MSK Block Book 2017

Musculoskeletal System
Block Book
Faculty of Medicine
Pelita Harapan University
Karawaci Tangerang
2017 /2018
AUTHOR AND CO-AUTHORS
Dr. John Butarbutar, dr., Sp.OT

Daniel R. Kambey, dr.
Mirna Phandu, dr ,SpOT
Musculoskeletal/MEU - FK UPH Page 1

Overview
The musculoskeletal block is designed to fulfill specific needs of students in relation to the
exiting subject of clinical disorders and injuries of the musculoskeletal system. Accordingly, its scope
includes the surgical subjects of orthopedics and fractures as well as the medical subjects of
rheumatology, metabolic bone disease, and rehabilitation.
The block is divided in weekly program comprises of lectures, practical and clinical skill
laboratory, as well as PBL group discussion.
Lectures include basic sciences such as human anatomy, physiology, histology, biochemistry,
pathology, pharmacology, as well a orthopedics, radiology, neurosurgery, pediatrics, internal medicine,
in order to introduce students to basic sciences pertaining to the musculoskeletal tissues as well as to
the clinical practice, that is, diagnosis and treatment of the wide variety of disorders and injuries from
which this tissues may suffer.
An integrated laboratory practice 4 hours once weekly is to have a three dimensional aspect of
the morphology and arrangement of macroscopic and microscopic structural components of
musculoskeletal tissues.
The selected clinical cases incorporating a multidisciplinary approach are discussed to illustrate
the meeting of different disciplines. This session is carried out in small group setting discussed three
times a week and wrapped up by an expert in the plenary session.
Lippo Karawaci, August 2017
Dr. JOHN BUTARBUTAR, dr., SpOT

List of Content
I. Course info
II. Standard of Medical Competencies
III. Teaching and Learning method
IV. Departments
V. Week Objectives
VI. List of disease
VII. References
VIII. Assessment
IX. Timetable

Chapter I
Course info
o Block : Musculoskeletal.
o Semester : 3 (three).
o Credits : 5 credits
o Duration : 5 Weeks.
o Started : August 7, 2017
o Ended : September 8, 2017
o Coordinator : Dr. John Butarbutar dr., SpOT.

Chapter II
Standards of Medical Competency
1. Effective Communication
Core competency
Able to explore and exchange information verbally and non-verbally with patients.
The graduate is able to:
1. Establish rapport with the patient and his/her family.
Greet the patient.
Make the patient feel comfortable.
Show empathy and trustworthiness.
Listen actively
2. Collect information.
Able to use open-ended and closed questions in acquiring information.
Ask for clarification from the patient about any of his/her statements.
Use clinical reasoning in exploring the history of the present illness, family
history, and history of past illness.
Conduct data exploration logically and efficiently.
Not give education and explanation prematurely while collecting
information.
3. Understand the patients perspective.
Respect the patients belief in everything related to his/her illness.
Explore the patients needs, worries, and hopes.
Respond professionally to the patients verbal and non-verbal language.
Use polite and understandable language which is appropriate to the
patients age and level of education.
4. Give explanations and information.
Anticipate and reduce the patients feeling of fright and stress before physical
examination.
Warn the patient when physical examination and clinical procedures may cause
pain or discomfort.

2. Clinical skills
Core Competency.
Conduct clinical procedures based on the patients problems and needs.
Perform history taking for musculoskeletal disorders
Collect and record accurate and important information about the patient
Conduct physical examination for musculoskeletal disorders.
Conduct physical examination in ways which minimise pain and discomfort for the
patient.
Conduct an appropriate physical examination based on the patients problem.
Conduct clinical emergency procedures.
Choose clinical emergency procedures which are appropriate for musculoskeletal
disorders such as bandage, splinting, suture and others
3. Scientific basis of medical knowledge

Core competency.
Identify, explain, and plan a scientific approach to health problem-solving, based on
current medical and health science, to get an optimal result.
Apply the concepts and principles of biomedical, clinical, and behavioural science,
and public health, appropriate to the delivery of primary health care.
Summarize an appropriate interpretation of the history, physical examination, and
laboratory tests for musculoskeletal disorders.
Explain the musculoskeletal disorders in terms of the principles of the basic medical
sciences, pathogenesis and pathophysiology.
Explain the molecular and cellular aspects of the musculoskeletal disorders, based
on an understanding of the normal mechanisms of the human body.
Explain the physiological and the molecular goals of treatment in musculoskeletal
disorders.
Explain the rational management of the musculoskeletal disorders, based on
clinical-epidemiology, pharmacology, physiology, diet, exercise, and behavioural
change.

Justify the chosen intervention based on pharmacology, physiology, nutrition,
exercise and behavioural change in musculoskeletal disorders.
Explain the possibility of drug interactions and side effects.
Explain the benefit of dietary therapy in the management of musculoskeletal
disorders.
Summarize an appropriate interpretation of the history, physical examination, and
laboratory tests of musculoskeletal disorders.
Explain the clinical and laboratory data to determine the diagnosis of
musculoskeletal disorders.

CHAPTER III
Teaching and Learning Method
Lecture : 6/week.
Tutorial and Plenary : 7 hours/week.
Laboratory practice : 4 hours/week.
Clinical skill : 4 hours/week.
Clinical exposure : 3 hours / week
Self-directed learning : 12 hours/week

CHAPTER IV
Departments Integrated in The Musculoskeletal System
Department of Anatomy.
Department of Anatomical Pathology.
Department of Biochemistry
Department of Histology.
Department of Microbiology.
Department of Medical Rehabilitation and Physiotherapy
Department of Neurosurgery
Department of Nutrition
Department of Orthopedic
Department of Pediatric
Department of Pharmacology.
Department of Physiology
Department of Radiology.

CHAPTER V
Learning Objectives
WEEK 1
Theme : Degenerative Bone Diseases
Week Chair : Mirna, dr , SpOT
Objectives :
1. Describe type 1 and 2 collagen: structure, function, and synthesis.
2. Describe the histology of normal particular cartilage.
3. Describe the articular cartilage changes in osteoarthritis.
4. Describe articular cartilage lubrication and healing.
5. Explain the role of proteoglycans and collagen and the changes in cartilage with disease and aging.
6. Describe the anatomy of the knee joint.
7. Explain the anatomy, physiology and biomechanics of the cruciate ligaments and menisci.
8. Describe fibrocartilage and menisci.
9. Describe the structure and function of ligaments and tendons.
10. Understand the pathophysiology of osteoarthritis.
11. Describe appropriate management options for symptomatic osteoarthritis (non surgical, surgical).
LECTURE
LECTURE 1 & 2
Duration : 100 minutes.
Topic : Pathological anatomy of the cartilage, ligaments, and tendon.
Lecturer : Darti Isbandiati, dr., SpPA, MS.
Objectives :
Students should be able to
Describe the histological changes of degenerative joint disease.
Explain the subchondral bone reaction in osteoarthritis (sclerosis, porotic, cystic lesion, and
osteophyte).
Describe the histological changes in degenerative tendon disease.

LECTURE 3 & 4
Topic : Anatomy of the lower limb.
Lecturer : Prof. Wahyuni L. Atmodjo, dr., PAK, Ph.D
Objectives :
Describe bone and joints of the Lower Limb
Describe the anterior, medial and posterior compartment of each region of the Lower Limb
Describe the origin and distribution of blood vessel supplying the muscles of Lower Limb.
Describe the innervations of Lower Limb by understanding the concept of lumbosacral plexus
and distribution their terminal branches.
Draw the cross sectional of proximal, middle, and distal part of each region of the Lower
Limb.
LECTURE 5 & 6
Topic : Knee Osteoarthritis.
Lecturer : Nicolaas , Dr dr Sp.OT
Objectives :
Understand the pathophysiology of osteoarthritis.

Describe appropriate management options for symptomatic osteoarthritis (non surgical,
surgical).
LABORATORY
LABORATORY 1
Topic : Lower limb
Duration : 2 x 100 minutes.
Instructor : Bernard Hutabarat, dr., PAK
Lab Assistant : Prof. Wahyuni L. Atmodjo, dr., PAK, Ph.D
Deisy Budiono, dr.

Objectives :
Student is able to
Identify the characteristic of the proximal and distal of femur
Identify the inguinal region
Identify the position and joints of tibia and os fibula
Identify the tarsal bones
Identify the flexor, extensor and adductor muscles of the thigh, and the leg
Identify the femoral, anterior tibial and posterior tibial vessels
Identify the femoral, sciatic, tibial and peroneus nerves
LABORATORY 2
Topic : Bone Histology.
Instructor : Jan Tambayong, dr., PAK.
Lab Assistant : Neneng Suryadinata, dr., M.Psi.T
Objectives :
Compare the histological features of compact and spongy bone in ground and decalcified
sections.
Describe the structure and composition of the osteon (of compact bone) and the trabecula (of
spongy bone).
Understand histology of osteoblasts, osteocytes and osteoclasts.
Differentiate between the periosteum and endosteum.
Compare the histological features of endochondral and intramembranous ossification

WEEK 2
Theme : Bone and Bone Healing
Week Chair : Mirna ,dr, SpOT
Objectives :
1. Bone Growth and formation.
Describe endochondral and intramembranous bone formation.
Describe the structure and explain the function of the normal growth plate.
Outline the events at each zone of the growth plate.
2. Bone as structures.
Describe bone types (cortical, trabecular, woven) and histologic features of each.
Know the basic structures of diaphyseal, metaphyseal bone and their blood supply.
Know the structure of periosteum.
Describe the major bone cells and their function.
Know the component of bone matrix (organic and inorganic substances).
Know the common type of collagen.
Describe the mineralization of bone.
3. Bone remodeling.
Reactions of bone to disorders and injuries.
Know the phases of bone healing.
Know the difference between metaphyseal and diaphyseal healing.
Know the reaction of growth plate. Recognize how bone attains in adult shape.
Know how cortical and cancellous bone remodel.
Explain the response of bone to stress.
Describe Wolffs Law
Know the types of bone deformity (loss of alignment, abnormal length, bony outgrowth.
Know in general common bone neoplasm.
4. Muscle Physiology.
Describe the innervations of muscle and neuromuscular junction.
Explain the physiology of muscle contraction.
Explain the mechanism of muscle growth (hypertrophy, atrophy, growth in length) and
contracture.

LECTURE
LECTURE 1
Topic : Bone Histology.
Lecturer : Jan Tambayong, dr., PHK.
Objectives :
Describe the difference between immature bone, cortical bone and cancellous bone.
Describe two ways of ossifications: endochondral and intramembranous.
Describe the five histologically distinct zones of the epiphyseal growth plate.
Understand how the plate is involved in the growth of the length of bones.
Describe the events of intramembranous bone formation and recognize key histological
features of such developing bone.
Know the structure of periosteum.
Describe trabecular structure of bone
Describe bones blood supply.
Describe bone cells and their function.
Explain the phases of bone healing.
Describe the reaction of growth plate to injury (increase, decreased, torsional growth).
LECTURE 2 & 3
Topic : Anatomy of The Upper Limb.
Lecturer : Prof. Wahyuni L. Atmodjo, dr., PAK, Ph.D
Objectives :
Describe bone and joints of the upper limb
Describe the anterior and posterior compartment of each region of the upper limb
Describe the origin and distribution of blood vessel supplying the muscles of upper limb.
Describe the innervations of upper limb by understanding the concept of brachial plexus and
distribution their terminal branches.
Draw the cross sectional of proximal, middle, and distal part of each region of the upper limb..

LECTURE 4
Topic : Cartilage, tendon and ligaments Histology.
Lecturer : Jan Tambayong, dr., PHK..
Objectives :
Describe type 1 and 2 collagen: structure, function, and synthesis.
Describe the histology of normal particular cartilage.
Describe fibrocartilage and menisci.
Describe the histology of tendon and muscle tendon junction.
Describe the structure and function of ligaments and tendons.
LECTURE 5 & 6
Topic : Bone and Muscle Physiology
Lecturer : Herman Mulijadi, dr., Sp.KP, PFK
Objectives :
Describe the neuromuscular junction.
Mention two main types of skeletal muscle fiber.
Explain the mechanism of all or none law, muscle tension, starting length in muscle contraction,
Explain the mechanism of isometric, isokinetic and isotonic contraction
Explain reactions of skeletal muscle to injury and disorders including atrophy, hypertrophy,
necrosis, contracture, regeneration
LECTURE 7
Topic : Congenital bone disorder
Lecturer : Mirna Phandu, dr., Sp.OT
Objectives :

Line out the common pediatric musculoskeletal disorder
Describe the pathology of developemental dislocation of the hip, genu varum, genu vagus, pes
planus,club foot, achondroplasia, and Marfans syndrome,
LABORATORY
LABORATORY 1
Topic : Anatomy of The Upper Limb.
Lab Assistant : Prof. Wahyuni L. Atmodjo, dr., PAK, Ph.D
Deisy Budiono, dr.
Objectives :
Identify the characteristic of the proximal and distal of Humerus
Identify anterior and posterior surface of scapula
Identify the lateral and medial extremity of clavicle
Identify the position and joints of ulnar and radial bones
Identify the proximal and distal row of the carpal bones
Identify the flexor and extensor muscles of brachii, antebrachii
Identify brachial, ulnar, radial vessels
Identify the axillar, musculocutaneus, radial, median, radial and ulnar nerves
LABORATORY 2
Topic : Histology of Verterbral Disc.
Duration : 2 x 100 minutes
Instructor : Jan Tambayong dr., PHK.
Lab Assistant : Neneng Suryadinata, dr., M.Psi.T
Objectives :
Identify normal and degenerated intervertebral disc

Describe the normal synovial histology
LABORATORY 3
Topic : Muscle Physiology.
Instructor : Herman Mulijadi, dr., Sp.KP, PFK
Objectives :
Demonstrate isotonic, isometric, eccentric contraction of muscle
Demonstrate initial length in muscle contraction.
Demonstrate muscle fatigue.

WEEK 3
Theme : Inflammatory Joint Disease
Week Chair : Mirna dr, SpOT
Objectives :
1. Line out classification of various forms of inflammatory arthritis.
2. Describe the changes in synovium histology in inflammatory arthritis.
3. Explain the pathomechanism(s) of joint destruction in inflammatory arthritis and the radiographic
and pathological changes of the joint in RA
4. Line out the extra-articular features of inflammatory arthritis
5. Understand the immune mechanisms in RA pathogenesis
6. Line out the laboratory tests used in the diagnosis of RA and SLE, with particular attention to the
rheumatoid factor and anti-nuclear antibodies (ANAs)
7. Describe the principles in the treatment of rheumatoid arthritis, particularly the role of disease
modifying anti-rheumatic drugs (DMARDs) to preserve joint function and to prevent disease
progression
LECTURE
LECTURE 1
Topic : Inflammatory Joint Diseases.
Lecturer : Darti Isbandiati, dr., SpPA., MS.
Objectives :
describe the structural changes of synovium, articular cartilage and subchondral bone
Describe the normal synovial histology and changes in synovium histology in RA
know the complication of inflammatory joint disease
LECTURE 2
Topic : Pediatric Hip Joint problem
Lecturer : Mirna Phandu , dr., SpOT.

Objectives :
Line out the common pediatric hip joint problem
Describe the pathology of Perthes disease, slipped epiphysis, flat foot
LECTURE 3 & 4
Topic : Pharmacology of Degenerative and Inflammatory Diseases.
Lecturer : Nicolaski Lumbuun, dr., SpFK.
Objectives :
Line out the basic therapeutic regimen for degenerative and inflammatory disease
Explain mechanism of action and side effects of drugs used in arthritis treatment.
LECTURE 5
Topic : Nutrition for Patients With Musculoskeletal Disease
Lecturer : Endang Darmoutomo, dr., SpGK.
Objectives :
Describe nutritional consideration in various musculoskeletal disease
LECTURE 6
Topic : Gout Diseases
Lecturer : Theo Audiyanto, dr., SpPD.
Gain an overview of classification and features of Gout Arthritis
Discuss some of the key mechanism(s) of joint damage in GA and the radiographic and
pathological changes of the joint
Gain insight Pathomechanisms in GA
LECTURE 7
Topic : Gout and Rheumatic Diseases

Lecturer : Euphemia S, dr., SpPD.
Gain an overview of classification, variation and features of of Rheumatic disease.
Discuss some of the key mechanism(s) of joint damage in RA and itsradiographic and
pathological changes
Understand some of the extra-articular features of inflammatory arthritis
Gain insight Pathomechanisms in GA
LABORATORY
LABORATORY 1
Topic : Synovial Fluid.
Instructor : T. Haryanto S., dr., SpPK.
Objectives :
Student is able to
describe normal characteristic of synovial fluid
describe synovial fluid types which have association with specific diagnose (non
inflammatory, inflammatory, septic and hemorrhagic)
Know the risk factor of synovial joint aspiration
LABORATORY 2
Topic : Pathology of Inflamatory Joint Disease
Instructor : Darti Isbandiati, dr., SpPA.
Suga, dr., SpPA.
Kistiandono, dr., SpPA.
Objectives:
- Identify degenerated vertebral disc
- Describe changes in synovium histology in RA
- Describe benign bone tumor
- Identify bone inflammation of the bone marrow cavity
- Describe malignant bone tumor.

WEEK 4
Theme : Metabolic Bone Disease.
Week Chair : Mirna dr, SpOT
Objectives :
1. Understand bone-remodeling process.
2. Describe bone density changes across the life cycles.
3. Line out metabolic bone disease (osteomalacia, Rickets, Paget, Osteoporosis)
4. Explain pathogenesis of osteoporosis.
5. Line out risk factors of osteoporosis.
6. Describe investigative findings in osteoporosis (laboratory, x-ray, bone densitometry).
7. Describe the physiological balance of calcium and phosphate, the roles of parathyroid hormone,
calcitonin, vitamin D hormones, the GI tract and kidney in this balance.
8. Line out the management of osteoporosis.
LECTURES
LECTURE 1
Topic : Cellular Biology of Metabolic Bone Diseases.
Lecturer : Darti Isbandiati, dr., SpPA., MS
Objectives : the students are able to
Understand bone remodeling process.
Describe bone density changes across the life cycles.
Describe pathologic findings in osteoporosis.
LECTURE 2
Topic : Anatomy of the Spine.
Lecturer : Bernard Hutabarat, dr., PAK
Objectives : the students are able to
Describe the bone and muscles of the back
Describe the structure of vertebral bones and vertebral column.
Describe the joints of vertebral bones

Describe the intervertebral disc and its content
LECTURE 3 & 4
Topic : Radiology of Musculoskeletal System
Lecturer : Subagia Santosa, dr., Sp.Rad
Objectives :
Describe types of bone fracture on plain x-ray photo
Describe types of joint dislocation on plain x-ray photo
Line out the radiology modalities to diagnose musculoskeletal diseases.
LECTURE 5 & 6
Topic : Metabolic Bone Diseases.
Lecturer : Dr. Franky Hartono, dr., SpOT.
Objectives :
Explain pathogenesis of osteoporosis.
Line out risk factors of osteoporosis.
Line out investigative findings in osteoporosis (laboratory, x-ray, bone densitometry).
Line out the management of osteoporosis.
Line out other metabolic bone disease including chondromalacia, Rickets, Pagets disease.
LABORATORY
LABORATORY 1
Topic : Anatomy of The Spine.
Lab Assistants : Prof. Wahyuni L. Atmodjo, dr., PAK, Ph.D
Deisy budiono, dr.

Objectives :
Identify of cervical, thoracal and lumbar vertebral and their processus, articular surface.
Identify the part of sacrum
Identify the curve of the spine
LABORATORY 2
Topic : Pathology of Bone, Cartilage and Tendon.
Duration : 2 x 100 minutes
Instructors : Darti Isbandiati, dr., SpPA.
Suga T A., dr., SpPA.
Objectives :
Describe callus formation, muscle fibrosis, tendinitis, synovitis
Identify fibrous displacia
Describe osteoid osteoma, ganglion, and other bone tumor

WEEK 5
Theme : Musculoskeletal infection.
Week Chair : John, dr SpOT
Objectives :
1. Line out classification and features of various form of musculoskeletal infection.
2. Describe the pathological features of pyogenic and granulomatous osteomyelitis
3. Explain the pathogenesis and principles of treatment of musculoskeletal infection.
4. Line out the common causative organism of bone and joint infection
5. Describe the clinical symptoms of musculoskeletal infection.
6. Explain the principle of antibacterial therapy in musculoskeletal infection.
LECTURE 1
Topic : Pathology of Bone Infection
Lecturer : Darti Isbandiati, dr., SpPA., MS.
Objectives :
Line out the classification of osteomyelitis.
Describe the pathology of acute and chronic hematogenous osteomyelitis and septic arthritis.
Describe the pathology of granulomatous bacterial infection.
LECTURE 2
Topic : Microbiology of Muscle and Bone Infection.
Lecturer : DR. Cucunawangsih, dr., SpMK.
Objectives :
Classify the common causative organisms of muscle and bone infections.
Line out the microbial etiology of septic arthritis and osteomyelitis (S.aureus, Streptococcus,
H.influenzae B, P.aeruginosa, and other microbial).
Describe the general concepts of anaerobic infection (Clostridia and other anaerobic
rods/cocci).

Line out the laboratory identification of significant isolate, including specimen collection,
microscopic exam, and culture.
LECTURE 3 & 4
Topic : Spondylitis TB
Lecturer : Mirna ,dr, SpOT
Objectives :
Explain pathogenesis of tuberculous osteomyelitis and how spondylitis developed.
Mention the common site of tuberculous spondylitis.
Describe the clinical features of tuberculous spondylitis.
Explain treatment options in general and complication of tuberculous spondylitis.
LECTURE 5 & 6
Topic : Musculoskeletal Infection
Lecturer : Dr. John Butarbutar, dr., Sp.OT
Objectives :
Explain pathogenesis of acute and chronic hematogenous osteomyelitis
Describe the clinical features of osteomyelitis
Explain treatment options and complication of osteomyelitis
LABORATORY
LABORATORY 1
Topic : Microbiology of Bone Infection.
Instructor : DR. Cucunawangsih, dr., SpMK.
Objectives :
To identify the shape of staphylococci with Gram-stained smear.
To identify the colony morphology of staphylococci.

To identify of S.aureus with tube coagulate test and catalase test.
To know the commercial identification system for S.aureus, including MRSA.
To know the anaerobic systems for cultivation of anaerobic bacteria.
LABORATORY 2
Topic : Pathology of Bone Infection.
Instructor : Darti Isbandiati, dr., SpPA.
Suga, dr., SpPA.
Objectives :
Identify degenerated vertebral disc
Describe changes in synovium histology in RA
Describe benign bone tumor
Identify bone inflammation of the bone marrow cavity
Describe malignant bone tumor.

Chapter VI
List of Musculoskeletal Disease
The list of diseases consist of chosen diseases which are derived from diseases burdens that arise
based on morbidity, mortality, and case fatality rate data estimated in primary health services; severity
of the problems and their effect to individual, family and society. Medical Doctor Graduates who will be
working in primary level should have adequate levels of competencies thus able to refer, to make a
diagnosis, to give an initial management, or to provide a comprehensive management. Therefore on
every chosen diseases, certain level of competency is set, which expected to be accomplished at the
end of Medical Doctor degree program, based on estimated competency which will be given when a
medical doctor work in primary health care, in line with common condition in Indonesia.
Provided, after graduated, a medical doctor would like to work in remote area where health care
services is very minimal, or in certain area which an extra competency is needed; the authority is
expected to give briefing prior to settlement.
The list of diseases is categorized based on systems, organs, and age. The levels of competencies
which are expected to be accomplished at the end of Medical Doctor degree program are as follow:
Levels of competencies expected to be accomplished at the end of Medical Doctor Degree

program:
Level of Competencies 1
A Medical Doctor is able to identify and to situate clinical features of the diseases when reading
references. In correspondences, he is able to identify these clinical features, and know how to obtain
further information. This level indicates overview level. When facing a patient with these clinical
features, and then assuming the diseases, the Medical Doctor directly refers.
A medical Doctor should be able to make a clinical diagnosis based on physical examination and further
examination requested (for example: basic laboratory examination or X-ray). Medical Doctor is able to
refer immediately to relevant specialist and able to manage afterward.

3a. A medical Doctor should be able to make a clinical diagnosis based on physical examination and
further examination requested (for example: basic laboratory examination or X-ray). Medical Doctor
is able to decide and provide initial management and refer to relevant specialist (not an emergency
case).
3b. A medical Doctor should be able to make a clinical diagnosis based on physical examination and
further examination requested (for example: basic laboratory examination or X-ray). Medical Doctor
is able to decide and provide initial management and refer to relevant specialist (emergency case).
A medical Doctor should be able to make a clinical diagnosis based on physical examination and further
examination requested (for example: basic laboratory examination or X-ray). Medical Doctor is able to
decide and independently manage problem comprehensively.

Chapter VII
References
1. Solomon, Louis .Apleys System of Orthopedics and Fractures, 8th edition., Duray
Nayagam & David War Louis Solomon wick. Arnold Publishers.
2. Salter, Robert B .Textbook of Disorders and Injuries of The Musculoskeletal System, 3rd
edition. Lippincott Williams & Wilkin,1999

Chapter VIII
Assessment
Attendance requirements and prerequisites to sit the examinations:

100% attendance at PBL tutorials
70 % attendance for all other activities
Exemptions permitted with doctors certificate, event of family crisis, disaster or extraordinary
reason with prior permission from tutor. Further criteria according to UPH criteria for exemption
Assessment of Student Performance

A. Tutorial performance
1. Formative: weekly discussions with tutor in the group
Preparation.
Participation.
Professional Behavior.
2. Formative: mid-block discussions with tutor in the group and written assessment
summary provided to the student.
Preparation.
Participation.
During this encounter, the tutor will identify any issues of concern with the student and
assist in efforts to improve.
3. Summative: students will be assessed at the end of the block on the following
performance in tutorial sessions:
Preparation.
Participation.
B. Knowledge assessment

Students applied knowledge will be assessed at
The end of each block using:
Tutorial (25%)
Multiple Choice Questions (55%)
Laboratory practical examination (OSPE) (20%)
The end of the year:
a. Total block relative value (45%)
Comprehensive Multiple Choice Questions (20%)
Longitudinal courses (15%)
OSCE (20%)
C. Skills Assessment
Students applied clinical skills will be assessed at
1. The end of semester using:
OSCE (10%)
Passing grade at UPH is 60.00% (C) and will be determined through recognized Standards
Setting processes. Relationship to the Grading system and GPA is as indicated in the table.
GRADE RANGE SCALE
A 90,00 100 4,00
A 85,00 89,99 3,70
B+ 80,00 84,99 3,30
B 75,00 79,99 3,00
B 70,00 74,99 2,70
C+ 65,00 69,99 2,30
C 60,00 64,99 2,00 (PASS)
C 55,00 59,99 1,50
F 00,00 54,99 0,00

CHAPTER IX
Timetable
Week 1 , Topic Degenerative bone disease

Time Monday 7/8/17 Tuesday 8/8/17 Wednesday 9/8/17 Thursday 10/8/17 Friday 11/8/17
07.15 - 08.05 Psikologi; Pengenalan
PBL/Tutorial PBL/Tutorial PBL/Tutorial
08.10 - 09.00 Clinical exposure II, Diri
Lecture 3 Prof.
09.05 - 09.55 Lecture 1 dr. Darti Small Group
Wahyuni Christian Worldview 2 /
Logika Terapan Plenary dr.
10.00 - 10.50 Lecture 2 dr. Darti Field Christian Worldview
Nicolaas/dr.Mirna
2
10.55 - 11.45 lunch break lunch break lunch break lunch break
11.50 - 12.40 Lab Introduction lunch break
Clinical Skill II Lecture 4 Prof. Clinical Skill II Faith activity
12.45 - 13.35
Wahyuni
13.40 - 14.30 Lab Practice I Lab Practice II Lab Practice II
14.35 - 15.25
Lecture 5 dr. Nicolaas/dr.
15.30 - 16.20
Mirna
Lecture 6 dr. Nicolaas/dr.
16.25 - 17.15 Clinical Exposure II
Mirna
(Lecture)
17.20 - 18.10
Week 2 , Topic Bone and bone healing
Time Monday 14/8/17 Tuesday 15/8/17 Wednesday16/8/17 Thursday 17/8/17 Friday 18/8/17
07.15 - 08.05
08.10 - 09.00 Clinical exposure II,
09.05 - 09.55 Lecture 1 dr. Jan Small Group Lecture 5 dr. Herman
10.00 - 10.50 Lab Introduction Field Christian Worldview Lecture 6 dr. Herman
10.55 - 11.45 lunch break lunch break 2 lunch break
11.50 - 12.40 lunch break
Clinical Skill II Faith activity
12.45 - 13.35 Lecture 4 dr. Jan
Lab Practice I
13.40 - 14.30 Lecture 7 dr. Mirna
Lab Practice II Lab Practice II
14.35 - 15.25 Plenary dr. Mirna
Lecture 2 Prof.
15.30 - 16.20
Wahyuni
Lecture 3 Prof.
Wahyuni
(Lecture)
17.20 - 18.10

Week 3 ,Topic inflamatory joint disease
Diri
08.10 - 09.00 Clinical exposure II,
Lecture 7 dr.
09.05 - 09.55 Lecture 1 dr. Darti Small Group Christian Worldview 2 / Lecture 5 dr. Endang D.
Euphemia
Logika Terapan
10.00 - 10.50 Lab Introduction Field Christian Worldview Lecture 2 dr. Mirna
10.55 - 11.45 lunch break lunch break 2 lunch break Plenary dr. Euphemia
Clinical Skill II Clinical Skill II Faith activity
12.45 - 13.35
13.40 - 14.30 Lab Practice I Lecture 6 dr. Theo
14.35 - 15.25
15.30 - 16.20
Guest Lecture
17.20 - 18.10 (Lecture)

Week 4 , Topic metabolic bone disease
Time Monday 28/8/17 Tuesday 29/8/17 Wednesday 30/8/17 Thursday 31/8/17 Friday
PBL/Tutorial PBL/Tutorial
Lecture 2 dr.
09.05 - 09.55 Lecture 1 dr. Darti Small Group Christian Worldview 2 /
Bernard
Logika Terapan
10.00 - 10.50 Lab Introduction Field Christian Worldview
10.55 - 11.45 lunch break lunch break 2 lunch break
Clinical Skill II Lecture 3 dr. Clinical Skill II
12.45 - 13.35
Subagia
Lab Practice I Lecture 4 dr.
13.40 - 14.30
Subagia
Lecture 3 dr.
14.35 - 15.25
Nicolaski L
Lecture 4 dr.
15.30 - 16.20 Lecture 5 dr. Franky H.
Nicolaski L
16.25 - 17.15 Clinical Exposure II Lecture 6 dr. Franky H.
17.20 - 18.10 (Lecture) Plenary dr. Franky H.

Week 5, Topic Musculoskeletal infection
09.05 - 09.55 Lecture 1 dr. Darti Small Group Christian Worldview 2 /
10.00 - 10.50 Lab Introduction Field Christian Worldview Logika Terapan
10.55 - 11.45 lunch break lunch break 2 lunch break lunch break
Clinical Skill II Clinical Skill II Faith activity
12.45 - 13.35 Lecture 2 dr. Cucu
Lab Practice I
13.40 - 14.30 Lecture 3 dr. Mirna Lecture 5 dr. John
14.35 - 15.25 Lecture 4 dr. Mirna Lecture 6 dr. John
15.30 - 16.20 Plenary dr. John
17.20 - 18.10 (Lecture)

CHAPTER X
APPROVAL
Block Book : Musculoskeletal System

Date August 2017
No.
FK/PRO-11.BB.6.08/REV-06
Dokumen Pages 1 - 37
Name Position Sign
Written by
Dr. John Butarbutar, dr., Sp.OT Block Coordinator
Supervised by
Dr. Allen Widysanto, dr., Sp.P Vice Dean Academic
Approved by Prof. George Matthew, MBBS, MS,

Executive Dean
MD, FCAMS
Legalized by Prof. Dr. Dr. Eka J.

Dean
Wahjoepramono., dr., Sp.BS, Ph.D

MSK Block Book 2017

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Musculoskeletal System

Dr. John Butarbutar, dr., Sp.OT

Musculoskeletal/MEU - FK UPH Page 1

Lippo Karawaci, August 2017

Dr. JOHN BUTARBUTAR, dr., SpOT

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3. Scientific basis of medical knowledge

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Understand the pathophysiology of osteoarthritis.

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Levels of competencies expected to be accomplished at the end of Medical Doctor Degree

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Attendance requirements and prerequisites to sit the examinations:

Assessment of Student Performance

Musculoskeletal/MEU - FK UPH Page 33

GRADE RANGE SCALE

A 90,00 100 4,00

A 85,00 89,99 3,70

B+ 80,00 84,99 3,30

B 75,00 79,99 3,00

B 70,00 74,99 2,70

C+ 65,00 69,99 2,30

C 60,00 64,99 2,00 (PASS)

C 55,00 59,99 1,50

F 00,00 54,99 0,00

Musculoskeletal/MEU - FK UPH Page 34

Week 1 , Topic Degenerative bone disease

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Musculoskeletal/MEU - FK UPH Page 3

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Block Book : Musculoskeletal System

Name Position Sign

Approved by Prof. George Matthew, MBBS, MS,

Legalized by Prof. Dr. Dr. Eka J.

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