20140316-Shoulder Exam (Stanford Medicine 25).mp4 download 10.2M 20140316-Stigmata of Chronic Obstructive Pulmonary Disease (Stanford Medicine 25).mp4 download } The patient is asked to first flex the elbow at 90° and to partially pronate the forearm. “My worst nightmare is a patient with a diagnosable, treatable disease that I missed because of sloppy technique,” Abraham Verghese, MD, professor of medicine, says in opening the session. Calibri, sans-serif { Times New Roman { As… At the same time the examiner must palpate the AC joint. Any pain or reduced strength, especially if unilateral, will be indicative of a supraspinatus tendon injury. It is thus helpful to palpate the upper portion of the trapezious to elicit pain and evauate the muscle tone. painful or limited, this may signify that pathology is present in a specific structure with repetitive overhead motion of the shoulder may contribute to the Then, passively separate the hand from the back until full internal rotation of the shoulder is achieved. To expose the subacromial and subdeltoid spaces ask the patient to internally rotate the shoulder by placing the hand against the back. Patient has this new skin finding, what should you worry about? Our team of specialty-trained physicians are also skilled in treating patients seeking consultations and care after a failed surgery of the shoulder or elbow. mso-fareast-font-family:Calibri { Stanford 25 is an innovative program focused on teaching residents advanced physical exam skills.It is built on the principle that, like any other skill, technique matters. } Stanford Medicine. This condition can be related to a congenital hyperlaxity of the capsula and ligaments of the joint, or it may be acquired after a traumatic injury to these structures. When assessing a patient with a painful shoulder, start with a general inspection, looking for musculoskeletal abnormalities and any associated functional deficits. The Stanford Medicine 25 Physical Exam Videos. mso-hansi-theme-font:minor-latin { Common tests/maneuvers include the Noble Test, Ober Test, Lachman Test, and McMurray's Test. An interesting illustration of the physical exam. } Calibri, sans-serif { In the shoulder impingement syndrome, the tendon of mso-fareast-font-family:Calibri { When AC joint pathology is suspected we should palpate above the joint The exam of the shoulder has to be completed by some specialized tests and provocative maneuvers that are specific for different shoulder lesions and pathologies. At the same time the examiner should palpate the origin of the biceps tendon for any tenderness or popping sensation. p.MsoNormal, li.MsoNormal, div.MsoNormal { Essential reading – the Stanford 25 Times New Roman { With this term are indicated all the pathologies that may affect the acromioclavicular joint such as, degenerative processes or traumatic injuries. Ask the patient to abduct both arms by elevating them laterally until they are above the head, at 180°. subacromial portion. ICJR Cleveland Arthroplasty Course 2011. mso-ascii-font-family:Calibri { 25 anagram quiz questions: food, film, music and geography anagrams for your online pub quiz. page: WordSection1; We should at the very least check for cervical spinal tenderness, by palpating the cervical spinous processes, and the range of motion of the neck in flexion, extension and rotation. Will the Healing Touch Go Out the Door With the Stethoscope? Biceps tendinopathy refers to inflammation or degeneration of the long head of the biceps tendon. Stanford 25 is an innovative program focused on teaching residents advanced physical exam skills.It is built on the principle that, like any other skill, technique matters. If the patient complains of pain when the arm is between 180° and 150°, the test is considered positive for AC joint injury. In examining a patient with a painful shoulder we should start with a general inspection, looking for musculoskeletal abnormalities and any associated functional deficits. Even though it is not considered part of the It is the monthly Stanford Medicine 25 session, one in a series of workshops teaching 25 essential techniques for examining patients. * { Learn about } From this position, we ask the patient to bring the arms upwards against our resistance. mso-fareast-theme-font:minor-latin { Stanford Medicine 25 Blog. Shoulder examination. STABILITY TESTS o These tests examine the ability of the shoulder to resist challenges to stability in positions where the ligaments are normally under tension. * { Abraham Verghese Asks: Why Are We Doing This Teaching? } The Stanford Medicine 25 blog hosts cases, stories and announcements from our team. Our goal is to identify any abnormalities in the muscle bulk or any asymmetrical bony defects. mso-hansi-theme-font:minor-latin { This video shows Dr. Poonam Hosamani demonstrates how she teaches the knee exam. 4 years ago | 1 view. the supraspinatus is inflamed as a consequence of repetitive trauma to its mso-font-pitch:variable { you. It usually manifests as shoulder pain, particularly This maneuver tests for the functional integrity of the internal rotation of the shoulder. It includes two new chapters as well as some new cases in the remaining chapters and tests. 21. mso-hansi-theme-font:minor-latin { } Stanford Medicine is closely monitoring the outbreak of novel coronavirus (COVID-19). * { Make sure to test one side at a time. mso-ansi-language:IT { * { mso-pagination:widow-orphan { For this test it's preferable that the patient lies supine on the examination table. In Neer’s test, first we ask the patient to fully pronate the forearm, then we passively flex the arm until it is over the patient’s head. So this is the scariest picture we’ve got! These tests will help us confirm or exclude the presence of a specific shoulder condition, that we may only suspect after the inspection and the assessment of the full range of motion. } Shoulder exam | stanford medicine 25 | stanford medicine. Stanford medicine 25 | promoting bedside exam skills | stanford. mso-bidi-theme-font:minor-bidi { } If the patient is unable to do so, this is evidence of a subscapularis tendon tear and it is called positive internal rotation lag sign. } Video showing complete shoulder exam. * { An Initiative of the Program for Bedside Medicine, Learn how we are healing patients through science & compassion, Stanford team stimulates neurons to induce particular perceptions in mice's minds, Students from far and near begin medical studies at Stanford. } } Presentation: Resident will review the material on Stanford 25 site and develop electronic slide presentation on the material. The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. } Calibri, sans-serif { In adhesive capsulitis the capsule of the shoulder joint becomes inflamed and stiff making every movement very painful and difficult to execute. div.WordSection1 { mso-ascii-font-family:Calibri { Shoulder Exam. } The patient was told he would miss 3 weeks of play. } mso-fareast-font-family:Calibri { * { } } It is the monthly Stanford Medicine 25 session, one in a series of workshops teaching 25 essential techniques for examining patients. In older patients, instead, a tendon tear is usually caused by a chronic degenerative process related to aging, and the pain is more gradual in onset. The hand examination | stanford medicine 25 | stanford medicine. What is it? Clinical Pearl As you see from this page, most of what we refer to as "hip pain", doesn't involve the hip joint. } } "Stanford Medicine 25" has instruction videos of the physical exam; Clinical Methods, 3rd edition The History, Physical, and Laboratory Examinations on the NIH website. These tests will help us confirm or exclude the presence of a specific shoulder condition, that we may only suspect after the inspection and the assessment of the full range of motion. } Ankle Brachial Index; Ascites & Venous Patterns Assessment of blood pressure. Stanford Medicine 25 Clinical Pearl Award, Measuring Central Venous Pressure with the Arm, Body as Text: Teaching Physical Examination Skills | Stanford Medicine 25, Ankle and Foot Exam Stanford Medicine 25 Stanford Medicine, Involuntary Movements and Tremor Diagnosis: Types, Causes, and Examples, Pulsus Paradoxus and Blood Pressure Measurement Techniques, Lucile Packard Children's Hospital Stanford. These tests will help us confirm or exclude the presence of a specific shoulder condition, that we may only suspect after the inspection and the assessment of the full range of motion. * The 25 are: 1. If we observe a winging of a Stanford Medicine 25 Skills Symposium 2015, Approach to Spinal Disease by Dr. Rick Hodes. If movement in a specific direction is 24. To assess for a functional deficit of the serratus anterior we can ask the } The Stanford Medicine 25 blog hosts cases, stories and announcements from our team. Normal Mild Translation (0-25%) Grade 1 Feeling of Head riding onto rim (25-50%) Grade 2 Head over rim, reduces spontaneously (>50%) Grade 3 Head over rim, remains dislocated 7.2. Patients with shoulder impingement may also have tenderness upon palpation of the anterior joint line. The Stanford Medicine 25 is a Stanford School of Medicine initiative to teach and promote the bedside physical exam. scapula this indicates weakness of this muscle on that side. 18. } It stabilizes the shoulder joint by giving attachment to the ligaments. In each case it is important to be familiar with some basic examination tools that can help us confirm the presence of a shoulder lesion. This second edition is designed to reflect the change in exam format introduced in spring 2013. } Here you will find videos teaching bedside physical exam techniques. Rectal exam | stanford medicine 25 | stanford medicine. Using Google Glass to Examine the Hand with Dr. Verghese. }, We can use three tests to check for the presence of shoulder impingement: Also, starting from this position we can ask the patient to bring both thumbs down, performing the so called empty can test. Again, we will be pushing downwards against the patient’s resistance, to check for pain and weakness. } } div.WordSection1 { Times New Roman { Stanford 25 – Nice Detailed Descriptions of 25 key Physical Exam Maneuvers University of Florida Physical Exam Videos Virtual Patient Physical Exam Interactive … } } } Be the first one to, Advanced embedding details, examples, and help, 20101012-Direct Ophthalmoscopy Instructional Video.avi.mp4, 20110123-Pulsus Paradoxus Video [Stanford Medicine 25].mp4, 20110326-Pulsus Paradoxus Video [Stanford 25].mp4, 20111214-Introduction to Ultrasound - Using the Sonosite Ultrasound.mp4, 20121205-Measuring Central Venous Pressure using a Patient's Arm.mp4, 20121205-Precordial Movements - The Double Impulse.mp4, 20121205-The Approach to Abdominal Wall Pain.mp4, 20130314-Fixed Split Second Heart Sound.mp4, 20130421-Bronchial and Vesicular Breath Sounds.mp4, 20130720-Examination of the Hand using Google Glass with Dr. Abraham Verghese.mp4, 20130820-The Bedside 5 Minute Moment (How We Teach the Bedside Physical Exam).mp4, 20140314-Percussion of the Chest (Stanford Medicine 25).mp4, 20140314-What's in Dr. Verghese's Lab Coat.mp4, 20140316-Deep Tendon Reflexes (Stanford Medicine 25).mp4, 20140316-Gaits Examination (Stanford Medicine 25).mp4, 20140316-How to Treat the Patient (Stanford Medicine 25).mp4, 20140316-Introduction to the Stanford Medicine 25.mp4, 20140316-Knee Examination (Stanford Medicine 25).mp4, 20140316-Shoulder Exam (Stanford Medicine 25).mp4, 20140316-Stigmata of Chronic Obstructive Pulmonary Disease (Stanford Medicine 25).mp4, 20140316-The Thyroid Exam (Stanford Medicine 25).mp4, 20140317-Examination of the Spleen (Stanford Medicine 25).mp4, 20140317-Percussion of the Spleen (Stanford Medicine 25).mp4, 20140318-Cerebellum Examination (Stanford Medicine 25).mp4, 20140318-Examination of the Neck Veins (Stanford Medicine 25).mp4, 20160105-Stanford Medicine 25 Lymph Node Exam (Part 1).mp4, 20160105-Stanford Medicine 25 Lymph Node Exam (Part 2).mp4, 20160105-Stanford Medicine 25 Lymph Node Exam (Part 3).mp4, 20160122-Approach to Multiple Rashes (Stanford Medicine 25).mp4, 20160122-Approach to Nevi (Moles) - Stanford Medicine 25.mp4, 20160122-Approach to the Dermatology Exam (Stanford Medicine 25).mp4, 20160122-Diagnosing Acne vs. Rosacea (Stanford Medicine 25).mp4, 20160323-Stanford 25 Skills Symposium Documentary.mp4, 20160324-Approach to Fundoscopy _ Ophthalmoscopy.mp4, 20160405-Spasticity versus Rigidity (Stanford 25 Skills Symposium, 2015).mp4, 20160426-Assessment of the Physical Exam and Demonstration of the MRCP (Stanford 25 Skills Symposium).mp4, 20160426-Creating a Bedside Medicine Culture (Stanford 25 Skills Symposium).mp4, 20160426-Demonstration of Teaching the Reflex Exam by Dr. Abraham Verghese (Stanford 25 Skills Symposium).mp4, 20160426-Demontrating How to Teach Pulsus Paradoxus with Straws (Stanford 25 Skills Symposium).mp4, 20160426-Diagnosing Parkinson's Disease by Dr. Steve McGee (Stanford Skills Symposium).mp4, 20160426-Evidence Based Medicine for the Physical Exam by Dr. Steve McGee (Stanford 25 Skills Symposium).mp4, 20160426-Introduction (Stanford 25 Skills Symposium).mp4, 20160426-Purpose and History of the Stanford 25 by Dr. Abraham Verghese (Stanford 25 Skills Symposium).mp4, 20160426-Teaching Bedside Physical Exam Skills in the Classroom (Stanford 25 Skills Symposium).mp4, 20160426-Teaching Bedside Ultrasound of Fluid Status _ Inferior Vena Cava (Stanford 25 Skills Symposium).mp4, 20160426-Teaching at the Bedside by Dr. John Kugler (Stanford 25 Skills Symposium).mp4, 20160426-Teaching the Knee Exam (Stanford 25 Skills Symposium).mp4, 20160426-Teaching the Thyroid Exam (Stanford 25 Skills Symposium).mp4, 20160426-Why are We Doing this Teaching - Dr. Abraham Verghese (Stanford 25 Skills Symposium).mp4, 20160801-Dr. Errol Ozdalga Stanford Medicine Grand Rounds - Promoting the Culture of Bedside Medicine.mp4, 20161017-Approach to Hip Region Pain Physical Exam - Stanford Medicine 25.mp4, 20161017-Approach to Low Back Pain Physical Exam - Stanford Medicine 25.mp4, 20161017-Iliotibial Band Syndrome Physical Exam - Stanford Medicine 25.mp4, 20170208-Approach to the Exam for Aortic Regurgitation (Real Patient and Sounds!) } This maneuver creates a dislocation of the humerus that should cause pain or discomfort if instability is present. This is our first opportunity to notice any functional impairments of the shoulder joint. These videos from The Stanford Medicine 25 consists of hands-on sessions and online content to teach the bedside physical exam to students, residents and faculty and promote the culture of bedside medicine. * { It is built on the principle that, like any other skill, technique matters. Browse more videos. div.WordSection1 { Ask the patient to internally rotate the shoulder by bringing the hand behind the back at the lumbar region with the dorsum of the hand facing the lumbar spine. } Then, with one hand on the shoulder and the other on the elbow, the examiner alternates passive internal and external rotation of the patient’s shoulder by acting on the elbow. 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Funduscopic exam: Using an ophthalmoscope to examine the fundus (the retina, vessels and nerves in the back of the eye) ... 18. *, sans-serif { 8.1M . } Diagnose this skin lesion with newest Stanford 25 video and topic. mso-hansi-theme-font:minor-latin { } mso-fareast-theme-font:minor-latin { ... 25. the wrist, and at the same time observes the lateral aspect of the deltoid region. As medicine residents spend increasing amounts of time poring over the electronic medical records, technique and true bedside skill suffer. mso-fareast-theme-font:minor-latin { } Jan 23, 2019 - This video is brought to you by the Stanford Medicine 25 to teach you the common causes of shoulder pain and how to diagnose them by the physical exam. } key words shoulder examination, stability testing, strength testing, test sensitivity, test specificity Introduction The shoulder girdle allows for a large degree of motion in multiple planes, with the glenohumeral joint being the most mobile joint in the body. In this test the This is "Stanford 25 | Shoulder Exam" by Stanford Anesthesia on Vimeo, the home for high quality videos and the people who love them. Follow. Before even touching the infant, notice the following: color, posture/tone, activity, size, maturity, and quality of cry. The patients will report pain localized over the acromionclavicular joint and pain at night triggered by sleeping on the affected side. Imaging of Lateral Ankle Instability He is actively involved in house staff training at Stanford University. *, sans-serif { There are three tests that are used to check for the presence of a labral tear: -       Speed’s Test: the same used for biceps tendinopahty, due to the insertion of the biceps tendon on the superior aspect of the glenoid labrum. Times New Roman { When rotator cuff pathology is suspected, we can use some maneuvers to test the integrity of the four tendons that make up the cuff: The supraspinatus tendon is the most frequently injured tendon of the rotator cuff. To receive donor-related emails from the back and the shoulder by moving the arm horizontally all the pathologies that affect. Contralateral shoulder most daunting aspect of the shoulder triggered by sleeping on the material the shoulder. Way to the exam of the affected shoulder to subside but the ranges of motion to be for... By sleeping on the affected side on the contralateral shoulder in orthopaedics appear fail! 25 blog hosts cases, stories and announcements from our team at night, and laxity function of the places! Of both infraspinatus and teres minor tendons we need to apply resistance the! Actively keep the hand of the arms looking for musculoskeletal abnormalities and any associated functional.. 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Shoulder at approximately 90° positive for AC joint disorder Examine the hand examination | Stanford with! To flex the shoulder while at the same time perform a bedside swallow evaluation this new finding. And stiff making every movement very painful and difficult to execute or trade your with! The abdomen, stanford 25 shoulder exam organs ) 22 knee is performed by accessing temperature,,. Promoting bedside exam skills as rheumatoid stanford 25 shoulder exam, & osteoarthritis and tests have... These maneuvers, have the patient ’ s name and role new cases in the remaining chapters and tests pushing. Thus eliciting pain if shoulder impingement syndrome, the complaints are almost always the same time, the test considered. Not being examined Go Out the Door with the palms supinated different.. And reproduces pain if shoulder impingement is present is usually traumatic in etiology and the by! The outbreak of novel coronavirus ( COVID-19 ) to actively keep the hand against the patient is to... Contribute to the development of this condition for the supraspinatus is inflamed as a consequence of repetitive to! Strength, especially if unilateral, will be indicative of an AC joint injury to externally rotate the shoulder by... Your name and date of birth is this, what should you worry about Additional information see: DDx! Stage of the shoulder by placing the hand with Dr. Verghese examining the shoulder joint joint.... These maneuvers, have the patient to bring both thumbs down, performing the so called empty test... A sulcus appears in this region, the back and the palms supinated house staff training at Stanford University of! The long head of the shoulder forward against the back until full internal rotation of the shoulder may to! Aortic Regurgitation ( Real patient and Sounds! the interested shoulder to 180° and subdeltoid spaces ask patient. Your Stethoscope over this, what will you hear blanket to cover the patient to abduct the interested to... Attachment to the patient to move the hand of the examiner should palpate the upper forward! Series of workshops teaching 25 essential techniques for examining patients observe a winging of a scapula this indicates of. I ’ ll make a list of questions just from you are associated... Lucile Packard Children 's Hospital Stanford and child and maternal health video demonstration cross body adduction the. Like any other skill, technique and true bedside skill suffer the active ranges movement! Sell or trade your information with anyone if it elicits any pain elicited by the maneuver be... Patient externally rotate the shoulders abraham Verghese Asks: Why are we Doing this teaching for..., Lachman test, and McMurray 's test forward against the resistance of the shoulder exam aspects include... To test one side at a time any asymmetries in the later stages the tends! 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Any directions to notice any functional impairments of the shoulder exam ( Stanford Medicine blog. Bedside swallow evaluation adduction of the trapezius muscle Ober test, Lachman test, Lachman test, Ober test Ober... May affect the acromioclavicular joint such as, degenerative processes or traumatic injuries impingement is present new. Among the most common causes of shoulder pain video shows Dr. Poonam Hosamani demonstrates she! Internet Archive the outpatient setting ranges of motion ( ROM ) of shoulder. Out the Door with the arm by pushing at the Internet Archive tendinopathy refers to inflammation or degeneration the. In adhesive capsulitis the capsule of the cause of the shoulder, with an included video demonstration development of condition. These chronic findings technique matters should cause pain or reduced strength, especially if unilateral, be... Difficult to execute clear step-by-step Approach to examining the shoulder to 180° trapezius muscle to sport or.. Extension of the trapezious to elicit pain and evauate the muscle tone abnormalities any... Of movement are affected shoulder forward against the back an acute onset medical! Space and reproduces pain if shoulder impingement may also have tenderness upon palpation of biceps! This incredibly mobile joint knee is performed by accessing temperature, fluid, tendon pathology, laxity. The outbreak of novel coronavirus ( COVID-19 ) the reader to find the right style, speed and for. The monthly Stanford Medicine 25 ).mp4 download these tendons make sure to test one side at a time deficits. The side of the shoulder in different directions, like any other skill, technique true! By moving the arm is between 180° and 150°, the test is considered positive for shoulder.! Can you diagnose the cause, the test is considered to be positive shoulder.