Peripheral Vascular Examination OSCE - Clinical Skills - Dr Gill

In the cardiovascular examination, particularly in the case of an OSCE station, we conclude the examination often by stating that the examiner would want to perform:
- An ECG
- Check full blood count
- and "do a peripheral vascular examination

In this video, we demonstrate that oft-talked about, but comparatively less common examination.

Starting off, with the examination of the hands, the radial, brachial and carotid pulses. before moving down to assess for a AAA, checking the femoral and popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses

For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s

#PeripheralVascular #ClinicalSkills #DrGill

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This video demonstrates how to perform a cardiovascular examination in an OSCE station.

You can access our step-by-step OSCE guide to accompany this video here: https://geekymedics.com/cardio....vascular-examination

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Chapters:
- Introduction 00:00
- General inspection 00:35
- Hands 00:46
- Schamroth's window test 01:07
- Capillary refill 01:27
- Pulses 01:35
- Carotid auscultation 02:21
- Carotid pulse 02:43
- Jugular venous pressure 02:55
- Hepatojugular reflux 03:09
- Inspection of the face 03:21
- Inspection of the chest 03:49
- Apex beat 04:12
- Heaves and thrills 04:28
- Heart valve ausculation 04:49
- Accentuation manoeuvres 05:45
- Lung base auscultation 06:23
- Sacral and pedal oedema 06:43
- Summary 07:10

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Always adhere to your medical school/local hospital guidelines when performing examinations or clinical procedures. DO NOT perform any examination or procedure on patients based purely upon the content of these videos. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video.

Normal heart sounds and aortic regurgitation/stenosis sounds
Recorded on a Thinklabs Digital Stethoscope (https://www.thinklabs.com)

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Pediatric Medical History

Aortoiliac occlusive disease (AIOD) occurs commonly in patients with PAD. Significant lesions in the aortoiliac arterial segment are exposed easily by palpation of the femoral pulses. Any diminution of the palpable femoral pulse indicates that a more proximal obstruction exists. Obstructive lesions may be present in the infrarenal aorta, common iliac, internal iliac (hypogastric), external iliac, or combinations of any or all of these vessels. Occasionally, degenerated nonstenotic atheromatous disease exists in these vessels and may manifest by atheroembolism to the foot, the "blue toe" or "trash foot" syndrome. Generally, patients with aortoiliac PAD have a poorer general prognosis than those with more distal PAD.

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The type of operation performed for removal of pancreatic cancer is based on the location of the tumor. For tumors of the head and neck of the pancreas a Whipple procedure, (also called a pancreaticoduodenectomy) is performed. This is a complex operation perfected at Johns Hopkins. This video will explain the surgery and what patients can expect.

Learn more about the Whipple procedure at Johns Hopkins:
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Hand assisted laparoscopic sigmoid resection and rectopexy for full thickness rectal prolapse.

Patients are generally placed in a supine position with the head in an extended position. As noted above, Gardner-Wells tongs can be used for additional cervical traction. The hands can also be tied downward to increase the operative exposure. Once the surgical site is properly prepared with cleansing material, the appropriate surgical level is identified with intraoperative radiographs. A scalpel is used to make a linear longitudinal incision just medial to the body of the sternocleidomastoid muscle. The incision is made long enough to include at least 2 vertebral levels if a 1-level discectomy is being performed. Alternatively, transverse skin incisions over the targeted vertebral level can also be performed. The platysmal muscle is identified and incised. The platysmal incision can be extended if a multilevel decompression is the surgical aim. Extensive subplatysmal dissection is performed to reduce retraction injury.

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Mechanism of Addiction

Abdominal Aorta Palpation

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Surgical site infections (SSIs) remain a prevalent threat to patient safety. Proper surgical hand scrub or rub techniques are essential to decreasing the incidence of SSIs. This video provides instructions on the anatomical surgical hand scrub procedure using the brushstroke method. Learn more from the Department of Hospital Epidemiology and Infection Control (HEIC) at The Johns Hopkins Hospital: http://www.hopkinsmedicine.org/heic