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A successful cardiovascular exam includes visual examination, palpation of the apical impulse, auscultation of Erb's point, auscultation of the carotids, and auscultation over the four different heart valve locations (aortic, pulmonic, tricuspid, and mitral). Additionally, the radial pulse is palpated while auscultating to distinguish whether a murmur is diastolic or systolic.
Video Index:
0:13 - Inspection of the thorax
0:29 - Palpation of the apex heart beat
0:59 - Auscultation of the heart
1:16 - Auscultation of the Erb’s point
1:33 - Using Erb’s point to check the heart rate
1:45 - Systolic and diastolic heart sound identification
2:01 - Ascultating individual valves: aortic, pulmonary, tricuspid, mitral
2:41 - Ascultation of the carotids
2:54 - Ascultating the pulmonary and aortic valves
3:04 - Ascultation of the mitral valve
3:16 - Mitral valve murmurs
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Elbow Exam - Orthopaedic OSCE - Clinical Skills - Dr Gill
The elbow examination is a core skill - in this video, we demonstrate how to perform an elbow EXAM for an Orthopaedic Clinical Skills OSCE, which should be one of the more accessible examination stations for medical students.
For a passing grade in your Clinical Skills OSCE, an elbow assessment should follow the LOOK, FEEL, MOVE approach
Initially looking for erythema, scars, swelling and position
Palpating the elbow - specifically the olecranon, medial and lateral epicondyles, and radial head for heat, oedema and crepitus
Finally assess range of movement with flexion and extension at the elbow, before determining for tennis and golfers' elbows
Watch further orthopaedic examinations for your OSCE revision:
The Elbow - Deep Dive
https://youtu.be/SX5buhtCVDw
The Spine Examination:
https://youtu.be/pJxMHa6SCgU
The Knee examination
https://youtu.be/oyKH4EYfJDM
The Hip examination
https://youtu.be/JC9GKq5nSdQ
The GALS examination
https://youtu.be/5qJaf7gW-B0 - Gait, Arms, Legs, Spine - GALS screen
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.
Some people viewing this medical examination video may experience an ASMR effect
#clinicalskills #Elbow #DrGill
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What Is It? Your wisdom teeth (third molars) usually start to erupt (enter your mouth) during the late teen years. Sometimes, there's not enough room for them. They may come into your mouth partially or not at all. Partial eruption of a wisdom tooth can create a flap of gum tissue next to the tooth. The flap can trap bits of food and debris. It can turn into a hotbed for bacteria. It's called pericoronitis if the tissue around the tooth becomes inflamed. Pericoronitis also can occur around a wisdom tooth that is still completely under the gums. Symptoms Symptoms include: Painful, swollen gum tissue in the area of the affected tooth. It can be difficult to bite down comfortably without catching the swollen tissue between your teeth. A bad smell or taste in the mouth Discharge of pus from the gum near the tooth More serious symptoms include: Swollen lymph nodes under your chin (the submandibular nodes) Muscle spasms in the jaw Swelling on the affected side of the face Diagnosis Usually, someone with pericoronitis goes to the dentist, complaining of pain in the area of the back tooth. Pericoronitis is diagnosed during the clinical exam. Your dentist will see inflamed gum tissue in the area of the unerupted or partly erupted wisdom tooth. The gums may be red, swollen or draining fluid or pus. Expected Duration Pericoronitis can be managed with antibiotics and warm salt water rinses. It goes away in about one week. However, it can return. This is likely to happen if the tooth does not completely enter the mouth and food and bacteria keep building up under the gum. Prevention You can help to prevent pericoronitis by brushing any erupting wisdom tooth and flossing around it. This will help make sure that food and bacteria do not build up under the gums. However, sometimes these steps do not work. If pericoronitis returns, you may need to have the flap of gum tissue removed. In some cases, the flap of tissue grows back and the wisdom tooth will need to be extracted. Treatment Pericoronitis can be tricky to treat. That's because the flap of gum tissue won't go away until the wisdom tooth emerges naturally, the tissue is removed or the tooth is removed. Your dentist will clean the area thoroughly by rinsing under the flap with water to remove bits of food and pus. Your dentist also may need to remove damaged tissue. If the area is infected, you'll most likely be given antibiotics. Your dentist will explain how to keep the area clean, which is the best way to prevent the problem from returning. This usually involves brushing and flossing daily and rinsing your mouth with water several times a day. These steps will help to prevent food from getting stuck under the gum flap. In some cases, your dentist may suggest removing the erupting tooth. Or the dentist may want to remove the tooth above it, which bites down on the gum below. If your dentist thinks the tooth may erupt fully into the mouth without problems, he or she may leave it alone. However, if pericoronitis comes back, the tooth may be extracted. Pericoronitis that causes symptoms should be treated as soon as possible. If it is not, the infection can spread to other areas of your mouth. The most severe cases are treated in a hospital. They sometimes require intravenous antibiotics and surgery. When To Call a Professional If you have symptoms of pericoronitis, make an appointment to see your dentist. If your wisdom teeth are coming in, visit your dentist at least twice a year for regular checkups. During those visits, the dentist can check on the progress of your wisdom teeth. Prognosis Pericoronitis does not cause any long-term effects. If the affected tooth is removed or erupts fully into the mouth, the condition cannot return.
A flail chest occurs when a segment of the thoracic cage is separated from the rest of the chest wall. This is usually defined as at least two fractures per rib (producing a free segment), in at least two ribs. A segment of the chest wall that is flail is unable to contribute to lung expansion. Large flail segments will involve a much greater proportion of the chest wall and may extend bilaterally or involve the sternum. In these cases the disruption of normal pulmonary mechanics may be large enough to require mechanical ventilation.
Alpha blockers relax certain muscles and help small blood vessels remain open. They work by keeping the hormone norepinephrine (noradrenaline) from tightening the muscles in the walls of smaller arteries and veins, which causes the vessels to remain open and relaxed. This improves blood flow and lowers blood pressure.
Priapism is a prolonged erection of the penis. The persistent erection continues hours beyond or isn't caused by sexual stimulation. Priapism is usually painful. Although priapism is an uncommon condition overall, it occurs commonly in certain groups, such as people who have sickle cell anemia. Prompt treatment for priapism is usually needed to prevent tissue damage that could result in the inability to get or maintain an erection (erectile dysfunction). Priapism is most common in men in their 30s.
Adult Still's disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain. Some people have just one episode of adult Still's disease. In other people, the condition persists or recurs. This inflammation can destroy affected joints, particularly the wrists. Treatment involves medications, such as prednisone, that help control inflammation
To facilitate the delivery of fluids during labour, obstetric anaesthetists from Coventry designed a triple IV peripheral connector with a central high-flow anti-reflux valve. This connector, now rightly known as the Coventry valve, can be used for all theatre settings and is especially useful in obstetrics, ICU, HDU and orthopaedics. More details on www.mediplus.co.uk
The anatomy of the direct and indirect inguinal hernia.
Music:
Berries and Lime by Gregory David
https://www.epidemicsound.com/track/z6iCiiyCPm/
The lumps may be hard or rubbery and can appear as a single breast lump that may be large or small. Fibrocystic changes also can appear as thickening of the breast tissue. Fibrocystic changes can occur in one or both breasts and are the most common cause of benign breast lumps in women age 35 to 50.
Rehabilitation time for a meniscus repair is about 3 months. A meniscectomy requires less time for healing — approximately 3 to 4 weeks. Meniscus tears are extremely common knee injuries. With proper diagnosis, treatment, and rehabilitation, patients often return to their pre-injury abilities.