EYE EXAM

Intro
-name
-CC

LOOK
-look at good eye 1st
-wash hands

FEEL
-bony prominences
-upper eyelid(jaundice) and lower eyelid(anemia)

TEST
1.Snellen (20ft/6m away)
2.Ishihara (arms length)
3.visual field
4.Blind spot
5.Accomodation
6.Pupillary light reflex
7.Ophtalmoscope

bye bye.

Upper Limb MSK

1) Introduction
2) Ask for Name
3) Privacy confidentality and Consent
4) Explain to patient the need for exposure, allow to stop if pain , and wash hands

5)Inspection!
Look for Sweats Signs + compare ( give a open commentary)

6) FEEL!
Jugular notch--->clavicle----> acromion---> superior border----> spine----> lateral border---> inferior angle---> medial border

coracoid process---> bicipital tendon--tenderness (ask patient to flex if you want)

7) MOVE!!
Place hand on acromio-clavicular joint when moving arm--> check for crepitus
ACTIVE FIRST, then passive

Flexion, extension
Abduction, adduction
Internal and external rotation

8) Painful arc syndrome - 60 degress to 120 degrees

Lower Limb MSK Examination

1) Introduce self, state purpose and ensure P&C
2) Ask patient's name & age
3) Short history- when and why?
4) Explain to patient about the examination about exposure
5) PLEASE TELL ME IF YOU FEEL ANY PAIN/ PLEASE STOP ME IF THERE IS ANY PAIN
6) WASH YOUR FREAKING HANDS

7) LOOK!!!!
SWEATS, Compare both sides

8) FEEL!!!
ASIS, pubic tubercle, (femoral pulse in between),
greater trochanter of femur,
tibial Tuberosity,
Feel for Baker's cyst
condyles,
patella, ( patella Tap, Bulge test-milk test)
medial and lateral malleolus

9)Movement (Active first , then passive)
Hip - Flexion/Extension , Abduction/Adduction, Internal/External R.
Knee - Flexion/Extension ,
Ankle - Plantarflex, Dorsiflex ; Eversion/Inversion

Specific Test
1) Tredenlenburg (double check this *)
2) Thomas Test *
3) Drawers Test
4) Lachman Test - ACL
5) Mcmurray Test - Medial Meniscus and Lateral Meniscus
6) Patella Apprehension *(during palpation)- move patella laterally, and extend your knee.
7) Bulge Test * (during palpation)- Milking
8) Semen Test - Squeeze your Calve muscles, if normal got plantarflexion
Measurement
1) True Length - asis to the medial malleolus
2) Apparent Length- belly button to medial malleolus

Back Examination

1) Introduce self, state purpose and ensure P&C
2) Ask patient's name & age
3) Short history- when and why?
4) Explain to patient that the exam requires him to remove shirt
5) Ask patient to remove shirt while YOU WASH YOUR FREAKING HANDS

6) LOOK!!! - curvatures, SWEATS, fasciculations

7) FEEL!!!-
Protuberance, C2, C7, C6, T1 ,
spine of scapula----> sup. T2, inf. T7,
Illiac crest- L4,L5
Spinous process + Transverse process
Erector Spinae muscles0- wasting? fasciculations?

8) Measure lumbar extension- locate L5, 10cm up, 5 cm down----> more than 4cm= normal

9) MOVE!!!
Neck- flexion, extension, lateral rotation, lateral flexion
Thoracic- Rotation
Lumbar- flexion, extension, lateral flexion

10) Specific Tests
SLR----> BARRRHHH GADD's test (dorsiflex), LARRR SARGGHH's test (flex hip, extend leg)

11) Say your farewells to the patient, and thank patient.

History Taking!!!!!

CC
HPI
Systems Review
PMH
Past Surgical Hx
Obs & Gyn
Drugs & Medication
Allergy
Smoking & Alcohol
Fam Hx
Social Hx
Occupational & Travel Hx
Sexual Hx

OSCE BABY

Possible Stations:

1) History Taking

2) Dealing with emotion- angry/ depressed

3) MSE- 9 points- refer to aussie discussion board- questions to ask?

4) Suturing

5) Injection

6)MSK- UL, LL, Back

7)PNS- UL, LL,

8)HEP- Lifestyle advice- exercise/ stop smoking/ dietary

9)Ear examination

10) Eye examination

11) BP/ Vital signs

UNLIKELY THAT CPR WILL COME OUT