Loyola Full Male Exam Part 1

I'm Dr. Michael Kohler and the purpose of this training video is to show students all of the steps of the physical examination from start to finish so that you get some idea of how the steps flow one to the other and how to make a transition from one body system to another. We're not going to focus on the details of the steps during this examination or any close-ups. If you feel like you need some reference to the details, I'd refer you back to the individual exam series for those details.

This examination is of course on the male patient so there will be no axillary lymph nodes or no breast examination and also we will not do a genital examination on this video. I'd like to thank John, one of our standardized patients, for agreeing to be part of this training video. The steps of course can be in a different order. It's not critical that every one of the steps follow the order that you see in your outlines from class. What is important is that all the steps are done.

You do want to make sure that if you rearrange the steps that you try to minimize patient movement up and down and pay attention to patient comfort if you arrange the steps so that there is a flow for the patient and there's no unnecessary movement. Of course before we begin any examination we always wash our hands so first I'm going to wash my hands. The first step of the examination would be to describe the patient's general appearance. Of course you're not going to describe that to the patient but throughout the

history you're going to be noting whether the patient looks that they're paying a parent age, whether they're in any parent pain or distress, and also whether their respiratory pattern is labored or is there any sign of distress. John certainly appears to stay at age, he doesn't appear to be any discomfort, his hygiene is good and there's no obvious signs of pain. So I'll just go ahead and move on. So the first thing I'm going to do is ask you to hold out your hands for me, John.

I'm going to take a look at your hands and your fingers here. Is there any pain or discomfort? No. How about that? How about these joints or knuckles or any pain? No. Then put your palms up. Okay, good. And put your wrists back down again. Any pain when I press on your wrist bones here? No. No? Good. Then I'm just going to feel along your forearms there. Okay. I'm going to feel different parts of your elbow. Is there any pain or discomfort? No. As I press on those bony prominences?

No. I'm just going to press a little bit higher. There's some time or some lymph nodes higher up in the arm but again I don't feel that. So you can rest your arms down. The next thing I want to do is to check some range of motion and muscle tone. So I'm going to ask you to kind of let your arm go loose and kind of floppy here. And move it back and forth. Good. Kind of bend your elbow back and forth. Then your wrist up and down.

In and out. Good. Then come around the other side and do that over here too. Again, just kind of back and forth. Just relax your arm. Good. Your wrist back and forth. Good. Okay. Now I want to have you test for you doing the range of motion. Can you hold your wrist up, cock him up and then down. Good. Then put your wrist in. Then out. Good. Spread your fingers out. And back in. Make a fist. And make muscles and go straight out. Good. Now I want to test the strength in your upper extremities.

So can you put your arms up like that? Hold them real strong. Don't let me push down. Good. And make muscles like that. Pull in toward you. Real strong. Push out against me. Good. Next I'm going to have you hold your wrists up. I'm sorry. Good. Now don't let me push them down. Real strong. Good. Now push down to my hands. Push down. Good. Make sure to grab my fingers. Squeeze real hard.