ASMR Head To Toe Assessments | ENT & Nervous System Evaluation | Soft Spoken Medical Exams

Added: 2026-05-25

[00:00:04]It stopped.

[00:00:19]Tell Hi, Nicole. My name is Dr. Matt. I'm going to do your exam today.

[00:00:37]So, go ahead and tell me a little bit about what's happening. Why are you here? Well, I've had a really stuffy nose. Um, and I've been getting these ear pains. It's ringing and um a little bit of a headache.

[00:00:56]Okay.

[00:01:01]So, headaches, ringing in the ears.

[00:01:10]Is that in both or just one?

[00:01:13]>> I would say it's mostly in this left ear, but it's a little bit in the right as well.

[00:01:18]>> Okay.

[00:01:20]left ear and pain. On a scale of 0 to 10, how would you rate your pain right now?

[00:01:29]>> Four.

[00:01:34]And how would you describe it? Is it achy, dull, achy?

[00:01:43]Okay.

[00:01:45]What about headaches? Are they localized in the front or they move more towards the back?

[00:01:51]>> It's in the front.

[00:01:52]>> Front.

[00:01:57]>> Okay.

[00:01:58]Are you taking any medications?

[00:02:01]>> No.

[00:02:07]>> Okay. Can you please verify your date of birth for me?

[00:02:11]>> February 3rd, 2002.

[00:02:17]Okay. Do you have any allergies?

[00:02:25]Okay. And what's your approximate height and weight?

[00:02:28]>> Um, I'm 5'4. I weigh 100 lb.

[00:02:37]>> Okay. This is just so we know how to dose your medication if we end up prescribing anything today.

[00:02:47]Okay.

[00:02:49]So, you said you're taking you're not taking any medications. You've been having this headaches for how long now?

[00:02:56]Past two days.

[00:03:02]Okay.

[00:03:05][snorts] Ringing in the ears. Pain. Are you having any sore throat or any difficulty swallowing? A little bit. Okay.

[00:03:29][snorts] Okay. Are you able to eat properly to drink fluids? Good. All right. That's good. We want you to stay hydrated.

[00:03:40]And and tell me a little bit about your nose. Have you noticed any nose bleeds recently?

[00:03:49]>> No, not recently.

[00:03:50]>> Okay.

[00:03:55][snorts] And is there anything coming out from your ears?

[00:03:59]>> No.

[00:03:59]>> Okay. So, no discharge.

[00:04:06]>> [snorts] >> Okay, let's go ahead and take your vital signs.

[00:04:28]Okay, just putting gloves on and we'll measure your oxygenation first.

[00:05:01]Okay, this will go on your index finger.

[00:05:36]This will go under your tongue. I'm going to have you hold it with your right hand. Okay, great.

[00:05:52]Okay, oxygenation is 95% on room air.

[00:05:57]Heart rate is 84 96% at room here. That's very good.

[00:06:09]Okay, let's go ahead and check this.

[00:06:20]90 9.3 F. It's a little bit elevated.

[00:06:25]Did you have anything to drink before coming in?

[00:06:30]Okay.

[00:06:39]and going to take your blood pressure.

[00:06:45]Okay, I'm going to have you relax your arm.

[00:06:59]I know you mentioned that you're not having any nose blades, but with your headaches, I think it's a good idea to have a base of how your blood pressure measures.

[00:07:43]118 over 70. That's That's normal.

[00:07:48]It's not too high and not too low either.

[00:07:52]Just going to slide this down. Let's go ahead and listen to your heart.

[00:08:06]Think it's going to feel a little bit cold.

[00:08:38]I can hear only S1 and S2.

[00:08:42]No S3, no S4.

[00:08:45]Going to listen with the bell.

[00:08:51]Go ahead and take a deep breath in and hold it for one, two, and three.

[00:08:59]Breathe out.

[00:09:02]Okay, go ahead and take a full breath in and exhale.

[00:09:12]Good. And again, take a full breath in and [gasps] exhale.

[00:09:18]>> [sighs] >> Okay, going to listen to the sides as well. Just going to lift your right arm a little bit higher. Okay, take a deep breath in and breathe out.

[00:09:35]And the other side.

[00:09:38]Take a deep breath in and breathe out.

[00:09:43][sighs] Good. I'm just going to have you turn and I'll listen to your back. Is that okay?

[00:09:49]>> Mhm.

[00:09:49]>> Okay.

[00:09:55]Okay. Take another deep breath in and full exhale again.

[00:10:09]Full exhale. [sighs] And again.

[00:10:18]Full exhale.

[00:10:27]One more time.

[00:10:30]Okay. Very normal breath sounds. Just stay right there. I'm going to percuss.

[00:10:52]Okay, very good. Going to take a look inside your ears first. Go ahead and turn your head that way for me. I'm going to have you relax. Let me know if you feel any kind of pain as I'm doing this. Just taking a look to see if there is any redness around the trachus.

[00:11:12]Okay. I want to turn around a little bit that way.

[00:11:16]Okay. You might feel a little bit of pressure. The ear canal does look inflamed.

[00:11:31]I'm not noticing any infection.

[00:11:35]The panic membrane is broken, some fluid buildup.

[00:11:47]Okay, let's go on and take a look at the other ear.

[00:11:52]Any pain with this ear? Does seem to be a little bit more red?

[00:11:57]Okay.

[00:12:08]Okay. So, go ahead and turn your head a little bit more that way.

[00:12:21]Not seeing any infection on the left side.

[00:12:28]Just some constriction of the canal.

[00:12:34]Okay, I'm going to perform an ear test. I want to see how good your hearing is. Go ahead and close your eyes.

[00:12:46]Tell me when the sound stops.

[00:12:54]can stop.

[00:13:00]Okay. Tell me when it stops.

[00:13:06]It stopped.

[00:13:08]Okay. Now, go ahead and tell me which position here is louder, one or two. I'm going to have you keep your eyes closed.

[00:13:15]So, this is one and two. Two.

[00:13:24]This is one, two, two.

[00:13:31]This is one, >> two, >> one.

[00:13:41]One, two, >> one.

[00:13:47]>> Okay. Go ahead and tell me when you don't feel the vibration anymore.

[00:13:56]I don't feel okay.

[00:14:23]Go ahead and keep your eyes closed.

[00:14:41]Okay, I'm going to try a different frequency. I did notice a little bit of delay on the left side and that's the affected ear. So, just trying to see if you have the same difficulty here. Okay, go ahead and tell me when you don't feel the vibration anymore.

[00:15:17]Okay, good.

[00:15:26]Turn your head just a tiny bit this way.

[00:15:28]Good.

[00:15:35]Okay.

[00:15:40]going to take a look at your mouth. Is that okay?

[00:15:44]>> All right. So, we're looking for any swollen lymph nodes, swollen tongue, or anything abnormal around the cheeks.

[00:15:52]Okay. I'm going to have you say a big ah.

[00:15:58]Okay. The soft pallet looks intact. I'm not seeing any things swollen.

[00:16:06]Tongue looks symmetric.

[00:16:10]Okay. Just going to lift it up a little bit to see if there is anything under salvary glands are normal.

[00:16:20]Okay. Go ahead and give me a big smile and frown above your cheeks. I'm going to have you keep them puffed. Don't let me unpuff them. Very good. Go ahead.

[00:16:33]Relax.

[00:16:38]I have here a few tastes since we are checking your throat. I feel like we should definitely do a test and see if your taste is abnormal or affected. What does that taste like?

[00:17:01]>> Not good.

[00:17:02]>> Okay.

[00:17:04]Is that salty? Bitter.

[00:17:07]>> Bitter.

[00:17:08]>> Bitter.

[00:17:13]And would you say you would associate it with almonds or strawberries?

[00:17:19]The first one.

[00:17:20]>> Okay.

[00:17:32]Okay, let's go ahead and try that one more time. Someone can have you close your eyes.

[00:17:40]What does that taste like?

[00:17:42]>> Oh, salty.

[00:17:43]>> Salty. Would you say that you associated with pretzels or bananas?

[00:17:49]>> Pretzels. Okay.

[00:18:03]One more time.

[00:18:08]It was sweet.

[00:18:10]>> Okay. Want to say that you associated with coffee or cinnamon?

[00:18:16]>> Cinnamon.

[00:18:17]>> Okay.

[00:18:22]Let's go ahead and check the patency of your nose first.

[00:18:28]So, you did say that you're having some stuff, right? On both or just one?

[00:18:34]>> Um, both, but mostly this side.

[00:18:37]>> Okay. So, the left side, that could be the sinuses. Is it okay if I pulpate your sinuses first?

[00:18:55]Okay, I'm pulpating the part that doesn't look as red or inflamed.

[00:19:04]Let's just see if there's any difference.

[00:19:24]Tiny bit of puffiness there. Definitely more red over here.

[00:19:30]Okay. There's another set of sinuses right in between your eyebrows. I'm just going to go ahead and fill that as well.

[00:20:00]Okay, I'm going to pulpate on your eyes as well. Very gentle. Let me know if you feel pressure more on the left or right or both sides.

[00:20:16]Okay.

[00:20:21]All right. I'm going to cover one nostril. Go ahead and try to breathe and breathe out through the other one.

[00:20:29]Okay.

[00:20:34]Let's take a look inside. Go ahead and look up for me.

[00:20:45]I'm not noticing any obstruction, but there are some glands inside your nose that are a little bit inflamed.

[00:20:56]We're just going to keep on investigating and see exactly what um could be the cause. Let's try and see if your sense of smell, so your alactory nerve is um damaged.

[00:21:11]You didn't have any accidents, correct?

[00:21:14]Any broken nose or and you are not into contact sports or something like that.

[00:21:22]Okay. So, these smells might be kind of strong.

[00:21:28]Wait, there you go.

[00:21:33]If they bother you or they give you headaches, just let me know. Okay. Okay.

[00:21:37]Go ahead and close your eyes and just gently waving the test tube around your nose. When you're ready, go ahead and tell me what this smells like. It smells like mint.

[00:21:57]>> Mint.

[00:22:01]Okay.

[00:22:06]I'm going to keep this one a little bit farther from your nose. Let me know if you can detect it.

[00:22:17]It kind of smells like cinnamon.

[00:22:21]Okay.

[00:22:23]Definitely. That was garlic and then it was very strong. So, that was one of the reasons why I didn't keep it so close to your nose.

[00:22:36]Okay, that one smells more like cinnamon.

[00:22:41]Okay, this is floral. Um, sometimes it could happen that we're smelling um something that is not there. It could indicate a nerve damage.

[00:23:03]It smells like mint.

[00:23:06]Okay.

[00:23:21]And one last one.

[00:23:23]>> It smells like ginger.

[00:23:40]Okay, I'm going to have you change into a gown and I'll have you lay down on the table and I'll take a look at your neck and throat and to see if there is any other damage that we haven't discovered yet. Okay. Okay, Nicole, I'm going to pulpate first your lengthen outs. Let me know if you experience any kind of pain as I'm doing that.

[00:24:21]We're tucking lymph nodes that surround the neck muscles including cervical and thoracic Sometimes throat discomfort could also come from an impinched nerve or a muscle that is Swollen.

[00:25:42]Just going to turn your head towards the right.

[00:26:10]Checking lymph nodes that are above.

[00:26:14]have the collar bone.

[00:26:18]Is it okay if I open the count a little bit on the side?

[00:27:11]Okay. Checking the left posterior side of your thyroid gland.

[00:27:22]It's part of the throat exam and we are expecting for it to be nonpable.

[00:27:34]As you turn your head towards the right, I do feel a little bit of a lump, but that's because of how you turn your neck. So, that's normal.

[00:27:45]And I'm not feeling any nodules, which means that the thyroid gland is normal size.

[00:28:03]Okay. Going to have you turn towards your left. Now I'm going to open the cone on the right side.

[00:29:14]I'm not feeling any enlarged lymphatinathy above the right clavicle.

[00:29:31]Go ahead and turn your head towards the center. Just going to pulpate your trachea now.

[00:29:52]Trus midline.

[00:29:56]I'm not sensing any obstruction.

[00:30:00]There's no inflammation around it.

[00:30:13]Okay. Checking thyroid from the anterior side.

[00:30:24]I'm not feeling any lumps and it's very hard to pulpate. So that's good.

[00:30:33]Can you go ahead and swallow for me?

[00:30:37]Okay. Very good.

[00:30:43]Checking poricular lymph nodes in front of the ears.

[00:30:54]and postricular lymph nodes.

[00:31:16]The tissue is soft.

[00:31:21]Not feeling any bubble like sensation.

[00:31:37]Going to page your head.

[00:31:44]Feeling for any asymmetry, lumps or bumps.

[00:32:19]>> [snorts] >> Heat.

[00:32:36]Heat.

[00:33:25]Okay, I'm just turning towards the other side now to check the right occipitus.

[00:34:39]Okay.

[00:34:45]pulpating TMJ to see if I feel any inflammation around it.

[00:35:02]removing that the temporal mandibular muscles that connect the jaw to the ear and cranium.

[00:35:17]So, you're going to feel my fingers right under your eyes.

[00:35:26]Did you feel that equally on both sides?

[00:35:29]Mhm.

[00:35:35]Did you feel that equally as well? Okay.

[00:35:41]It was a bit harder on the right side.

[00:35:45]Okay.

[00:36:01]Let's check that with two.

[00:36:26]Looking for any abnormal muscle movement.

[00:37:49]Okay, go ahead and open your mouth slowly all the way as much as you can.

[00:38:05]And now close it slowly.

[00:38:10]Okay, just going to move my fingers to a different point. Pressure. Go ahead and do that one more time.

[00:38:24]Little bit of interior movement on the left side. I did not hear any popping.

[00:38:33]Let's do that one more time.

[00:38:42]Okay. Now, I'm going to have you open and try to move the jaw towards the right.

[00:38:51]Okay.

[00:38:53]Come back to center.

[00:38:55]And let's do that one more time. And move to the left.

[00:39:01]and come back to center.

[00:39:05]Okay. Did you have any pain while you were doing that?

[00:39:08]>> Okay.

[00:39:12]Okay. So, I'm going to give you three numbers. One, two, three. Three is the worst pain. Two is so so one is very little pain.

[00:39:27]Go ahead and tell me if it's one, two, or three. So, I'm pushing down.

[00:39:33]>> One, one, one, two. Okay.

[00:39:50]So, these muscles are the ones that are affected.

[00:40:00]I'm going to touch you with two textures. One is going to feel dull.

[00:40:04]This is what dull is going to feel like.

[00:40:06]And the other one is going to be sharp.

[00:40:09]This is what sharp is going to feel like. Go ahead and tell me if you feel this sharp or dull.

[00:40:16]Go shirt.

[00:40:32]Sure.

[00:40:35]Done.

[00:40:42]Sure.

[00:40:47]Do short.

[00:41:14]Toe toe toe toe.

[00:41:29]Sharp sharp.

[00:41:36]D.

[00:41:43]Sure.

[00:41:47]Sure.

[00:41:53]Sharp.

[00:41:56]Sharp.

[00:41:59]Sharp.

[00:42:01]Tough.

[00:42:05]Sure.

[00:42:09]Sure.

[00:42:11]>> Okay.

[00:42:33]Go ahead and tell me if you feel this on the left or right.

[00:42:38]Left.

[00:42:40]Left.

[00:42:43]Right.

[00:42:45]Right.

[00:42:49]Left.

[00:42:52]Left, right, right, right, left, left, left, right, right.

[00:43:21]Okay.

[00:43:35]Going to try to listen to your TMJ and see if I hear any microscopic sounds that can be picked up through the stethoscope only.

[00:43:50]Go ahead and try to open your jaw slowly.

[00:43:57]Okay. And close.

[00:44:01]And do that one more time.

[00:44:07]And close.

[00:44:16]One more time.

[00:44:19]and close.

[00:44:23]One more time.

[00:44:26]And close.

[00:44:29]Yeah. So, just like I suspected, I did hear the cracking sounds, which are normal in your diagnosis. Let's go ahead and take some measurements.

[00:44:54]Okay, go ahead and open as much as you can.

[00:45:02]Okay, so that's 4.6. You can go ahead and close.

[00:45:09][snorts] What we can do today before we set you up with an orthodontist to try to fix the jawline, we can do a TMJ massage that really helps with inflammation and to subside the pain that you're having, especially in the back of your neck.

[00:45:36]The pain is coming from the front and that's why you're experiencing some pain towards the left side right under your eye here.

[00:45:46]>> So let's go ahead and start by applying an anti-inflammatory medication. It has three medications in it. One is anti-inflammatory, the other one is for pain relief and third is to um increase circulation.

[00:46:32]Okay. I warmed it up in my hands. Now I'm going to go ahead and apply it.

[00:47:33]Put just a little bit more.

[00:47:46]These are the pressure points that we're going to trigger to relieve pain.

[00:48:03]First, I'm using a lymphatic movement that helps to drain the liquid that is stagnant.

[00:48:44]Using a very gentle brusher. Yeah.

[00:50:05]Okay.

[00:50:13]going to apply acupressure. Let me know if you feel any kind of pain as I'm doing that. Okay.

[00:50:21]We're trying to trigger the points that are very tight.

[00:53:00]Just applying gentle pressure.

[00:53:53]Okay, I'm going to go ahead and ask you to get dressed.

[00:53:59]Well, we will do another exam in about 2 weeks for a followup to see how this looks. In the meanwhile, I'm going to set you up with a TMJ specialist who's going to help you to rebalance your jawline and that's going to cause a little bit less pressure on the TMJ.

[00:54:18]Okay. I'm going to prescribe some medication to help with uh stress and as well with the pain that you're having.

[00:54:28]Do you have any questions for me?

[00:54:31]>> No.

[00:54:31]>> Okay. Thank you, Nicole. Thank you.

[00:54:47]What about now?

[00:54:59]Oh, I'm going to go ahead and take a look today at your TMJ. Okay.

[00:55:18]>> This is a followup for your orthopedic examination.

[00:55:22]And can you please verify your date of birth before we continue?

[00:55:26]>> Yes, that's June 22nd, 1992.

[00:55:31]>> Okay. And your allergies still the same?

[00:55:34]No. Non allergies.

[00:55:36]>> Right.

[00:55:38]Okay.

[00:55:42]All right. Go ahead and describe the pain a little bit. Um, so I've been feeling this kind of like I would say dull pain all around the ear. Um, I was just uh recently diagnosed with TMJ disorder.

[00:55:59]Okay.

[00:56:00]>> I've also been um hearing some like popping sound mostly in my right ear.

[00:56:07]Okay. Most of the times, even though you hear the popping sound just on one side, it [snorts] could um be affected your both sides. It's just that you're not exhibiting any symptoms on the left side yet. Um but that's a good sign that only the right side is um is affected and showing symptoms because it would be a lot worse to have both sides.

[00:56:30]>> Okay.

[00:56:31]>> So, you said popping sounds and is it constant or it comes and goes? pretty constant.

[00:56:38]>> Okay. The pain. Do you have any uh facial pain?

[00:56:42]>> No.

[00:56:44]>> Okay.

[00:56:46]What about uh inside your mouth in the throat? Do you have any pain when you swallow?

[00:56:53]>> No, I don't think so. Okay.

[00:56:59]and any denture uh procedures in the last 6 years?

[00:57:09]>> No, probably just like regular cleanings.

[00:57:13]>> Could be a few cavities that they fixed, but >> Okay. And are you having any jaw pain?

[00:57:22]Um, yeah, kind of when I move it more towards the right side.

[00:57:32]Okay.

[00:57:37]Are you taking any medications on a daily basis? Um, I take ibuprofen here and there to try to help. Um, not every day though.

[00:57:47]>> Okay. And is it helping with the pain?

[00:57:50]>> Not really. Okay. So, if it is TMJ and um you know you are diagnosed with it, then ibuprofen doesn't really do much for a muscularkeeletal thing that you are having, we're going to go ahead and prescribe just a a lotion that is topical and you can apply three times a day. It's going to really help with the pain.

[00:58:13]>> Okay, sounds great.

[00:58:17]>> Okay.

[00:58:19]And have you noticed any grinding at night or throughout the day?

[00:58:25]>> No, I do tend to tense up my jaw a lot when I'm stressed.

[00:58:30]>> Okay.

[00:58:31]>> Um but not grinding.

[00:58:33]>> Okay.

[00:58:35]The tension, do you feel it more on the on one side?

[00:58:39]>> No, it feels pretty even.

[00:58:41]>> Okay. Are you having any frequent headaches?

[00:58:45]>> Yeah, migraines a lot.

[00:58:51]Okay. And migraines, do they tend to radiate towards the front side or the back?

[00:59:00]I don't know. I have not paid attention to that.

[00:59:02]>> Okay. Try to pay attention to that next time and let me know when when we see each other. Okay. Okay.

[00:59:10]Okay.

[00:59:13]>> All right. We're going to do some tests first.

[00:59:28]Okay, we're going to start with just a gentle patient examination. Okay.

[00:59:46]Any pain here? A little bit more towards the ear.

[01:00:08]Yeah, right there. Okay.

[01:00:15]On a scale of zero to three, how bad is it when I press down here? Maybe four or five.

[01:00:24]>> Okay.

[01:00:25]And go ahead and gently open your mouth.

[01:00:30]Any pain now? Is it increasing as you're opening it?

[01:00:33]>> Um, no. It's kind of the same. I did feel like it cracked or it popped a little bit.

[01:00:40]>> Okay. And I'm going to just apply some pressure here on this trigger point. Any pain here?

[01:00:48]A little bit less. Maybe like a two.

[01:00:51]>> Okay.

[01:00:53]What about here?

[01:00:56]No. Okay.

[01:01:02]And here very slightly. Maybe like a two. Okay.

[01:01:11]And here.

[01:01:14]Same thing.

[01:01:17]And what about here?

[01:01:20]No. All right.

[01:01:23]Any pain as I'm pressing down here?

[01:01:27]Yeah, a little bit.

[01:01:30]Okay. Go ahead and give me a number from zero to three. How bad is it now?

[01:01:36]Um maybe like a two on the right side or was a little bit more on the left.

[01:01:42]So let's say like a four on that side and three on this side.

[01:01:50]Okay. What about now?

[01:01:52]>> No.

[01:01:55]What about now?

[01:01:58]Maybe like one or two. It's very slight.

[01:02:03]Any pain here?

[01:02:11]Yeah, a little bit. Like it too.

[01:02:29]I do have encapsulitis on the right side which is an inflammation of the joint and that could mean there is also some fluid buildup.

[01:02:48]Okay.

[01:03:01]Any pain here in the back of your ear?

[01:03:06]A little bit like maybe like one or two.

[01:03:10]>> Okay.

[01:03:12]What about here?

[01:03:15]>> Yeah, it feels pretty tense in there.

[01:03:18]Maybe like a three, four.

[01:03:21]Okay.

[01:03:24]And here. No. All right. This one.

[01:03:27]There's a good sign that it's not traveling down the trapezius muscle and affecting this joint as well.

[01:03:38]And here very slightly one.

[01:03:44]Okay. Gets a little bit worse.

[01:03:47]And what about here?

[01:03:51]Yeah, maybe like three.

[01:03:55]Not down there.

[01:03:56]>> Okay.

[01:03:59]Go ahead and tell me which side hurts more. Okay.

[01:04:02]>> Okay.

[01:04:08]How pretty.

[01:04:14]Right.

[01:04:21]They're right. I think right.

[01:04:36]I didn't really feel pain.

[01:04:44]No pain.

[01:04:52]I'm going to check your arms as well.

[01:04:54]Okay.

[01:05:44]Okay.

[01:05:55]Okay, I'm going to have you put your arms like this above your head and let me know if you feel any pain as I'm pressing down here.

[01:06:05]>> No.

[01:06:08]No.

[01:06:11]No. What about now?

[01:06:14]a little bit of discomfort. Okay, go ahead and relax.

[01:06:22]All right, I'm going to put this in the bony prominences. Let me know when you don't feel the vibration anymore. Okay.

[01:06:32]No.

[01:06:41]No.

[01:06:59]No, no, no.

[01:07:24]No.

[01:07:32]No.

[01:07:36]Okay. Do you hear this equally on both sides?

[01:07:39]>> Yeah.

[01:07:43]Go ahead and tell me if you feel the vibration more on the left, the right.

[01:07:48]>> Feels pretty warm.

[01:07:54]What about now? Yeah, I feel the same.

[01:08:02]Okay. Don't know when it stops.

[01:08:05]No.

[01:08:11]No.

[01:08:17]All right. We're going to go ahead and just took some neurological responses here.

[01:08:48]Okay, go ahead and relax your jaw for me.

[01:08:53]Good.

[01:10:16]Okay, I'm going to close your eyes and I'm going to draw something on your face. I'm going to need you to tell me if you can identify um the letter. So, I'm going to use the alphabet letters.

[01:10:36]Z.

[01:10:41]X.

[01:10:47]O.

[01:10:53]T.

[01:10:59]M.

[01:11:05]P.

[01:11:07]Good. What number is this?

[01:11:12]Three.

[01:11:17]Ask eight.

[01:11:25]What number is this?

[01:11:30]about four. Okay.

[01:11:33]All right. I'm going to go to go ahead and take some measurements.

[01:13:04]Okay.

[01:13:34]There's about a 10 degree imbalance on the left and the right.

[01:13:49]What I'm going to do is I will start by adjusting your face a little bit. So you're going to feel my fingers kind of pressing on the joint and try to move it a little bit.

[01:14:00]>> This will help to stimulate the nerve endings to regenerate and to shift into the right direction. Okay.

[01:14:40]Any pain? A little bit. It feels like a little bit of pressure.

[01:15:13]As we're moving the muscles, you might feel some release.

[01:18:24]Okay, I'm going to apply some pressure on the lower side of your neck. This will help to release some of that lymphatic fluid that has been accumulated in this area.

[01:18:37]It's putting a lot of pressure on your joint.

[01:20:17]Okay, I'm going to have you make some rotation movements. So, let's go ahead and start with the left side first.

[01:20:24]>> Okay, >> and tell me if you feel any pain as you're doing that. So just rotate your head like this. Yes, >> it does feel pretty tense.

[01:20:35]Okay. And go ahead and change direction.

[01:20:48]Okay.

[01:20:50]All right. I'm going to do some tests to um make sure that your strength is still normal. All right. What I'm going to have you do is I'll have you try to lower your chin.

[01:21:03]I'm going to push the chin up and I'm going to need you to listen to that.

[01:21:08]Okay. Good. And now I'm going to push your chin this way. I'm going to have you um put force by the way. Okay.

[01:21:16]Good.

[01:21:19]Okay. So, that is pretty good. Go ahead and try to lift your eyebrows up. I'm going to try to push the mouth down.

[01:21:27]Okay.

[01:21:36]Can you go ahead and shrug your shoulders?

[01:21:41]All right.

[01:21:42]Pretty tense, though. And it seemed like you have you were having some difficulty there, too.

[01:21:48]>> Can you go ahead and put your arms in front of you? I'm going to try to push them up. Don't let me do that. Okay.

[01:21:58]And I'll push them down now.

[01:22:04]Okay. Very normal reaction. Going to try to open them. Don't let me do that.

[01:22:13]Okay. I'm going to try to close them.

[01:22:17]Slight problem with the left side. Okay.

[01:22:25]All right.

[01:22:27]Go ahead and tell me if you feel this on the left or right. Okay.

[01:22:33]Left, right, both.

[01:22:44]Both. Okay. And are you having any pain when I'm brushing your skin?

[01:22:50]>> No, not at all. What about here? No.

[01:22:59]No. Okay. What about your face? Do you feel this on the left or right?

[01:23:06]Left.

[01:23:09]Right.

[01:23:13]Both.

[01:23:16]Both. Did you feel that equally on both sides?

[01:23:19]>> Yes. And now Yeah. Was that equal? Mhm.

[01:23:30]Okay. So, I think I'm going to have you um do an MRI. We're going to do an MRI of the joint and we're going to diagnose it. Usually um the diagnosis goes from 1 to five. five being the um kind of like the worst scenario, but even those kind of cases we can still fix. So, as soon as you get that done, we're going to be able to figure out exactly what the treatment plan is. But from my point of view, I think we are definitely good here. And as soon as I have the MRI results, we're going to ask you to come back to the office and we're going to uh talk about what we can do.

[01:24:10]>> Okay, sounds good. All right. Well, do you have any questions for me?

[01:24:18]>> No, not right now.

[01:24:19]>> Okay. Thank you.

[01:24:20]>> I'll talk to you soon.

[01:24:21]>> Okay. Thank you. Exhale.

[01:24:29]Sharp.

[01:24:31]D vibration.

[01:24:36]Warm.

[01:24:51]Good.

[01:24:57]One.

[01:24:59]>> Hi Sarah. Hi. My name is Dr. Mad. How are you doing today?

[01:25:04]>> Good. How are you?

[01:25:04]>> I'm good. Thanks for asking. So, I have here your file. You're a transfer patient from another hospital. I'm just going to go over your medical history to make sure that I have everything before we do the exam. Okay. Mhm. When was your last checkup? About a year ago.

[01:25:23]>> Okay.

[01:25:27]Can you please verify your last name?

[01:25:29]>> Uh, yes. Um, Russell.

[01:25:32]>> And your date of birth? November 18th, 1998.

[01:25:39]>> Okay, perfect.

[01:25:41]Do you have any allergies?

[01:25:43]>> Um, just pollen.

[01:25:47]>> Are you taking any medicine on a daily basis?

[01:25:50]>> No.

[01:25:54]Okay.

[01:25:56]Any surgeries?

[01:25:58]>> No.

[01:26:06]Okay. Any recent headaches >> or migraines? I've had a couple migraines in the past year.

[01:26:14]>> Okay.

[01:26:16]On a scale of 0 to 10, how bad are they normally?

[01:26:20]>> About a six.

[01:26:24]Okay. And how often do you get them?

[01:26:26]>> Um, every maybe five months or so.

[01:26:31]Do you know what they are triggered by?

[01:26:34]>> I suspect stress.

[01:26:36]>> Stress. Okay.

[01:26:40]Have you been under a lot of stress in the last year?

[01:26:44]>> I'd say so.

[01:26:45]>> Okay.

[01:26:46]Any recent changes in at home or at work?

[01:26:51]>> Um, I've switched jobs twice.

[01:26:53]>> Twice. Okay.

[01:27:00]Okay. Have you noticed any palpitations, difficulty breathing? Uh, >> no.

[01:27:06]>> Any vision changes?

[01:27:09]>> Okay. Any skin changes, discolorations, or eczema?

[01:27:14]>> Uh, no.

[01:27:19]>> Okay. And how is your sleep pattern? How long do you sleep a night? Uh, usually about eight hours a night.

[01:27:27]>> Okay, that's amazing.

[01:27:28]>> Pretty regular.

[01:27:29]>> Okay.

[01:27:32]And do you follow a normal diet?

[01:27:35]>> Mhm.

[01:27:39]>> Okay.

[01:27:41]What about exercise? How often do you exercise per week?

[01:27:44]>> Um, my job's pretty active, which helps.

[01:27:47]Um, but usually I'll go to the gym about three times a week.

[01:27:50]>> That's amazing.

[01:27:54]Okay.

[01:27:56]Any family history of hypertension, thyroid disorders, any neurological disorders? Um, I think some thyroid stuff on my dad's side, but otherwise nothing.

[01:28:10]>> Okay.

[01:28:18]All right. So, I'm going to go ahead and insert this into your file since you're going to our patient here. And we'll take your vital signs to make sure that we have a good baseline for you.

[01:28:30]>> Great.

[01:28:32]Are you experiencing any migraines at the moment?

[01:28:35]>> No, not at the moment.

[01:28:37]>> Okay. Any pain anywhere in the body?

[01:28:40]>> Some back soreness, but that's all.

[01:28:42]>> Okay. On a scale of zero to 10, how would you rate the back pain? Probably a two.

[01:28:49]>> A two. And is that constant where it comes and goes? Comes and goes.

[01:28:53]>> Okay.

[01:28:59]So, this is going to go under your tongue. I'm just going to have you hold it for me.

[01:29:06]Thank you.

[01:29:10]And then this will go on your index finger.

[01:29:14]It's going to measure your oxygenation and your heart rate.

[01:29:30]9876.

[01:29:32]Perfect.

[01:29:38]Perfect.

[01:29:40]Okay. So that is 98.

[01:29:43]six fah. That's very normal.

[01:29:52]And now I'm going to take your blood pressure. Is your left arm okay? So this is going to go on your upper arm.

[01:30:01]Notice that there is no hypertension in the family. You're not feeling any palpitations, no headaches at the moment either. So, I'm going to have you relax your arm, uncross your legs.

[01:30:15]Perfect.

[01:30:16]Just going to place this here.

[01:30:24]Okay, this is going to go right here.

[01:30:27]I'm going to have you relax.

[01:30:35]>> [snorts] >> Blood pressure is 116 over 75.

[01:31:04]I'm just going to slide this down.

[01:31:18]And how tall are you? I'm 5'4.

[01:31:22]Okay.

[01:31:24]Perfect. I'm going to listen to your heart.

[01:31:28]So, I'm just going to have you scooch a little bit closer. That's perfect. Okay.

[01:31:32]Go ahead and relax.

[01:32:02]I can hear only S1 and S2. Noise S3, no S4.

[01:32:14]Good to listen with the bell.

[01:32:18]Go ahead and take a deep breath in and hold it for one, two, three. Breathe out.

[01:32:28]Okay. Going to listen to your lungs in the front. And then we're going to listen to back two. Go ahead and take a deep breath in and exhale.

[01:32:42]Breathe in.

[01:32:44][snorts] Exhale.

[01:32:49]Breathe in.

[01:32:52]Exhale.

[01:32:55]Is it okay if I listen to the back?

[01:32:57]Okay. I'm going to have you turn around towards the wall. Perfect.

[01:33:04]Go ahead and take a deep breath in and exhale.

[01:33:10]And again, breathe in, breathe out.

[01:33:17]Breathe in.

[01:33:19]Breathe out.

[01:33:23]Breathe in.

[01:33:25]Breathe out.

[01:33:28]Breathe in.

[01:33:31]Exhale.

[01:33:34]Breathe in.

[01:33:36]Breathe out.

[01:34:05]Where is the pain located? The on the back.

[01:34:10]>> The >> the back pain. Can you go ahead and point it?

[01:34:14]>> Oh, down here.

[01:34:15]>> Lower.

[01:34:16]>> Lower. Okay. Mhm.

[01:34:19]>> And does it get worse when you're standing or sitting?

[01:34:24]>> Uh, standing.

[01:34:26]>> Standing.

[01:34:28]>> How is the pain right now?

[01:34:30]>> Right now it's fine.

[01:34:31]>> Okay.

[01:34:34][snorts] I'm looking for signs of scoliosis or lowertosis which is a deviation of the spine normal angle and it could indicate that the vertebrae are moving shifting in the wrong direction and that could cause strain on the muscles around nerve pain associated ated with it.

[01:35:23]Okay, I'm going to do a sharp or dull test. Go ahead and tell me if you feel this sharp or dull.

[01:35:35]Sharp.

[01:35:38]Sharp doll.

[01:35:44]Sharp.

[01:35:47]Doll sharp.

[01:35:55]Doll sharp.

[01:36:02]Doll sharp.

[01:36:08]Still sharp.

[01:36:15]Does this feel the same as this?

[01:36:20]>> Yes.

[01:36:21]>> Does this feel the same as this?

[01:36:25]>> No.

[01:36:27]>> Does this feel the same as this?

[01:36:32]Okay.

[01:36:36]Go ahead and tell me if you feel this pressure or vibration.

[01:36:42]Pressure.

[01:36:48]Vibration.

[01:36:52]Vibration.

[01:36:57]Vibration.

[01:37:01]Pressure.

[01:37:04]pressure.

[01:37:07]>> Does this feel cold or warm?

[01:37:09]>> Warm.

[01:37:11]>> What about now?

[01:37:12]>> Warm.

[01:37:14]>> And now >> cold.

[01:37:17]>> And now >> warm.

[01:37:21]Warm.

[01:37:24]Cold.

[01:37:26]Warm.

[01:37:29]Cold.

[01:37:32]Warm.

[01:37:36]Warm.

[01:37:38]Cold.

[01:37:41]Cold.

[01:37:45]Warm.

[01:37:47]Cold.

[01:37:49]Cold.

[01:37:52]Warm.

[01:37:54]Warm.

[01:37:56]Warm.

[01:37:58]Cold.

[01:38:00]Cold.

[01:38:02]warm.

[01:38:04]Warm.

[01:38:05]>> Okay.

[01:38:08]So, I'm going to have you change into our count and we're going to go ahead and do a head exam first and move down.

[01:38:15]Mhm.

[01:38:20]Okay. To put gloves on. Mhm.

[01:38:27]>> [snorts] >> could start by pulpating your face. Let me know if you're feeling any kind of pain.

[01:38:52]Pulpating massitor muscles to check for any inflammation.

[01:39:00]Checking lymph nodes.

[01:39:24]Checking pre-uricular lymph nodes for any inflammation.

[01:39:30]Posturicular lymph nodes.

[01:39:38]Also, we're checking thyroid gland to make sure that there is no nodules.

[01:39:47]Both Wings are nonpable.

[01:39:57]Trachea is midline.

[01:40:23]pulpating mastoid bone, just a bone right behind your ears. Checking to see if there is any signs of mastoiditis, an inflammation of the bone that sometimes could be discovered through just regular pulpation.

[01:40:48]going to pulpate your sinuses right in between your eyebrows.

[01:40:57]Sometimes we could notice a little bit of swelling, tenderness, redness.

[01:41:13]and right under your eyes.

[01:41:30]Just going to slowly pulpate around the fa the orbital part is definitely very sensitive.

[01:41:54]Okay.

[01:41:57]Pulpating the hairline to see if there are any nodles, asymmetries.

[01:42:12][snorts] I'm going to take a look at the sculp to see if there's any inflammation.

[01:42:19]If you're suffering from any disorders of the skin that may be a little bit difficult to assess >> [sighs and snorts] >> Looking at the hairline, noticing a little bit of flakiness.

[01:43:14]iness, dandruff. So, you might be having a combination of oily and dryness, but I'm not seeing any redness, so that's good.

[01:43:49]Okay, I would really like to take a sample and see if there is any fungi or bacteria that we are dealing with. So, what I'm going to do is I'll apply a toner that helps to balance the pH. And then we're going to take a sample and send it to the lab.

[01:44:16]>> Okay.

[01:44:39]So, we want to scratch off as many dermal cells as possible.

[01:45:48]This also helps to regulate the pH of the hair follicle.

[01:46:28]This is going to feel a little bit wet.

[01:47:04]Okay.

[01:47:10]So now we're trying to see if there is any redness that appears after the treatment.

[01:47:19]Okay.

[01:47:21]Normal coloration, normal hair distribution, no signs of alopecia.

[01:48:04]Okay, this is going to help to soothe any inflammation from the test that we did just so that we balance the pH and allow for healing.

[01:48:22]Going to check your hearing. Go ahead and tell me if you feel this on the left or right.

[01:48:27]>> Left.

[01:48:31]Right.

[01:48:33]>> Okay. Go ahead and tell me when you don't hear the vibration anymore.

[01:48:43]I don't hear it.

[01:48:48]Okay. Call it in. Tell me when you don't feel the vibration anymore.

[01:48:54]You know, I don't feel it.

[01:49:06]Okay.

[01:49:11]Stop.

[01:49:13]Okay. Go ahead and tell me which position here is louder. Position one or two? Two.

[01:49:25]one or two.

[01:49:28]One. Okay. So, on the right side, there's definitely a little bit imbalance.

[01:49:36]I'm going to go ahead and examine your abdomen. Mhm.

[01:49:42]Okay. Sarah, I'm just going to go ahead and take a look at your abdomen. First, I'm going to listen with a stethoscope.

[01:49:54]This is going to feel a little bit cold.

[01:50:05][snorts] Normal abdominal. No sounds.

[01:50:47]Have you noticed any swelling, any pain?

[01:50:51]>> No.

[01:50:52]>> Okay.

[01:51:17]Going to go ahead and precuss.

[01:52:14]Just a gentle pulpation to check for any organ enlargement.

[01:52:21]So, we're checking all four quadrants.

[01:52:24]Here we have the liver that usually is encapsulated under the ribs.

[01:53:03]Okay.

[01:53:07]Going to go ahead and close this. Going to take a look at your legs.

[01:53:15]Just going to go ahead and just pulpate to see if there is any edema.

[01:53:44]>> [snorts] >> Okay. No more normal temperature.

[01:54:07][snorts] Going to check beetle pulses to plus strong and symmetric.

[01:54:25][snorts] I'm going to check neurological response. Go ahead and tell me if you feel this vibration or pressure.

[01:54:35]Pressure.

[01:54:39]Vibration.

[01:54:42]Vibration.

[01:54:47]Pressure.

[01:54:50]Pressure.

[01:54:51]>> Does this feel cold or warm?

[01:54:54]>> What?

[01:54:57]Cold.

[01:55:00]Cold.

[01:55:03]Warm.

[01:55:05]Do you feel this pressure or vibration?

[01:55:08]>> Vibration.

[01:55:11]Pressure.

[01:55:17]Vibration.

[01:55:19]Pressure.

[01:55:21]Okay. I'm going to check your reflexes.

[01:55:26]I'm going to have you relax your leg.

[01:55:31]Just relax. Good.

[01:55:36]Good.

[01:55:43]Relax.

[01:55:46]Okay. Little bit diminished on the left side.

[01:55:51]I'm going to have you relax and just twist this. Perfect.

[01:56:02]Good.

[01:56:06]Same thing on the other side.

[01:56:13]Okay, very good. Go ahead and relax.

[01:56:18]Going to check your pins reflex.

[01:56:22]Good.

[01:56:32]Do that one more time.

[01:56:35]Okay, very good.

[01:56:42]Just looking in between your toes to see if there is any eczema, dryness.

[01:56:48]Maybe we can recommend like a special cream that can help with that, especially when you stand up for a longer period of time. It could affect our feet as well. I'm going to move your big toe either towards you or towards me. Go ahead and let me know which position you feel.

[01:57:13]Towards me, towards you.

[01:57:19]Towards me.

[01:57:22]Towards me.

[01:57:25]Okay.

[01:57:27]Go ahead and wrap your toes around my fingers.

[01:57:34]Okay, I'm going to push towards you.

[01:57:37]Don't let me do that.

[01:57:40]Okay, I'm going to push them away. Don't let me do that.

[01:57:44]Going to try to open them. Don't let me do that.

[01:57:48]Going to try to close them. Don't let me do that.

[01:57:52]Okay, good motor strength there. I would say four out of five. That's perfect.

[01:58:02]Okay, I know I already pulpated your back. So, I'm going to go ahead and listen for any abnormal sounds.

[01:58:12]You can go ahead and just breathe normal and relax.

[01:59:27]Hearing a little bit of crackles at the base of the lungs.

[01:59:41]But only on the right side.

[02:00:23]I'm not sensing any inflammation.

[02:00:28]around the spine.

[02:00:33]It is normal size.

[02:00:41][snorts] Going to check hydration status.

[02:01:04]>> [snorts] >> Go ahead and tell me if you feel this two or one pressure points.

[02:01:26]One, two, one.

[02:01:37]One, two, two.

[02:01:47]One, one, two.

[02:01:56]One, two, two, one.

[02:02:13]One, two.

[02:02:26]Okay.

[02:02:29]The same thing. Go and tell me you feel this. Two or one.

[02:02:34]One.

[02:02:36]One.

[02:02:39]Two.

[02:02:42]One, two.

[02:02:49]One.

[02:02:51]One, two, two.

[02:02:58]One.

[02:03:01]One.

[02:03:03]Two.

[02:03:06]Two.

[02:03:08]One.

[02:03:11]Two.

[02:03:14]One.

[02:03:20]One.

[02:03:23]Two.

[02:03:26]One.

[02:03:29]Two.

[02:03:32]One.

[02:03:36]Two.

[02:03:39]Two.

[02:03:41]One, one, two, one, one.

[02:03:56]To take some measurements to check for asymmetry.

[02:04:16]14.

[02:04:33]42.

[02:04:40]18.5 [snorts] cuz there's about a 2 degree difference which is not indicative of inflammation in the back area. I'm going to go ahead and run a few more tests and we're going to take some X-ray of the back just so that we rule out any scoliosis or lurtosis of the back spine.

[02:05:31]Okay. something that could definitely explain your back pain and also the migraines. So, I'm going to have your cat dressed and we're going to discuss the results.

[02:05:44]I'm going to take off my gloves and I want to do one [snorts] quick exam. So, check your vision and your pupil response.

[02:05:56]There you go.

[02:06:07]Okay. So, I'm going to have you look right here.

[02:06:17]Okay. I apologize for the light. Go ahead and look up for me.

[02:06:24]Okay.

[02:06:26]Not noticing any yellowish discoloration.

[02:06:32]Okay.

[02:06:35]Okay. Eyes are symmetric.

[02:06:38]Go ahead and look right here.

[02:06:43]Look right here.

[02:06:48]Okay. How many fingers am I holding?

[02:06:51]>> Two. Go ahead and cover one eye.

[02:06:54]How many fingers am I holding now?

[02:06:56]>> Two.

[02:06:57]>> Okay. Go ahead and cover your other eye.

[02:07:00]How many fingers am I holding now?

[02:07:02]>> Two.

[02:07:03]>> And now >> one.

[02:07:05]>> Okay. Very good.

[02:07:09]Okay.

[02:07:12]So, Miss Russell, everything looks good.

[02:07:16]Um, I think the migraines might be from a lack of caffeine. So, I do recommend that you start a low dose of caffeine.

[02:07:26]Um, that will help to stimulate your nervous system and take it only as needed. So, it doesn't have to be on a regular basis, just uh probably when you feel like you get a new migraine. Okay?

[02:07:40]And then [snorts] we're going to run some x-ray of your back just to check for any scoliosis or lower doses.

[02:07:46]something that could definitely either trig the migraines and the back pain, but otherwise everything looks good. And I'm hoping that the X-ray will reveal what we're looking for.

[02:07:57]>> Sounds good. Thank you.

[02:07:58]>> You're welcome. Just going to go ahead and write this down. So, [clears throat] do you have any questions for me?

[02:08:06]>> Um, no, I don't think so.

[02:08:08]>> Okay, sounds good.

[02:08:09]>> Thank you so much for coming in. I'll see you soon. Okay. Yes.