SECTION – 2

Third Year

GENERAL MEDICINE
Subject Description
This subject follows the basic science subjects to provide the knowledge about relevant aspects of
general medicine. The student will have a general understanding of the diseases the therapist
would encounter in their practice. The objective of this course is that after 60 hrs of lectures and
discussion the student will be able to list the etiology, pathology, clinical features and treatment
methods for various medical conditions.

Subject Title : GENERAL MEDICINE

Duration : 25 – 36 Months
Total Hours : 60
Theory / Lecture : 2 Hours / Week

Method of Assessment : Written

1. Infection : Effects of Infection on the body – Pathology – source and spread of infection –
vaccinations – generalized infections – rashes and infection – food poisoning and
gasteroenteritis – sexually transmitted diseases – HIV infections and Aids [3 Hours]

2. Poisoning : Clinical features – general management – common agents in poisoning –

pharmaceutical agents – drugs of misuse – chemical pesticides – Envenomation [2 Hours]

3. Food and Nutrition : Assessment – Nutritional and Energy requirements; Deficiency diseases –
clinical features and treatment; Protein – Energy Malnutrition : Clinical features and treatment;
Obesity and its related disorders : Causes – Complications – benefits of weight loss –
management of Obesity – diet, exercise and medications.[4 Hours]

4. Endocrine diseases : Common presenting symptoms of Endocrine disease – common classical

disease presentations, clinical features and its management; Diabetes Mellitus : Etiology and
pathogenesis of diabetes – clinical manifestations of the disease – management of the disease –
Complications of diabetes. [4 Hours]

5. Diseases of the blood : Examinations of blood disorders – Clinical manifestations of blood

disease; Anemia – signs and symptoms – types and management ; Hemophilia - Cause –
clinical features severity of disease – management – complications due to repeated
haemorrhages – complications due to therapy. [4 Hours]

6. Diseases of the digestive system : Clinical manifestations of gastrointestinal disease –

Aetiology, clinical features, diagnosis, complications and treatment of the following
conditions : Reflux Oesophagitis, Achlasia Cardia, Carcinoma of Oesophagus, GI bleeding,
Peptic Ulcer disease, Carcinoma of Stomach, Pancreatitis, Malabsorption Syndrome,
Ulcerative Colitis, Peritonitis, Infections of Alimentary Tract ; Clinical manifestations of liver
diseases - Aetiology, clinical features, diagnosis, complications and treatment of the following
 conditions : Viral Hepatitis, Wilson’s Disease, Alpha1-antitrypsin deficiency, Tumors of the
Liver, Gall stones, Cholycystitis. [7 Hours]

7. Cardiovascular Disease : Examination of the Cardiovascular System – Investigations : ECG,

Exercise Stress Testing, Radiology ; Clinical manifestations of Cardiovascular disease ;
Definition, Etiology, Clinical features, signs and symptoms, complications, management and
treatment of following diseases and disorders of the heart : Pericarditis, Myocarditis,
Endocarditis, Rheumatic Fever – resulting in valve disorders, Ishemic Heart Disease, Coronary
Valve Disease, Congenital disorders of the Heart, Cardiac Arrest ; Examination and
Investigations of diseases of arteries and veins ; Hypertension : Definition, causes,
classification, types, assessment, investigations and management. [8 Hours]

8. Respiratory Disease : Examination of the Respiratory System – Investigations : Chest

Radiographs, Pulmonary Function Testing, Arterial Blood Gas Analysis ; Clinical
manifestations of Lung disease ; Patterns of lung disease – Chronic Obstructive Lung Disease
and Restrictive Lung Disease ; Definition, Etiology, Clinical features, signs and symptoms,
complications, management and treatment of following lung diseases : Chronic Bronchitis,
Emphysema, Asthma, Bronchiectasis, Cystic Fibrosis, Upper Respiratory Tract Infections,
Pneumonia, Tuberculosis, Fungal Diseases, Interstitial Lung Diseases, Diseases of the pleura,
diaphragm and chest wall ; Respiratory failure – Definition, types, causes, clinical features,
diagnosis and management. [9 Hours]

9. Diseases of the Skin : Examination and clinical manifestations of skin diseases ; Causes,
clinical features and management of the following skin conditions : Leprosy, Psoriasis,
Pigmentary Anomalies, Vasomotor disorders, Dermatitis, Coccal and Fungal Parasitic and
Viral infections. [6 Hours]

10. Pediatrics : Problems and management of LBW infants, Perinatal problems and management,
Congenital abnormalities and management, Respiratory conditions of childhood, Cerebral
Palsy – causes, complications, clinical manifestations, treatment ; Spina Bifida – management
and treatment, Epilepsies – types, diagnosis and treatment; Recognizing developmental delay,
common causes of delay ; Orthopedic and Neuromuscular disorders in childhood, clinical
features and management ; Sensory disorders – problems resulting from loss of vision and
hearing ; Learning and behavioural problems – Hyperactivity, Autism, Challenging
behaviours, Educational delay, The Clumsy Child. [8 Hours]

11. Psychiatric Disorders: Classifications, Causes, Clinical manifestations and treatment methods
used in Psychiatry. [5 Hours]

Recommended books:

1. Davidson’s Principles and Practice of Medicine

2. Harrison’s Internal Medicine
3. Braunwald Text of Cardiology
4. Text Book of Cardiology by Hurst
 GENERAL SURGERY

Subject Description

This subject follows the basic science subjects to provide the knowledge about relevant aspects of
general surgery. The student will have a general understanding of the surgical conditions the
therapist would encounter in their practice. The objective of this course is that after 60 hrs of
lectures and discussion the student will be able to list the indications for surgery, etiology, clinical
features and surgical methods for various conditions.

Subject Title : GENERAL SURGERY

Duration : 25 – 36 Months
Total Hours : 60
Theory / Lecture : 2 Hours / Week

Method of Assessment : Written

1. Fluid, Electrolyte and Acid-Base disturbances – diagnosis and management ; Nutrition in the
surgical patient ; Wound healing – basic process involved in wound repair, basic phases in the
healing process, clinical management of wounds, factors affecting wound healing, Scars –
types and treatment. Hemostasis – components, hemostatic disorders, factors affecting
bleeding during surgery. Transfusion therapy in surgery – blood components, complications
of transfusion ; Surgical Infections ; General Post – Operative Complications and its
management [6 Hours]

2. Reasons for Surgery ; Types of anaesthesia and its affects on the patient ; Types of Incisons ;
Clips Ligatures and Sutures ; General Thoracic Procedures – Radiologic Diagnostic
procedures, Endoscopy – types, Biopsy – uses and types. Overview and Drainage systems and
tubes used in Surgery.[3 Hours]

3. Causes, Clinical Presentation, Diagnosis and treatment of the following Thoracic Trauma
situations – Airway obstruction, Pnuemothorax, Hemothorax, Cardiac Tamponade,
Tracheobronchial disruption, Aortic disruption, Diaphragmatic disruption, Esophageal
disruption, Cardiac and Pulmonary Contusions. [4 Hours]

4. Surgical Oncology – Cancer – definition, types, clinical manifestations of cancer, Staging of

Cancer, surgical procedures involved in the management of cancer. [3 Hours]

5. Disorders of the Chest Wall, Lung and Mediastinum – Definition, Clinical features, diagnosis
and choice of management for the following disorders – chest wall deformities, chest wall
tumors, Spontaneous Pneumothorax, Pleural Effusion, Empyema Thoracis, Lung abscess,
Bronchiectasis, Tuberculosis, Bronchogenic Carcinoma, Bronchial Adenomas, Metastatic
tumors of the Lung, tracheal Stenosis, Congenital tracheomalacia, Neoplasms of the trachea,
Lesions of the Mediastinum. Carcinoma of the female breast. [5 Hours]

6. Disorders of the Heart – Definition, Clinical features, diagnosis and choice of management for
the following disorders : Congenital Heart diseases – Acyanotic congenital heart disease &
Cyanotic congenital heart disease : Patent Ductus Arteriosus, Coarctation of Aorta, Atrial
Septal Defect, Ventricular Septal Defect, Tetraology of Fallot, Transposition of Great
 Vessels ; Acquired Heart Disease – Mitral Stenosis & Insufficiency, Aortic Stenosis and
Insufficeiency, Ischemic Heart Disease – Coronary Artery Disease, Cardiac tumors. [6 Hours]

7. Thoracic surgeries – Thoracotomy – Definition, Types of Incisions with emphasis to the site of
insision, muscles cut and complications. Lung surgeries : Pnumonectomy, Lobectomy,
segmentectomy – Indications, Physiological changes and Complications ; Thoracoplasty,
Pleurectomy, Pleurodesis and Decortication of the Lung. Cardiac surgeries – An overview of
the Cardio-Pulmonary Bypass Machine – Extracardiac Operations, Closed Heart surgery,
Open Heart surgery. Transplant Surgery – Heart, Lung and Kidney – Indications,
Physiological changes and Complications. [6 Hours]

8. Diseases of the Arteries and Veins : Definition, Etiology, Clinical features, signs and
symptoms, complications, management and treatment of following diseases : Arteriosclerosis,
Atherosclerosis, Aneurysm, Buerger’s disease, Raynaud’s Disease, Thrombophlebitis, Deep
Vein Thrombosis, Pulmonary Embolism, Varicose Veins. [5 Hours]

9. Definition, Indication, Incision, Physiological changes and Complications following Common

operations like Cholecystectomy, Colostomy, Ileostomy, Gastrectomy, Hernias,
Appendicectomy Mastectomy, Neprectomy, Prostectomy. [4 Hours]

10. Burn: Definition, Classification, Causes, Prevention, Pathological changes, Complications,

Clinical Features and Management. Skin Grafts – Types, Grafting Procedures, Survival of
Skin Graft ; Flaps – Types and uses of Flaps. [4 Hours]

11. Womens Health : Menstrual cycle and its disorders. Hormonal disorders of females-obesity
and female hormones. Cancer of the female reproductive organs-management Infections and
sexually transmitted disease in female Menopause - its effects on emotions and
musculoskeletal system. Malnutrition and deficiencies in females. Sterility-pathophysiology-
investigations-management. Maternal physiology in pregnancy. Musculo skeletal disorders
during pregnancy. Prenatal complications-investigations- management. Child birth- Stages -
complications-investigations-management – Pain relief in labour - Purperium - Post Natal
care. Surgical procedures involving child birth. Incontinence – Types, Causes, Assessment and
Management. Definition, Indications and Management of the following surgical procedures –
Hysterosalphyngography, Dilatation and Curettage, Laproscopy, Colposopy, Hysterectomy. [8
Hours]

12. ENT: Common problems of ear, otitis media, Otosclerosis, functional achonia and deafness,
management facial palsy classification, medical and surgical management of lower motor
neuron type of facial palsy. [3 Hours]

13. Ophthalmology: Ophthalmologic surgical conditions, refraction’s, conjunctivitis, glaucoma,

corneal ulcer, iritis, cataract, retinitis, detachment of retina, defects of extra-ocular muscles-
surgical management[3 Hours]

Recommended books:

1. General Surgical Operations – by Kirk / Williamson

2. Surgery by Nan
3. Bailey and Love’s – Short Practice of Surgery
4. Chest Disease by Crofton and Douglas.
5. Patrica A Downie, Text book of Heart, Chest Vascular Disease for physiotherapists, JP Bros.
 ORTHOPEDICS & TRAUMATOLOGY

Subject Description

This subject follows the basic science subjects to provide the knowledge about Orthopedic
conditions the therapist would encounter in their practice. The objective of this course is that after
60 hrs of lectures and discussion the student will be able to demonstrate an understanding of
orthopedic conditions causing disability, list the etiology, clinical features and methods of
investigations and management.

Subject Title : ORTHOPEDICS & TRAUMATOLOGY

Duration : 25 – 36 Months
Total Hours : 60
Theory / Lecture : 2 Hours / Week

Method of Assessment : Written

1. Introduction [3 Hours]
Introduction to orthopaedics. Clinical examination in an Orthopedic patient. Common
investigative procedures. Radiological and Imaging techniques in Orthopeadics. Inflammation and
repair, Soft tissue healing.

2. Traumatology [3 Hours]

Fracture: definition, types, signs and symptoms.Fracture healing.Complications of

fractures.Conservative and surgical approaches.Principles of management – reduction
(open/closed, immobilization etc). Subluxation/ dislocations – definition, signs and symptoms,
management (conservative and operative).

3. Fractures and Dislocations of Upper Limb [6 Hours]

Fractures of Upper Limb - causes, clinical features, mechanism of injury, complications,

conservative and surgical management of the following fractures:
Fractures of clavicle and scapula. Fractures of greater tuberosity and neck of humerus. Fracture
shaft of humerus. Supracondylar fracture of humerus. Fractures of capitulum, radial head,
olecranon, coronoid, and epicondyles. Side swipe injury of elbow. Both bone fractures of ulna and
radius. Fracture of forearm – monteggia, galaezzi fracture –dislocation. Chauffer’s fracture.Colle’s
fracture. Smith’s fracture. Scaphoid fracture. Fracture of the metacarpals. Bennett’s fracture.
Fracture of the phalanges. (Proximal and middle.)

Dislocations of Upper Limb - Anterior dislocation of shoulder – mechanism of injury, clinical

feature, complications, conservative management (Kocher’s and Hippocrates maneuver), surgical
management (putti plat, bankart’s) etc. Recurrent dislocation of shoulder. Posterior dislocation of
shoulder – mechanism of injury, clinical features and management. Posterior dislocation of elbow
– mechanism of injury, clinical feature, complications & management.
4. Fracture of Spine [4 Hours]

Fracture of Cervical Spine - Mechanism of injury, clinical feature, complications (quadriplegia);

Management- immobilization (collar, cast, brace, traction); Management for stabilization,
management of complication (bladder and bowel, quadriplegia). Clay shoveller’s fracture.
Hangman’s fracture. Fracture odontoid. Fracture of atlas.

Fracture of Thoracic and Lumbar Regions - Mechanism of injury, clinical features, management
—conservative and surgical of common fractures around thoracic and lumbar regions.Fracture of
coccyx.

Fracture of Rib Cage - Mechanism of injury, clinical features, management for Fracture Ribs,
Fracture of sternum.

5. Fractures and Dislocations of Lower Limb [5 Hours]

Fracture of Pelvis and Lower Limb - causes, clinical features, mechanism of injury, complications,
conservative and surgical management of the following fractures:
Fracture of pelvis. Fracture neck of femur – classification, clinical features, complications,
management - conservative and surgical. Fractures of trochanters. Fracture shaft femur—clinical
features, mechanism of injury, complications, management-conservative and surgical.
Supracondylar fracture of femur. Fractures of the condyles of femur. Fracture patella. Fractures
of tibial condyles. Both bones fracture of tibia and fibula. Dupuytren’s fracture Maisonneuve’s
fracture. Pott’s fracture – mechanism of injury, management. Bimalleolar fracture Trimalleolar
fracture Fracture calcaneum – mechanism of injury, complications and management. Fracture of
talus. Fracture of metatarsals—stress fractures jone’s fracture. Fracture of phalanges.

Dislocations of Lower Limb - mechanism of injury, clinical features, complications, management

of the following dislocations of lower limb.
Anterior dislocation of hip. Posterior dislocation of hip. Central dislocation of hip. Dislocation of
patella. Recurrent dislocation of patella.

6. Soft Tissue Injuries [3 Hours] - Define terms such as sprains, strains, contusion, tendinitis,
rupture, tenosynovitis, tendinosis, bursitis.
Mechanism of injury of each, clinical features, managements- conservative and surgical of the
following soft tissue injuries: Meniscal injuries of knee. Cruciate injuries of knee. Medial and
lateral collateral injuries of knee. Lateral ligament of ankle. Wrist sprains. Strains- quadriceps,
hamstrings, calf, biceps, triceps etc. Contusions- quadriceps, gluteal, calf, deltoid etc. Tendon
ruptures-Achilles, rotator cuff muscles, biceps, pectorals etc.

7. Hand Injuries [2 Hours]- mechanism of injury, clinical features, and management of the
following - Crush injuries. Flexor and extensor injuries. Burn injuries of hand.

8. Amputations [2 Hours] - Definition, levels of amputation of both lower and upper limbs,
indications, complications.

9. Traumatic Spinal Cord Injuries [2 Hours] - Clinical features, complications, medical and
surgical management of Paraplegia and Quadriplegia.

10. Deformities [6 Hours] - clinical features, complications, medical and surgical management of
the following Congenital and Acquired deformities.
Congenital Deformities - CTEV. CDH. Torticollis. Scoliosis. Flat foot. Vertical talus. Hand
anomalies- syndactyly, polydactyly and ectrodactly. Arthrogryposis multiplex
congenita(amyoplasia congenita). Limb deficiencies- Amelia and Phocomelia. Klippel feil
syndrome. Osteogenesis imperfecta(fragile ossium). Cervical rib.

Acquired Deformities - Acquired Torticollis. Scoliosis. Kyphosis. Lordosis. Genu varum.

Genu valgum. Genu recurvatum Coxa vara. Pes cavus. Hallux rigidus. Hallux valgus. Hammer
toe. Metatarsalgia.

11. Disease of Bones and Joints [4 Hours]: Causes, Clinical features, Complications,
Management- medical and surgical of the following conditions :

Infective conditions: Osteomyelitis (Acute / chronic). Brodie’s abscess. TB spine and major
joints like shoulder, hip, knee, ankle, elbow etc.
Arthritic conditions: Pyogenic arthritis. Septic arthritis. Syphilytic infection of joints.
Bone Tumors: classification, clinical features, management - medical and surgical of the
following tumors : Osteoma. Osteosarcoma, Osteochondroma. Enchondroma. Ewing’s
sarcoma. Gaint cell tumor. Multiple myeloma. Metastatic tumors.
Perthes disease, Slipped Capital Femoral Epiphysis and Avascular Necrosis.
Metabolic Bone Diseases: Rickets. Osteomalacia, Osteopenia. Osteoporosis.

12. InfIammatory and Degenerative Conditions [4 Hours]: causes, clinical feature, complications,
deformities, radiological features, management- conservative and surgical for the following
conditions :
Osteoarthritis. Rheumatoid arthritis. Ankylosing spondylitis Gouty arthritis. Psoriatic arthritis.
Hemophilic arthritis. Still’s disease (juvenile rheumatoid arthritis). Charcot’s joints.
Connective Tissue Disorders- Systemic Lupus Erythematosis, Scleroderma, Dermatomyositis,
Poliomyelitis, Mixed connective tissue Disease (MCTD)

13. Syndromes [3 Hours]: Causes, Clinical features, complications, management- conservative

and surgical of the following :
Cervico brachial syndrome. Thoracic outlet syndrome. Vertebro- basilar syndrome. Scalenus
syndrome. Costo clavicular syndrome. Levator scapulae syndrome. Piriformis syndrome.

14. Neuromuscular Disorders [3 hours]: Definition, causes, clinical feature, complications,

management. (Multidisciplinary approach) medical and surgical of the following conditions :
Cerebral palsy. Poliomyelitis. Spinal Dysraphism. Leprosy.

15. Cervical and Lumbar Pathology [3 Hours]: Causes, clinical feature, patho-physiology,
investigations, management-Medical and surgical for the following :
Prolapsed interverbral disc (PID), Spinal Canal Stenosis. Spondylosis (cervical and lumbar)
Spondylolysis. Spondylolisthesis. Lumbago/ Lumbosacral strain. Sacralisation. Lumbarisation.
Coccydynia. Hemivertebra.

16. Orthopedic Surgeries [3 Hours]: Indications, Classification, Types, Principles of management

of the following Surgeries :
Arthrodesis. Arthroplasty (partial and total replacement). Osteotomy , External fixators. Spinal
stabilization surgeries(Harrington’s, Luque’s, Steffi plating) etc , Limb re-attachments.

17. Regional Conditions [4 Hours]: Definition, Clinical features and management of the following
regional conditions
 Shoulder: Periarthritic shoulder (adhesive capsulitis). Rotator cuff tendinitis. Supraspinatus
Tendinitis. Infraspinatus Tendinitis. Bicipital Tendinitis. Subacromial Bursitis.
Elbow: Tennis Elbow. Golfer’s Elbow. Olecranon Bursitis (student’s elbow ). Triceps
Tendinitis.
Wrist and Hand: De Quervain’s Tenosynovitis. Ganglion. Trigger Finger/ Thumb. Mallet
Finger, Carpal Tunnel Syndrome, Dupuytren’s Contracture.
Pelvis and Hip : IT Band Syndrome. Piriformis Syndrome. Trochanteric Bursitis.
Knee: Osteochondritis Dissecans. Prepatellar and Suprapatellar Bursitis. Popliteal Tendinitis.
Patellar Tendinitis. Chondromalacia Patella. Plica Syndrome. Fat Pad Syndrome (Hoffa’s
syndrome).
Ankle and Foot: Ankle Sprains. Plantar Fasciitis / Calcaneal Spur. Tarsal Tunnel Syndrome.
Achilles Tendinitis. Metatarsalgia. Morton’s Neuroma.

Books Recommended:

1. Outline of Fractures—John Crawford Adams.

2. Outline of Orthopedics.— John Crawford Adams.
3. Text book of Orthopedics.—Maheswari.
4. Apley’s Orthopedics.
5. Textbook of Orthopedics and Traumatology— M.N.Natarajan