CONTENTS Vascular examination & peripheral Neuropath) Varicose veins, Cardiovascular Respiratory Examinatiot Abdominal Examination. Cranial Nerves Examination.ANKLE Outside the station the stem written is eg, a soccer player injured his Lt enkle during the match & came complaining of severe pain * Relax , take a deep breath & read it more than once You have o full minute for that. Tf you feel any confusion regarding stem , there is another copy inside the station you can have a lock to it”. % Enter the station , Wash your hands , Great the examiner & the patient with « nice confident smile & introduce yourself & ask your patient te confirm his/her name & age for you. % Explain the procedure to the patient & Gain verbal consent * Today I have been asked to examine your Lt leg , this includes looking, feeling, moving & doing some special tests * is that ok with you? % Gain exposure consent * It's needed To expose your both legs from knees downwards, is that ok with you ? Do you need a chaperone ? * % Askif he is feeling poin right now & provide to give painkiller if needed at any moment during examination, % Start examination. Look Feel oa ken + Gait (Antelgic). + Ask about pain before you + Observe for ROM + Thompson's / Simmonds's + Then to feet & stort. A tenderness & for Achilles tendon rupture. ‘ankles from + ‘Polpatebothankles &feet feel for crepitus. 4 Anterior drawer for ATFL. front , back & for’ + Active & passive: + Talar tilt: sides for: > Temp & tenderness. > Plenter flexion > De inversion with: > Swelling. > Pulses, > Dersiflexion. Planter flexion for ATFL. > Asymmetry. > Achilles tendon + Passive only: Y _Dorsiflexion for PTFL. > Deformity. (thickening or swelling). > Inversion > Inanatemical position: > Erythema. > Joints & bones: > Eversion. ¥ Doinversion for CFL. > Scors. Y Stert distal te proximal. Y Doeversion for Deltoid + Walking aids. Y Squeeze MTP & observe complex. face. ¥ Tarsals & ankle, ¥ Medial & lateral malleol. ¥ Proximal fibula. % Thank your patient & provide to help him to redress. Wash your hands & summarize your case in 30 seconds (pesitives & important negatives only. Dorr't mention al the steps you went through during examination.) % To complete my examination (I need to do whatever you missed if the time ended before you finish) & T must examine both knees & do full neurovascular examination of lower limbs.€&D 3 of 30 KNEE ® Outside the station the stem written is eg. a soccer player injured his Lt knee during the match meny years ago fer which surgery done & mow came complaining of severe pain * Relax , take a deep breath & read it more than once . You have a full minute for that. If you feel any confusion regarding stem . there is another copy inside the station you can have a look to it” © Enter the station . Wash your hands . Great the examiner & the patient with a nice confident smile 4 introduce yourself & ask your patient to confirm his/her name & oge for you. Exploin the procedure to the patient & Goin verbal consent * Today I have been csked to your Lt knee , this includes looking, feeling, moving & doing some special tests * is that ok with you? Gain exposure consent It's needed to expose your both legs from hips downwards with keeping your dignity, is that ok with you ? Do you need a chaperone ? * @ Ask if he is feeling pain right now 4 provide to give painkiller if needed at any moment during examination. ® Start examination. en Feel Move Pena + Gait + Ask about pain before you + Observe for “+ Posterior sag sign (hip & s(Antalaic). start. ROM& knee at 90 deorees) for PCL. 4 Then from 4 Polpate both knees for: tenderness & feel 4 Anterior & posterior drawer front ,back& © > Tempé tenderness. for crepitus. (knee at 90 degrees) for sides for: > Quadriceps bulk. + Active & passive ACL & PCL. > Swelling. > Joint line (in flexed knee) extension & 4 Lachman's (knee at 30 >» Asymmetry. for: flexion. degrees) for ACL. > Deformity. ¥ Femoral condyles. + Varus & valgus stress (in > Erytheme. Y Medial tibial condyle. straight leg & at 30 degrees > Scars. ¥ Neck of fibula, flexion) for MCL & LCL, + Walking aids ¥ Patella 4 McMurry’s for merisci Y Tibial tuberosity. ¥ Collateral ligaments. > Popliteat fossa (at 90 degrees). > Effusion (patellar tap or bulge stroke test), ‘ Thank your patient 4 provide to help him to redress. Wosh your hands & summarize your case in 30 seconds (positives & important negatives only. Don't mention all the steps you went through during examination.) & To complete my examination (I need to do whatever you missed if the time ended before you finish) & I must examine both hips & ankles & do full neurovascular examination of lower limbs.HIP % Outside the station the stem written is eg. an old man presented following an old surgery to his Lt hip & now come complaining of severe pain * Relax . take a deep breath & read it more than once . You have a full minute for that. If you feel any confusion regarding stem , there is another copy inside the station you can have a look to it Enter the station , Wosh ycur hands , Great the examiner & the patient with a nice confident smile & introduce yourself & ask your patient to confirm his/her name & age for you. + Explain the procedure to the potient & Gain verbal consent * Today I have been asked to examine your Lt hip , this includes looking, feeling, moving & doing some special tests * is that ok with you? Gain exposure consent “ It's needed to expose your both legs & back with keeping your dignity, is that ok with you? Do you need a chaperone ? @ Ask if he is feeling pain right now & provide to give painkiller if needed at any moment during examination. Start examination es Feel La Re ‘4. From front For: ‘4 Ask about pain “Observe for ROM& 4. Thomas test for > Position of shoulders & trunk. before you start. tenderness & feel fixed flexion > Position of ASIS. + Palpate for: for crepitus. deformity. + From sides for: >» Tempé& tenderness. 4 Active & passive > lumbar lordosis. > Greater extension , flexion, » Buttocks. ‘trochanters. adduction, abduction, > Scars > AsIs. internal rotation & > Erythema, > Pubic symphysis. external rotation, > Swelling > Length 4 DONT do external + From behind for measurements: rotation if your > Scoliosis. ¥ True (ASIS to patient has history > Muscle wasting, med, Malleolus). hip replacement. + Gait. Y Apparent + Walking aids. (unbilicus to med ‘+ Trendelenburg test. Malleolus). + Goleazzi test for limb length. 4 Thonk your patient & provide to help him to redress Wash your hands & summarize your case in 30 seconds (positives & important negatives only. Don't mention ail the steps you went through during examination.) To complete my examination (I need to do whatever you missed if the time ended before you finish) & I must examine spines & knees & do full neurovascular examination of lower limbs.SHOULDER % Outside the station the stem written is eg. an old lady presented following on old surgery or trauma to her Lt shoulder & now come complaining of severe pain 4 inability to move it, * Relax , take @ deep breath & read it more than once . You have o full minute for that. Tf you feel any confusion regarding stem , there is another copy inside the station you can have a look to it” + Enter the station , Wash your hends , Great the exominer & the patient with a nice confident smile & introduce yourself & ask your patient to confirm his/her nome & age for you. + Explain the procedure to the patient & Gain verbal consent ~ Today T have been asked to examine your Lt shoulder , this includes looking, feeling, moving & doing seme special tests "is that ok with you? + Gain exposure consent “ It's needed to toke your shirt off with keeping your dignity, is that ok with you? Bo you need a chaperone * @ Ask if she is feeling pain right now & provide to give poinkiller if needed at any moment during examination. Start examination Look Feel ms prrkran + From front, + Ask about pain + Observe for ROM & + For subacromial sides & behind before you start. tenderness 4 feel for impingement (only one for: + Palpate for: crepitus. eitea nay 4 Symmetry. > Temp 4 tenderness, 4 Active & passive: flexion, + swelling. > Shoulder girdles ‘extension, abduction, er soon Dl + Erythema. including: adduction, internal rotation s oi + Muscle ¥ Sternoclaviculer & external rotation. roller laiatiriy wasting. joi _ + Then do against resistance dey + Sears. ¥ Cvicles. to test rotator cuff > aes + Deformity. Y Acromioclavicular strength: Tegtihea costo OR 4 Winging joints. 4 Abduction for bilgi E akowes ‘scapula. ¥ Humeral head. ‘supraspinatus. ~ Greater + External rotation for tuberosity, infraspinatus & teres ~ Biceps tendon, minor, ¥ Teopezius. ‘+ Internal rotation for toh tape while feeling the joint. % Thank your patient & provide to help her to redress, % Wash your hands & summarize your case in 30 seconds (positives & important negatives only. Don't mention all ‘the steps you went through during examination.) + To complete my examination (I need to do whatever you missed if the time ended before you finish) & I must examine spines & do full neurovascular examination of upper limbs.