551 - Unintentional ASMR - Assessment / Exam / Head to Toe

Ajouté : 2026-05-20

[00:00:03]Come in.

[00:00:04]>> Hi, my name is Madison Baker. I'm a PA student. Do you mind if I do a quick physical exam?

[00:00:09]>> No, that's fine. Okay. Um, first, can you verify your name and date of birth for me?

[00:00:13]>> Maline Brownley 4597. Okay, great. So, first I'm just going to start by taking your vitals. I'm going to take your temperature. This is an oral probe, so I'll just put it under your tongue and have you close.

[00:00:26]All right. 97.6. That's good. Next, I'm just going to take your heart rate. And while I'm doing that, I'm also going to be doing your respiratory rate. So, I'll be doing that for 30 seconds.

[00:00:50]All right. So, your heart rate was um 16 beats per minute. Normal rate um rhythm and strength was 2 plus. And your Respiration rate was 14 breaths per minute, normal rate, rhythm, effort, and pattern.

[00:01:04]Next, we will be doing your blood pressure. So, um, I'll have you turn around this way for me.

[00:01:14]I'm just going to attach this.

[00:01:21]Okay. And then I'm going to feel for your brachial pulse.

[00:01:34]the pediatric one.

[00:01:40]All right. So, then I'm just going to pump up the um the cuff until I stop feeling your radial pulse.

[00:01:56]I'll let your arm up relax a little bit.

[00:02:08]I'll actually hold your arm like this so you relax.

[00:02:22]All right. 102 over 72. That's good.

[00:02:49]All right. Great. So, now I'll have you It's me again and we're going to move on to um me just asking you a few questions. So, do you currently know your name?

[00:03:01]>> Maline Brown.

[00:03:02]>> And where are you right now?

[00:03:03]>> At the doctor's office.

[00:03:04]>> All right. And what is the date?

[00:03:06]>> It is Tuesday, August 25th.

[00:03:09]>> Okay, great. So, you are alert and oriented times three to person, place, and time. Um now I will um just kind of take a look at you. Um you appear to have good hygiene, normal eye contact, good um nourishment is appropriate and your affect is appropriate as well. Now we're going to move on to the eye exam. So first I'm just going to do um confrontation by visual field. So I'll have you cover your eye with one hand and whenever you see my fingers wiggle in your visual field, tell me when.

[00:03:39]Okay.

[00:03:41]No.

[00:03:45]No.

[00:03:47]No.

[00:03:50]Now, now.

[00:03:54]Okay. Now do the other eye. The same thing. Now, now, now, now, now, now. Okay, great. Now, I'm going to be testing your um light reflex of your pupils. So, I'm just going to shine this light in your eye, and you can just relax.

[00:04:22]Okay. Um, pupils were um equal in size, round and reactive to light. And then normal um consensual and direct light response. Um, so now I'm going to be making an H with my finger. So you're just going to follow um my finger with your eyes. Don't move your head. And then at the end I'll be going towards your nose. Okay.

[00:04:49]Okay, good. All right, so next we're going to move on to the ear exam. Um, so I'm just going to um Okay, so I'm just going to first just look at your ear. Um, so I'm just going to take a look here and on the other side.

[00:05:11]Okay, good. So, no drainage or lesions.

[00:05:14]Um, I don't see any like masses or anything like that. Um, when I do this, do you have any tenderness?

[00:05:19]>> No.

[00:05:20]>> What about on this side?

[00:05:21]>> No.

[00:05:22]>> Okay, great. So, first I'm just going to look in your ear really quickly here.

[00:05:33]Okay, good. Now, I'm going to go to the other side.

[00:05:44]Okay, good. So, um, your TMs were normal, pearly gray. I didn't see any discharge and you have normal light reflex on both sides. So, next I'm going to look at your nose. Um, your septum appears midline. I don't see any drainage. And, um, now I'm going to just look up there. Um, if you feel uncomfortable at any moment, just tell me. So, I'm going to put my hands on your forehead and then I'll just kind of lift up.

[00:06:10]Okay, good.

[00:06:13]Okay, good. So, um your turbinets, the inferior and middle were visible and normal and the mucosa was normal with no dryness or discharge. Um so, now we are going to be doing the mouth. So, I'm just going to um take a look here. Turn my light first.

[00:06:31]Okay. Or ference is normal. Dentition appears normal. And teeth are correct number and size and shape. Okay. So now I would elicit the gag reflex. I'm not going to do that today, but we would do that. And then I'll have you say ah. Ah.

[00:06:47]Okay. So symmetric elevation of the soft pallet. And then I'll have you stick your tongue at me. All right. So midline profusion of the tongue. That's good.

[00:06:56]All right. So next is going to be the neck. And I'm going to have you turn around in your chair.

[00:07:02]And I am just going to look. Um, your trachea appears midline. Now, I'm going to actually come behind you. And my hands are a little cold, but I'm just going to pull and then I'll have you swallow.

[00:07:14]Okay, good. Uh, normal symmetry, um, size shape. And did you have any tenderness when I did that? No. Okay.

[00:07:21]So, no tenderness. Now, I'm going to be listening for corateed brewies. So, um, I'm just going to go to one side. And when I do this, I'll actually have you hold your breath.

[00:07:32]>> Okay?

[00:07:32]>> Um, so I'll tell you when to hold your breath and then I'll tell you when you can breathe again. And I'll be doing this with the bell.

[00:07:38]So go ahead and hold your breath.

[00:07:42]Okay, you can breathe. We'll do it on the other side. Okay, go ahead and hold your breath.

[00:07:51]Okay, and you can breathe in. All right, so no presence of brewies in the karate.

[00:07:56]And Next, I'm just going to be feeling your lymph nodes. So, if you want to turn this way for me. And then I'm just going to feel um preuricular, posturricular, occipital, tonsular, submandibial, submental, and then um anterior cervical, posterior cervical, and then I'm going to do your superclavicular. So, do you mind if I pull your shirt?

[00:08:31]Okay, good. And I didn't feel any um abnormalities. It all felt good. Did you have any tenderness there? No. Okay. So, no tenderness. Um so, next I'm going to be doing your um upper extremities. So, I'm just going to take a look at first um and feel your skin. So, no rashes or lesions, no arythemma or edema, normal temperature. Um, so everything looks good there. And then I'm going to do some tests on your strength. So, I'll have you put your arms out like this.

[00:09:05]And I want you to resist me pushing down. And then you're going to try to um push up and I'm going to try to push you to pull you down. And then I'll have you go like this with your elbows and I'm going to try to pull you down. And then you go the other other way. And then I'll try to Okay. Great. Um and then after that, we'll do your wrists. So I'll have you go like this and I'm gonna try to pull you and then um do it the other way and then I'll try to pull you. Okay. Good.

[00:09:35]Um next I'm going to feel your radial pulses. So I'll just put my hands right here bilaterally.

[00:09:44]Okay. Good. Good. Two plus strength there. And then next I'm just going to do your capillary refill. So, I'll just push on your fingers.

[00:09:53]Okay, good. That's normal as well. And then we're going to move to the lower extremity. So, I'm just going to look um feel. I don't see any rashes or lesions.

[00:10:03]Um your temperature is normal. No aiththemma or edema. And then I'm going to do your pulses. So, I'll just do um dorsalis pedus bilaterally.

[00:10:18]and then posterior tibial bilaterally.

[00:10:22]Okay, good. And now we're going to test your lower um your lower extremity strength. So when I pushed on your thigh, you're going to try to push up against my resistance. And then I'm going to put my hand underneath and have you push down. Okay, good. Now, same on the other side. Okay, good. And then try to push down. Good. And now I'm just going to move the camera a little bit.

[00:10:45]so we can see.

[00:10:48]Okay. So, now I'm going to do the same thing with your knees. So, I'll have you um try to push your feet out towards me and I'm going to try to push against you. Okay, good. And then try to kick your heels towards the chair and I'm going to try to pull. Okay, good. And then the same with your feet. I'll have you try to push your feet towards the ceiling and I'll resist. And then try to point your feet down. Resist. And then on the same side. Good. And then the other way. Good. Okay. Great. So, Next, we're going to move on to the heart exam. Um, I'm just going to listen. So, I'll have you um take your shirt off and all right. So, I'm just going to listen.

[00:11:35]Um, and then do you mind if I like displace your bra a little bit?

[00:12:00]And then do you mind just placing your breath just like a little bit? Great.

[00:12:12]Okay, good. All right. Um, S1 and S2 were normal. I didn't hear any murmurss, gallops, or rub, so that's great. And next, I'll just have you um turn around and we're going to do some lung sounds now. Um, so what I'll have you do is cross your hands on your on your shoulders. And then I'm going to um just Once I am in my stethoscope, I'll have you take a deep breath in through your mouth.

[00:13:05]Okay, good. So, I didn't hear any wheezes, run high or rolls when I did that. So, that's all normal. Um, so next we're going to do the abdominal exam.

[00:13:15]So, I'll have you um go over to the patient bed and lay down and um so first I'll just oscultate.

[00:13:29]So, I'm just going to listen um in each quadrant.

[00:13:35]All right.

[00:13:50]Okay, good. Um, no hyper hypoactive bowel sounds and that sounded normal.

[00:13:55]So, next I'll listen to your abdominal aorta and then the renal arteries.

[00:14:08]Okay, good. No presence of Ruby there.

[00:14:11]So now I'll just um be palpating. Before I start, do you have any tenderness anywhere?

[00:14:16]>> No.

[00:14:17]>> Okay, good. So first I'll just start with a light palpation.

[00:14:29]Okay. And now I'll do a deeper palpation.

[00:14:40]Good. Any sugars when I do that? No.

[00:14:42]Okay, great. So, we're all done there.

[00:14:44]You can get up and put your shirt back on.

[00:14:54]All right. So, now we're going to just move on to some coordination and neuro stuff. So, I'm going to first just test your reflexes. So, I'll have you just relax your arm, put it this way, and then I'm just going to hold here.

[00:15:10]Good.

[00:15:13]On the other side.

[00:15:15]Okay. Good. So, biceps tendons were reflexive. And now I'm just going to do the patellar. So, just relax your legs.

[00:15:28]That's very good. Okay. So, after that, um, I'll have you stand up for me and I'm going to have you walk like you're on a tight rope. Okay.

[00:15:41]All right. Good.

[00:15:46]All right. Good. So, gate appears normal. And now I'll have you stay standing up and I'm going to have you um I'm going to move my finger. And as I move it, you're going to touch your nose and then touch your my finger. Okay.

[00:15:59]Good. And then I'm going to move it, not touch my own.

[00:16:07]Okay, good. Now, we're going to do rom test. So, I'll just have you stand with your feet together and close your eyes for me. And I would be doing this for 30 seconds.

[00:16:17]All right, it's been 30 seconds and the patient didn't sway or fall. So, that's great. Um, next I'll have you stand like that, but I'll have you put your arms out like this. And then um I'll have you close your eyes. And I did this for 30 seconds as well. And then once I knew the patient was stable, I can push down a little bit and see if she wavers. And she does not. So that's great. All right. So that's good. Um next I'll have you sit down and um I will have you um I will be cranial nerve five. So, I will just be pushing this. I'll have you close your eyes and then I'll be pushing this on your face in a light touch. Um, raise your hand for which side it's on and then tell me if it's on your forehead, your cheek, or your chin.

[00:17:10]Okay, two forehead chin for All right, that's good. And then next I will testing cranial nerve eight.

[00:17:28]So I will um actually just kidding before we do that let's do cranial nerve seven and I'll have you um smile for me frown. Puff your cheeks out and then raise your eyebrows and then um have close your eyes and I'm going to try to pull a little more. Okay, good. All right. So now I'm going to be testing cranial nerve eight. So, I'll be going behind you and I'm going to do what we call the the um whisper or um finger rub test. So, I'll be doing it on one of your ears. I'll have you close your eyes and then raise your hand for which side you feel it on.

[00:18:14]Okay, good. So, that's done. And now we are going to be doing um let me just think for a second here.

[00:18:24]Let's do cranial nerve 11. So um I'm just going to have you I'm going to push my hand on your head and you're going to try to look this way and I'm going to try to resist you. Okay. Good. And then we'll do the other side.

[00:18:39]Good. And then the same thing with your shoulders. I'll have you try to shrug your shoulders and I'll push them down.

[00:18:44]Okay. Great. And then we would also do a genital urinary exam, but we're not going to do that today. And let me just think if I forgotten anything.

[00:18:57]I think we're good. All right. Thank you. Thank you.