Abdominal Clinical Examination OSCE - Clinical Skills - Dr Gill
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- Опубліковано 22 тра 2024
- Abdominal Clinical Examination OSCE
The abdominal examination is a relatively straight forward clinical examination and is an opportunity for medical students to pick up easy marks during their exams.
There are however several specific clinical skills which need to be focused on during medical school revision for the effective completion of an abdo exam
Inspection, looking over the hands, face and abdomen
Palpation is needed both superficially, looking for pain, but also with increased force checking for the presence of abdominal masses.
Percussion - listening for changes in town
Auscultation - including listening for renal bruits as well as bowel sounds
________
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 recognized standard textbook for clinical skills.
#AbdominalExamination #ClinicalSkills #DrGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
00:00 - Introduction
00:49 - Hand Examination and Pulse Check
01:36 - Blood Pressure Check
02:48 - Head and Neck Examination
03:36 - Stomach Examination
06:36 - Legs Examination
07:01 - Conclusion
Hi dr Gill. At 1:42 you are checking something... but what? Looks like you are checking if the blue matches his skin tone?
We’re ensuring the size of the cuff is appropriate for his arm.
Wrong sized cuffs can affect the blood pressure. We explain it a little more in the video “understanding blood pressure”
ua-cam.com/video/rLEbOjWgmvE/v-deo.html
😊
For patients who are Smurfs, you often need to opt for a differently colored cuff.
🤣🤣🤣
@@meltee01 Or if they’re cosplaying as someone from the X-Men! 😂
He's so kind to answer it. Loved it
This man has fully accepted his role in the asmr community without even batting an eye. We love a multifaceted king
ASMR has taught me more about medicine and anatomy than 7 years of science classes in school ever did
The internet can be quite surprising
I took and failed/passed anatomy classes for a degree I have never used in my life (shows you how much i hate that degree) now i am back in school for something i have passion for but we had to learn how draw anatomy which i hissed on 😂 anyway I agree with you though. ASMR is better than learning anatomy in science classes.
What are yous studying now?
@@DrJamesGill I don't know why but whenever I am reading your comments or replies I always imagine you doing the Basil Rathbone voice from Sherlock Holmes movies. Your voice has so much similarity, just if you add the sharp sophistication which Rathbone did.
@@jassinghchaney6141 it’s pretty cool how he interacts with the fans. One of the few ‘celebrities’ on UA-cam that actually do. Much respect!
One day I think we should get a full head to toe cranial nerve assessment
agree💫💫💫
Not sure if brilliant joke or mild confusion
Head to toe cranial nerve haha. Cranial nerves are the one directly connected to the brain in the head. Head to toe would just be a physical exam
Oh baby yes
Please signed me up!
“Hello there I’m Dr Gill, open the cash register and give me all your money”
Nope. Doesn’t work 😔
“Let me putapitapaper” would allow the register to be opened
**cashier hands over bag of money** "That's lovely thank you." ;)
🤣🤣🤣
@@89horizon Any double vision!
"Going to check your liver"
Me: "During Quarantine? uhh......... uuuuuuuuuuuhhh....... how bout next year?"
Hahaaaa I relate to this 😆
Same here👍👍🤣
😂
😂😂😂😂😂
ok
Well with the mask the patient don't have to worry about sandwich breath
these r my fave comments
1:09 “Can you please do the Macarena”
Pressing on your stomach is a way to find out if the size of your internal organs is normal, to check if anything hurts, and to feel if anything unusual is going on. Looking, listening, and feeling are all part of a physical exam.👍
Why so deep though 😟
Yeah well these virtual appointments cannot tell most of that.
"Hello MyNamesDr Gill"
Me: well hello sleep :d!
Are you SURE you are not one of my students?? 😂😂
@@DrJamesGill haha we all wish we were
@@DrJamesGill OMG A LEGEND HAS ANSWERED ME!!! Wish I were but although I have been learning from your videos I mostly use them to relax because ASMR haha You’re awesome! Both as an instructor and as a asmrtist Saludos!
@@emmanuelk.4520 aint that the truth 😊
The doctor always asks how the patient is doing. But I want to know how the doctor is doing. So.
How are you Dr. Gill?
Considering all things. Could be worse! Thanks for asking 😊
Hope you’re still doing good Doc. We care about your well being
Thanks guys. We’re ticking along. Trying to keep smiling 😊
Dr James Gill How is kitty doing??
Dr Gill, since the birth of my children I’ve not slept well only averaging around 4 hours per night and taking forever to finally fall asleep. I now play your videos every night and the soothing tones of your voice coupled with the interesting subject matter get me off to sleep within 30 mins. I don’t mean that in a bad way, your not boring me just relaxing my mind and putting me at ease. I can’t thank you enough.
Omg. You are just like me. I have been listening to him to relax and eventually sleep.
@@alizay3026you recently had a kid too?
@@iloveyouskii no dear. 🙂
Someone please do a "in and out" 1hour loop....it really make me relax 😂
I’ll take that with an “any double vision” loop
OMFG I definitely would "second" that! :D
And putapitofpaper
Yes pleaseeeee
I don’t know if this works for you guys, but know UA-cam lets you to repeat indefinitely the video ❤️
This patient obviously works hard. The Palms of his hands tell the tale.
He a climber
@@juanmanueljorgeleonarte5038 oh right. Thanks mate. 👍
@@juanmanueljorgeleonarte5038 How'd you know? Do you have his Instagram?
@@spencerschmidt75 I'd quite like to know too. Who is the patient in the video
@@benjaminn8534 Yup. It's been months but haven't found it yet
1:42 "Ah yes. He is not blue. Perfect."
Anyone knows why he did that?
We’re checking the size of the cuff, against the size of the arm.
If the cuff is too small, then it will mean the blood pressure is artificially elevated
3:27 doc be wearin his watch everyday holy fahk the hair is gone and the tan line strong 🤣🤭
I used to think I was weird as a kid cos I loved when the nit nurse used to come to school and check our hair for lice . The sensation is now known as ASMR and everyone loves it. Happy days . Great vid
Ha! Not just me then 😀
Yes!
I just love these relaxing videos and the sound of his voice
Much love for that thorough and aggressive hand sanitizer use !
Dr Gill:
Patient: But are you gonna putapitapaper?
Not in an abdo exam
@@DrJamesGill When the man himself responds. I am humbled sir.
This reminded me of the type i had a tumor in my ovary for over a year.
STORY: I went to my dr to get checked since I was gaining weight fast, wasn't pooping, and looked pregnant. (I was in 8th grade). They did blood work, I took a pregnancy test, and my dr did an abdominal check. She felt something so she sent me to a small local hospital. There they did xrays, an ultrasound, and another pregnancy test. They ended up telling me that I had poop stuck in there and so they gave me medication to help me. Months passed and the pain got worse. It was so bad I couldn't get out of bed and 3 500mg pain killers did nothing. I went to me dr again and she did an abdominal check again. She told she didn't think it was poop and that i needed to go to bigger hospital ASAP. I was scared so I waited a month. In that month I couldn't even get out of bed. On the day I finally went, the hospital run xrays, an ultrasound, pregnancy test, and did some more blood work. Within 4 to 5 hours a dr came in and said, "yeah, your going to need emergency surgery. We don't know what it is. And whatever it is, it has taken over your entire ovary. So yeah your getting surgery tomorrow at 7am." When I got out of surgery he told me things were a bit complicated so he had to basically do a c section. He said that I had a tumor the size of a melon in my ovary and that my ovary was literally about to rip. He couldn't save my ovary but the good thing is that he took it out when he did since he said it could of caused cancer if it erupted. What was funny about his visit is that he brought in the tumor in a container that had some liquid. IT WEIGHTED 5 POUNDS! I was as fascinated as he was when I saw it. His eyes lit up like Christmas lights when he saw it. 😂
For years I didnt know what caused it but finally, fast forward to today, 26 years old now. I just found out that I have PCOS... which *drumroll* causes tumors to grow in your ovary.
Point of the story, GET YOUR ABDOMIN CHECKED!
You poor thing.
It’s shocking how they miss so many womens issues
Any1 else get proper buzzing when dr gill uploads a vid? I instantly know I’m going to drift into a deep sleep tonight. Also. I’m pretty sure I’ve become a qualified doctor as a sideline of asmr.
Could you imagine Dr. Gill and Hollie doing a video together... the medical ASMR world would implode
That would be my dream come true...💥
1:18
"Love you Dr. Gill!"
Cannot wait until this video goes viral so glad thar Dr gill is bringing another Asmr video for us
Actually, Dr. Gill videos are for educational purposes. For Warwick students, and others with diverse interests in health. Of course there we are, the asmr fans.
This man deserves all the good things in life. 🤍
ive had enough "going viral" this year
@@La_sagne valid Point
The asmr is what YOU take away from this
It isn't his intent
Nice! The mask didnt hurt the audio quality at all
Awesome video Doc :)
👍
Μου αρεσουν πολλυ τα βιντεοσας ειστε πολλυ καλος σας θαυμαζω σαν ανθρωπο και σαν επιστημονα και την ευγνειασας
I would love to have Dr. Gill as my physician. He’d make me feel so comfortable I’m already nervous doing physical exams and so shy. I love his accent too!
Imagine in 20 years someone will find out this video and will think: Why those ppl are wearing masks?
Wouldn’t it be lovely in 20yrs if we’re that far past it!
Imagine they are saying: "Damn they already wore them 20 years ago"
Who says we won't still be wearing masks in 20 years?
I think it’s unlikely. Partially due to cultural reasons.
I think once the covid 19 vaccines are being widely administered I think use will reduce
@@DrJamesGill That implies that enough of the herd will take the vaccine. Not sure how it is for you guys in England, but here in the US half the population is INSANE.
OMG my favourite exam. And I’m Not even a doctor. Just love it!
Have to hand it to you; you are the only channel that I can watch and not fall asleep because I am too immersed in watching the examinations and explanations despite not being a medical student.
I never would have thought that I enjoy watching an examination, but dislike being in one. The more you know 😅
Great video, I’ve been watching this as a registered nurse to review some of my assessment skills I haven’t used in a while. One thing I noticed that was different from what I’ve been taught though is the order you assessed in. We were always taught to inspect, auscultate, percuss, and then palpate on an abdomen inspection since palpating May cause the bowels to produce some slight sounds that wouldn’t be there otherwise. Just wanted to throw that out there to highlight some of the difference in technique! Thank you for the videos they’re much appreciated!
I'm not sure why some countries approach it differently. I've tried to address that fact in the Abdo exam explanation
ua-cam.com/video/pEKWIMBpKRs/v-deo.html
the video- *a detailed professional examination by a doctor for informational purposes*
the people who watch it- *unintentional asmr and memes*
If people are learning, I’m happy 😊
Good video Dr Gill
Hace ud un gran trabajo con estos videos, no solo educa y enseña, sino que tambien entretiene. Le animo a seguir en esta linea. Saludos desde España
You are doing a great job with these videos, not only educates and teaches, but also entertains. I encourage you to continue with your job. From Spain, greetings
Thank you! I appreciate that 😊
i had an examination today and i was so stressed before but after watching this i was all good!
An hour long compilation of all these examinations and Ill never wake up
The lord of the ASMR kingdom is back! Thanks for another great video Dr.!
More to come!
love dr Gill!!! THE KNOWLEDGEYOU LEARNED AND ASMR YOU EXPERIENCED!!! LOVE FROM NYC WASHINGTON HEIGHTS!!🔥🔥💯💯
Thanks 😊
Great informative video Dr. Gill as always!
Thanks 😊
You have the voice of an ASMRtist 😌 Stay Safe Doctor Gill! 😷
Such a friendly doctor
Excellent video. It really helped me in my OSCE.
Couple of things that were needed in my station and not here were:
1- Inspection & palpation of the testicles for testicular atrophy (Cirrhosis)
2- Per Rectal Examination
Thank you very much for the video Doctor
Reference: Clinical Examination by Nicholas And Simon
They are mentioned at the end of the video as things which are often required to “complete” the exam.
However more often than not for osce purposws they are considered separate exams - certainly in the two Med schools around here
I love this man❤️greetings from Bosnia🤗❤️
🔥🔥💪💪🙏🙏💯💯!! DR GILL THW GOAT OF ASMR AND DOCTOR SUBJECTS!!💪💪💯💯
I like this channel .... because always check pulse. Blood pressure etc. To patient ...
Good atitude....
BP is an essential vital sign, and should really be part of most examinations
Quick question; why did you start with palpation before auscultating and percussion? I have always been taught auscultation first, then percussion, and then palpation... in order to avoid potential changes you will make in hearing bowel sounds and tympani; from the applied pressure of palpation to the abdominal organs.
Hello and thank you for your fantastic videos! My only wish -if you could have an explanation of why you are doing what you are doing for each manoeuvre-or what you are looking for. I think this could enhance learning! Again, thank you so much-you have such a wonderful manner with patients!
Already done 😊
Here is the playlist for all of the medical Deep Dive videos where we look at what is being done in the demos 😊
ua-cam.com/play/PLi9o6OEHhWUiM6z1GNGpdQZTqf9PQqzDT.html
Question Doctor. Wouldn’t the JVP also be examined during the Abdominal Examination?
“I can’t see any ABnormal issues on ur stomach.” Very clever Dr Gill
I’ve been camped outside of this clinic for 2 days waiting for this premier. I haven’t showered and I’m using a Hawaiian Punch bottle to pee in.
Best videos in the world !
Imagine Dr. Gill doing the Glengarry Glen Ross speech.
"ABC. Always. Be. Checking for lumps and bumps."
"If you'd be so kind to put that coffee down? Splendid. "
No...
ABC is Airway, Breathing, Circulation,
Plus you can extend it:
ABC...DEFG - Don’t Ever Forget Glucose
@@DrJamesGill thank you
👍
For all the dislikers , there is special room in hell for specially those who dislike Dr gill's videos.
Wish I had a doctor this good, really bad waistline pain while sat at desk. Have to undo trousers.. just flares up for weeks at time
It would definitely be worth while talking to your doctor. There are a couple of things, which you could easily be helped with 😊
The Return of The King
Thank you for all you do!
👍
Dr. Gill does it again!
👍
Awesome, thank you! I learned so much from the chat, gotta look more into some of the conditions mentioned :)
Really pleased to hear that 😊
The best. The only one I would trust to be examines by
I really want to know how you check the organs when you tap your finger on them. What kind of sound you want to hear and what should alarm you?
Excellent vid!
Thanks 😊
New episodes of Dr Gill? Yaasssssss keep this up and I just may be a qualified medical professional
well I think a couple of people have said they're considering medical school...
Exciting. Thank you 👍🙂
Thanks for watching!
Great video, Dr. Gill! :)
👍
I listen to this Drs voice to fall asleep. It tickles my brain.
Always been curious about the tapping technique. What kind of reaction does it cause and what is James feeling for?
Listening for dullness - obstructions of some form, and hyper resonance which might also be associated,
นำ ำทยีา
Based on his hands and feet, this man is hardworking
No word of a lie, when the Doc started washing his hands, all I could smell for the next 5 minutes was sanitiser.. ghost smells on another level ! Lol
Now that’s an interesting hallucination
Meanwhile I was thinking, "oh, name brand. Fancy."
@@XSemperIdem5 😂
Your glasses don't seem to be fogging...I have found one of Dr. Gill's superpowers!! :)
Love your videos 👏🏼
🙏
Excellent abdominal exam given the constraints of covid
👍
Dr. Gill checking for lumps and bumps is a huge ASMR trigger.
Best upload time!!:) Love the videos
Glad you like them!
Well done
Dr Gill, when percuss what actually are you doing/learning?
Next level ASMR from the doctor of ASMR.
Could you please do a video on how an abdominal exam is preformed differently in a pregnant patient?
glad to see you're still posting videos Dr. Gill, and staying safe!
Thanks? You too! We’re trying 😊
Dr Gill, I was wondering why do you ask the patient to do that with their fingers at 1:18. I've seen many videos where doctors do this and I'm curious.
Hey Dr. Gill. It seems that in UK-based videos, the auscultation is done after the palpation and percussion, but in American-based videos, the auscultation is specifically done prior to the palpation and percussion, typically citing that it must be done in that order as the palpation and/or percussion could artificially alter the bowel sounds. I'm curious why this big difference seems to exist.
I’m honestly not sure. But given it’s my main academic subject, I did try to look at the literature, and as mentioned in the video auscultation is quite a weak sign in terms of assisting with the diagnosis. So doesn’t really matter I thin
Same here in Australia. I’m a nurse educator and auscultating last is a no-no here.
As mentioned, it appears to be a conserved flaw in methodology. There is I) not evidence it has to be last ii) evidence is a really poor clinical skill - 50% of consultant reviews for obstruction based on BS were not borne out on scan
@@DrJamesGill thank you!! It’s interesting to follow up on the evidence behind these practices. Thank you for explaining, your channel has been invaluable!! 🙏
Glad it’s been useful 😊
Nice approach doctor , but do you think u must auscultate before you palpate ned percuss the patient's abdomen ? It may be sound wired to jump right away to auscultation , but I guess u know why?
I like the patient's body and he's very laidback
Dr. Gill has nice hands.
Did I go to medical school
No. Have I watched all of these a thousand times
Yes
Really helpful hank you doctor
Glad it was helpful!
Just a heads up, at the end there's a list of possible abnormal findings, which isn't legible due to a suggested playlist.
This might be something you'd want to solve, or not.
Thanks I’ll tweak that shortly 😊
A question Dr. Gill; obviously due to covid-19 restrictions (and for demonstration purposes) the oral section of the standard of the HEENT check was omitted. In a true clinical environment, would this be performed by a nurse, with proper protection (mask, gloves, face shield..etc)?
Love your videos and your calming demeanor. 👏
At the moment, if we need to examine someone’s mouth - for example ? Tonsillitis, one of the practices has erected a larger tent where we do the flu jabs. I see then in there, so plenty of air flow AND PPE
So what is the benefit of running the blood pressure twice with and without the stethoscope?
Dr Gill I realy like your
voice
Good doctor
Hi The patient's legs were not hooked when examining the abdomen. Did you look at the hernias? What about the appendix? Very good video btw
Esto es súper relajante
3:00 ‘your tong’ I’m deffo calling it that from now on
Nice!
I’ve noticed in many of your videos, which I’ve re-watched many a time, that when you check the blood flow in the fingernails, you choose the ring finger. Any particular reason why?
No reason at all. Any finger will do. Likely just a habit of my internal examination protocol 😊
I was taught to auscultate the abdomen before palpation and percussion because this could influence bowel sounds
In the same way that “ninety nine” was previously taught for vocal resonance, I feel that the direction to auscultate first is similarly outdated.
We address the point in the abdominal deep dive video and touch on the lack of evidence to support auscultation being first
ua-cam.com/video/pEKWIMBpKRs/v-deo.html
Hi thank you so much dr. Gill! One question tho, auscultation should come first before palpation shouldn’t it?
Not according to Macleod Clinical Examination textbook. A few people have raised the point, but the literature searches I have done not support an alternative approach.
I wonder if these is USA / Europe divide. In the same way we perform prostate checks with the patient lying down, but I believe it is different in the USA
I've been watching your videos for like 3 years now and I've just realized, how do you get all these different camera angles?
We re film MANY times. I think the abdo film took us about 3 hours
@@DrJamesGill you re-film each time??? You don’t just have multiple cameras???
00:39 How goes Purell now with this new situation?