpnoea.
9. Name the factors that affect diffusive transport of a gas between alveolar gas and pulmonary capillary blood.
10. Identify the regions in the central nervous system that play important roles in the generation and control of cyclic breathing.

 

Outline: Definition and functions of the respiratory system. Physiologic anatomy of the respiratory system. Respiratory dynamics and work. Pulmonary ventilation: Lung volumes and capacities. Spirometry. Mechanisms and mechanics of breathing, Lung surfactants, pulmonary circulation. Gas exchange and gas transport. Oxygen haemoglobin dissociation curve. Hypoxia and dyspnoea. Respiratory changes in exercise and barometric changes. Control of breathing.

 

 SECOND SEMESTER, 200 LEVEL

COURSE CODE: PIO 211 (6 units) (4 units, Lectures; 2 units, Practicals)

COURSE TITLE: INTRODUCTORY PHYSIOLOGY II

 

Course Contents

Renal Physiology and Temperature Regulation

Learning Outcomes

At the end of the lectures, students should be able to:

1. Identify from a cross section of the kidney, the renal cortex, renal medulla, renal calyces, medullary pyramids, renal pelvic space, renal artery, renal vein, and ureter.
2. Explain the role of somatic, (pudendal) sympathetic, and parasympathetic nerves in the micturition reflex and in urination.

• Explain the clearance principle. Use the clearance equation and an appropriate compound to estimate the glomerular filtration rate, renal plasma flow, and renal blood flow.

1. Define renal blood flow, renal plasma flow, glomerular filtration rate, and filtration fraction and list typical values.
2. Given the capillary and Bowman’s capsule hydrostatic and oncotic pressures, calculate the net filtration force at the glomerular capillaries. Predict the changes in glomerular filtration
3. Describe the myogenic and tubuloglomerular feedback mechanisms that mediate the autoregulation of renal plasma flow and glomerular filtration rate.

• Describe the contribution of the major nephron segments to the reabsorption of the filtered load of solute and water.
• Identify the normal range of pH values, and the upper and lower limits compatible with life. Describe the role of buffers in maintaining pH, including the roles of the lungs and kidneys.

Outline: Definition and functions of the kidney. Physiologic anatomy of the kidney. Glomerular filtration Rate and Renal Haemodynamics. Tubular functions. Urine formation: Dilute and concentrated urine, counter current mechanism, plasma clearance, renal autoregulation, ECF regulation, Acid base balance, Renin- Angiotensin system. Body temperature and the environment, Mechanisms of heat Exchange, Peripheral thermoreceptors, central thermoreceptors, hyperthermia and hypothermia, Fever, heat exhaustion and heat stroke.

 

Gastrointestinal Physiology

Learning Outcomes

At the end of the lectures, students should be able to:

1. Identify the different parts and layers of the gut and explain their functions.
2. Know the different secretory glands and the substances secreted with their functions.

• Explain movement across the different parts of the gastrointestinal tracts

1. Understand the mechanism behind digestion and the enzymes responsible for this process
2. Explain the different reflex mechanism in the gastrointestinal system.

Outline: Physiologic anatomy and innervations of the GIT. Hormones and Neurotransmitters of GIT. Deglutition and Mastication. Gastric Motility, Secretions of the GIT. Digestion and Absorption as function of the GIT. Splanchnic supply of the GIT. Vomiting.   Liver and General metabolism. Pathophysiology of the gastrointestinal tract

 

Endocrinology and Reproduction

Learning and Outcomes

At the end of the lectures, students should be able to:

1. Differentiate the different types of hormones, their mechanism of actions and synthesis.
2. Explain the different endocrine glands and the hormones they secrete.

• Explain the hypothalamo-hypophyseal portal system.

1. Identify the different parts of the male and female reproductive organs.
2. Explain the processes of gametogenesis and female menstrual cycle.
3. Understand pregnancy and process of childbirth

Outline: Methods of measurement, types and mechanisms of action, regulation, Physiologic anatomy, hypothalamus-hypothalamic releasing factors. Hypothalamic nuclei, Hypothalamo-hypophyseal system, Pituitary gland, trophic hormones, Structure and functions of the male and female reproductive organs, Androgens, Spermatogenesis and fertility. Infertility in male. Oogenesis, Sexual cycle and hormonal regulation. Fertilization, Pregnancy and Parturition, Fertility and infertility in female, Family planning, Ageing and sexuality, Sexual problems and dysfunctions.

 

FIRST SEMESTER, 300 LEVEL

COURSE CODE: PIO 301 (4 units, Lectures; 2 units, Practicals)

COURSE TITLE: Neurophysiology and Clinical correlates

 

Course Contents

Neurophysiology

Learning Outcomes

At the end of the lectures, students should be able to:

1. Describe the major areas of the cerebral cortex and their roles in perception and motor coordination. Identify the Brodmann areas for visual, auditory, somatosensory, motor, and speech areas
2. Compare and contrast the functions of the medial and dorsolateral prefrontal cortex and describe the classic lesions of the human cortex and the associated symptoms

• List the three functional divisions of the cerebellum, detailing the input and output connections of each. Describe how these areas are integrated with the lateral and medial motor pathways

1. Describe the major interconnections between components within the basal ganglia and between the basal ganglia and the cerebral cortex and identify the associated neurotransmitters
2. Describe the overall function of the basal ganglia in the initiation and control of movement
3. Describe the main functions of the limbic system (LS) and associate them with one or more major anatomical structures of the LS

• Outline the current understanding of regulatory mechanisms in the brainstem and diencephalon regulating the appearance of NREM, REM and wake states. Include the neurotransmitters and the mechanism of the circadian rhythm underlying the sleep-wake cycle
• Explain the electrophysiological basis and origin of the electroencephalogram (EEG)

1. Describe the cutaneous and proprioceptive mechanoreceptors and their function: Pacinian corpuscles, Meissner’s corpuscles, Ruffini endings, Merkel cell, A-delta and C free nerve endings, Golgi tendon organ, muscle spindle.
2. Define rapidly and slowly adapting sensory reception and correlate these with the types of sensory receptors serving the Dorsal Column-Medial Lemniscus system and the spinothalamic system, respectively.
3. Discuss what is meant by the Fine Touch System, Pain/Temperature/Coarse Touch System and be able to trace its connections to the cerebral cortex.

• Describe the anatomy and functions of the major ascending tracts (anterolateral and dorsal column-medial lemniscus systems) and descending spinal cord tract (cortico-spinal tract, CST), including crossing of midline.
• Describe the hypothalamus in terms of body homeostasis and integration with the ANS, and relate the functions of the supraoptic and paraventricular nuclei to water balance and thirst behaviour and their response to circumventricular osmoreceptors, the control of body temperature, appetite, defecation, micturition, heart rate, arterial pressure, sexual reproductive activity, lactation, and growth..

Outline: Classification of nerves, sensory organs and receptors, modalities of sensations. Reflexes: Reflex arc, act and motion. Myotatic reflexes, postural reflexes, Mono and polysynaptic reflexes. Organisation of the nervous system, spinal cord. Brain stem and Brain localisation of functions. Sensory and Motor tracts. Pyramidal and extrapyramidal tracts. Basal ganglia. Thalamus and hypothalamus. Cerebellum. Reticular formation and limbic system. Alertness, sleep, memory and learning.

 

Physiology of Special Senses

Learning Outcomes

At the end of the lectures, students should be able to:

1. Describe the gross structure of the eye and basic physiological optics.
2. List the structure and cell types, the intrinsic circuitry and functioning of the retina.

• Describe the basic biochemistry of the photo-transduction process, the “dark current,” and the photoreceptor response to capturing a photon.

1. Demonstrate by a diagram of the central visual pathways and the retino-thalamo-cortical pathway.
2. Describe the location, structure, and afferent pathways of taste and smell receptors.
3. Describe the structure and function of the central taste centres.

• List the basic taste sensations, i.e., identify the five distinct gustatory modalities.
• Describe the structure and function of the central olfactory centres beyond the olfactory bulb.

1. Describe the function of the outer, middle, and inner ear structures in the mechano-electrical transduction process of sound energy into nerve impulses.
2. Describe the following hearing tests and explai