I appreciate everyone's patience for this video! It took an unusually long time to edit, and came at an unusually busy period for me for patient care. A few additional comments: - Unfortunately, my patient was an example of how not everyone's JVP is equally clear as a demonstration of how JVP is "supposed to" look like. For some great examples of both normal and abnormal JVP, I suggest: physicaldiagnosispdx.com/card-tutorial/#Jugular_Venous_Pulse - I appreciate that some clinicians argue for carotid auscultation to be relegated to the "archaic" maneuver category that we should no longer be teaching everyone. This position is most succinctly outlined in the Aronson paper listed in the above references. In extreme brief, the argument is basically that screening for, confirming via ultrasound or CT angiogram, and "fixing" asymptomatic carotid obstructions initially identified via hearing bruits leads to only small, non-cost-effective benefit. I don't know if the evidence fully supports that position. However, even if it does, patients with carotid bruits do have significantly increased rates of overall cardiovascular death, demonstrating that it's a general marker for atherosclerosis. Therefore, the presence of a carotid bruit could reasonably shift one's threshold for more aggressively treating hypertension or hyperlipidemia in a similar way to prediabetes, obesity or a sedentary lifestyle.
Respiratory (i.e. pulmonary) exam is already posted. The others will be a while since our med school is currently enforcing face masks for all patient and standardized patient encounters.
@StrongMed Doctor, does stethoscope really matter during auscultation? In other words, is a 20 dollar stethoscope the same as a Litmann Cardiology IV (220 dollar) when it comes to auscultation?
It does matter, up to a point. In other words, a $220 Littmann Cardiology IV is far superior to the $20 disposable stethoscopes used in contact isolation rooms, but is only modestly better than a $110 Littmann Classic III. For most medical students and medical residents, the Classic III is probably the best trade-off between cost and quality.
I appreciate everyone's patience for this video! It took an unusually long time to edit, and came at an unusually busy period for me for patient care.
A few additional comments:
- Unfortunately, my patient was an example of how not everyone's JVP is equally clear as a demonstration of how JVP is "supposed to" look like. For some great examples of both normal and abnormal JVP, I suggest: physicaldiagnosispdx.com/card-tutorial/#Jugular_Venous_Pulse
- I appreciate that some clinicians argue for carotid auscultation to be relegated to the "archaic" maneuver category that we should no longer be teaching everyone. This position is most succinctly outlined in the Aronson paper listed in the above references. In extreme brief, the argument is basically that screening for, confirming via ultrasound or CT angiogram, and "fixing" asymptomatic carotid obstructions initially identified via hearing bruits leads to only small, non-cost-effective benefit. I don't know if the evidence fully supports that position. However, even if it does, patients with carotid bruits do have significantly increased rates of overall cardiovascular death, demonstrating that it's a general marker for atherosclerosis. Therefore, the presence of a carotid bruit could reasonably shift one's threshold for more aggressively treating hypertension or hyperlipidemia in a similar way to prediabetes, obesity or a sedentary lifestyle.
physical exam videos are much needed. I'm OMS2 about to enter rotations and these videos will help me improve my clinical skills
thank you dr strong, the cuality of your videos has improved immensely
Thanks! Unfortunately, the time that it takes to makes these has also increased immensely! ;)
I have waited for this for a long time
Thank you, Dr. Strong! I can see you've got a real passion for the medicine, unlike quite a number of other doctors I happened to come across.
Excellent video, waiting excitedly for the abdominal video.
Thank you, Dr. Strong! This will help me for next week’s head to toe midterm demonstration 😊
Impressed and equally felt happy that you people cares so much about ethics 😊
Thanks a lot! This is a great video, well explained for health care workers, especially the nurses like me who plan to return back to school
Thanks
Thank You!
Thanks!
You are very welcome! Thank you!
Absolutely amazing
Дякую, дивлюся вас з України, дуже допомогає пояснити студентам базові аспекти! Дякую ❤
Thank you so much Dr Strong, Kindly Upload for Respiratory, Neurological and MSK examination too 🙏
Respiratory (i.e. pulmonary) exam is already posted. The others will be a while since our med school is currently enforcing face masks for all patient and standardized patient encounters.
Landmarking interstitial spaces/ribs is my real weakness on some people.
Mine Too 😊
Thank you for the great content!
Well detailed
Sir kindly upload video on abdomen exam😢😢😢
Don't worry, it's coming!
@StrongMed Doctor, does stethoscope really matter during auscultation? In other words, is a 20 dollar stethoscope the same as a Litmann Cardiology IV (220 dollar) when it comes to auscultation?
It does matter, up to a point. In other words, a $220 Littmann Cardiology IV is far superior to the $20 disposable stethoscopes used in contact isolation rooms, but is only modestly better than a $110 Littmann Classic III. For most medical students and medical residents, the Classic III is probably the best trade-off between cost and quality.
Thankssss
Pitting oedema
Pregnancy and Pills
Infected (cellulitis) and impairment (heart, liver, kidney)
TED
Stasis (CVS), starvation
impatiently waiting for abdomen exam
cant we appreciate pocus echo for valve assessment auscultation will be an indication for an echo why not to echo the patient