Abdominal Examination Master Class - Medical School OSCE Revision - Clinical Skills - Dr Gill
Вставка
- Опубліковано 13 чер 2024
- Abdominal Examination Master Class - Medical School OSCE Revision - Clinical Skills - Dr Gill
This video details each step of the abdominal exam, highlighting why each step is being taking to maximised your clinical skills OSCE revision.
In this video, we demonstrate how to perform a clinical examination of the ABDOMINAL SYSTEM for your medical school Clinical Skills OSCE. As the gastrointestinal exam is sure a core skill when it comes to examining patients, students should assume that an abdominal assessment is a high yield station for any clinical exams or clinical assessments.
For a passing grade in your Clinical Skills OSCE, for Abdominal exam follow the approach of:
- Inspection
- Palpation
- Percussion
- Auscultation
We will also address why in the UK the auscultation is placed higher on the examination approach
HOWEVER, an abdominal examination OSCE station does not just involve pressing around the stomach, this video also demonstrates some of the specialised examination techniques required in examining patients such as shifting dullness for ascites, and checking the size of the liver which may be seen to be enlarged in cirrhosis as an example.
Diarrhoea, pain and general concerns about the abdomen are a common reason for patients to see a doctor, and in any speciality is probably the most commonly performed patient examination
This video has three other abdominal system-focused videos associated with it:
• Abdominal Clinical Exa... - Abdo Demo
• Male Genital Examinati... - Male Genital Exam
• Rectal Examination and... - How to perform a DRE
------------
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.
#clinicalskills #drgill #abdomen
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.
Kayser-Fleischer ring - Herbert L. Fred, MD, Hendrik A. van Dijk - commons.wikimedia.org/wiki/Fi...
Map - commons.wikimedia.org/wiki/Fi...
Ascites - James Heilman, MD - Own work
Angular stomatitis - en.wikipedia.org/wiki/Angular...
Cold Sore - en.wikipedia.org/wiki/Herpes_...
B12 - www.health.harvard.edu/stayin...
Glottis - en.wikipedia.org/wiki/Glossit...
Gynaecomastia - en.wikipedia.org/wiki/Gynecom...
Spleen - en.wikipedia.org/wiki/Spleen
#clinicalskills #abdominalexamination #DrGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
As a primary care mental health provider, I really appreciate your emphasis on getting affirmative consent for hands-on examination. I work with military veterans and very often these semi-intrusive exams can be overwhelming and reason enough to avoid being seen altogether. Giving a person a chance to say no if they’re not comfortable makes a really big difference. It’s so important for your students and residents (and frankly your colleagues) to see good doctoring is about much more than remembering anatomy and following procedure and algorithms.
It’s also incredibly effective at building trust, which then flows over into the management plan
As a patient: Last time I was examined, the doctor didn't even tell me what he was actually examining. Telling me beforehand definitely would've made me feel more comfortable.
It seems to be a British dr thing. My question is, what if they say no? What do you do then?
@@bofa83 good call.
@@bofa83 you talk to them and ask how / what you can do to make them comfortable and what they are ok with.
COMMUNICATE!
I came for the ASMR to sleep
Stayed awake for the info
Now I can relax with open eyes
The balance ⚖️
Any learning is good 😊
I came for Asmr too and I completely agree with what you said
As someone with sensory processing disorder whose body overreacts to certain types of touch as a result I really appreciate the emphasis on making the patient aware of you touching them from behind! When I know I’m going to be touched from behind I’m less likely to move/overreact as a result because my brain has the time it needs to tell my body to relax in advance which significantly improves my body’s response to the touch.
It’s also just polite 😊
This is one of the best videos you've made. The detailed explanations and the annotations make it extremely informative and helpful. Thank you!
Thanks. It’s taken three days of editing, so I’m really glad you find it useful
If you’d consider sharing it, others might also find it useful 😊
Dr . Gill , as a paramedic in the U.S , I liked this ! However , the assessment guidelines set don't allow us to go into that much detail . The examination of the abdomen on the focused patient assessment is brief . The EMT or paramedic exposes and visualizes the abdomen looking for Deformities , Contusion , Abrasions , Penetrating injury , Burns / Bleeding , Tenderness , Lacerations , and Swelling . Then on palpation of the abdomen in 6 regions ( upper , mid , and lower quadrants ) we feel for associated pain , look for guarding of the abdomen by the patient , rigidity and distention .
That is interesting, but I suppose you are looking for different things.
I for example never need to worry about penetrating abdominal issues - that would VERY much be outside of my job description!! 👍
I appreciate that he specified how auscultation is the last step of an exam specifically in the UK vs it being different in other locations. As an RN practicing in the US, our EBP and most facility protocols call for auscultation between inspection and palpation with percussion last. His justification is also sensible, and his detailed yet professional approach is great as I continue to learn and develop my clinical assessment skills as I progress (hopefully) towards becoming a DNP specializing in geriatric primary care.
I’m happy you found this useful. I think everything we do should be evidence based, even if that means challenging something which has been done before
Another perfect video to rest to, thank you once again Doctor :)
Absolutely loved this video. Explaining everything was much more relaxing to me. These are the kinds of “asmr” videos I enjoy watching. Thank you. Very calming. 😊
I hope you found it useful 😊
@@DrJamesGill very useful 😁
Very thorough and well explained with a touch of calmness, perfect teaching environment. As always thank you Dr. Gill for the video. Your videos allow me to replay them in my mind and connect the assessment to their rationale.
Where in Texas are you studying? Any other areas we can help cover?
@@DrJamesGill good morning I live in a bordertown to Mexico called Eagle Pass. I work at a ER where focus assessments are required depending on the issue? Common topics ENT (conjunctivitis, foreign objects, infections) chest pain & abdominal pain ( from MI, pancreatitis, cholicystitis, to epigastric pain like GERD) musculoskeletal (sprains, fractures, and dislocations), respiratory ( COVID, FLU A and RSV), gi ( diverticulitis, n/v/d), and strokes. 👍
Stumbled upon a video a few months ago (not even remotely related to my field of work). Yet, I keep coming back for the great content……. and David. Great video Dr. Gill.
Thank you for joining us anyway. What is your field?
Political Analyst in America.
WONDERFUL it would be so good to have such explicative videos for each system 👌🏼
We’ve completed abdo now, we also have cardiac, knee and hip with this level of content.
Also a playlist on cranial nerves examination
But I think we perhaps need a step by step cranial nerve like this
Such a soothing voice, and love learning new things about the human body 😊 thank you for these videos, they're brilliant
Thanks. This one took quite a bit of work, but it’s the final part of the abdo series, so worth it.
I think I’m going to redo the other masked videos now
@@DrJamesGill it's definitely a video I'll revisit 😊 I look forward to seeing the rest
@@DrJamesGill .... would you add to the list of consideration an in-depth GALS screening tutorial? 😊 The masked version was great 👍 but I feel there's so much more to it.
Hi. Greetings from Argentina! I like your videos. This one is great. So many details.
👍👍 took a while to film, but glad it’s useful
Brilliant presentation ! One thing I would suggest : as medicine is moving really fast forward I'm always telling my juniors we should consider bedside ultrasound as ''the fifth element '' in the abdominal examination after inspection, palpation, percussion and auscultation.
I agree ultrasound is going to be massively important, but until there is ubiquity like stethoscopes, I don’t think it will be part of the year 1 clinical skills syllabus. But hopefully one day
I've been examined by many gastroenterologists (in the US). Not once has any of this been done, apart from two or three seemingly arbitrary proddings at my belly.
same in canada, but its probably because theyre specialized doctors, theyll always send you to do scans and scopies instead cause theyre the ones doing these things (vs a gp doctor that has to do a diagnostic without these tools)
I really like these videos. You learn from them.
So pleased you find it useful
Wow, this is extremely informative and helpful. Thanks!
Glad it was useful😊
My aunt had Wilson’s disease - really good to see you mentioned it, as very few people seem to know about it.
It’s normally a year 1 disease at med school, we discuss it in the first month, BUT it’s quite rare, so tends not to get a lot of exposure in the rest of the syllabus
I hope your mun is ok?
Wow! This made me look deeper into a B12 deficiency because I have those facial features and I will definitely be visiting my doctor now. I also realized my symptoms lately align with this.
Oh, I hope that you don’t have an issue with B12!
It would be useful if you could tell us the outcome please 😊
I’m not a medical student but I enjoy trying to understand all the medical stuff. The whole area of the abdominal palpation looks very nuanced. Is it something that is difficult to get confident at? The sound differences seem not hugely dramatic and seem like they could lead to a misdiagnosis given the fairly broad range of issues possible?
It’s very much something that comes with time.
We teach students on “normal” so that when they come across something abnormal it stands out very obviosuly
Brilliant. Also that sudden excitement in your voice when you saw the jvp react to liver pressure made me laugh
Sometimes clinical medicine is cool!
Nice to see you again Doctor (and David of course) 😁
The benefits of having found the internet again!
Dr Gill,
Love your videos.
Can you tell me more about the Stethoscope you used today? I don’t think I’ve seen one like that before.
It’s a Littman 3000 so there is an electronic filter in it
This is exciting,l love to your channel,l am a first year nursing college. I will be very useful from your channel and your information,Thank you very much doctor💗💗
Thank you 😊
Are there any areas it would help if we covered?
Great video
Greetings from Uruguay!!!
Welcome 😊
Bravissimo dott jamens molto professionale
👍
Informative and pleasant to listen to :)
👍
Your vids are always so interesting!! How do you remember all that info!?!?! You have my absolute respect Doc!
Years of practice and revision. The first year of medical school, doing it the first time is HARD
EXCELLENT
👍
2:45 MVP throw
Did you know that I never liked MacLeod’s book and when I want to study it I go to UA-cam for understanding because I do not like reading in UA-cam there are many long videos and I was bored and hated studying more, but there was in me the motive of research I wanted to learn but I was unable, thank God that God guided me To you in one of the difficult coincidences, and I began to listen to your theoretical explanation with all the motive of love of learning and benefit, and I became like to study the theoretical book and I like to link your theoretical speech with practical application. There is such an effect in all of UA-cam and I am sure of my words because I spent four years of my life searching and I did not find anything that matches your explanation. Thank you very much. I wish you stability and inner peace
It’s all about finding the type of learner you are.
Many books are written from the perspective of “I want to tell you this” rather than “I want you to learn and know this”
@@DrJamesGill Thank you so much
OK, the eyeballs shot in the thumbnail freaked me out! LOL!
Eyeball?
The GOAT 🙌
Ok there is a question I have is your stomach does have like a pulse (as in it moves up and down) when relax what might that suggest?
Can you do "deep dives" for the other systems?
This is Good 👍
@Dr James Gill Have you ever considered conducting an in person clinical course (of course paid course,your time needs to be valued lol)for doctors so we could learn from you in person.I know a lot of newly graduated doctors would love this.Please let us know
It’s a recurring thought, but I don’t really think I’ve anything to offer beyond year 1 & 2 of med school.
My knowledge base is very much basic clinical skills
I think a back to basics before PACES course by you Dr Gill would actually be fantastic!
How does an abdominal examination vary in terms of patient BMI? How does a patient with a lot of abdominal fat or obesity affect both palpitation and percussion?
It becomes more difficult that is for certain
Greeaaat
👍
@@DrJamesGill thanks for all your work!
Hi doc, I am diagnosed with peptic ulcer but h.pylori negative, can spicy food or stress cause it ?
After watching this video… I can confirm I am not an alcoholic 😰 I was worried
This video identified clinical markers of liver disease.
What is that makes you feel you are an alcoholic?
You don’t have to have liver damage to be an alcoholic
Ohh ok… so I’m an alcoholic… but with good liver I guess 🤷🏻♂️
25:22 I never seen that before
I’ve just discovered I have clubbing
What does it means ?? My doctor never made me do that taste before
Please we want to see models
Unfortunately I’ve only been able to use the abdominal model once, as the plastic model is too expensive to buy
@@DrJamesGill ya I totally comprehensive totally true but in a same time in osce examination , thoose models use there
Tajo... mohl by mi někdo také namasírovat zádíčka? 🤭 a prsíčka😋
2:40 shirt removal was not bad.
6/10
Hahahaha. Someone really should put up a chart!
Balloting the kidneys sounds like a great way to knock stones loose...
USA doct. Ck ur labs blood pressure weight ask any problems then ur done.
They will be getting a lot of additional information when they are looking at a patient too
Which is exactly why people hate going to the doctor in the states.
I agree with the doctor.he’s definitely not pregnant lol 😂
👍
Awe.! Everyone left the chat. 😭😭😭
It seemed to crash out here.
Im so confused I’ve had 2 clinic drs tell me different things . At least I dont have rabies.
I’m sorry to hear that. Unfortunately medicine is an art and a science. Often it’s about fitting things to patterns.
Hopefully you’ve an answer you can work with 😊
@@DrJamesGill thank you sir. As of now they determined my kidney pain swelling is ‘idiopathic” which points to autoimmune disease. I also have erythromelalgia ( a blood vessel disorder).
They want to try Humira injection for me.
I enjoy your videos you have a calming nature.
I study school medical Yale 22:05
4:38 Women have more testosterone then estrogen.
Very true. One of the issues with the classic graph showing female oestrogen and testosterone is the two different scales used on the same graph
At this point anybody can become a doctor lmfao
I’m actually of the opinion, if you can pass the OSCES, the written papers and the TDOCS then yes
Anyone is allowed to sit a driving test.
Meet the criteria, pay the fees, sit the test. Bingo
That said, I can’t imagine how difficult “self taught” medicine would be
How dare you assume his gender!! Damnit I’ve done it too!
" patients being pregnant , not going to be the case here" i dunno man they are trying to tell use in the past few years that men can get pregnant... Don't assume as you will be called a biggot.
Pretty muscular guy right there. Even his obliques are lookin good