Video summary

Respiratory Examination | OSCE Guide | UKMLA | CPSA | PLAB 2

Main summary

Key takeaways

Educational

Main ideas / lessons conveyed

  • The video demonstrates a structured OSCE-style respiratory examination for a standardized patient (Ollie Walker).
  • It emphasizes:
    • Consent and comfort checks before starting.
    • A systematic sequence of assessment: inspection → palpation → percussion → auscultation (front, then back).
    • Asking the patient to perform specific movements/breathing tasks to enable proper examination.
  • It ends with an example of normal findings and how they would be interpreted clinically.

Respiratory examination methodology (OSCE sequence) — detailed steps

1) Introduction, identification, and consent

  • Introduce self and role (final-year medical student performing exam).
  • Confirm patient identity:
    • Ask for name and date of birth.
  • Explain the procedure: look, listen, feel of the chest.
  • Obtain permission to proceed.
  • Check for pain:
    • Ask if there is any pain (none reported).

2) Setup and general inspection

  • Ask patient to:
    • Remove t-shirt.
    • Lie on an examination couch.
  • Inspect hands/upper limbs:
    • Ask patient to hold arms out in front, turn hands over, keep fingers together.
    • Ask patient to extend arms forward, keep wrists back in the same position.
  • Assess temperature (temperature check performed after initial hand positioning).
  • Take pulse.

3) Head/neck assessment and oral observation

  • Ask patient to:
    • Rest head back and turn away from examiner.
  • Inspect neck.
  • Inspect face:
    • Pull down lower eyelid, ask patient to open mouth and stick tongue to roof of mouth.
    • Then close mouth.

4) Anterior chest inspection and palpation

  • Inspect chest:
    • Ask patient to raise one arm to view the side of the chest; repeat for the other arm.
  • Feel for tracheal (windpipe) position (noted as potentially uncomfortable).
  • Feel for heartbeat.
  • Assess chest expansion:
    • Examiner squeezes slightly to assess expansion.
    • Ask patient to take a deep breath in and out.

5) Percussion (tapping)

  • Percuss/tap the chest (tapping performed on sides).

6) Auscultation (front of chest)

  • Ask patient to take deep breaths in and out through the mouth.
  • Listen at the sides (front/lateral auscultation).
  • Use a structured counting instruction:
    • Patient instructed to say “99” every time the stethoscope touches the chest.
    • Repeat across multiple sites on the sides.

7) Posterior chest examination

  • Ask patient to sit forward.
  • Examine neck glands while examiner stands behind.
  • Look at back.
  • Breath cycle for visualization:
    • Ask patient to take deep breaths in and out (repeated).
  • Ask patient to cross arms over chest before posterior auscultation.
  • Listen to breathing on the back:
    • Ask deep breaths in and out through mouth.
  • Posterior auscultation with counting:
    • Patient instructed to say “99” each time the stethoscope touches the back, repeated across sites.
  • Palpation at lower back:
    • Press firmly at the bottom of the back.

8) Lower limb/ankle assessment (checks related to systemic signs)

  • Examiner moves to legs and ankles.
  • Perform firm pressure/squeezing at the ankle/leg area (examiner checks for tenderness/pain).
  • Patient is asked to indicate if it is painful.

9) Conclusion and next steps (as stated in the video)

  • Examiner states the respiratory examination is complete.
  • Patient allowed to get dressed.
  • Example interpretation given as normal respiratory exam, and next planned steps:
    • Perform a full cardiovascular examination.
    • Check vital signs, including oxygen saturations.

Example patient findings and interpretation (as given)

For Ollie Walker (30-year-old man):

  • Comfortable at rest.
  • Pulse: regular, 75 bpm
  • Respiratory rate: 15 breaths/min
  • Chest expansion: equal throughout
  • Percussion note: resonant in all areas
  • Auscultation (oscillation/auscultation): normal vesicular breathing throughout
  • Added sounds: none

Summary interpretation: findings consistent with a normal respiratory examination.

Speakers / sources featured

  • Hassan (final-year medical student/examiner in the video)
  • Ollie Walker (simulated patient)
  • Geeky Medics (mentioned as a resource/collection for OSCE stations and virtual patients)

Original video