Final OSCE-1 useful for practicals for mbbs

Students practicals

1. OSCE

2. OSCE - 1 Examine the radial pulse: Reg.No 1.Get consent 2. Give instructions to the subject 3.Stand on the right side of the subject (1 mark ) Place the right hand of the subject in a semipronated position, slightly flexed at the wrist. (1 mark) Place three middle fingers on the radial artery just above the wrist with index finger towards the heart. (1 mark) Count the pulse for 1 minute (1 mark ) Compare with the radial pulse of the opposite side and report. (1mark) Total (5marks) Inference: Radial pulse is 72/ minute,regular in rhythm, normal in volume, vessel wall not thickened, felt equally on both the sides

3. OSCE - 2 Demonstrate Rinne’s Test: Reg.No 1.Get consent 2. Give instructions to the subject 3.Stand in front of the subject (1 mark) Select the tuning fork having frequency of 512Hz and hold its stem and strike it against the hypothenar eminence (1mark) Keep the vibrating tuning fork on the mastoid process (1mark) When bone hearing stops bring the tuning fork in front of external ear of the subject. Confirm with examiner’s ear. (1mark) Repeat in the other ear and report. (1 mark) Total (5 marks) Inference: Air conduction is better than bone conduction. Rinne’s test is positive

4. OSCE - 3 Locate the apex beat: Reg.No 1.Get consent 2.Give instructions to the subject 3.Stand in the front of the subject (1mark ) Expose the precordium, look for the apical impulse over the precordium and place the palm over the precordium (1 mark) Use the ulnar border of hand and then with the tip of the index finger locate the apical impulse. (1mark) Count the intercostal space from the sternal angle and note the position of the apical impulse in relation to the mid clavicular line. (1mark) Report the position of the apex beat (1mark) Total (5marks) Inference: Apex beat is located in the left 5 th intercostal space ½ “ medial to the midclavicular line

5. OSCE - 4 Elicit the biceps jerk : Reg.No 1.Get consent 2. Give instructions to the subject 3.Stand on the right side of the subject (1 mark) Position the elbow in right angle position and forearm in semipronated position (1mark) Strike on the thumb placed on the biceps tendon using the pointed end of the knee hammer (1mark) Look for the contraction of biceps and flexion of elbow (1mark) Elicit the jerk on the other limb and report (1 mark) Total (5marks) Inference: Biceps jerk elicited . Normal

6. OSCE - 5 Elicit the direct light reflex: Reg.No 1.Get consent 2. Give instructions to the subject 3.Stand on the right side of the subject (1 mark) Instruct the subject to look at a distant object. (1 mark) Throw bright light from the side of the right eye. (1mark) Observe the constriction of pupil in the same eye. (1mark) Repeat the procedure on the left eye and report (1 mark) Total ( 5 marks) Inference: Constriction of the pupil on the same eye

7. OSCE - 6 Elicit the knee jerk: Reg.No 1.Get consent 2. Give instructions to the subject 3.Stand on the right side of the subject (1 mark) Ask the subject to sit on a chair with the legs crossed and divert the attention of the subject (1 mark) Expose the quadriceps muscle and identify the patellar tendon (1 mark) With the narrow end of the knee hammer hit the patellar tendon. Feel the contraction of quadriceps muscle and extension of knee joint (1 mark) Repeat in the other limb and report. (1 mark) Total (5marks) Inference: Knee jerk elicited and present on both the sides

8. OSCE - 7 Elicit plantar reflex & report: Reg.No 1.Get consent 2. Give instructions to the subject 3. Stand on the right side of the subject .(1mark ) Expose the plantar aspect of both limbs of the subject lying in the supine position and fix the leg above the ankle joint with one hand. (1 mark) With blunt end of knee hammer give a gentle stroke from heal to the little toe and medially across the metatarsals till the great toe. (1 mark) Repeat the same on the other limb. (1 mark) Observe the response and report. (1 mark) Total 5 marks Inference: Plantar flexor response on both the sides

9. OSCE - 8 Position of trachea and report : Reg.No 1.Get consent 2. Give instructions to the subject 3.Stand in front of the subject (1mark ) Place the index finger and ring finger on the medial ends of the clavicle. (1 mark) With the middle finger gently trace the trachea from above to the supra sterna notch (1 mark) Insinuate the middle finger in the space between trachea and sternocleidomastoid muscle and compare between both sides (1 mark) Report. (1 mark) Total (5marks) Inference : Trachea is in the midline

10. OSCE - 9 Examine the vocal fremitus on the posterior aspect and report: : Reg.No 1.Get consent 2. Give instructions to the subject 3.Stand at the back of the subject. (1mark ) Ask the subject to cross the forearm across the front of the chest and to say “one” “one” in clear voice. (1 mark) Feel the vibrations using ulnar border of the hand over right and left suprascapular , right and left interscapular and right and left infrascapular areas. (1 mark) Compare the vibration on both sides of the chest. (1 mark) Report. (1 mark) Total (5marks) Inference: Vocal fremitus equal on both the sides

11. OSCE - 10 Elicit the indirect light reflex: : Reg . No 1.Get consent 2. Give instructions to the subject 3. Stand on the right side of the subject. (1mark ) Instruct the subject to look at a distant object and place the hand in between the two eyes (1 mark) Throw bright light from the side into the right eye. (1mark) Observe constriction of pupil in the other eye. (1mark) Repeat the procedure on the left eye and look for constriction of the pupil in the right eye and report. (1 mark) Total (5marks) Inference: Constriction of the pupil observed on the opposite eye

12. OSCE - 11 Palpate the liver in the given subject and report Reg.No 1.Get consent 2. Give instructions to the subject 3. Stand on the right side of the subject. (1 mark) Ask the subject to lie down on the couch in supine position and flex his legs slightly (1 mark) Expose the abdomen and place your right hand in the right subcostal region, lateral to the rectus muscle (1 mark) Ask the subject to take a deep breath and at the height of inspiration, press the fingers firmly inwards and upwards and palpate the liver (1 mark) Report (1 mark) Total (5marks) Inference: Liver is not palpable

13. OSCE - 12 Examine for anemia in the given subject and report : : Reg . No 1.Get consent 2. Inform the procedure (1mark ) Stand in front of the subject (1 mark) Ask the subject to look upwards and evert both the lower eye lids (1 mark) Look for pallor in the palpebral conjunctiva ( 1 mark ) Report : Anemia +/- (1 mark ) Total (5marks) Inference: The subject is not anemic

14. OSCE - 13 Examine for jaundice in the given subject and report : : Reg . No 1.Get consent 2. Inform the procedue (1mark ) Stand in front of the subject (1 mark ) Ask the subject to look downwards and evert both the upper eye lids and (1 mark ) Look for yellowish discoloration in the bulbar conjunctiva ( 1 mark ) Report ( 1 mark ) Total (5marks) Inference: The subject is not jaundiced

15. OSCE - 14 Examine pedal edema in then given and report: : Reg.No 1.Get consent 2. Give instructions to the subject 3.Stand at the back of the subject . (1mark ) Stand on the right hand side of the subject. Make the patient sit comfortably in a chair with both the legs extended. Expose both the feet. (1 mark) Apply pressure over the skin above the right medial malleolus for 15 sec. Remove the fingers and look for depression. (1mark) Repeat the same procedure in the left leg (1mark ) Report. (1 mark) Total (5marks) Inference: No pedal edema

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17. OSCE – 15 AETCOM Examine for anemia in the given subject and report : : Reg . No 1.Greet the subject politely in subject’s own language Vanakkam (1 mark ) Self introduction of examiner ( Tell your name) (1 mark ) Informed consent I am going to examine your eyes, tongue, and hands for anaemia. Can I? (1 mark) While examination have eye contact on and off with the subject and communicate empathetically to the subject (1 mark ) Closing interaction Nothing to worry . You are anemic/ not anemic ) . If anemic ask him to take iron rich foods healthy diet You will be alright Thank you in Tamil ( Nandri ) (1 mark ) Total (5marks) Inference: The subject is not anemic

18. OSCE – 16 AETCOM Palpate the liver in the given subject and report Reg.No 1.Greet the subject politely (1 mark ) Self introduction. of examiner Tell your name (1 mark) Informed consent (1 mark) I am going to examine your abdomen. Can I? Ask the subject to lie down on the couch in supine position and flex his legs slightly While examination ( 1 mark ) have eye contact on and off with the subject and communicate empathetically to the subject Expose the abdomen and place your right hand in the right subcostal region, lateral to the rectus muscle Ask the subject to take a deep breath and at the height of inspiration, press the fingers firmly inwards and upwards and palpate the liver .Look at his face for pain Closing interaction Nothing to worry . You are alright (1mark) Thank you in Tamil ( Nandri ) Total (5marks) Inference: Liver is not palpable

19. OSCE – 17 AETCOM Position of trachea and report : Reg.No 1.Greet the subject politely in subject’s own language (1 mark Self introduction of examiner ( Tell your name) (1 mark Informed consent I am going to examine your neck. Can I? (1 mark) While examination have eye contact on and off with the subject and communicate empathetically to the subject (1 mark) Place the index and ring fingers over the medial ends of the clavicle and with the middle finger gently trace the trachea from above to the supra sternal notch Insinuate in the space between trachea and sternocleidomastoid muscle and compare between both sides Closing interaction Nothing to worry . You are alright . Thank you in Tamil (1 mark ) Total (5marks) Inference : Trachea is in the midline