Step by Step Hand Examination Guide - Clinical Skills - Dr Gill
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- เผยแพร่เมื่อ 16 มิ.ย. 2024
- Step by Step Hand Examination Guide - Medical School Revision - Dr Gill
Clinical examination of the hand can be quite challenging, as it is more engaged than many of the other orthopaedics examinations. We'll help with your medical school revision through guided explanation of how to examine the hands
As with any orthopaedic assessment, the Hand Examination Clinical Skills OSCE examination will be expecting you to approach with the standard Look, Feel, Move approach which you'll be already familiar with
People often find the Clinical Skills OSCE to be daunting and the Hand examination even more so, as it is quite an engaged OSCE station. However, as with everything at medical school, repetition is going to be key in understanding how you are assessing the patient, positioning your hands, and manipulating the patient.
Please note the hand examination also includes the special tests Tinel's Test and Phalen's Test to examine for carpal tunnel syndrome, which can be worsened in pregnancy, osteoarthritis and rheumatoid arthritis
During the Hand examination, the wrist is also assessed, as you should always examine the joint above and the below the joint are focusing your initial assessment on
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This video is part of a series focusing on the hand
- Hand Examination Explained - • Step by Step Hand Exa...
- Hand Exam Demonstration - • Hand Examination Clin...
- Older Hand Exam Demo - • Hand Examination Clin...
- Carpal Tunnel Examination - • How To Check for Carpa...
- Carpal Tunnel Anatomy - • Hand Anatomy - The Car...
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.
Some people watching this video may experience and ASMR phenomenon
#clinicalskills #hands #DrGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
00:00 - Introduction
00:24 - Patient Identification and Consent
00:50 - Identifying Dominant Hand
01:33 - Observing Wrist and Hand Swelling
02:17 - Palm and Nail Examination
02:58 - Checking for Muscle Wasting and Nerve Compression
03:21 - Checking for Psoriasis
03:56 - Palpation Techniques for the Hand
04:59 - Identifying Inflammation and Synovitis
05:50 - Anatomical Snuff Box Examination
07:00 - Importance of Scaphoid Bone Health
07:44 - Palpation on the Opposite Side of the Hand
08:27 - Testing for Trigger Finger
09:01 - Assessing Hand and Finger Movement
09:27 - Observing for Osteoarthritis Signs
10:47 - Recognizing Structural Deformities
11:51 - De Quervain's Tendonitis Assessment
12:56 - Movement Testing
14:29 - Opposition Movements
15:30 - Movements of the Thumb
16:20 - Assessing Nerve Function Through Hand Gestures
18:14 - Effective Movements and Functional Testing
18:51 - Special Tests for Carpal Tunnel Syndrome
19:55 - Conclusion
I know it's not the purpose of this channel, but your soothing voice has been my favorite sleeping aid for a good while now.
It might not be the sole purpose, but these days it’s definitely one of them
Oh, it’s definitely the purpose. Everything else is secondary.
Trust me when I tell you… I truly watch to learn but wake up hours later as to what happened… man that dude got a soothing voice to knock anyone out 😅
@@AwakenToReality Yeah for real, I could listen to Dr. Gill read a shampoo bottle with his golden voice :D
+1. I've been putting this on to sleep for the last few nights. One of the only things that's really helped my insomnia. Here again tonight, tried sleeping without it for a few hours but it's 2:30am now and I'm desperate 😅
Definately a Doctor who has a calming reassuring voice which is crucial to decrease possible Patient anxiety
I think it’s important that the patient be at ease with the doctor
My man's got the most spectacular watch tan I've ever seen.
I am almost so thankful for doctors on TH-cam who don't just make "Popular" videos but who actually want to help and inform. I have been to many doctors in the past years due to an unidentified pain illness I have and it really sparked my interest in my own body and understanding it. Videos like these are so great and informative and I feel like they help me understand doctors a bit better. I just wish every doctor would learn to view patients as people and not just a Box to be checked off.
Just got ouf of bed, best morning surprise is a Dr. Gill stream :D
morning 👋
How interesting, you also include bedside manners in the lesson. I got diagnosed with my autoimmune disorder when I came in thinking I'd broken my pinky finger lol. Now I've got carpal tunnel too (when stressed out) and tremors, but i don't mind the tremors are my new party trick, because I go, “LOOK AT MY HANDS, I'M STEPHEN STRANGE!” 😂
the tremors are only inconvenient/embarrassing when I'm on stage holding a paper & people think I'm nervouse but i'm really not.
thanks Dr. Gill 🙏🏼
They are both fantastic
It’s interesting for me to hear all of these same unusual terms, said in a similar British accent, but by a different doctor. I’ve watched the Curtis Robb hand examination video tons of times. It’s crazy how complex the hand system is!
New video in the morning? A surprise to be sure, but a welcome one.
The moment I saw the thumbnail I heard the "putabitofpaper" in my ear 😂
Im just headed to bed, perfect timing dr. Gill, perfect timing :)
Perhaps a lot of writing or revision in studying. Nice.
As a normal, I truly appreciate the "don't let me move you're thumb" option in allowing me, as a normal patient, to not worry about what your medical mind is thinking. That's a very clever way of allowing you to assess me and not making me worry that I'm "doing it right."
They are the “tricks” of the trade I find make the examinations much easier
great upload and information Dr. G. in your opinion, what is the average time period for the hand nervus medianus to heal?
Megan must be close to taking Abbey’s crown for Dr G’s number one patient 😊
Tutt will always be a fan favourite in the Dr Gill Cinematic Universe
Astonishing
Love these ‘deep dive’ videos.
Glad you like them! Esp as they are the most work out of all the videos 😊
This one was very good! Thank you, @DrJamesGill and Ms. Struthers.
👍
awesome timing doc i was just watchin some of your other vids
Glad you like them!
This is good 👍
You knew what you were doing with that thumbnail!
Excellent video! Very useful.
I think the FDP and FDS tests are the other way around
I'm what scientists like call "a regular ass dude" yet I find these videos incredibly fascinating and informative on what my doctor is looking at during check ups. Even if my watching does devolve into "oh! I know what that word mean!"
Dr. Gill I've recently discovered your videos during adeep dive for a manuscript Im working on for c wide competition and I love how informative your videos are, along with how direct you are with the patients while remaining kind and informative towards your patients. I must say you vaguely remind me of Hugh Laurie during his early house days (Maybe its the stubble and the face!). Cheers from the states!
Thank you for the feedback 😊
What is a “c wide competition” and how did they bring you to clinical skills?
ah I mean county wide. Because my script largely takes place within a hospital and to establish scenery and the doctors character himself, it opens with the doctor doing clinical examination.@@DrJamesGill
I knew it! The pale rings on your arms are a clear indication they lock you up between videos and only bring you out for content!
😂😂
Good advice on the scaphoid. In some places it is advised to go to MRI rather than repeat XR, so check with your local advice.
Very true. An MRI is often the best option, but it can sometimes be a challenge getting the scan within the time window
God bless you and World Diosito y lo Celestial nos cuidan y protegen de todo mal a los que amamos el mundo entero gracias por tanto amor bendiciones ❤️🥺🙏
Megan has big shoes to fill in succeeding the legendary Abbie Tutt!
My mother broke her scaphoid a couple years ago (our dog pulled on its leash and broke it), it's crazy how much it can affect the hand, she sometimes has strength losses and has to deal with pain on a regular basis, even after 4 or 5 years.
That’s unfortunate. I’m aware of patients how have been severely impacted by scaphoid fractures
Has she seen anyone about the injury now she has long term issues. There are treatments
@@DrJamesGill She has, yes, she went through some x-rays but the fracture has been diagnosed a couple months to a year after the accident, she has a splint that she wears when experiencing pain but that's all, unfortunately.
It might be worth while asking to see an orthopaedic surgeon
@@DrJamesGill I'll tell her that, thank you ! 🙏
Good luck 😊
That’s quite the watch tan-line!
Sports watches need close skin contact for the HRM to work 😊
On both wrists too
man i tried that scaphoid pressing technique and I did not like it made me feel nauseated a little. would be interesting to see this examination on someone who uses their hands a lot at the beginning of the day and then at the end of the day to see the differences.
“Normally” like to avoid hurting the patient…😂
We knew what you meant, but that made me chuckle.
🤣
더 길게....plz...
This type video looks good. Do you any plan for the feet? consensus for what type of shoe to wear etc...
I've seen videos from Leicester University that are exactly like the ones you've done now, first with just the examination and then with the explanations. Are they are common thing then in the medical world Doc?
I honestly don’t know. I do it this way, as it makes the work flow easier for ms
@@DrJamesGill maybe Leicester did it for the same reason then.
@Dr James Gill as i sit and watch these exercizes in examination ,i am wondering who was it that created them or did these examinations evolve organically?
They evolved as people discovered new tests
1st comment! 😊
I’m guessing he wears two watches usually however he does look a bit like he’s been left in handcuffs for a while
One is the Fitbit or apple watch or something like that. Can't remember.
Garmin and Whoop
Just an idea for a video, Im looking at getting a fitness tracker or smart watch. Wondering what is the best way to use the features during exercise or day to day life.
Perhaps we could run with that. Hmmm
Haven't watched yet, did he say the thing?????
Not sure yet, hope so 😂
I still remember losing my child fingers before my adult fingers started coming in.
"Snuff Box " is that a reference to Snuff that was sniffed at one time in history?
Absolutely
Came for the putapipaper 📄🩺
Would you ask the patient to remove any rings worn before the tests are done?
1:27 doctor is literally talking about me 😅
Do you wear two watches??
A whoop band for health monitoring, and a regular watch
@@DrJamesGill Ah now that makes sense. I have a Fitbit that I can't be without, but my Grandma just passed away a couple of weeks ago and she left me a beautiful gold watch that I really want to wear but don't know how because of my Fitbit, but maybe I'll take a leaf out of your book and just wear one on each arm
@sibby84 I have almost the identical problem. My father left me a lovely watch, but I need all the things my sports watch does
@@DrJamesGill Definitely a 2020s problem isn't it 😂
I have a real question: isn't it bad for you using a wrist watch way to tight?
It’s not particularly tight. The straps are elasticated due to the HRMs
Does this man regularly wear two watches??
A Garmin watch and a Whoop health tracker
Hojlund’s sister
Necesito subtitulos en español 🥺
si se puede,en traducir eliges el idioma y hay esta el español
Fai clic sulla ruota BTS nell'angolo destro, seleziona Didascalie, quindi seleziona Traduci automatica, quindi scorri verso il basso per trovare lo spagnolo. Ecco fatto Gilly!!
How'd you get a tan line on both wrists 😂 who bound you!?
Meghan is a medical student ?
Yes
@@DrJamesGill Nice
Who else here for the asmr
As a male I would consider my ⚽️🏀🏈are my most sensitive.
🤣🤣 wrong type of sensitive!
she is cute, very informative
?
She looks so worried lol
You would trip if you saw my hands. A scar in the shape of a unicorn on one wrist. And a strawberry patch the size of a strawberry on my palm
Dr. Gill needs to sunbathe without watches.....
I don’t really sunbath, unless it’s the rare occasional that my wife tells me I must have down time!
Everything is fine until we realise its not Abbie Tutt 7th of December 1996 😔
Daddy chill
Yoda: Asmr this is.