Locomotor Module Guide

INTRODUCTION
• This module is regarding the parts of the body involved in locomotion.
• The total span of this module is 9 weeks.
• The bulk of the syllabus is comprised of Gross Anatomy, in which you will be studying mainly
the upper limb and the lower limb.
• Since this module provides the first exposure of Gross Anatomy to the students, it is often
considered the toughest module of the first year by many.
• However, using visuals can help facilitate understanding the Gross Anatomy.
• The Locomotor Module, nevertheless, is quite extensive, thus requiring considerable time and
dedication.

SUBJECTS
• The major subjects for this module are Gross Anatomy, Histology, Embryology, and
Physiology.
• The minor subjects for this module are Biochemistry, Pathology, Pharmacology, Community
Medicine, Behavioral Sciences, and Radiology.
• The major subjects contribute more to the proportion of questions in the modular and annual
exams and are tested in annual internal evaluation.
• The minor subjects contribute less to the proportion of questions in the modular and annual
exams and are not tested in annual internal evaluation.
• However, in the first year of D’28, there was an internal evaluation of Biochemistry in modular
exam, and many questions from Pathology appeared in its internal evaluation.
• Prioritize major subjects first, covering minor subjects towards the end.
• This module guide is based on D’28 Locomotor Module syllabus; the syllabus can have minor
changes, so beware of them.
• Keep yourself updated with what is being taught in the lectures to be aware of what topics are
omitted or added.
• To have an idea of what topics to cover from the book, keep an eye on the topics being taught in
the lectures.
• Learning objectives listed in DUHS official module guide can also give an idea of what to cover.

GROSS ANATOMY
• Gross Anatomy is the most important and the most extensive subject of this module.
• As a rule, you will be studying the following for each region of the limbs: bony landmarks,
muscle attachments, blood vessels, nerves, and clinical correlates.
• For example, while studying the forearm, you will study the bones, muscle attachments, blood
vessels, and nerves found in the forearm, as well as its clinical correlates.
• In addition, you will study vasculature, nerve supply, clinical correlates, and some other features
of the breast.
• Besides, you should also know about the fasciae, joints, lymphatics, and any distinct fossa, space,
or other such structures with their boundaries and contents found in the upper and lower limbs.
• You should know the features of a bone and be able to identify its side.
• You should also know the muscles of each region, their actions, their nerve supply, and their
origins and insertions or at least a general idea about them.
• For blood vessels, you should have an idea of their course and the areas supplied by them.
• Memorizing which muscles each nerve supplies would be sufficient.
• For clinical correlates, do go through the blue boxes in KLM; for revision, you can look into the
clinical correlates provided in BRS Gross Anatomy.
• Make sure you have an idea of dermatomes of the limbs, especially of the hands and feet.
• Books:
1. KLM Clinically Oriented Anatomy (8th Edition): it is dense with information, having ample
clinical correlates, and nerve and blood supply tables and charts excellent for revision.
However, often the text and diagrams are difficult to comprehend, and at certain places
unnecessary details are given.
Chapters to be covered:
I. Chapter 3 (Upper Limb)
II. Chapter 4 (Thorax, breast and its clinical correlates only)
III. Chapter 7 (Lower Limb)
2. Gray’s Anatomy for Students (4th Edition): it has a much easier text to comprehend and has
excellent diagrams to facilitate understanding. However, it may lack some pieces of
information that might be tested in exams, has no tables for blood or nerve supply, and has
less clinical correlates.
Chapters to be covered:
I. Chapter 3 (Thorax; breast only)
II. Chapter 6 (Lower Limb)
III. Chapter 7 (Upper Limb)
3. BRS Gross Anatomy (9th Edition): it is an excellent book for revision once you are done
with the long books, also being good for revision of clinical correlates. However, it lacks
certain important information, for example the features of bones, so you should refer to long
books for that.
Chapters to be covered:
I. Chapter 3 (Thorax; Breast and Mammary Glands only)
II. Chapter 6 (Lower Limb)
III. Chapter 7 (Upper Limb)
4. Netter’s Atlas of Human Anatomy (7th Edition): it is an atlas, meaning it has illustrations
and diagrams only. These illustrations help tremendously to visualize and understand
what you read. For example, if you are studying the muscles, nerve supply, and blood
vessels of the arm, you can see their illustrations on the atlas after reading their description,
enabling you to visualize what you have read. Ultimately, it helps in building strong concepts.
Moreover, the visuals are very useful to predict what structures will be affected if a particular
 area is fractured, compressed, or torn.
Chapters to be covered:
I. Section 4 (Thorax; Mammary Gland only)
II. Section 7 (Upper Limb)
III. Section 8 (Lower Limb)
• Video Suggestions:
1. The Noted Anatomist (for bones),
2. AnatomyZone (for muscles),
3. Dr Sumit Gupta (not recommended for whole of the anatomy as these are long videos but
give a clear understanding of difficult topics like the hip bone)
4. Osmosis (covers KLM content with good animations)
5. Ninja Nerd (highly recommended for brachial and lumbosacral plexuses)

HISTOLOGY
• Histology in this module is relatively easy.
• You have to cover only the histology of cartilages, bones, and muscles.
• You should be well-versed regarding the structure and composition of each type of cartilage as
well as where each type of cartilage is found in the body.
• You should be well aware of the organic and inorganic components of bone, the types and
functions of different cells of bone tissue, the microscopic structure of bone, and the zones of
epiphyseal cartilage.
• Having an understanding of the histology of skeletal muscles is essential to understand their
physiology as well.
• Books:
1. Medical Histology (Text & Atlas) by Laiq Hussain (8th Edition): it is simple and concise,
covering all the important information you need to know. However, it lacks pictures.
Chapters to be covered:
I. Chapter 7 (Cartilage)
II. Chapter 8 (Bone)
III. Chapter 10 (Muscle Tissue)
2. Junqueira’s Basic Histology Text & Atlas (15th Edition): it is detailed and sometimes
sophisticated. Nevertheless, it has quite many pictures to aid understanding.
Chapter to be covered:
I. Chapter 7 (Cartilage)
II. Chapter 8 (Bone)
III. Chapter 10 (Muscles)
• Video Suggestions:
1. MBS MediLectures (covers Laiq Hussain’s content)
2. Osmosis (provides good animation for histology of bone)
EMbRYOLOGY
• Embryology is quite brief and easy in this module.
• Molecular regulation of limb development is not necessary to study.
• Do cover the clinical correlates for the development of muscular system, limbs, and mammary
glands.
• Books:
1. Langman’s Medical Embryology (14th Edition): it is brief yet comprehensive. Using this
book to cover this module’s embryology would be sufficient. However, it does not have as
good diagrams as KLM Clinically Oriented Embryology.
Chapters to be covered:
I. Chapter 11 (Muscular System)
II. Chapter 12 (Limbs)
III. Chapter 21 (Integumentary System; Mammary Glands only)
2. KLM Clinically Oriented Embryology (10th Edition): it is relatively detailed and has good
diagrams.
Chapters to be covered:
I. Chapter 14 (Skeletal System; no need to cover Development of Axial Skeleton)
II. Chapter 15 (Muscular System)
III. Chapter 16 (Development of Limbs)
IV. Chapter 19 (Integumentary System; Mammary Glands and Clinical Correlates only)
• Video Resources:
1. Ninja Nerd (covers development of muscular and skeletal systems)
2. Dr. Najeeb (covers the topics from each and every aspect; long videos as compared to those
of Ninja Nerd; covers congenital anomalies of limbs too)
3. Essentials of Medical Science (for mammary glands development)

PHYSIOLOGY
• Physiology is the other major subject after anatomy in this module.
• It is pretty straightforward in this module; the course can be covered with slides only as well.
• The major topics in the course are generation of action potential and its propagation, the
neuromuscular junction, muscle contraction, and associated disorders.
• The structure of sarcomere and its constituent proteins should not be taken lightly as they are also
tested.
• In the topic of muscles, pay special heed to the types of contractions (isotonic, isometric) as they
are asked in the viva and exams.
• Books:
1. Guyton and Hall Textbook of Medical Physiology (14th Edition): it is the standard and
recommended book for this module. Its text is easy to comprehend.
Chapters to be covered:
I. Chapter 4 (Transport of Substances Through Cell Membranes)
 II. Chapter 5 (Membrane Potentials and Action Potentials)
III. Chapter 6 (Contraction of Skeletal Muscles)
IV. Chapter 7 (Excitation of Skeletal Muscle: Neuromuscular Transmission and
Excitation - Contraction Coupling)
V. Chapter 8 (Excitation and Contraction of Smooth Muscle; skip Nervous and
Hormonal Control of Smooth Muscle Contraction)
2. Review of Physiology by Firdaus (20th Edition): this book is excellent for revising
Locomotor’s physiology. It has almost all the important details.
Chapters to be covered:
I. Chapter 2 (Membrane Physiology, Nerves, and Muscles)
3. BRS Physiology (7th Edition): it is another good book for revision, particularly for those
people who do not find Firdaus suitable.
Chapters to be covered:
I. Chapter 1 (Cell Physiology)
• Video Suggestions:
1. Ninja Nerd (covers membrane potentials, neuromuscular junction, skeletal muscle and its
mechanics)
2. Medical Gateway (teaches according to Guyton)
3. Dr. Najeeb (comprehensive videos)

PATHOLOGY
• It is another minor subject in this module.
• To understand bone pathology, you should have prior concepts regarding the structure of
bone, its development, and its homeostasis and remodeling.
• You should have an understanding about dysostosis and dysplasia and be able to differentiate
between them.
• Osteogenesis imperfecta, osteopetrosis, osteopenia, osteoporosis, osteomalacia, rickets, and Paget
disease are commonly tested in the exam.
• Osteomyelitis is another important topic in this subject.
• The types of bone fractures too is an important topic.
• Joints, although not included in the previous year syllabus, still had some questions appearing in
the exam; you can cover several topics of joint pathology from Pathoma, especially osteoarthritis
and rheumatoid arthritis, to be on the safe side.
• Books:
1. Robbins & Cotran Pathologic Basis of Diseases (10th Edition): This book is detailed but
well-organized. It discusses each and every aspect of the abnormalities discussed in this
syllabus,
like their causes, their pathogenesis, their morphology, their clinical features, and treatment.
The charts given in this book very well summarize the different pathological conditions.
Moreover, the book is rich in images.
Chapters to be covered:
I. Chapter 26 (Bones, Joints, and Soft Tissue Tumours; cover till osteomyelitis only; no
need to do Bone Tumors and Tumor-Like Lesions, Joints, and Soft Tissue Tumors)
 2. Fundamentals of Pathology by Husain A. Sattar (2022 Edition): This book is not as detailed,
missing some information that can be tested in your exam. However, it is easier to
comprehend. The blood findings of the different pathological conditions are given in
Pathoma, but are not discussed in Basis. These are often tested in the exam.
Chapters to be covered:
I. Chapter 18 (Musculoskeletal Pathology; skip Bone Tumours, Joints, and Soft Tissue
Tumours)
• Video Suggestions:
1. Osmosis (for osteoporosis, Paget disease, and bone repair)
2. For other topics, random YouTube videos can be watched

bIOcHEMISTRY
• Biochemistry too is a minor subject and is quite simple in this module as well as interesting.
• Nevertheless, it is still an important subject in this module, as making it strong would help you
better understand the Physiology and Pathology of this module.
• Some topics overlap with those in the Foundation Module, like the extracellular matrix.
• Interpretation of markers of bone diseases is an important topic, and you can cover it from lecture
slides.
• You should have strong concepts of calcium homeostasis.
• The topic of extracellular matrix can be covered from Harper’s Illustrated Biochemistry,
though slides would suffice.
• Books:
1. Lippincott Illustrated Reviews Biochemistry (8th Edition): it is the standard book for this
subject, being quite sufficient for this module. However, you have to cover certain topics
from slides, which are mentioned above.
Chapters to be covered:
I. Chapter 4 (Fibrous Proteins)
II. Chapter 14 (Glycosaminoglycans, Proteoglycans, and Glycoproteins; headings of
Structure, Degradation, and Mucopolysaccharidoses only)
III. Chapter 27 (Minerals; calcium and phosphorus only)
IV. Chapter 28 (Vitamins; vitamin D only)
• Video Suggestions:
1. Biochemistry by Dr Rajesh (covers extracellular matrix, calcium and phosphate biochemistry,
and vitamin D metabolism)
2. MBS MediLectures (covers calcium, phosphorus, and vitamin D metabolism according to
Lippincott)

PHARMAcOLOGY
• It is a minor subject.
 • You should have a strong understanding of difference between COX-1 and COX-2 enzymes
and the classification of NSAIDs.
• You should also know the functions and modes of action of aspirin and acetaminophen.
• Slides would suffice for this subject, but for more details you can look into the book.
• Books:
1. Lippincott Illustrated Reviews: Pharmacology (7th Edition)
Chapters to be covered:
I. Chapter 27 (Drugs Affecting Bone Metabolism)
II. Chapter 40 (Anti-inflammatory, Antipyretic, and Analgesic Agents; NSAIDs and
Paracetamol only)
2. Katzung and Trevor’s Pharmacology Examination and Board Review (12th Edition)
Chapters to be covered:
I. Chapter 36 (NSAIDs, Acetaminophen, & Drugs Used in Rheumatoid Arthritis &
Gout; Aspirin, other Nonselective NSAIDs, and Acetaminophen only)

cOMMuNITY MEdIcINE
• It is a minor subject; there will be only a handful of lectures.
• It can be covered by skimming through lecture slides only.
• If you want to study in depth, you can refer to the book.
• Books:
1. Public Health and Community Medicine by Shah, Ilyas, Ansari (7th Edition)

bEHAvIORAL ScIENcES
• It is another minor subject that can be covered by skimming through slides only.
• For more details, you can have a check on the book.
• Books:
1. Handbook of Behavioral Sciences by Mowadat H. Rana, Roop Z. Rana, Mansoor Mustafa
(3rd Edition)

RAdIOLOGY
• It is a minor subject and is quite interesting.
• Doing slides would suffice, but you can study articles on internet if you find anything vague.
• You should remember certain features visible in the x-rays, such as the Shenton’s line.
• You should be well aware of the advantages and disadvantages of Magnetic Resonance Imaging
and Computed Tomography.
cASE bASEd LEARNING
• Last year, there were 7 CBLs in the syllabus, which are as follows: Osteomalacia, Breast Lump,
Supracondylar Fracture, Ulnar Nerve Palsy, Gunshot (at thigh), Dermatomes, and Myasthenia
Gravis.
• CBLs correlate your theoretical knowledge with practical knowledge, so you should have a
strong grip over your theoretical knowledge.
• Covering CBLs from slides would suffice.

To get to know how you will be tested in the module and annual exams, refer to the SAP Foundation
Module guide.
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