Peripheral Vascular Examination - Clinical Skills - Dr Gill
Вставка
- Опубліковано 30 тра 2024
- Examination of Peripheral Vascular System - Clinical Skills OSCE Revision - Dr Gill
In this video, we demonstrate the peripheral vascular examination - a less common examination, but still vitally important, particularly amongst the older population
Starting with the examination of the hands looking for clinical signs of vascular compromise, we then check the pulses of the major arteries of the upper body - the radial, brachial and carotid arteries, before moving down to assess for an abdominal aortic aneurysm.
At this point, I feel it's a practical step to check the femoral pulses before doing the overview of the legs.
After visually assessing we must examine the major vascular areas of leg.- namely the popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses
For completeness, the cardiovascular examination is demonstrated here
• The Cardiac Examinatio...
#PeripheralVascular #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/...
She went from socks to wearing shoes in a blink of an eye. Doctor and magician.
🪄
Or a continuity error.
Given the two options I’ll prefer to claim to be a magician
The waistcoat isn't just because he's well-dressed.
Then back to socks again. That's hilarious
Here for the ASMR. Stay for the medical information. In addition, the shot from the carotid artery with the reflection of Dr. G in the stethoscope was a nice piece of artistic flair. 👌
I really didn’t see that. I’ll take a look
Súper ASMR.
yeah at 5:23
Thanks Dr Gill. Very happy you’re still making videos after all these years and the quality just keeps getting better
More to come!
the hits just keep on rolling. Gill is the Beatles of educational/ASMR videos
Love how her shoes magicaly appeared on her feet during the exam 🤣😂🤣😂 1:47
What the. Lol
They kept appearing and disappearing throughout the video. Glad I’m not the only one who noticed that
Came here to comment that 😂
For the incredible Dr Gill I must say thank you for these videos im Not learning to be a Dr but I do find these videos very informative
Who would have thought this channel would be as big as it is.
I remain eternally surprised
Since I just came from a vascular surgeon, this video is very relevant to me!
Good luck!
Me too and i am scheduled to have surgery soon.
I wish every doctor I visited was as informative as Dr. Gill.
It is important to get consent from a patient if you going to touch near a sensitive area especially when palpating for a femoral pulse . I learned this from my first EMT instructor and stressed this to my EMT students .
I would stress, it’s important to get consent for anything with a patient
Thanks for posting all these years Doc.
I thank you as a med student for the medical info and I thank you as ASMR fan.
You are welcome. Where are you studying?
Are there any topics we can help with?
@@DrJamesGill Thanks for your reply! I live in Brazil! This is my 2nd year in med school!
I went here to learn english, medecine and ASMR. 3 in 1 videos. Thank you Dr Gill !
Crazy I’ve been watching these videos for literal years.
Keep up the great work Dr. Gill!
The videos when your checking a patient are the best.Informative and very relaxing at the same time.
Aah yes, the Bob Ross of medical exams
Very informative even for a non student,thanks for the video Dr Gill,a hug from Brazil
Glad it was helpful!
I found your videos looking for cranial nerve ASMR a couple years ago. I still watch you’re videos because they and you are relaxing, but I also like feeling like I’m learning something along the way.
Informative and entertaining as usual Dr. Gill.
👍
Dr Gil never fails,,much love to you brother 🙏🏼💪💯🔥
The close-up of the Purel is a nice touch.
Love these videos because as an anxiety sufferer it’s so calming to understand the why’s behind the things you do and the reasons they matter and as someone with sensory issues I also appreciate your open communication about touch so that people aren’t caught off guard by it because things like that help me a lot! Great magician skills too with the disappearing and reappearing shoes 😂, love it!
Who would of thought 15 years ago my favorite show would be Dr Gill in 2023.
So glad that i find you before my exam
When do you have the exam?
We have a playlist on looking at the science behind the exams
I could listen to this guys voice for hours😍
Thank you Dr Gill !
Shout out to the magic shoes at 1:48 and 3:11!
Your voice is perfect for ASMR, love your vids! I'm learning a lot too
Lovely video as always. Super high quality!
Glad you think so!
Put a pit of paper
Not this one
I love your videos Dr James, regards from Mexico
👍
More of these types of videos please.
Is there any chance of these being uploaded to Spotify? I listen to them all so often! Thank you so much!
Hi Dr. Gill,
I had a recommendation for a video or series of videos (which you have likely planned to make already. Admittedly I’ve been caught up in coursework to have kept up to date fully with your channel) regarding the doctor patient relationship.
We have standardized patient encounters for breaking bad news to patients, difficult/angry patients, and the motivational interview.
I think seeing these videos from your perspective would be tremendously helpful for other medical students.
I think there is an area to look at doing MEC consultations initially - so making every contact count
Well done, Dr Gill. Happy New Year.
The patient has been diagnosed with a mild case of intermitent shoes. Treatment is very simple and effective, fortunately!
As always, excellent and very instructive video👍
Hope it was helpful
Gotta respect the doctor drip
My apologies. I forgot to put a bit of pay-pah on your hands. If I may... That's better. 🤓
Who turned off the- ooh, you're done.
Great video as always, thank you very much! And perfect timing as well :)
Glad you enjoyed it! Hope it was useful
Esta muy bien el examen periférico, ahora veamos el perianal.
Professional 👍💤
Great green eyes.
I have noticed this Med Student? has become more comfortable on camera, compared to her first video appearance, must be helpful with the demonstrations knowing they are not as tense as their first time on camera
2:10 Blood pressure check
"...we're going to do first without the blood pressure cuff."
That's some cutting-edge medicine right there. Dr. Gill is just that bloody AWESOME!!! 😃👍
Shoes magically appear and disappear in this one XD
Esse médico fala tão calmo q parece vídeo de asmr eu assisto os vídeo pra dormi kk amo
Mano eu tbm kkkkkkkkkkk
Hi Dr Gill, non medical student here. Is there actually a reason why you might detect a different or abnormal pulse in the abdomen or lower extremities compred with the neck or upper body and what would that mean? Presumably it wouldn't be a good thing? Love your channel and content.
Yes. You are looking for different things, but as a big example. The abdominal pulse you are looking for a medical problem called an abdominal aortic aneurysm
We will be doing a deep dive on this exam later
Check out the medicine explained playlist, it has all of our current deep dives
Excellent video as always. The only flaw, Abby not there anymore 😔
Loved the video, actually would like to hear issues you could find during examination. I have some problems like, deep pulsating feeling on left side of abdomen, my big toe has turned purpleish and sometimes goes back to normal. Also when I lidt my left arm, it gets weak and I feel tingling. Sometimes my veins on my hands bulge up to the point it hurts and they get very hot, when I out my hands up in the air, the blood goes down and creates a relief. Had this since an accident after broken collar bone. Which doctor should I go to? Primaru care didnt take me seriously
Love these videos, but like many here I guess none of us are even slightly medically trained, would it be possible to explain why these checks are required and the likely issues a patient may face if say the pulse on either arm were not in sync?
That will come in the deep dive that we’ll record soon
A lot of the explanations are on the “medicine explained” playlist
We are medical furniture and device supplier in China,I am very glad to study some medical knowledge.
Am I remembering correctly that the scar on Megan’s L knee is an old hockey injury? 🤔
Is there any way to make a video explaining syncope? and the best way to deal with it? I really enjoy your videos!!!! they are very informative :)
We could certainly look at that - it doesn’t need a student, so perhaps a medicine explained video
The question is always “what is CAUSING the syncope.” As it is a symptom
Soothing
Dr. Gill. Are these routines happen like this on a daily bases in the UK? In America, and Japan. Doctors usually just kinda look at you, and say. Well everything is normal, without even checking my blood pressure the way I see UK doctor do. It seems like the UK health care system is more advanced at checking for problems or complaints from a patient than in America and Japan. What are your thoughts, Dr. Gill?
It’s more that we still rely on the basics rather than ordering scans. It also might be related to the teaching I had a Warwick, where I was told
“Be proud of your clinical skills and be able to work even when the power cuts”
@@DrJamesGill I don't believe clinical skills are applied. Information America and Japan seek as.drug seekers
@@DrJamesGill Your skills will be the most useful when the inevitable apocalypse hits XD
@@DrJamesGill that's great, I wish I had access to that kind of doctors
generally curious how the body size of the patient affect these tests (being adipositas)?
I guess it is harder to 'feel' the important stuff with my belly haha
Also does the heart beat sound changes with the body size of person? e.g. lower frequency, quieter?
thx in advance!
Good question
I wonder how bad something would have to be to be caught by the initial visual examination. ie. the neck around halfway through the vid
Continuity director needs sacking lol. One minute she’s got shoes on during the bp test next minute she’s not then whoa back on again. Lol.
Yup. I could actually do with someone helping for the filming, I’d likely get more done!
I thought I was going crazy. She had socks on, then shoes on, then socks on again. Had to make sure I wasn’t seeing things. Never thought I’d be gas lit like that 🤣
Yup. Slight editorial issue
I had never noticed before, but you have your name engraved on your stethoscope, that's so cool !
In one video Dr Gill said it was a gift from his parents IIRC, after he lost his old one.
You can order them that way from the shop
Yes that is correct. My medical school one disappeared in my second job in ITU after graduating 😐
those eyes 😍😍😍
Intro Inline is a great font indeed
Is there any significance to the number of fingers used when taking a pulse? Sometimes two are used, sometimes more.
Not really.
I can’t see any double vision?
When you lift the leg & say you are looking for changes, what changes are you looking for? When you hold any limb in the air the veins go into hiding.
It’s called Buergers test - if the foot / leg goes pale it indicates distal ischaemia - which is then confirmed later getting the patient to sit up and see if the skin goes red
If you turn on Subtitles ...when the Lady states her name the Subtitles say " Making Struggles"....poor Lady
Think I need one of these, my feet are always cold.
Sometimes when my hands or feet get cold the fingers and toes can go completely white and I lose most of the sensation and feeling in them...they feel like lifeless little bricks! This only started happening after I had gastric bypass surgery and lost around 180lbs in 18 months. Would the weight loss be the cause of it?
Its driving me nuts at the minute because the weather is cold here and when I go walking the top half of my feet are so numb it is starting to affect my balance when I try to walk fast.
You need to speak to your GP
Yeah you should ask your doctor, but I will say you do get a lot colder after such significant weight loss. It may help to move around more or wear warm socks or slippers etc. if that’s the problem
Not a Dr but between personal experience and general knowledge, but as I understand people who undergo gastric bypass can often suffer from nutrient deficiency due to decreased absorption. Since we build blood through the transformation of food, could certainly see how that could affect blood supply/flow. Believe there are recommendations for those with this surgery to optimize their nutrition so might want to look into that and ask a Dr.
I notice the faint tan lines from a time piece, as a horology enthusiast and a long time fan I'd love to know why you choose to film without it and also what Dr Gills daily watch might be.
We should be bare below the elbows in the clinical setting - certainly in the hospitals
As for watch, I’m currently using a Garmin Fenix 😊
Have you ever found any issues while conducting these examinations ?
Dr Gill, what can u tell me about kidney stones with a composition of calcium oxylate?
Ouch. I bet that is uncomfortable
They are the most common type of stones. Occasionally they can resolve
A urologist is normally involved with the care even if not their removal
Diet is a huge factor, there is an older, but good paper here
www.ncbi.nlm.nih.gov/pmc/articles/PMC1455427/
Thank you Dr Gill
Looks like a fine specimen.
In previous videos when you demonstrate your examinations you explain what you are doing, why and what to look for... in this one you are examining without any detail as to why and what exactly you are looking for. Is this because this is used as a teaching aid and you play to students and reply and pause to ask them questions on each part of the examination?
Yes the videos are two fold. We do the demonstration, and then we do the deep dive
(I’m working on the deep dive for Romberg’s atm, the deep dive for this week be a little longer )
Can you do a video on the Achilles tendon. Did something to mine playing basketball. 🦶 👢
It’s on the list. Just need to get there
@@DrJamesGill Awesome!!! Love the videos and time and effort you put into them. Congrats on getting married.
So I noticed during this you also checked temperature of extremities? Is it an issue if say the hands or feet or legs or something is an extreme temp change from the rest of the body?
It’s that poor circulation may result in a colder limb, perhaps seen more clearly when comparing to the other limb
How did i get here?
I've always wondered, why do it once without the stethoscope and then with? I've never had that done here in the US.
I think we covered that in the cardiac deep dive - I know it’s in that or one of the blood pressure videos
It’s about ensuring the measurement is accurate
Cardiac Examination Deep Dive - Clinical Skills Explained - Dr Gill
ua-cam.com/video/dxUHp85M8kQ/v-deo.html
Thank you so much for answering. I haven't seen that one yet!
You are checking for the Auscultatory gap after which you add 30mmHg to it and pump the cuff to the reading so you don't miss the accurate systolic reading
Am I THE ONLY ONE WHO TRY FEELING PULSE AROUND MY GROIN??😅😅😅
1:48 shoes randomly appear
3:09 shoes randomly disappear again 😂
Magic 🪄
Genuinely curious as to whether this is your natural voice or if you happen to embellish or alter it Dr Gill. In addition what are your thoughts on ASMR? In my opinion it appears to be evolutionary leftovers from humans long distant ape relatives, as social grooming was certainly a factor there and relaxation and feelings of bliss or euphoria are visible when these things are observed in nature with great apes and monkeys today.
Detroit in the building...
Wish my bp was that good
Wait how the hell did she get her shoes on when she had socks on whilst dr gill was examining her
Megan Struthers is the new Abbie Tutt
This guy literally has a stethoscope with his own name ingraved in it 😂😂 doctor's flexing in the lunchroom be like
Is having pulse in the abdomen normal?
Yes. But having an expansile pulse is not
Her eyes are beautiful
Cripes, even stethoscopes are digital now? My Doctor's still on analogue.
The legendary Abbie Tutt MD has been followed by the beautiful Megan Struthers. Love those unusual bright turquoise eyes! 😍💘
Until 3:00 she had her shoes, suddenly her shoes dissapear
I drop my thumbs up before beginning the video, particularly if the mighty mighty Meghan is featured. 😀
For some stupid reason I thought I would try a clinical health degree despite my absolute, phobic disgust of veins. I noped out of there quick smart. I couldn't even take a radial pulse on the test dummies without cringing. I have no idea what I was thinking.
If I was his patient..
Dr Gill: let me just look at your legs....holy shyt, they are jacked up!! I see a lot of abnormalities, what is wrong with you!! 😂
His voice is lulling. That's probably the way it's meant to be)
She has beautifull green eyes
Chevrolet, Zebra and Honesty
In the stomach, I thought you auscultate first before palpating?
That would be listening for bowel sounds, which is not what is being listened for here
Have a look at the abdominal exam deep dive, and we discuss that very point about auscultation of the bowel - when to do it, and what the clinical effect of the timing is
ua-cam.com/video/pEKWIMBpKRs/v-deo.html here is the deep dive video
@@DrJamesGill I understand, but after you palpating the stomach, the bowel sound would interfere and make the listening of the pulse much more difficult. I always teach my students, for the stomach, always auscultate it first, whatever you want to hear
When I looked at the research on it, there were a few papers looking at when auscultation is performed, the general conclusion was it actually had an insignificant impact on auscultation findings, and no impact on clinical pathology detection (although I think that is partially as the bowel sounds are an incredibly weak clinical sign - there are some shocking research numbers where consultants were finding up 50% difference between clinical suspicion from bedside vs on imaging)
- but I’ll admit, I was looking from the perspective of palpation affecting bowels sounds rather than being how it would affect presence of bruits
@@DrJamesGill I agree, in most patients, the bowel interferes insignificantly, but there're some patients, especially elderly, the GIT of which can react in an unpredictable way to palpation; some of my patients could not lie still after palpation. Anyway, you're doing a great job and there's nothing wrong with the video. Thank you for your work
In love again
a sneaky part of this examination seems to be putting the patient's shoes on mid-exam without anyone noticing. Is this something only qualified doctors can do?
No. Just qualified magicians 🧙♂️
Very interesting. When Dr. Gill starts taking Megan's blood pressure, she is in shoes, then during the measurement, Megan is in socks. When did she get her shoes off so quickly? :)
I'm a little disappointed with some viewers... look at the most played section of the video... :/ it's an examination guys.
Woof woof