Respiratory Examination Explained - Clinical Skills Deep Dive - Medical School Revision - Dr Gill
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- čas přidán 30. 07. 2024
- This Respiratory Examination Explained - Clinical Skills Deep Dive video looks at the details of the examination of a respiratory patient, highlighting what is being checked for during special tests and examination findings
In this video, we demonstrate how to perform a clinical examination of the RESPIRATORY SYSTEM for your medical school Clinical Skills OSCE. As the resp exam is sure a core skill when it comes to examining patients, students should assume that a respiratory assessment is a high yield station for any clinical exams or clinical assessments.
For a passing grade in your Clinical Skills OSCE, for resp examination follow the approach of:
- Inspection
- Palpation
- Percussion
- Auscultation
HOWEVER, a respiratory examination OSCE station does not just involve auscultating the lungs, this video also demonstrates some of the specialised examination techniques required in examining patients such as tactile vocal resonance, and checking the JVP which may be seen to be elevated in pulmonary hypertension. There are many parts of the respiratory exam, that overlap with the cardiac exam, thus these shared parts could be considered essential for any chest examination and always included as core medical school revision for clinical skills or OSCE prep
Coughs, colds and general concerns about the chest 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 two other respiratory system focused videos associated with it:
• Taking a Respiratory H... - How to take a respiratory history
• How to do the Respirat... - Understanding the techniques of the respiratory examination
Performed by Dr James Gill
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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 recognised standard textbook for clinical skills.
#clinicalskills #respiratoryexamination #DrJamesGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
This all started as ASMR but now I have a medical degree.
Also, nice to see Wilson is doing well after Tom discarded him in the ocean.
Omg...Wilson! 😂
@@eileenlanducci8277 he's not moving
Congratulations Doctor Hugheszie 🤣
Even though I have no outstanding knowledge on any medical topics, I just find these incredibly soothing and interesting to listen to. Thank you Dr Gill, hope you are keeping safe!
I’m glad you’ve found it interesting 😊
D
Nyc
@@mattgamache6834 🙃😅
?
One of these days, Dr. Gill needs to finish a video shredding a killer electric guitar solo, staring into the camera like he doesn't care.
🤨
....🤣🤣🤣🤣
I vote for this 🙋
I ve heard about a teacher who would just lay down on the floor when he knew his students were not paying attention to the lesson.
I’ve been watching your videos for ASMR benefits, but this one and the previous pulmonary exam, have been hugely interesting to me. My mother passed away from idiopathic pulmonary fibrosis. The clubbing of her fingers should have been an early sign, but was never noticed. Thank you for making sure this small detail is highlighted!
I see my man Wilson over in the corner. I appreciate that random detail.
Was a present when returned from the island
Dr: Gill Feat Dr: Wilson
Everyone loves a bloody hand!
Wilson!!!!
Thought you were talking about Dr. Wilson from House until I looked to the right a little
I'm not sure he's a doctor. I demand to see his credentials!
I was diagnosed with tinnitus two months ago have suffered a serious lack of sleep since then. Luckily I found this channel and others like it to help sooth me to sleep while learning along the way. Thank you!
You must be a great teacher when so many non medical students such as myself regularly come to learn from your content. Keep up the great work 😁
Even as an IM Attending physician I really enjoy your videos and learn so much. Keep doing these videos and never ever stop posting your work. You're doing service to all physicians as a doctor.
Thank you Sir! That’s huge praise coming from IM!! Where do you work?
@@DrJamesGill USA
This was absolutely fascinating and relaxing. Please, please never stop making these videos.
Thank you very much! Always so interesting to listen to. Giving a lot of information on how to examine ourselves more precisely, in order to evaluate the gravity of our issues.
new video from Dr. Gill? Oh yesss boyyyy
Great watch, articulated so much better than anything else I’ve watched! Thanks Dr Gill.
Now that’s great feedback. Thanks
You’re the best Dr. Gill!!!
I dont have medical knowledge but I have a heart condition called Tetralogy Of Fallot and found this really interesting. Thank you Dr Gill!
Thank you so much for your videos! Glad to have you back in my subscription feed with a medical video!
This one had some major birthing pains. I had to re-record it THREE time’s due to various issues. 😐
Best of both worlds with your channel Dr Gill, learning about the body, and soft spoken definitely very relaxed but focused great channel!
You're a peaceful soul Dr. Gill
This video is fantastic. Thank you!
no one does dipthongs quite like Dr Gill ;)
thanks for your excellent videos. I have OSCEs end of January 2021 so very glad I found you!
Good luck Claire!
I have problems with your amazing lectures ....your voice is soft and smooth that let me sleepy in each time i open them
I literally listen to this every single night.
That’s dedicated revision 😊
Tell me I'm not the only one laughing at his Wilson volleyball.
This gentleman has the perfect ASMR voice
I love the bottle of pop idea, thank you 🙏
Thank you so much for your efforts.
Great video again!
I enjoyed the segment regarding the JVP. The illustrations at the same time as hearing the explanation was pretty useful!
The JVP is always a difficult one to get across, to I’m glad this one came over.
I’m going to do a whole video just on the JVP as there is a lot of additional detail about the wave forms
@@DrJamesGill Fantastic, thank you. Looking forward to it and sharing with colleagues.
Dr Gill you’re the best
👍
I’ve seen it is better to do the auscultation before the palpation and percussion, what do you reckon?
Wow, your bedside manner must be incredible.
Thanks, Doctor.
Ha! We do walking assessments in massage therapy too! So helpful!
I actually really enjoy teaching the students these “tricks”
Dr James Gill Every bit helps! The work you do is appreciated. 🙏
fantastic video,thanks!!
🙏
I wish you could've read books to me as a child because your voice is soo soothing and calming
We’ll, Winnie the Pooh is now public domain, so I may do a recording for Harrison!
Great video!! Thanks for the upload
Hope it helps 😊
Regarding chest expansion test during breathing - what if I normally breathe expanding my belly (mostly without chest expansion)? Would that work the same&
Very good informative video and such a relaxing calming voice too --Thank you Dr Gill
You are very welcome
Congrats for 30k subscribers
Not quite yet. I’ve 29,925 on my side. But NEARLY!! Hopefully this week 🤞
It may be a problem related to my country, but i feel like physical examination is tought more through experience sharing than through medical evidence. Every brazilian book (and every teacher) says something bit different, giving me different things to do in general in the same situation. For some unknown reason im trusting you and the book you are using to form my solid base of physical examination. Btw, nice to know Wilson is fine =)
The Macleods book is pretty much a gold standard world wide 😊
Recomendo o Porto&Porto, livro bem completo de semiologia e bem detalhado. Não concordo que o exame físico seja ensinado só pela experiência, sem nenhuma base científica por trás, até hoje não peguei nenhum professor que não explicasse o porquê de um sinal ou sintoma ou de realizar uma ação específica no exame físico.
Fica a dica do livro. O Isabella também é bom, caso você queira algo mais resumido.
Thank you.
Cheers to 30.000 subscribers!
Deep Drive Respiratory Time Stamps (now added to the correct video)
The very beginning of the examination 01:10
What to look for before you’ve even said hello 02:13
The Examination 03:25
Hands: 03:28
Hands - Look 03:50
Nail Signs 03:59
Tremor 05:48
The palms 07:08
Clubbing 07:18
Pulse 08:12
Radial: Radial Delay 08:30
Features of the Pulse 08:54
Character of Pulse 09:08
Basic Observations 09:29
Oxygen Saturations 09:45
Face 10:46
Anaemia/ Eyes 10:54
Horner’s Syndrome 11:18
Mouth 11:59
Oxygen Saturations and Central cyanosis 12:31
The Neck 13:34
JVP 13:34
Hepato-Jugular Reflux 15:51
Separating the JVP from the Carotids 17:17
Lymph Nodes 17:38
Virchow’s Node 18:37
Trachea 19:24
Tension Pneumothorax 19:46
Lung Cancer 20:06
Fibrotic Lung disease 20:14
Pneumothorax 20:20
Palpating the Trachea 20:30
The Thorax 21:04
End of Bed Examination Part Two 21:18
Abnormalities of the chest wall 21:26
Hyperinflation 21:27
Pectus Carinatum 21:28
Pectus Exavatum 21:35
Dilation of Blood Vessels 22:20
Watch Movement of Chest Wall during inspiration and expiration 22:34
Problems that can cause unequal chest movement 22:52
Costochondritis 23:25
Pulmonary Embolism 23:33
Physical Assessment of chest expansion during respiration 23:50
Apex Beat 24:27
Apex Beat Location 24:45
Conditions Affecting the position of the Apex Beat 25:04
Percussion of the chest wall 25:20
Percussion technique 25:30
Abnormalities heard with percussion 25:58
Normal Percussion Findings 26:14
Pneumothorax 26:21
Haemothorax and Pleural Effusion (Stony Dullness) 26:28
Practise Percussion at home 26:54
Locations to percuss 27:33
Auscultation 28:00
Normal Breath Sounds 28:12
Consolidation 28:22
Crackles 28:46
Wheeze 29:25
Stridor 29:39
Pleural Rub 30:11
Vocal Resonance 31:20
Final Steps 33:51
Summary 34:19
Gibe Away 34:30
Good job Dr Gill
👍
I truly wish we had doctors where I'm from who are as professional and as comforting as you are. I think I need to move to the UK lol
Love the YT name btw - Alucard. Have you watched the series
Dr James Gill please Sir don’t tell me that you’ve seen Castlevania as well? Studio Ghibli and now this? You’re becoming more and more awesome with each video. Eventhough I study psychology and live in Hungary, I would die for a professor as cool as you, maybe to be our neuroanatomy prof. That’s the only medical related.
@@DrJamesGill Thank you, sir. That means alot coming from you!!! Yes, I have watched the series, and I absolutely love it. Thanks so much for replying. Totally made my day!
Dr. Gill. Can you make a video on your opinion, description and I guess tips for Covid 19 and the CoronaVirus. I work in the ER , but I want to know your opinion and description of it. I’m sure everybody else wants to also!
Wilsonnnnnn!!!! I'm digging the decor
My best mate thought it was an appropriate gift after Bear Grylls The Island
@@DrJamesGill love it!!
Thank you, you consolidated my knowledge for my respiratory OSCE.
terrific! so pleased to hear that! when is the exam?
@@DrJamesGill end of Feb🤓
Good luck! Drop us all a line here when you get the results 👍
@@DrJamesGill I will. Thank you so much.
Guess what? I received a clear pass in my OSCES. Thank you for your videos they helped greatly 😊
great video dr james! so soothing too! but I have a questions at @19:40 do you mean that the "trachea" is pushed away from the problem, instead of the "clavicle"?
Ah yes.
Sorry, misspoke there!
If there is a pneumothorax then that would push the trachea away, where as a collapse, would pull it towards the affected lung
Ninety-nine DOES have diphthongs in both of the letter “I”s. It is just a different diphthong than the one found in the “eu” of “neunundneunzig.”
Love Wilson at the start of the video XD
Dr Gill. I reside in the United States and just turned 60 years of age. I have never been examined using the methods demonstrated on your channel. In fact, many physicals I have had do little more than listen to my chest. Is there a difference in teaching/methods in UK vs. the US?
No. The teaching, the science and the medicine is the same.
In all honesty, time is a big factor. If a patient sounds like they have a chest infection, then often that patient will get a focused examination. If the full exam takes 6 mins, of your 10 min consultation, then certain bits may not be performed.
However, when we’re not sure, or need absolute 100% detail then the full examination will be done.
Masterpiece
That Wilson ball is hilarious
You should do one on sleep apnoea and CPAP.
For the lymph node exam, would you try to massage around? I see conflicting information about how to palpate for the lymph nodes
Honestly, I don’t think it there should be one “absolutely” approach. As long as you as happy you can say the patient doesn’t have LN, use any and all techniques
Wilson is just chillin in the background lol
Always 😊
I watch your channel for the asmr...but my golly I’m slowly becoming a doctor.
And congratulations on 30k. Been here from the start!
Not quite yet. 29,925 on my side - hopefully this week
Dr. Gill: checks nails
Me with multiple coats of holographic nail polish: good luck with that
Also FYI, if someone wears nail polish a lot, especially darker colors without a thicker base coat, their nails can be stained yellow. I don't wear nail polish enough for that to happen but it's good to keep in mind.
Found it interesting and ASMR like have u ever thoight of trying asmr or even unintentinal asmr?
It's half four in the morning and I'm addicted to watching your videos. What am I doing with my life 😂
Educating yourself 😊
This explains much of the lore.
🤣🤣
Dr gill is the picasso of asmr
What are lymph nodes ? And their purpose?
They are part of the immune system, where the white blood cells gather in infection
wilsonnnnnnnn!
He was a present when I got back from The Island
I ve been diagnosticated with pneumothorax 2 times tho. I am very tall like 1.97 and skinny and like 64 kilos. I start Kickboxing at 12-13 yo i can t remember then also i start playing fotball, handbal, tenis i ran a lot like endurance runs. At 17 yo i started MMA. At 19 i got diagnosticated with pneumothorax and my life collapsed for real. One year later again on my left side i got surgery now i am good. I start putting some kilos and feeling good but still anxious. Take care little boys do not push yourself too much in doing a lot of things. Also if u are like me skinny and tall please for god sake don t do sports that are about punching, kicking, slamming you on the ground etc. The first symptom u get when u have this is a big pain ( knife stabs) in your back and chest right and the top of your lung and you cannot breath correctly bcs of the pain. Do not ignore this go to the doctor if this happens. Also if u hear this sound at night WHEN YOUR ARE IN BED LAYING ON YOUR BACK like something is popping in your chest like ( puc poc poc puc) and u feel pain you are kinda done i m afraid to say this but this is the truth. Also this pneumothorax is ridiculously retarded because it can happen from idiotic stuff like: SNEEZING, COUCHING TOO HARD, FAST TURNING LIKE U TURN 180 IN NO TIME, SCREAMING, STAYING FOR TOO LONG ON CHAIR AND DOING A WRONG MOVE, CARRYING TOO HARD EVERY DAY LIKE FURNITURE FOR EXAMPLE AND YES U GONNA HEAR IT NOW FROM A MASSAGE THAT HAS BEEN DONE IN THE WRONG SPOTS OF YOUR BACK O YES U HEARD IT. Doc I hope u see this and I hope you gonna have a opinion on this.
What stethoscope do you use, sir?
Littman 👍
@@DrJamesGill which exact model ?
Littman 3200 - unfortunately doesn’t record sounds
This video made me both feel very chilled and also violently ill. Also, throw out my pack of cigs because I dont want any of those please and thank you
If you’ve thrown out the cigarettes because of this video, I’d genuinely consider that to be one of the greatest results of these videos so far!! 😊
If there is anything we can do to help support you in stopping smoking, please shout out, and we’ll do what we can 😊
Cardiac exam next
PLEASE MOVE TO
NEW YORK
I do what to visit the USA, but I’ve developed an acute fear of planes for some reason at the moment 🦠
@@DrJamesGill , funny , me too !
Surely if you unstrip then you're putting your clothes on? haha
🤔 I think you might have a point there.
Hmm. I guess it should be “strip off”
Wehen you dr gill tap on the chest its sounds like a heartbeat 😊
Hi! You might want to consider a “deesser” plugin. That 5khz and 9.9khz can get pesssssky sometimessss :))) . Huge fan of your work!
Ok... I have no idea what you are meaning there, but it sounds like you are trying to help.
When we say 5 and 9 kHz how is that affecting the video
@@DrJamesGill At 5:26 there is a sharp "S" sound, that can be reduced by mitigating the audio at around 5kHz and 9.9kHz. In your editing software, is there an EQ (equalizer) function for audio where you can take out about 1-2 decibels of those frequencies? There might also be a Deesser function in your editing software as well.
With the vocal resonance test, what about the sound that Doodle Bob from Spongebob Squarepants makes; that "Heenoimenoi"
Well that might work, but I’d perhaps suggest something less unusual for the patient
Like many folks in the comment section, I to have been asked by my doctors what degree I earned in college. I have graduated from the medical asmr community my friends.
At 19:40 Trachea*
Dr Gill your exemplary teaching via video was informative. I do not have Twitter account. I would like to have your McLeod book sent at my add
Wiiilllssoooooonnnnm!!!!!!!
🏝️
WWWIIIILLLLLLLSSSSOOOOOOONNNNNN
Quick question, who is Macleod?
Prof John Macleod. Bit of a hero by all accounts when it comes to medical literature.
en.m.wikipedia.org/wiki/John_George_Macleod
Dr gill, dr sandwich breath (James Kelly) and bob ross need too get together. Imagine the holy trinity
come back Wilson
Wilson!!
I blame Pink Floyd for confusing people about nicotine stains on fingers.
True. True
MAAD Asmr 😍😍
Wilson...
Wilson !!!!!
OK, who had 6:08 in the sweepstake? 🤣🤣🤣
I almost yelled PUTABITOFPAPER ON IT!! lol! 🤣
Wilson
Just let them sing Neunundneuzig Luftbalons from Nena, who doesn't know that song right? Lol
🤣🤣
Plus you could also use volume and speed of singing as respiratory monitoring metrics!
@@DrJamesGill it's at own risk for hearing damage due to singing off key though!
WILSOOOOON!
A friend gave it me when I can back from The Island
21.14 "unstrip" surely to unstrip is to put clothes on. 😂
Please, give that man money for a proper hair cut!
🤣 it was lock down, and I couldn’t get the cut I DESPERATELY needed!
Tom Hanks wants to know your adress... (Wilson in the back ground)
Yeah thanks. Now I will definitely think of respiratory disease when I walk on fresh snow early in the morning when I'm out hunting rabbits. But I will not let you ruin my early morning hunts of solitude sir. It's one of my main sources of respite. Nothing but my breathing and my breath in the air.. the fresh crunch of lung disease.. coffee in my thermos.. the slight ruffle of a rabbit moving, then the bang of my shotgun and rabbit in the pot for that evening while fresh snow falls to do it over again. I love the fall/winter
6:07 You don't say...
English: Res spearo tree
American: Res pit oree
In America, we say Res purr a tore ee
Wiiiiilsoooonnn
🏐 🏝
WIIILLLLSSSSSSOOOOOOOOOOOOOOONNNNNNNN!
0:25
Wilson ? Wilson !!!!!!!!