Examination 8: Hands Examination OSCE – Talley & O'Connor's Clinical Examination



58 year old lady has difficulty in using a hands we're asking the student to examine her hands and they should accept the hand function the findings are she has got a very tight skin here she got some catharsis and you can see really closely if you look you see it's got some teal and Octavia and ten-year-old yeah very nice spot of Kelsey casinos is here and she also may have some still and Octavia here I'm seeing that elastic part of the finger here the hand function can be done by using the root routine movement or legal examination notes are looking for things like trying to open here on all these screwtops bottles can you open that first please so difficult that's okay that's okay when you look at a face a face skin is very tight again she has some Chilean dictator here have you opened her mouth okay are you able to put three fingers in their mouth how many can you put maybe two okay thank you and she also has some tightening of the skin in the chest here we won't be asking the students to take a history but if they had to take a history they should be asking for what happened to her hands when she goes out in the court looking for Raynaud's syndrome particularly in soloing and also asking history regarding pulmonary fibrosis that'll be a very excellent assessment external all those things hi cutie huh my name is Kylie unaware yet so dis could you using your hands is it okay if I have a look at your hands to that busily yes thank you and could have a look at you over and above and put your hands to make it small okay so now I different I have a feel of your wrists and your hand joints are you in any pain at the moment No okay forget to close your fingers as far as I know I'm just gonna rip your hands enjoy it give try to relax for me thank you could you put your hands out and kind of you like that and try to bend your wrist down as far as we can and up trying to keep some of it thank you and could you wave it side to side your hand like that like that and could I get you to squeeze my finger and put your hands in a fist if you can close and stretch your fingers out as much as we can as straight of him and together and so I just get you to point your head your thumbs towards and feeling like that weekend and don't let me push me down and then I'll push down towards my fingers and push out if you can do it on can you do this for me make a pizza group and you know how to try and hold the grip turn don't really call it stir it and with your pinky as well in family pinky now come to know me okay are you able to flex your fingers at all and could I get you to do this with your hand if you can all the other way thank you and if I can grab my britches do it open this jar for me okay so thank you so anything else you would like to do I'd like to have a look at the sector unless you figure open your mouth means wide as you can thank you okay let's cook would you like to tell us what your piece along with this lady and your assessment of our hand function please I think this play has squared their love and the hands very stiff weave seeking the skin and loss of movement in nearly all the joints especially the they RTMP up a joint risk movement is also reduced from the inspection I can see the skin is very second and there are some areas of ulceration and calcinations I have assigned the joints shared some weakness as well and she's got and her facial skin is also effective worker and her neck skin so what's the diagnose it done scleroderma help systemic sclerosis mm-hmm so if you have time what would you ask her anymore history please be excluded Alma and I would ask about um crest syndrome and so whether she has red nodes in her hand esophageal problems okay that's good thank you this student did a very good examination she was asked to examine the hand and the hand function she did a very detailed examination of the hand function then she went on and looked at the skin and picked up discluded actally she found the calculus she also looked at the face and the mouth so overall I think she did extremely well I think her level of performance is almost 4 out of 4 I was extremely happy with the presentation today you

44 comments

  1. Bro there is some serious ASMR to this. I just came back to it after watching earlier tonight and realize I only got to like 3 min in before I fell asleep and woke like 30 mins ago (about 4 hours later).

  2. The way she drops her hand onto the pillow then says "I'm aware you have some difficulty using your hands" 😂

  3. I know the patient probably volunteered for this but damn lol. He said "tell us what you think is wrong with this woman."

  4. Only feedback would be to tie hair back… our assessors dock marks or even fail you if you touch your hair/body and touch the patient again…

  5. My grandmother had hands similar to these resulting from rheumatoid arthritis. Hers were similarly scrunched up and crossed over one another

  6. looks like she has scleroderma, her skin texture, wounds, and the restriction of her fingers flexing all are common symptoms of scleroderma

  7. Ah, yes… I remember tests like that while I was at Uni. A stone-faced professor glaring at your every move, fraying your nerves to the point where you can't remember your own name, never mind what you're supposed to be doing. The young lady did far better than I would have under those circumstances.

  8. This is so saddening for me tbh. My grandma had same finger problems left hand worse and non-usable and right hand only usable a little. Unfortunately my grandma passed away exactly last year. Watching this video made me think of her. Great video, great doctors. Thank you.

  9. I see Samuel L. Jackson from Amos & Andrew.
    Nurse handles patient's limitations perfectly.
    Most boxers don't have hands that bad. Poor woman.
    ALL physicians should see this video to learn how to be with such a patient.

  10. For self-examination purposes, I just attempted to stick 6 fingers (on top of each other) in between my teeth – managed to do it, and felt like breaking my neck afterwards …

  11. how many times has different ways has she asked the patient to flex her fingers when she clearly is restricted in that movement…goon

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