Pulmonary Exam Demo (Strong Exam)

A demonstration of the core pulmonary exam, appropriate for the first visit with a new primary care patient.
#physicalexam #osce #respiratoryexam

[@Argendoom244]

Very nice! Thank you very much!

[@aliabbaswadia3974]

Thats's so kind of you.

[@adrianadinatacandra2274]

Thank you for the demonstration... Very informative video

[@waelfadlallah8939]

Hello, Dr Strong! First to watch 😊

[@jonny5676]

🙏

[@alirezazakaie1106]

Thanks so much...why new videos don't come out?

[@StrongMed]

You're welcome. New videos haven gotten posted yet because they take time to research, film, and edit; and I have a completely separate full time job.

[@Matthew-ky6it]

When would you percuss? Only if you hear something abnormal on auscultation?

[@StrongMed]

I might go as far as saying percussion has almost no role in the practice of medicine in developed nations in the 21st century. Here's why: 1. There is virtually no clinically significant finding that percussion will pick up that wouldn't either be picked up on history or on auscultation.* 2. Anyone with new respiratory symptoms (e.g. dyspnea, hemoptysis) on history, or with an abnormal auscultation should get a chest X-ray. (may not be standard practice in resource-limited areas). 3. There is no pathology that percussion provides additional information to a chest X-ray. 4. Until recently, percussion still had a role in identifying the location of a known effusion at the bedside immediately prior to thoracentesis. But now we use ultrasound for that. (This is obviously not available in all parts of the world.) * The one debatable exception would be picking up hyperresonance in someone with subclinical (i.e. presymptomatic) COPD/emphysema. Although this possible role is suggested by the literature, I'm underwhelmed by its usefulness because the only treatment for subclinical COPD is smoking cessation, which a doctor should be recommending to their patient anyway, irrespective of chest percussion findings.

[@jonahansen]

It might be helpful to explain, perhaps parenthetically, what you are testing for with each step.

[@AhsanKhan1998]

He's done that in another video