MED 292 — الجهاز العضلي الهيكلي والجلد
السنة 2 · 38 محاضرة · 5 ساعة معتمدة
العناوين والأهداف منقولة من خطة كلية الطب الرسمية.
1. Introductory lecture
Multidisciplinary
- Highlight the features, objectives, rules and regulations of the course.
2. Shoulder girdle and shoulder joint
Anatomy
- Describe the principal distinguishing features of the scapula, clavicle, and humerus.
- Discuss the intermuscular spaces related to the scapula and their contents.
- List the rotator cuff muscles.
- Axilla: boundaries and contents.
- Describe the components of the shoulder joint.
- Describe the muscles acting on the shoulder joint according to the type and movement they perform.
- Describe the bursae in relation to the shoulder joint.
- List the blood supply and innervation of the shoulder joint.
3. Resting membrane physiology and action potential generation and conduction
Physiology
- Study the principles of membrane physiology in the resting state in excitable tissues (i.e. muscles and nerves).
- Describe how an action potential is generated and propagated along the cell membrane.
4. Biochemistry of bone and connective tissue
Biochemistry
- Describe the biochemical structure of bone tissue, the collagen matrix and the hydroxyapatite cement.
- List bone matrix proteins and describe their functions.
- Describe the composition of calcified tissues, calcification in bones and teeth, and formation of hydroxyapatite.
- Understand the role of alkaline phosphatase, calcium and phosphate.
- Role of vitamin D and 1,25-dihydroxyvitamin D in bone formation and remodeling.
- Review calcium and phosphate homeostasis.
5. Muscles of arm and forearm
Anatomy
- List the muscles attached to the arm and their attachments.
- List the muscles attached to the forearm and their attachments.
- Classify the muscles of the arm according to function.
- Classify the muscles of the forearm according to function.
- Describe the innervation of the muscles of the arm.
- Describe the innervation of the muscles of the forearm.
6. Elbow joint and cubital fossa
Anatomy
- Describe the principal distinguishing features of the radius and ulna.
- Describe the cubital fossa and its contents.
- Describe the components of the elbow joint (including the ligaments and bursae).
- List the muscles acting on the elbow joint according to type and action.
- Describe the stability of the elbow joint.
- List the blood supply and innervation of the elbow joint.
7. Neuromuscular junction (NMJ) and general mechanism of skeletal muscle contraction
Physiology
- Understand the sequence of events at the neuromuscular junction.
- End-plate potential: definition and its relation to miniature end-plate potential.
- Understand how NMJ is turned off.
- Understand the pathophysiological basis of myasthenia gravis.
- Understand the effect of some agents on transmission at the NMJ.
- Describe the general mechanism of skeletal muscle contraction and relaxation.
- Meaning of excitation-contraction coupling.
8. Molecular mechanism of contraction and its characteristics in skeletal muscle
Physiology
- Understand the molecular structure of the skeletal muscle and its division into functional units.
- Describe the acto-myosin crossbridge cycle.
- Explain rigor mortis.
- Explain the muscle twitch.
- Distinguish between concentric, eccentric and isometric contractions.
- Describe recruitment and tetany and their effects on muscle force.
- Describe the muscle force-velocity relationship.
9. Hand and wrist joint
Anatomy
- Describe the principal distinguishing features of the carpus, metacarpus and phalanges.
- Describe the components of the wrist joint (including the ligaments and bursae).
- List the muscles acting on the wrist joint according to type and action.
- List the blood supply and innervation of the wrist joint.
- Describe the carpal tunnel, flexor and extensor retinaculae, and the structures passing in relation to them.
- List the muscles acting on the fingers and their actions.
10. Non-neoplastic bone conditions and joint diseases
Pathology
- Describe congenital and developmental conditions of bone.
- Understand distinguishing features of skeletal dysplasias (e.g. achondroplasia, osteogenesis imperfecta, osteopetrosis).
- Describe the pathogenesis and pathologic features of osteoporosis, rickets/osteomalacia and influence of hyperparathyroidism on bone.
- Describe Paget’s disease of bone.
- Describe the pathogenesis and pathologic features of osteomyelitis.
- Describe the pathogenesis and pathologic features of joint diseases of inflammatory (e.g. rheumatoid arthritis), degenerative (e.g. osteoarthrosis) and metabolic joint diseases (e.g. gout, pseudogout).
11. Gluteal region and hip joint
Anatomy
- Describe the distinguishing features of the hip bone and femur.
- List the muscles of the gluteal region.
- Describe the attachments and innervations of the gluteal region muscles.
- Describe the greater and lesser sciatic foramina and their contents.
- Describe the components of the hip joint (including the ligaments and bursae).
- Describe the muscles acting on the hip joint according to type and action.
- Describe the blood supply and innervation of the hip joint.
12. Muscles of thigh, femoral triangle, and subsartorial canal
Anatomy
- List the muscles of the thigh.
- Describe the attachments and innervations of the thigh muscles.
- Describe the femoral triangle.
- Describe the subsartorial canal.
- Classify the muscles of the thigh according to action.
13. Knee joint and popliteal fossa
Anatomy
- Describe the distinguishing features of the tibia, fibula and patella.
- Describe the popliteal fossa and its contents.
- Describe the components of the knee joint (including the ligaments and bursae).
- List the muscles acting on the knee joint according to type and action.
- List the blood supply and innervation of the knee joint.
14. Metabolic disorders of muscle and bone
Biochemistry
- Discuss the markers for bone formation and resorption and their clinical use in diagnosis.
- Describe the molecular bases of Duchenne muscular dystrophy, glycogen storage diseases of muscle, and muscle mitochondrial diseases.
- Describe the molecular bases of osteogenesis imperfecta and Ehlers-Danlos syndromes.
15. Bone tumours
Pathology
- Describe the basic principles in diagnosis of bone tumors.
- Understand the classification of bone tumors.
- Discuss the common benign bone tumors and tumor-like conditions.
- Discuss the common malignant bone tumors.
16. Muscles of leg and ankle joint
Anatomy
- Describe the distinguishing features of the talus and calcaneus bones.
- Describe the components of the ankle joint.
- List the ligaments associated with the ankle joint and their attachments.
- List the muscles of the leg acting on the ankle joint according to type and action.
17. Muscle relaxants
Pharmacology
- Know the historical background of muscle relaxants.
- Know the conditions and clinical uses of muscle relaxants.
- Differentiate between depolarizing and non-depolarizing muscle relaxants in regards to pharmacokinetics and pharmacodynamics.
- List examples of depolarizing and non-depolarizing agents.
- Understand the mechanism of action of each drug and possible drug-drug interactions.
- Study spasmolytic drugs and their therapeutic uses.
18. Soft tissue tumours
Pathology
- Describe soft tissue tumors.
- Understand the classification of soft tissue tumors.
- Understand the importance of cytologic and histologic features of soft tissue tumors in identifying type and behavior.
- Discuss the commonest benign and malignant soft tissue tumors.
19. Foot
Anatomy
- Describe the distinguishing features of the tarsal metatarsal bones and phalanges.
- Describe the movement of the toes.
- List the muscles acting on the toes.
- Describe the retinaculae which related to the foot and the structures passing in relation to them.
- Describe the four muscle layers of the foot.
- Describe the arches of the foot.
20. Skin anatomy
Anatomy
- Describe the layers of the epidermis.
- Discuss the development of integumentary system.
- Describe structure of the dermis, and compare the structure and distribution of hair follicles, nails, sebaceous and sweat glands.
- Differentiate between thick and thin skin.
21. Views of skull
Anatomy
- Describe the antero-posterior views of the skull both internally and externally.
- Describe the lateral view of skull both internally and externally.
- Describe the supero-inferior views of skull both internally and externally.
- Describe the base of the skull with major foramina and related structures.
22. Non-neoplastic muscle disorders
Pathology
- Overview the histology of skeletal muscle.
- List the main types of skeletal muscle diseases.
- Discuss the two main types of muscle atrophy.
- Discuss the main inflammatory myopathies.
- Discuss muscular dystrophy and understand the pathogenesis and pathological features of Duchenne and Becker muscular dystrophies.
23. Joints of vertebral column and thoracic cage
Anatomy
- Describe the components of the atlantooccipital and atlantoaxial joints, their ligaments, movements and stability.
- Describe the components of the intervertebral joints, their ligaments, movements and stability.
- Describe the components of the costovertebral and costosternal joints, their ligaments and movements.
24. Bacterial skin infections
Microbiology
- Describe the morphology of common cutaneous bacterial infections.
- Discuss the bacterial etiologies of cellulitis and erysipelas.
- Recognize clinical patterns and risk factors that suggest methicillin-resistant Staphylococcus aureus (MRSA).
- Recommend initial steps for the evaluation and treatment of common cutaneous bacterial infections.
- Recognize characteristic features of necrotizing infections.
25. Viral skin infections
Microbiology
- Be able to identify and manage common viral skin infections.
- Be familiar with the range of appearance of viral infections.
- Identify and manage herpes simplex infections.
- Identify and manage herpes zoster infections.
- Identify and manage viral warts.
26. Skin tumours
Pathology
- Understand the classification of epithelial skin tumors (i.e. benign, premalignant, malignant).
- Understand the importance of cytologic and histologic features of soft tissue tumors in identifying type and behavior.
- Discuss the commonest epithelial skin tumors.
- Understand the classification of melanocytic conditions.
- Discuss benign melanocytic tumors and malignant melanoma.
27. Pharmacology of skin: topical medications I
Pharmacology
- Understand the main pharmacological differences between topical and systemic drug administration.
- Study differences between forms of topical formulation (e.g. creams, lotions, ointments).
- Study antibacterial topical medications (e.g. bacitracin, polymyxin B, neomycin, gentamycin, Neosporin).
- Understand the pathophysiology of acne vulgaris and its pharmacological and non-pharmacological treatment.
- Study topical and systemic antifungal medications.
- Study viral infections of the skin and its topical antiviral medication (acyclovir).
- Study the pharmacological treatment of leprosy and scabies.
- Understand the pathophysiology of psoriasis and its management.
- Get familiar with other dermatological conditions (e.g. urticaria, eczema).
28. Muscles of back
Anatomy
- Describe superficial muscles of the back including their attachments.
- Describe the components of the deep muscles of the back including their attachments.
- Describe the innervations and actions of the back muscles in detail.
29. Fungal and parasitic skin infections
Microbiology
- Describe the fungi that infect the skin and subcutaneous tissues, their identification and treatment (including dermatophytes, Candida and mycetoma agents).
- Describe parasites that infest the skin, their life cycles, treatment and prevention (including leishmaniasis, cutaneous larva migrans, onchocerciasis, loiasis, fleas, and scabies).
30. Embryology of MSS
Anatomy
- Describe the development of the axial skeleton.
- Describe the development of the appendicular skeleton.
- Describe the development of the skeletal muscles.
- Describe the related congenital anomalies.
31. Acute and chronic inflammatory dermatoses and blistering skin conditions
Pathology
- Understand general macroscopic and microscopic terms as applied to skin lesions.
- Define etiology, pathogenesis and pathologic features of urticaria, acute eczema and erythema multiforme.
- Define etiology, pathogenesis and pathologic features of psoriasis and lichen planus.
- Define etiology, pathogenesis and pathologic features of blistering (bullous) disorders (e.g. pemphigus, bullous pemphigoid, dermatitis herpetiformis).
32. Pharmacology of skin: topical medications II
Pharmacology
- See lecture 26 (Pharmacology of skin: topical medications I): continue topical versus systemic administration, topical formulations, antibacterial/antifungal/antiviral topicals, and the treatment of acne, leprosy, scabies, psoriasis, urticaria and eczema.
33. Anaerobes and gas gangrene
Microbiology
- Describe anaerobic bacteria, including their sensitivity to oxygen and their niches within the environment and the human body.
- Give indicators of possible anaerobic infections and name the most probable etiologic agents of gas gangrene.
- Describe the microscopic and colony morphologies of anaerobes.
- Discuss antimicrobial susceptibility testing of anaerobes, including methods and antimicrobial agents to be tested.
- Describe the major approaches to treat anaerobic-associated diseases, whether medical or surgical.
34. Antirheumatic medications
Pharmacology
- Understand the pathophysiology of osteoarthrosis and rheumatoid arthritis and differentiate between them in regards to clinical picture, and goal of treatment.
- Study available medications used in the management of rheumatoid arthritis (e.g. paracetamol, NSAIDs, DMARDs).
- Study drugs that fall in the category of disease-modifying antirheumatoid drugs (DMARDs) and their mechanism of action.
35. Introduction to dermatology
Dermatology
- Understand the basic anatomical and histological structure of skin layers (i.e. epidermis and dermis) and the barrier functions of skin (anatomical and immunological).
- Understand the process of epidermal turnover and desquamation.
- Understand the basic skin lesions: terminology of primary and secondary lesions.
- Clinical approach to patients with dermatologic disorders: dermatologic history and clinical examination.
- Know the bed-side diagnostics in dermatology: Wood’s light, KOH examination, Tzanck smear, and dermoscopy.
36. Introduction to MSS radiology
Radiology
- X-ray technique of creating images of internal body structures.
- Develop an approach to reading bone radiographic films.
- Describe morphology of bone fractures and pathological lesions on radiographs.
- Know the role of CT scan in orthopedic practice.
- Know the role of MRI in orthopedic practice.
37. Introduction to orthopedics
Orthopedics
- Identify and describe bones, muscles and joints of the upper and lower limbs as well as the vertebral column, together with the innervations and actions of the muscles associated with them.
38. Trauma and fractures
Orthopedics
- Understand the epidemiology and control of the common injuries that may affect the human musculoskeletal system.