This particular video is intended as a demonstration of a physical exam that may be useful in evaluating a patient with shoulder pain.

It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction. It is also intended not as a perfect example of a physical exam that would be performed for a patient in clinical practice, but is designed to optimize function and efficiency for a OSCE testing setting.

Instead, it should be treated as a supplement to independent learning using primary Osteopathic Physical Examination instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum.

Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner.

Attributions:
Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Medical Education Training (MET) facilities and equipment during the production of this video.

Additional thanks to the UNTHSC-TCOM learner and faculty volunteers who participated in this production and provided permission for the use of their image in this video.

A stepwise approach to the causes and diagnosis of Anaemia in clinical practice. This presentation includes the all important concept of the Reticulocyte production index. Discussion of Hereditary and acquired causes of Anaemia has been included in detail.

The thyroid gland lies in the midline of the anterior neck, just caudal to the thyroid cartilage. To inspect the thyroid gland, the examiner stands in front of the patient. The examiner asks the seated patient to dorsiflex (extend) the neck and swallow a sip of water. Minor enlargement of the gland may only become apparent on inspection in this position. Palpation of the thyroid gland is typically performed with the examiner standing behind the patient. Both lobes and the isthmus of the thyroid gland should be palpated for any nodules or diffuse enlargement. Mobility of the thyroid gland with swallowing should be assessed with palpation. Nodules arising from the thyroid gland typically move with swallowing. A hard, fixed thyroid gland could indicate malignancy. If a central nodule is identified, the patient is asked to protrude the tongue. Upward movement of the central nodule on protrusion of the tongue indicates a thyroglossal cyst. Auscultation is performed at the superior poles of bilateral lobes as this is where the superior thyroid artery is most superficial and bifurcates into its terminal branches. A bilateral bruit over the superior poles suggests Graves disease. Examination of the thyroid gland is completed by palpating the regional cervical lymph nodes for any enlargement.

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Although your body may harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between: Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB. Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later. Signs and symptoms of active TB include: Coughing that lasts three or more weeks Coughing up blood Chest pain, or pain with breathing or coughing Unintentional weight loss Fatigue Fever Night sweats

2 year old boy with chronic sinusitis, headache, vertigo problem, decreased vision and hearing. Repeated lung infections. Can you see it? Pay also special attention to the ears.

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Leopold's Maneuvers are difficult to perform on obese women and women who have hydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder. If she has not, she may need to have a straight urinary catheter inserted to empy it if she is unable to micturate herself. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation. First maneuver: Fundal Grip While facing the woman, palpate the woman's upper abdomen with both hands. A professional can often determine the size, consistency, shape, and mobility of the form that is felt. The fetal head is hard, firm, round, and moves independently of the trunk while the buttocks feel softer, are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk. Second maneuver After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities (arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the upper abdomen and also a mass in the maternal inlet, lower abdomen. Third maneuver: Pawlick's Grip In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor, this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be gently pushed back and forth. The Pawlick's Grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman. Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part. Fourth maneuver The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back. Cautions Leopold's maneuvers are intended to be performed by health care professionals, as they have received the training and instruction in how to perform them. That said, as long as care taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.

Orthopedic spine surgeons and vascular surgeons at UW Health in Madison, WI work together to perform minimally invasive anterior lumbar interbody fusion (Mini-ALIF). With this type of spinal fusion surgery, patients have smaller incisions, usually spend less time in the hospital and typically return to daily activities more quickly. Learn more https://www.uwhealth.org/ALIF

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A lot of women want to know what type of vaginal discharge is normal during pregnancy, and when you're not pregnant. So let's start out by talking about what's normal when you're not pregnant. It's normal to have about 1/2 teaspoon to 1 teaspoon of whitish, creamy, tannish discharge on most days of your cycle in between periods, with the exception of the time of ovulation. Actually, around the time of ovulation, it's normal to notice the discharge becoming more slippery and clear, almost like egg whites. And this is actually a sign that you can watch for to know when you're ovulating. And if you're seeing this type of discharge and you're trying to have a baby, then you should start to time intercourse with ovulation to increase your chances of conceiving.

Development and Maintenance of Bone

Piriformis syndrome refers to when the piriformis muscle irritates the sciatic nerve and caues pain along the back of the leg and foot.

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