医学osce考核流程图

hi， there， my name is andrew， one of the final medical students go to confirm your name and age please yeah my name is robert brown and 21， nice to meet you robert， today， i've been us to examine your cranial nerves these are the nerves that supply your face and your neck would that be okay yeah that's fine brilliant are you in any pain at all i mean no pain okay first of all robert， i just like to check if you noticed any changing your sense of smell at all no， i'll let to test your vision would that be okay that's why i now like to assess you visual acuity do you usually wear glasses robert， no okay if you could cover one eye with the palm of that hand and starting at the top i'd like you to read down as far as you can on the snell and chime front of you e h n d， f， n p t x z user， d t f， d， f， n p t h p h u n t d zed n p x t z f h fantastic if you cover the other eye and do the same eh， n d f， n p t x， z， u z， d t， f， d， f， n， p， t h p h u n， t， d， z， n， p， x， t z f h brilliant i'd now like to assess your pupils this will involve shining a bright light into your eyes would that be okay yes， brilliant if you could just pick a point on the wall in front of you and keep looking at that that's great and i like to swing the light between your eyes if you just keep looking at the point on the wall in front of you finally， i'd like to assess the ability of your eyes to focus if you could look at the point on the wall in front of you and i'll look at the pen that's great robert， i'd now like to do some specific tests to the vision if you could just keep looking into my eyes i'd like you to point at the finger c moving and now let's test your visual fields if you just cover one eye with the palm of that hand for me i'm going to cover the opposite eye let me know when you see my finger moving keep looking into my open eye？ yes yes yes yes cover the opposite i for me same again yes yes yes yes and now like to assess the movements of your eyes first of all if you got any double vision at the moment no okay do you let me know if you have any double vision throughout the exam but i need you to keep your head perfectly still and i'd like you to follow my finger the germany double vision at all no okay fantastic okay now like to assess the sensation on your face first of all i start with a piece of cotton wool and then a small newer tip would that be okay yes brilliant this is what the cotton wool feels like can you feel that brilliant？ if you could just close your eyes and let me know when you feel the cotton will on your face？ no， no no no did it feel the same on both sides of your face yes， it did that's great i'm now gonna assess it with this newer tip can you feel that fantastic again if you could close your eyes for me no， no no no， no， no and again did it feel the same on both sides yes it did that's great okay i'm not gonna feel some of the muscles around your face now just clench your jaw for me and relax clench your jaw for me and relax open your mouth and don't let me close it have an accessory reflex that's okay what i'd like you to do is just relax your jaw down slightly for me i'm just going to place my finger on your chin fantastic so i just like to assess some movements of facial expression now rub it first of all can you start by raising your eyebrows great and now if you can close your eyes as tight as you can and don't let me open them you can put out your cheeks don't let me push them in you can push your lips for me and bare your teeth that's great thank you two quick questions for you robert， firstly have you noticed any changing your taste at all no okay and secondly have you noticed that you're hearing sounds louder than usual no good robert， an electric session hearing if that's okay to start with i'm gonna place one hand on one ear and i'm gonna whisper a number or a word into the other ear and just like you to repeat it okay sixty， six seventy， nine fantastic and just the same on the other side 83 97 that's great so i'm now going to use the tuning forks to assess you hearing first of all i'm going to place the tuning fork on the bone behind your rear i'd like you to let me know whether you can hear it and when you stop hearing it can you hear that yes let me know when it stops it stops and can you hear that yes i'm just gonna do the same on the other side so i'm now gonna place the tuning fork in the middle of your forehead can you hear that robot yes and is it loudest in one ear or the other or in the middle in the middle that's great i now like to assess the nerve that assists with your balance and i'll get you standing up what i like you to do is close your eyes and i like you to march on the spot for me that's great you can stop now robert， if you could just cough for me finally if you could just take a sip of this water and when you're ready swallow so now i like to just assess the power in your shoulders and your neck robert， if you could just start by shrugging your shoulders for me and don't let me push them down fantastic now if you could turn your head to the right against my hand and don't let me stop you fantastic turn your head to the left against my hand and doll let me stop you that's brilliant so now like to examine your tongue first of all if you can just open your mouth for me that's brilliant and if you can stick your tong out fantastic if you can just press your turn into my fingers and the same on the other side today， i did a cranial nerve exam on robert brown， a twenty one year old male on examination of cranial nerves wanted 12 there were no abnormalities detected to complete my examination i'd like to do a motor and century exam above the upper and lower limbs。

hi there nice to meet you my name is rob i'm one of the medical students sir， let's check your name in your age， please！ it's colin bristo i'm 24 how they call them？ i've been asked today to perform a peripheral vascular examination on you， what that will involve is me having a quick look at your hands look at your face and then feeling the pulses in your arms and your legs let that be okay with you yeah no problem yeah excellent！ if i could ask you to remove a t shirt at this point and i'll have a quick look at you from the end of the bed okay， yeah！ are you comfortable with that column yeah excellent okay！ colin let's have a quick look at your hands then please and if you could turn them over for me， you need to assess the temperature on your hands and arms now as well that's great so i'm just going to squeeze on your fingers now column i'm just gonna fill your post now and draw the post that's fine straighten your arms out for me excellent and again to feel the posters in your neck that's great and at this point calling glutter sauce that we put the bed down flat yep excellent！ i'm just going to have a feel in the center of your optima now it might be a little uncomfortable if i could ask you to lift your right leg up！ please call him！ that's great and your left leg now place excellent！ thank you！ i'm going to have a look at your toes now and can you wiggle your tires to me please color i'm just going to assess the temperature in your legs and your feet and i'll press on your toes i'm just going to feel the pulses in you're growing now colin could ask you to lower your boxer slider yep i'm just going to have a listen to the post as well， if you can let me take the weight of your leg nowadays i'm going to have a listen behind your knees now again just let me take the weight of your leg i'm going to fill the pulses in your feet in your legs right left， right left so that concludes my examination thank you very much for letting me examine you today column you can get dressed now okay， thank you today i performed a peripheral arterial examination on colin， the examination was unremarkable with no stigmato of peripheral arterial disease present to complete my examination i could perform burger's test if there was a suspicion of critical askemia， i would measure abpi and i'd like to carry out a full cardiovascular examination，