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

Added: 2026-05-05

[00:00:01]Hi Nancy Kay, I'm Sarah. I'm going to be performing a physical exam on you today.

[00:00:05]So first I'm going to start with a general survey. I'm going to assess your overall appearance, um, your level of consciousness, emotional state, if you look like you're in any distress or pain, and then your overall health and hygiene. So that completes the general survey. Now we're going to move on to the vital signs. So first I'm going to start with blood pressure. So I'm going to go ahead and make sure your legs are uncrossed.

[00:00:25]That's perfect.

[00:00:27]And then put this around your arm. Just nice and nice and tight.

[00:00:32]Okay.

[00:00:33]All right.

[00:00:41]And then let's try that.

[00:00:44]Tighter.

[00:00:53]Okay.

[00:00:54]Let's try that.

[00:00:58]Make sure that's lined up.

[00:01:00]Put my stethoscope on.

[00:01:02]And bell's on.

[00:01:08]Good.

[00:01:10]Thank you.

[00:01:28]Hold on. Make sure that's lined up. A little tight.

[00:01:50]Okay. 114 over 72. So that's a good reading. Okay, perfect. So now [snorts] I got blood pressure checked. Now I'm going to assess, um, your heart rate and respiration rate.

[00:02:01]So Thank you.

[00:02:25]Okay, perfect. So your heart rate was about a 72. And so now I'm going to check your respiration rate. Just watching just move up and down.

[00:02:52]And that's about 14. And then at this time I would also check, um, check your temperature and your oxygen saturation, but we don't have that equipment. And then what's your height and weight? Uh, 135 45 55. Okay, perfect.

[00:03:05]>> [laughter] >> And then I would use that to calculate your BMI. Okay, so that, um, com- completes the vital sign portion of the exam. So now we're going to move on to the skin portion of the exam. So first I would, um, just take a look at your skin and I'm just going to assess, um, the color, any changes in color I see, looking at for any moles or lesions anywhere on the skin, um, and then after completing that, um, I would take my hands, using the back of my hands I'm going to run my hands down um, the front and back of your arms, bilaterally assessing for any, um, changes in temperature, texture, or moisture. And then you could just go ahead and stand up.

[00:03:46]So if you if it was in the back, um, then assessing the back temperature, texture, and moisture. And then same thing on the front, temperature, texture, and moisture.

[00:03:56]And then I'm making sure to check between the toes and the fingers for any of those, um, abnormal color changes or moles or lesions. And same thing.

[00:04:06]Um, check the bottoms of the feet, too.

[00:04:07]Make sure we're not seeing anything.

[00:04:09]Okay. Um, So that Oh, and checking, um, for the [clears throat] stomach and everywhere and then also on the back, too. Making sure I'm not seeing anything in the back area, either. Any new moles, skin lesions, or anything like that. Um, perfect. Okay.

[00:04:30]So now that, um, completes the skin portion of the exam.

[00:04:35]So now we're going to move on to the hair portion. So I'm going to assess the scalp and hairline and near the ears, too.

[00:04:43]Looking to see if I see, um, any abnormalities. And then I'm looking at, um, the distribution, quantity, I'm just going to go ahead and actually take your hair out so I can look at that.

[00:04:56]Distribution, um, quantity, and texture of the hair.

[00:05:01]Looking at all the different areas.

[00:05:03]Looking for any abnormalities.

[00:05:08]Okay, perfect. Um, and then go ahead and get that back to you.

[00:05:13]And then after doing that, so that completes the hair portion of the exam.

[00:05:16]Now we're moving on to the nail portion.

[00:05:18]So first I'm just going to look at your nails.

[00:05:20]Uh, I'm looking at any, um, abnormalities I see just looking at them. Then I'm going to feel for any abnormalities.

[00:05:29]Looking at the toes, too. Hold that. And then, um, Can you get that?

[00:05:36]I'm going to do a form of capillary refill.

[00:05:40]Also capillary refill. And I forgot to Your nails are painted so I can't see it. Okay, and then I forgot turgor on the the back to the skin portion of the exam. So I'm just going to pinch and just checking for your hydration. So skin, hair, nails, um, now we're going to move on to the the head portion of the exam. So I'm going to check, um, check the head for any abnormalities.

[00:06:05]Just the overall shape. Looking at that, I don't see anything, any protrusions, bony protrusions. Now I'm going to assess the, um, [clears throat] frontal sinus, frontal sinus, maxillary sinus, parotid glands, um, and temporal arteries. Feeling for any abnormalities and just let me know if any of that hurts. It's all good. Okay, perfect. That completes the head portion of the exam. Now I'm going to be moving on to the eye portion of the exam.

[00:06:34]So let me make sure I got all my stuff set up.

[00:06:37]Okay. So for the eye portion of the exam, first I'm going to assess the, um, external appearance of your eye, looking for any abnormalities I see. Um, then I'm going to assess the internal appearance of your eye. So looking in.

[00:06:50]Looking in for any abnormalities there.

[00:06:53]Perfect. Okay. Then I'm going to assess your pupillary size.

[00:06:58]First I'm going to check it just looking in the normal light.

[00:07:02]So if you could look straight ahead at me. Awesome.

[00:07:07]Good.

[00:07:08]And then I'm going to check it using the light. So let me check. Look straight ahead at me.

[00:07:15]This could be bright.

[00:07:17]Okay, good. Okay, perfect. So I checked the pupillary size. Now I'm going to be move on to the light reaction test. Um, checking direct and consensual response.

[00:07:26]And so if you could just look right over my shoulder.

[00:07:33]Good. Now over here.

[00:07:36]Good. Now I'm going to check, um, the near reaction test.

[00:07:40]Um, so this one I'm just going to get you to look at my finger then look at the wall and then look back at my finger, okay? So look at my finger. Look at that wall.

[00:07:49]Look at my finger. Look at the wall.

[00:07:52]Okay, perfect. Now we're going to do, um, so we did external, internal, light react- pupillary size, light reaction, near accommodation. So now we're going to do corneal, um, light reflex test. So if you could just look straight at me, I'm just going to assess. I'm just going to shine this light in your eye real quick.

[00:08:11]Okay, good. Now, um, we're going to test the extraocular muscles, um, with convergence. And so I'm just going to get you to keep your head still, look at me, and you just follow me with follow my finger with your, um, eyes, okay?

[00:08:26]>> [laughter] >> Okay, ready?

[00:08:29]Good.

[00:08:30]Keep going.

[00:08:34]Good. Keep going.

[00:08:36]Boop. Okay.

[00:08:37]Okay, now, um, we've tested that. So now we're going to go ahead and test, um, your visual acuity. Um, do you wear contacts or glasses? Do you wear contacts? Okay. Perfect. So Let me So this says hold this card at about 14 inches. So I'm actually just going to get you to hold it about 14 inches. And let's do both eyes uncovered first. So can you tell me the smallest, um, let's see.

[00:09:03]Let's do the smallest numbers you can read.

[00:09:05]9 5 6 2 3 Okay. Now cover up your right eye.

[00:09:10]Same thing. Read that line backwards or the smallest line backwards.

[00:09:14]2 3 6 5 9 Okay. And now [clears throat] cover up the other eye, same thing.

[00:09:19]2 3 6 5 9 Okay, perfect. Okay, so now we're going to test, um, your, um, visual fields now. And so for this one I'm going to hold numbers um, in different quadrants and you guys tell me what they are. Um, but first I need you to cover up your right eye and I'm going to cover my left eye. And [clears throat] you're still just going to move your going to look straight ahead. So you're not going to move your head or eye when I'm doing this, okay?

[00:09:44]Okay.

[00:09:45]So let's do two one two three Okay. Now cover [clears throat] up the other eye, same thing.

[00:09:55]And two one three two. Okay, perfect. Um, so now we've done visual fields and now let's go ahead and make sure I'm just making sure I get everything. Uh, let's go ahead and do the ophthalmic exam.

[00:10:15]Okay.

[00:10:20]Go a little more.

[00:10:23]Yeah, okay, perfect.

[00:10:25]I'm going to go ahead and dim the lights for this one, too.

[00:10:28]Okay.

[00:10:36]Okay, perfect. And you can just look straight ahead now. I'm just going to check the red reaction.

[00:10:42]Good.

[00:10:43]Come a little closer. I don't want you to be out of the way of that. Yeah.

[00:10:46]Sorry. Okay. Now it's all right. I'll just check your red reflex from over here.

[00:10:52]That's better. Okay, yeah, that's better. Okay, >> [clears throat] >> good. Checking your red reflex.

[00:10:57]Now I'm just going to You know, then I might touch my um hand on you, so Okay, awesome. That's awesome. I can actually see something. Okay.

[00:11:14]>> [laughter] >> Now same thing over here. Just look straight ahead.

[00:11:17]Good.

[00:11:20]That's awesome. Okay, same thing.

[00:11:38]Okay, perfect. Okay, so that completes the eye portion of the exam. Now we're going to move on to um ears. Um, so I'll put my good back on the light.

[00:11:47]Okay, so the ear portion of the exam, um first off I'm just going to check the external appearance of your ears, both of them, making note of any abnormalities, uh, and then I'm going to um touch around the ear in some different areas, the tragus, auricle, um mastoid process.

[00:12:06]Do you feel any pain anytime I'm touching anywhere?

[00:12:12]There we go.

[00:12:13]Okay, now I'm going to perform the tug test on the ear. Um, so just let me know if you feel any pain. All good?

[00:12:21]And then over here.

[00:12:23]All good?

[00:12:25]Okay, perfect. And now I'm going to perform um the whisper test. So this one I'm just going to stand behind you and whisper um a series of letters and numbers and you just repeat back what you hear, okay?

[00:12:42]2 B 3. Perfect. Um, and now can you occlude one of your ears, too? Good. And now same thing.

[00:12:51]F 4 5. Okay, now occlude the other one.

[00:13:00]2 8 B. Okay, okay. So now that I'm going to check to go look inside your ears.

[00:13:22]So I'm sure Yeah, that's great.

[00:13:25]Okay.

[00:13:27]And I'm also touching with my um your ear and around here, okay?

[00:13:39]Yeah, that's perfect. Okay, now I'm going to go ahead and do the other ear, too.

[00:13:43]Looking to see if I see any abnormalities in the inside of your ear.

[00:13:54]Okay, perfect. All looks good there.

[00:13:56]Um, so that completes the um ear portion. Now we're going to move on to the nose.

[00:14:00]I'm just going to assess the external appearance of your nose, looking at any abnormalities, um anything I see. And now I'm going to do the nasal patency test. So if you could just occlude one of your nostrils and breathe in like normal.

[00:14:13]Perfect. Now occlude the other one.

[00:14:14]Breathe in like normal. Okay.

[00:14:16]And now let's go ahead and do um the rhinoscopic exam.

[00:14:22]So this one I'm just going to look at the inside of your nose.

[00:14:25]Same kind of thing with the ear and hands and eye.

[00:14:27]Good. So let me look at that.

[00:14:35]>> [clears throat] >> Good. Now same thing over here.

[00:14:40]Let's see. I know, sorry. I'm still going to do this one here.

[00:14:48]Good. That's awesome. Okay, so that completes the um nose portion of the exam.

[00:14:55]>> [snorts] >> Okay, so now we're going to do So we did eyes, ears, nose. Now we're going to do Sorry.

[00:15:01]>> [laughter] >> You're really upset. And now let's do We're going to do the the mouth portion of the exam. So I'm just going to assess the external appearance of your mouth and if you could open your mouth.

[00:15:11]Um, and I'm looking at mucosa, lips, um posterior pharynx, um teeth, all that, gums, making sure everything looks healthy. Now if you could lift up your tongue, I'm looking under your tongue to see if I see anything. And then I'm assessing your um posterior pharynx. If you could say ah. Ah. Good. And now I'm checking uh if you could stick out your tongue and I'm checking for that, too. Good, that's perfect.

[00:15:39]Um Now so that completes the mouth portion of the exam. Now we're going to move on to the neck portion. Um, so first off I'm just going to assess the external appearance of your neck, looking for any abnormalities that I see, um then I'm going to palpate the um musculature, your trachea, um all of that, great vessels, anything like that, um feeling for any abnormalities, um and then I'm going to reach around you real quick. This one's a little weird, but I'm just going to check your thyroid real quick.

[00:16:15]I'm just going to put my hands around your neck.

[00:16:18]And then I want you to just swallow for me.

[00:16:21]Good, that's perfect. Okay. And now I'm going to um palpate some lymph nodes and I just want you to tell me if you feel any pain, okay?

[00:16:30]So first um submental, sub submandibular, um tonsillar, preauricular, postauricular, occipital, um superficial, um uh sur superficial cervical, posterior cervical, um deep cervical chain, uh supraclavicular.

[00:16:54]Okay, so all that looks good, no pain.

[00:16:57]Awesome. Okay, now we're going to move on to the lung portion of the exam, uh lung and thorax portion of the exam. So first I'm noting your color, making sure you're not seeing any signs of hypoxemia, cyanosis, anything like that.

[00:17:11]Looks good. Um, I already assessed it uh I already assessed your respiratory rate, your depth and level of breathing um earlier in the exam during the vital signs.

[00:17:22]So now I'm looking at your um chest shape contour. Looking at your chest wall movements, making sure you're not seeing anything abnormal. All looks good. Um, so now I'm going to perform the posterior portion of this exam. So if you could um Yeah, [clears throat] keep your legs out and then I want you to Yeah, that's good. If you could just cross your arms for me.

[00:17:44]Awesome.

[00:17:45]And so I'm just going to palpate um four areas or four I guess on each side of your back and I just want you to um tell me if you feel any pain, okay? Okay.

[00:17:57]Good. Two.

[00:17:59]And let's get under there.

[00:18:02]No pain? Nope. Okay. Um, now if you could just take I'm just take one big deep breath in and out.

[00:18:10]Good. Just one more time.

[00:18:13]Testing the chest wall expansion, that's good. Okay, now I'm going to place my hands on your um back in that same kind of pattern um and if you could just say toy boat every single time you feel my hands, okay?

[00:18:28]Toy boat.

[00:18:29]Toy boat.

[00:18:30]Toy boat.

[00:18:31]Toy boat. Okay, perfect. Um, now I'm going to um just tap on your back in a couple different places and so you just continue to breathe like normal for this one.

[00:19:03]One more time up here.

[00:19:08]Perfect. Now I'm going to um place my [clears throat] stethoscope on your back in a couple different locations. If whenever you feel my stethoscope, I just want you to take a deep breath in and out with your mouth open, okay? Okay.

[00:19:21]Ready?

[00:19:24]Perfect.

[00:20:03]>> Okay, awesome. Now that completes the posterior part. Now we will move on to the anterior portion of the exam. Um So it's going to kind of follow the same pattern. So first I'm just going to feel some areas of your chest and just let me know if you feel any pain, okay?

[00:20:19]Okay.

[00:20:21]Three areas down now. Same thing, take a deep breath.

[00:20:26]Good, that's perfect. Okay, now um I'm just going to anytime you feel my hands again, I want you to say toy boat, toy boat, toy boat, okay? Okay.

[00:20:34]Toy boat.

[00:20:36]Toy boat. Yeah, let me do one right here, sorry. Toy boat.

[00:20:39]Toy boat. Okay, perfect. Um now I'm going to um tap just in a couple six different or six different areas um on your chest again, so.

[00:21:04]Sorry.

[00:21:05]>> [clears throat] >> And You're good.

[00:21:15]And then finally one more over here.

[00:21:20]Good. Can you still see me?

[00:21:23]Okay, now same thing. Um I'm going to auscultate um in the same area since I went You feel my stethoscope or see it, I guess. Um just take a deep breath, okay?

[00:21:36]Sorry.

[00:21:40]I put it in the wrong way, so that's why I can't hear anything.

[00:21:42]>> [clears throat] >> Okay, right?

[00:21:47]Oh.

[00:21:48]And since I'm doing the apical Okay, so I'm going to do the bell.

[00:21:57]That's perfect. Now switching to the diaphragm.

[00:22:18]Okay, perfect. Okay, so now that completes the um lung and thorax portion of the exam.

[00:22:23]So now we're going to move on to cardiovascular. Okay, so um first off I'm going to I already noted your color and all of that earlier. Um I already noted your depth and effort of breathing earlier, too, and if you were any level of distress. Um so that's all checks out.

[00:22:41]Um I'm going to make sure um also this would be the time that I would assess the vitals again if I need to. So if I see anything abnormal, I'd do that now. But now I'm going to make sure you're at a 30 or 45° angle.

[00:22:53]So let's say I don't know. That looks That's You know, that's good.

[00:23:00]That's good. That's perfect, okay. So made sure that the patient was at a 30-45° angle.

[00:23:05]So now I'm going to assess the JVP of the right side.

[00:23:11]The JVP of the right side. Um so I'm going to make sure my patient turns their head towards their left.

[00:23:16]Good.

[00:23:17]Um I'm just going to look at note Let me grab some things real quick over here.

[00:23:23]Um Let's bring this over here.

[00:23:28]Yeah.

[00:23:30]That's perfect. Okay, so I'm going to So make sure my patient turns to the left, that's perfect. I'm going to take my pen light. I'm going to um look for the pulsations of the JVP.

[00:23:43]Okay, good. And then I'm going to note where it stops.

[00:23:50]Okay, that's good. Okay. And then I'm going to make make a note of where it stops.

[00:23:56]Good, and then where I can no longer see a pulsation. And then I'm going to measure that. I'm going to take it from the sternal angle.

[00:24:04]And then take a straight edge and a ruler.

[00:24:07]And I'm going to measure that.

[00:24:12]Sorry.

[00:24:15]And it's about 2 cm, so that's the normal range. Good, perfect. Now I'm going to move on to the carotid portion of the cardiovascular exam. So I'm going to assess your pulses of the carotid um artery, um making sure >> [snorts] >> I see the pulsations and then first um before I palpate anything, I'm going to make sure I auscultate um listening for any bruits.

[00:24:42]I'm going to use both the bell and diaphragm for this.

[00:24:47]Oop.

[00:24:48]Why did I keep doing that? Okay.

[00:24:55]Okay.

[00:25:10]Okay, so I don't sense any bruits, so um I'm good to palpate. So I'm going to palpate um the carotid arteries one at a time noting for any uh the amplitude and for any thrills.

[00:25:23]Good.

[00:25:27]Awesome. So carotid looks good. Um now I'm going to move on to the precordium part portion of the exam.

[00:25:32]So I'm going to assess the anterior chest making sure I don't see any abnormalities. Um and then I'm going to um check for the heaves using the base of my hand in the five cardiac areas, so.

[00:25:51]Come up here.

[00:25:54]One, two, three.

[00:25:57]And then am I over here?

[00:25:59]Same thing, with my fingertips I'm going to check for thrills.

[00:26:14]Okay.

[00:26:15]Okay, now um after that I'm going to um assess the PMI. So I'm going to start with my um palm and then ruling uh single into my fingertip, I'm checking for location, diameter, um duration and amplitude.

[00:26:30]So those are the things.

[00:26:32]So let me see.

[00:26:45]Okay, so I narrowed it in to my fingertip. Good.

[00:26:49]Now I'm going to auscultate these five um cardiac regions um listening for any abnormal heart sounds or um extra heartbeats such as S4, S3, friction rub, and um gallop.

[00:27:04]And I'm going to um for this use my um bell and my diaphragm.

[00:27:32]Okay.

[00:27:34]Same thing with the bell.

[00:27:36]One.

[00:27:38]Two.

[00:27:47]Okay, good.

[00:27:49]Everything looks good there. there. So now we're going to move on to the peripheral um our the um peripheral vascular portion of the exam.

[00:27:56]Um so for this one I'm going to I kind of already did this with the skin portion of the exam, but I'm checking again um if you Yeah, if you actually go ahead and sit up for me.

[00:28:07]Or just this is good. So I'm just assessing the upper extremity and lower extremity um noting for any changes in color, um warmth, or ulcerations anywhere, especially the medial ankle, anywhere. And then if you could stand up for me, I'm just going to check your back, too.

[00:28:22]On the extremities. Good.

[00:28:25]Good.

[00:28:26]Good. Okay.

[00:28:27]Now if you could go ahead and have a seat again.

[00:28:31]Good.

[00:28:35]Okay, so now I am going to assess um the pulses of your upper extremity.

[00:28:42]So I already did the radial pulse earlier in the exam and I also did the capillary refill, so I just need to check your ulnar um and your um radial.

[00:28:52]So I did this. I'm just going to check your ulnar and radial again.

[00:28:58]Just make sure I feel both.

[00:29:03]Good.

[00:29:07]And Good. Now um I'll check the lower extremity um pulses. So first um I would assess your femoral, but we won't do that today. Um then I'll assess your popliteal.

[00:29:28]So You could scoot your scoot up a little bit. There we go.

[00:29:36]>> [laughter] >> Good.

[00:29:39]Then your posterior tibial.

[00:29:42]Right there. And then your dorsalis pedis.

[00:29:48]There we go. Hold on.

[00:29:51]Okay, perfect.

[00:29:52]Then I would assess your lower extremity for any signs of edema.

[00:29:57]So I check your um your shins your medial ankle bilaterally. Good.

[00:30:08]Um and then also uh dorsalis pedis bilaterally. And also for the pulses, um I just did unilaterally pulses but I would assess bilaterally for all the pulses. Um and Sorry, bug. And so that completes the peripheral vascular portion exam.

[00:30:25]So now we're going to move on to the abdominal portion of the exam. Sorry, it's the bug. Um So first I would assess or note the skin appearance. Oh, first off actually, if you could go ahead and lean back.

[00:30:37]I'm going to practice proper draping technique.

[00:30:41]So Yeah, if you could do that.

[00:30:45]Good. We have another blanket.

[00:30:47]And then Good. [snorts] Good. Good.

[00:30:49]Good. [clears throat] Tuck. Tuck. Tuck.

[00:30:50]Tuck. Tuck. Tuck. Tuck.

[00:30:52]Tuck. Tuck. Tuck.

[00:30:54]Good. All right. So I'm assessing um uh the overall appearance of your ab- abdomen area looking for your skin appearance um the symmetry of it, shape, contour, if I notice any movements. All looks good. Um And for the abdominal portion of the exam, before I um palpate or percuss or anything, I'm going to need to auscultate. And there it is. Um so I'm going to auscultate all four quadrants of the abdomen.

[00:31:27]Um I'm going to auscultate for uh 30 seconds or unless I hear um bowel sounds. And then I know don't have to do 30 seconds.

[00:31:35]And I for for this I just um use a diaphragm.

[00:31:47]Good.

[00:31:50]Awesome.

[00:31:54]Good.

[00:31:55]Okay. Um and so now I've auscultated all four areas.

[00:32:00]Um and then I would also also auscultate um the vasculature in the abdominal area. Um so that's going to be and I'll use the bell and diaphragm for this one. So first I'm going to check the abdominal aorta.

[00:32:17]Then the renal arteries.

[00:32:23]Then the um iliac arteries.

[00:32:27]And then I would also check um the femoral arteries using the same technique.

[00:32:32]So and then um doing the same thing with the um bell.

[00:32:38]abdominal aorta renal iliac femoral Or I would check femoral. Okay.

[00:32:52]Okay. Um so after I've auscultated um all the areas, I'm now going to percuss in all four quadrants of the um abdomen making note of dullness and tympany throughout it.

[00:33:14]Okay, perfect. Um now I'm going to um palpate um to assess the um the uh the your liver, how big the liver is. And so first I would Sorry.

[00:33:29]I'm going to take this pen.

[00:33:34]Good.

[00:33:36]And I'm going to percuss um First off I'm going to percuss up until I hear dullness.

[00:33:50]Good. You can hear dullness there.

[00:33:53]And mark. And then I'm going to percuss down now until I hear dullness again.

[00:34:08]Perfect. And then I will measure the size of the liver.

[00:34:16]Perfect.

[00:34:18]Awesome. Okay, so now I finished the percussion portion of the exam so or this part of the exam. So now I'm going to move on to um uh Gosh, what's the word? Palpating. Okay.

[00:34:31]Um so first um if there was patient was in any sort of pain or distress, I would definitely palpate that portion last. Um so I'm going to um And I'm also going to make sure I note if the patient's in distress or anything when I'm palpating. But first I'm going to palpate each um for each of the four quadrants slightly.

[00:34:53]So Good. Perfect. Then I'm going to palpate each of the sections um deeply assessing for any masses and with lightly I was assessing for rigidity um or anything like that or um if the patient was guarded or anything like that. So now we use two hands for palpating deeply.

[00:35:21]Good.

[00:35:22]Perfect. Good.

[00:35:24]Now after that um I'm going to um also I would palpate any areas concerned. Sorry.

[00:35:31]The draping is moving. I wasn't looking.

[00:35:33]No, you're good. Now I'm going to um palpate if I felt any hernias or extra masses I would palpate those more too.

[00:35:42]Um now I'm going to palpate the liver and to find the surface of the liver. So I'm going to come over here to do like a hooking technique. And so I'm just going to feel it first. I'm going to take Ask the patient to take a deep breath in.

[00:35:54]And I'm going to push back.

[00:35:56]Good. Okay, perfect. Okay, so now after um I palpated that. Good. Now I'm going to uh palpate and estimate the measurement of the abdominal aorta.

[00:36:09]So Oh, you can turn.

[00:36:13]>> [clears throat] >> Okay.

[00:36:17]Looks good. Okay, so um now that uh completes the abdominal exam. Now finally we're going to move on um to the MSK portion of the exam. So you can go ahead and remove the drape.

[00:36:31]Woohoo. Um now the MSK part Yeah, good.

[00:36:38]There we go.

[00:36:40]Oh, yeah.

[00:36:42]Yeah. Good. Good. Good. Good. We're good.

[00:36:46]Perfect.

[00:36:47]So first things first I'm going to assess the TMJ. So I'm looking at the TMJ and look looking for any erythema, swelling, any other abnormalities, anything like that. I'm not seeing any of that. So now I'm going to um palpate TMJ, also temporalis muscle those muscles of mastication.

[00:37:09]And now I'm just going to get you to do a couple movements. If you could open and close your mouth.

[00:37:14]Good. Now stick out your teeth. And then now pull back retraction. And then lateral protrusion moving it back and forth.

[00:37:22]Good. Perfect. And that performs the TMJ. So now we're going to do the spine.

[00:37:26]So I'm going to assess your spine from the side, posterior. Now if you could lean forward. I'm assessing all this.

[00:37:34]The your posture, curvature, um any abnormalities I see.

[00:37:39]Um And then now I'm going to um palpate your spine.

[00:37:45]Feeling for Yeah, feeling for any abnormalities, any protrusions, anything like that. And then also your SI joint.

[00:37:52]Feeling for any abnormalities. Good.

[00:37:56]Perfect.

[00:37:58]Good. Um then now we're going to um check the range of motion for your neck first. So if you could just go like this.

[00:38:08]Go like this backwards now.

[00:38:09]Now lateral flexion side to side.

[00:38:12]Now lateral rotation. Go like this.

[00:38:16]Good. Now for the lumbar um spine. So first you're going to lean forward.

[00:38:24]Lean back kind of go run your fingers down your back. And now um go side to side.

[00:38:30]Now for rotation keep your hips still.

[00:38:32]And I want you to rotate like this.

[00:38:34]It's good.

[00:38:36]Good.

[00:38:37]Good. All good?

[00:38:38]>> [laughter] >> Okay. And now um that completes the um spine portion. And so now we're going to move on to the shoulder. And from here on I'm going to be assessing um the active range of motion in these different joints um but I would also and um I'll assess bilaterally but I would also assess um passive bilaterally too. So first off let's do the shoulder. So I'm assessing the inspecting the shoulder looking for any abnormalities I see.

[00:39:08]Good.

[00:39:09]And then I'm going to palpate the shoulder.

[00:39:12]All the joints.

[00:39:14]scapula acromion coracoid process all that good stuff.

[00:39:20]Looking for any abnormalities. Um and now we're going to do range of motion.

[00:39:23]So you can follow me. Let's do lift your arms up like this. Good. Flexion extension. Good. Now go like this.

[00:39:32]And ab- adduction adduction. Yeah.

[00:39:37]And then let's do um lateral Yeah, internal or external rotation, internal rotation, good.

[00:39:46]Um so your shoulder looks great now.

[00:39:50]Let's do the elbow.

[00:39:52]So looking at your elbows, inspecting [snorts] them first, no abnormalities.

[00:39:57]No abnormalities.

[00:40:00]Yeah, okay. Now I um palpating it. Looking for any abnormalities, looking feeling those all those joints. Good stuff. Everything looks good.

[00:40:11]Um and now let's do bilateral. And again, I would do passive for this one though, too. Um so flexion, extension, um and then pronation and supination.

[00:40:22]Sup- pronation, supination, good. Okay, perfect. So that checks out for the elbow. Now we're going to do the wrist and hands portion of the exam.

[00:40:29]So inspecting your wrist and hands, looking for any abnormalities.

[00:40:33]Um nothing, okay. Now feeling, palpating, for any abnormalities.

[00:40:39]Everything looks good. Okay.

[00:40:41]So now we're going to do the wrist.

[00:40:45]>> [clears throat] >> So good.

[00:40:46]Flexion, extension.

[00:40:48]Ulnar deviation, radial deviation.

[00:40:51]Good, everything looks good. Now we're going to do um >> [clears throat] >> the uh fingers. So flexion, extension.

[00:40:58]Everything looks good. Now abduction, adduction. Now the good old thumb.

[00:41:03]>> [clears throat] >> Um can you go like So go like this?

[00:41:07]Go like this?

[00:41:08]Go like this?

[00:41:09]Go like this? And then go like this?

[00:41:12]So that was for the thumb, that was flexion, extension, abduction, adduction, and opposition.

[00:41:18]So now we are done with the um wrist and hands. And so now we're going to move on to the hips. So if you could just take a couple steps. Good. Moving and assessing your gait. I'm assessing overall appearance of the hips, no abnormalities, anything like that. Good, gait looks good. Now I'm going to palpate the anterior and posterior parts of the hip. Feeling all those joints and stuff, making sure I don't feel anything abnormal.

[00:41:50]All looks good. Okay, so now we're going to do some good old dancing real quick.

[00:41:55]So first, if you could kick your leg out, good. Kick your leg back.

[00:42:01]Good. Now I want you to kick your leg to the side.

[00:42:04]Kick your leg back in.

[00:42:06]Yeah.

[00:42:07]Um or you could just Yeah, and then now I want you to pick your leg up, go like this.

[00:42:14]Ooh, I felt my knee pop. And then go [clears throat] like this, good. Okay.

[00:42:19]So that was flexion, extension, abduction, adduction, and internal and external rotation of the hip.

[00:42:25]So now we're going to do the knee. So I'm assessing the knee, inspecting it, making sure I don't see anything abnormal. Erythema, swelling, deformities, anything like that.

[00:42:34]Everything looks amazing. Now I'm going to Now I would bilaterally inspect all these um the the midline landmarks, lateral landmarks, and medial landmarks of the knee.

[00:42:51]Assessing for or feeling for any abnormalities, I would do that bilaterally.

[00:42:55]And now for range of motion of the knee, flexion, extension, flexion, extension, flexion, extension. Now you can just go ahead and do the other one, too.

[00:43:04]Good.

[00:43:06]And again, I would assess passively, too, uh bilaterally.

[00:43:10]Now knee ankle You can go ahead and sit for this one.

[00:43:14]Um so the ankle one, I'm assessing the ankle, looking for any abnormalities again. Now inspecting it, now I'm palpating it. Achilles tendon, too, all the way back here.

[00:43:25]All the joints, calcaneus, all that good stuff, assessing for any abnormalities.

[00:43:31]Good, palpating, don't feel anything. A little bruise-y. Um now if you could um looking at the toes, too. Good.

[00:43:40]No abnormalities. Now um if you could point your toes. So dorsiflexion, plantarflexion, good. Dorsi, plantar.

[00:43:49]Now um um move your ank- Try to I don't know, you could stand up for this one.

[00:43:57]Cuz you got to move your ankle like inversion and eversion.

[00:44:01]Good.

[00:44:03]Good. Both things do the other one, too.

[00:44:06]So she's she's moving inversion, eversion.

[00:44:09]And then now for the toes, if you could do flexion and extension of the toes.

[00:44:14]And flexion and extension of the toes.

[00:44:17]All right.

[00:44:18]And that it completes everything for MSK and for the whole exam. Thank you and good night. Thank you.