Spine Medical Examination - Spine OSCE - Medicine Explained - Clinical Skills - Dr Gill

Spine Medical Examination - OSCE Explained - Clinical Skills - Dr Gill
This Spine Exam Deep Dive looks at the details of the examination of a patient with back issues, highlighting what is being checked for during special tests and examination findings
In this video, we demonstrate how to perform a clinical examination of the spine for your medical school Clinical Skills OSCE. As orthopaedic exams are core skills when it comes to examining patients, students should assume that a spinal assessment is a high yield station for any clinical exams or clinical assessments.
For a passing grade in your Clinical Skills OSCE, in a spine exam follow the approach of:
- Look
- Feel
- Move
HOWEVER, a spine examination OSCE station does not just involve pressing around the back, this video also demonstrates some of the specialised examination techniques required in examining patients such as Schober's test for ankylosing spondylitis, and checking sciatic nerve stretch
Reduction in movement, pain and general concerns about the back is a common reason for patients to see a doctor, and in general practice is probably the most commonly performed patient examination
This video has three other spine demonstration videos associated with it:
• Spine Examination - Ba... - Spine assessment Demo
• GALS Screen - Gait, Ar... - Gait, Arms, Legs, Spine - GALS screen
• Rectal Examination and... - How to perform a DRE - digital rectal examination
------------
Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.
Some people viewing this medical examination video may experience an ASMR effect
Kayser-Fleischer ring - Herbert L. Fred, MD, Hendrik A. van Dijk - commons.wikimedia.org/wiki/Fi...
Map - commons.wikimedia.org/wiki/Fi...
Ascites - James Heilman, MD - Own work
Angular stomatitis - en.wikipedia.org/wiki/Angular...
Cold Sore - en.wikipedia.org/wiki/Herpes_...
B12 - www.health.harvard.edu/stayin...
Glottis - en.wikipedia.org/wiki/Glossit...
Gynaecomastia - en.wikipedia.org/wiki/Gynecom...
Spleen - en.wikipedia.org/wiki/Spleen
#clinicalskills #abdominalexamination #DrGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...

[@ultimomos5918]

Dr Gill training the ASMR community to be doctors.

[@DrJamesGill]

Perhaps that should be the trigger for me to do a CPR video?

[@ultimomos5918]

@@DrJamesGill ooooh that would be great! A skill everyone could use!

[@naotenhocpf5364]

@@DrJamesGill Not only useful as a life skill but i feel like people would focus more due to the "accidental" asmr tone of the videos. Maybe that would save some lives, who knows?

[@AL-jo2vp]

@@DrJamesGill 'Hello, I'm going to attempt to resuscitate you, can I confirm your name and date of birth please? '

[@yourgirleft]

yes amen 😮‍💨

[@justicealistair7774]

"You've joined us for a demonstration and explanation of the spine examination." Dr. Gill spittin' BARS! 🔥🔥🔥🔥

[@chris16durban]

Lil Gill

[@karlofrancisbitare4503]

This is a good idea doc..having a patient with a complaint and trying to locate what the problem is..looking forward to more videos like this

[@DrJamesGill]

Honestly, I didn’t intend to find anything, but he winced, so looked a little further We’ve tried to do that with the asthma and diabetes reviews

[@dd11111]

I wish I had a Doctor like Dr. Gill near me. Someone who actually explains whats wrong and doesn't just tell you that your joint pain is caused by stress. I think Dr. Gill is the only Dr. I still trust.

[@DrJamesGill]

The thing is pain CAN be hugely influenced by stress, but what matters is how you treat the problem the patient is experiencing.

[@rageagainstthebath]

I really appreciate the new approach to these demos, the additional commentary is really valuable. Thank you!

[@DrJamesGill]

Thank you. Where do you think we could improve?

[@rageagainstthebath]

​@@DrJamesGill I'm not sure if I have any major suggestions at this point. I'm not a native English speaker, so sometimes I check subtitles for medical terminology or harder words in general. Your pronunciation is very clear, so even the auto-generated subtitles appear to be correct. Text comments on the video are very helpful as well. Perhaps some pictures were presented not long enough for me to understand what I'm looking at and what exactly should I observe. But then again, I represent that fraction of your audience that came for ASMR but stayed for medical lessons, so I may be a rather slow learner. Thanks again for your unique content. Stay safe!

[@dariarubisch981]

I like the blended style! I'm not a med student, but as a patient I always appreciate when doctors explain to me what they are doing and looking for in an examination, or even a conversation. I think most people are interested enough to have an examination on them performed exactly like this (minus looking off to a non-existent camera maybe) Greetings from Vienna

[@profbrunch]

I am no longer a med student due to complications with COVID, but after finding your channel recently, I feel at home watching your videos. They really allow me to keep some of my skills sharp and in the front of my mind, so thank you!

[@DrJamesGill]

I’m sorry to hear that. Hopefully it will just be a postponement of the academic year When did you get it?

[@profbrunch]

@@DrJamesGill Only recently did this happen, but it looks like we will be able to be back on campus and working with our professors directly in January, so heres to hoping!

[@DrJamesGill]

Fingers crossed. I genuinely feel sorry for our students

[@anthonypegnataro8386]

9Kim. __

[@Raquel96]

This format is awesome! I'm not currently a medical student, I'm an art uni student who enjoys ASMR (& with that I often practice drawing different poses in these vids so thank you) but I feel like I've learned a lot with this one 😊It's definitely helpful to have the explanations along with the examinations for students + having a patient that has something that's out of the ordinary does offer a good example & point of reference too

[@ImaginaryMdA]

I can imagine this could be quite useful for an art student!

[@DrJamesGill]

Interesting. I’d not thought if that. How do?

[@benjaylehman]

Girl same!!

[@ajlouis6038]

@@DrJamesGill Art school alumni here. Examination videos give me a fair share of insight into the movement's as well the structure of the human body. Really helps out in anatomy drawings. Used to check these out quite a bit back in school and I must say this whole comment trail has reminded me to revisit these videos for sketches once again.

[@DrJamesGill]

Ah. Thank makes sense! Thanks - I’ve learned something now 😊

[@remyhadley6595]

I know this is educational, but dayum, the young guy in the video got cakeeeee

[@Backto5oh5]

🍰🍰😂

[@rbtkng2438]

I would join his onlyfans account if David would be naked. Hot

[@notatuba7986]

The blended style of this video was much more informative and just as easy to watch and understand. Great job

[@DrJamesGill]

Thank you. What would you feel if we added in “break outs” where we discussed pathology in more detail?

[@brum4692]

@@DrJamesGill ur a legend

[@notatuba7986]

@@DrJamesGill Sorry for the late reply. Not certain what you mean about break outs. But more information is always great.

[@WillyWonkasCrack]

The patient is quite the specemin!

[@user-qb7ex5it5q]

The cakes

[@tanksoldier]

Outstanding. I really like that the patient had a complaint for you to look into…. When they say nothing is wrong, then why are we here?

[@lewissimpson7572]

Because it’s a KZbin tutorial?

[@tanksoldier]

@@lewissimpson7572 Except it isn’t really tutoring. Few physicians will perform a spine exam on a patient with no complaints. Do you go see the doc when nothing is wrong?

[@DrJamesGill]

Because when we train the medical students, they have to focus on understanding the normal findings Keeping in mind that often people will see the doctor with pain in the back, but on the examination we find no clinical signs In terms of tutorials we focus on getting the students to have a really strong baseline for “no issues” so that when they do come across something abnormal - whilst they may not be able to say what it IS straight away, they should hopefully recognise that SOMETHING is presenting that doesn’t match their internal reference for normal

[@DrJamesGill]

Frankly it annoyed me at medical school, I wanted to see and learn about pathology. But I do understand it now You teach someone to drive a car safely and normally, before teaching them how to deal with snow driving or ice skids etc 😊

[@Kaanka09]

This is exactly what I wanted! So happy that it is a mix of the two!!

[@DrJamesGill]

Thank you. I’m still trying to get the best balance 😊

[@TheBoarderland]

In my opinion it becomes even more interesting when the patient actually reports an issue and we can see that "process of elimination", concerning the complaint/diagnose. So going from one test to another, noting any positive findings and building the diagnosis. I can imagine that being rather difficult to do, without getting too much into detail but even the slight discomfort on this patient was already very interesting. I enjoyed this video very much :)

[@DylanWarcraft]

Every medical school needs to have Dr James Gill's world class clinical skills demos!

[@nafaydothem]

Sometimes i think how much this would actually help me academically if i was studying medical. Kudos to Dr Gill

[@leurts]

Ah he is back! The GOAT in speed shirt removing

[@mashudakhandokar8294]

I've always wanted examination videos with a reference to conditions and anatomy, to explain exactly what we are supposed to be looking out for, and this has come at exactly the right time, thank you so much Dr Gill!

[@DrJamesGill]

👍 thanks. We’ve just filmed the thyroid exam to produce a similar style video 😊

[@matthewmacdonaldchannel1]

Enormously informative, Dr. Gill. As someone with neuromuscular damage from an ADR, this type of content is helpful in forming questions I can pose to both GP’s and specialists. Thank you.

[@DrJamesGill]

👍

[@adefay7813]

I'm a paediatric nurse who just discovered yout channel in the last 24 hrs amd it's been a blast. I'm enjoying and absorbing a lot informationand learning. I'm gaining more indepth understanding of a lot of conditions than I ever have. Thank you so much . This is so helpful for both personal and professional development.

[@DrJamesGill]

Thank you. I’m glad you found it helpful, and other areas we could cover to help you further?

[@Vylo44]

Look I know this isn’t the right place or time but…. 9:37 GYATTTTTT DAYUM BRODIE GOT CHEEKS

[@werkturn7539]

I knew I couldn’t have been the only one that noticed.

[@sarahmorris4410]

No way bro said gyatt in a medical explanation video 💀💀

[@aryehburg7785]

This was incredibly engaging and informative!!! I really enjoyed the added diagrams and breakdown of the spinal regions and what was being looked for and why!!!

[@chukwunyereiv3]

This blended approach is quite comprehensive. I think you should continue and make more like it.

[@Jonathan-gj2fe]

David is, by a country mile, your best "patient" for these videos. And this new format adds a whole lot more value, if I may put it like that, to the understanding of an examination. Quick question... what would have been done to determine the cause and possible treatment for David's pain?

[@outdatedoutdated9142]

CT go brrrrrrr MRI go brrrrrr

[@arthurkirkland1419]

@@joncampos5551 indeed

[@SparkesIsRunning]

Yes yes! Love this new format! Keep em coming. I feel an OBE coming Dr Gill!

[@uio3289]

An educational video + a soft spoken man = Dr. James Gill

[@t0raneko]

I'm not a med student, but I've never understood how a clinical exam video without explanation would be helpful to those trying to learn these skills.

[@livmarie2000]

I think it’s showing how it would be done in the work place, a lot of people learn by watching someone doing it beifre they do! I learn like that :)

[@queenofkiwis4795]

Good ASMR

[@danielney6]

Go be med student then lol

[@DrJamesGill]

The original demos are teaching tools. I would use them, as pause the video. Ask students what was going on, what was being looked for etc. Plus in self directed learning, the students could follow the flow and timing For OSCE examinations, students often struggle with getting everything within the time. In the demos I’m showing the relatives speeds at which I’m doing the examination

[@maxlove8894]

@@DrJamesGill and it’s rather relaxing

[@AJ_real]

It's interesting to get the explanation of all the checks that are done. I really learned something, and I am not a medical student.

[@jasminegann]

I really appreciated this video and I wish this is how my spinal examinations were treated when I was being examined by both family doctors and a chiropractor. They did a poor job and made me feel very unwelcomed as well as uncomfortable in my own body by scolding me for having the back issues to begin with. I hope that others in the medical field see your videos and are motivated to be better professionals than most of us are used to. ♥️

[@neptunepirate1981]

This blended format is really phenomenal.

[@DrJamesGill]

Thank you. Any suggestions one what you think we could do better?

[@davidchristian4417]

Dr. Gill is a legend. Enough said.

[@3DGvisuals]

You're so much more thorough than any doctor I've ever had, I hope the young doctors coming up emulate you. 😊

[@Celticshade]

This is for training purposes. So doctors, especially in the US and we’ll probably everywhere tbh, aren’t doing basically anything this thorough unless they feel they have to. Which means they won’t unless the patient says anything. Not mention so many doctors are basically coming in and trying to go as fast as they can and move onto the next patient. I would assume since they have so many patients (especially in a hospital setting). But I’m also not even blaming doctors since I have to deal with appointments a lot, it’s just the vast amount of patient per 1 doctor. Cause I bet the majority of doctors would love to spend a solid hour or longer with each patient to get the entire picture.

[@28loss]

Excited waiting for another great video from our ASMR guru!

[@mrpatatas18]

I was suppose to sleep while listening to your vid. Instead I got interested and watch it. 😊 Thank you so much. I learned a lot today! Cheers!

[@DrJamesGill]

👍

[@mistyrain2532]

I'm not a student anymore, but I watch at least one video a night. A patient with an actual complaint great idea. David was perfect this exam! And I appreciate that this one was a medium amount of minutes.. More than 5 but less than 30.. :-)

[@mach5jeep]

All those years they tried to force me to classes in the morning when it turns out I learn more after midnight on KZbin

[@DrJamesGill]

Absolutely. The education systems are - from a chronobiology state point - terrible for 50% of people

[@gavinprosser]

Just found this. What a amazingly informative video for the non professional and a lovely calming voice

[@Flippirino]

I don't quite know what it is yet, but David has it, I can tell he'll be an even greatee patient Thank you for a more in-depth spine demonstration, reminds me of the one that happened over a year ago

[@DrJamesGill]

Hopefully they didn’t find any issues?

[@Flippirino]

@@DrJamesGill yes? I'm currently lost myself as my comment is not quite the best.. But thank you all together

[@starfishgurl1984]

Loved this format, great video! It’s reminding me that I need my spine examined again though to make sure nothings changed, my back hasn’t been the same since a nasty bike accident landed me backwards right on it on the ground and working on my feet all day I have to make sure that I’m using proper posture at work to protect it and doing yoga poses to help keep it in shape to prevent me from needing physical therapy again. Great job as always and look forward to the next one!

[@DrJamesGill]

For something like that seeing the physio might be the best option 😊

[@Billy-dj8zw]

This doctor is quite a catch. I love his soothing voice, the way he dresses, his accent, everything about him.

[@katietucker4778]

These videos are great for my OSCE practice, so glad I found them and the causes are explained as you go along!

[@maskedasmr2156]

The Winnie the Pooh reference while being a fully qualified doctor in a snazzy waistcoat. *swooooooooon*

[@darksector_0675]

This is really calming. It's something about the soft spoken aspect

[@NickzAndMikz]

Really like this format -med student

[@tehflip]

Thank you very much Dr. Gill! I am here for the ASMR. However, would you have a differential diagnosis based on the patient's initial reported symptoms?

[@9senel]

I like this new blended approach, its easy to follow with plenty of useful explanation. It's a different format when compared to other KZbinrs and so I think you should carry on doing more of these videos. Improvement wise - perhaps in the end you can briefly summarise what you did / covered, safety netting and how would you further explore the problem.

[@DrJamesGill]

That’s a really good idea re safety netting and summary

[@mikeking6130]

Ddsddxxxc

[@bicchu68]

This is far far better with the explanations than the previous ones. Earlier you only showed the process and steps but we were unclear about the why's & the reasons for doing them.

[@DrJamesGill]

Thanks. The demos specifically were in-annotated as we would use them for teaching, and discuss over the top But pretty much all covered now. So we’ll be doing these going forwards (when the students return)

[@donttalktomebye]

Big fan of the blended approach!

[@QwertyDFTBA]

Oh thanks goodness, I have a back pain exam next week that I was worried about. Thanks for explaining what I should expect!!

[@DrJamesGill]

This is a complete examination, often clinicians will focus the examination to the presenting area, but hopefully you’ll understand why we are doing things now

[@blammela]

Love the blended format! So informative

[@supernath80]

I am really loving this new approach, and definitely would like to see more videos in this style. I found this really valuable. Thank you!

[@DrJamesGill]

We’ll do thyroid after Christmas 😊

[@supernath80]

@@DrJamesGill oh... that means you'll be putting a bit of paper on it. The internet will go wild!

[@LUckybones25]

Amazing Doctor, and gorgeous patient!

[@saz2707]

I’m glad he’s establishing things early on.

[@gaz3097]

Ever the professional, Doc. It's a solid 10 from me!

[@horium2501]

This is quite illuminating. Added explanations during the examination are a welcome addition.

[@daltonjenkins2916]

I definitely enjoy your videos and this new approach breaking everything down and explaining it i not only enjoy it but really appreciate it

[@DrJamesGill]

Thank you 😊 I think this is a better teaching approach for individual learning. The demos are useful in that we can talk over them and ask questions when learning

[@americahasaproblem2632]

Good Afternoon Gill community / hope u are all well. Thanks to Doctor Gill I now feel confident to start practising as a doctor - due to the low pay that the NHS offers I shall run my practice from my studio apartment and charge accordingly. Thanks again 👍🏾

[@KParks]

I've got some kind of 6th lumbar or something going on so I've been looking up videos lol this guy has a perfect public speaking voice, Very easy to listen to and understand.

[@facundogomez4513]

The man si back!!! Greetings from Uruguay

[@LIKETHESTREAM]

As someone with undiagnosed back pain (I have a fear of doctors...) This is a very interesting video. Very calming voice and very educational. Thanks for making this.

[@DrJamesGill]

Perhaps you’d be able to see someone else. Have you tried a physio?

[@LIKETHESTREAM]

@@DrJamesGill unfortunately in America I have to see a general physician to get a referral to a specialized doctor so it's covered by insurance. I'll get over my fear eventually, thanks for your reply. 🙂

[@DrJamesGill]

Over here the physio is an “allied health professional” - to get an NHS referral you’d need to speak to a doctor, but many physios call also be seen privately It might be worth looking at the cost, to see if it is possible, as you may get a big benefit from just seeing them once. Obviously this is all said as opinion not medical advice 😊

[@daniellancaster9971]

Really interesting and informative, great work you two!

[@HienNguyenHMN]

Blended approach (with explanations) is super useful.

[@DrJamesGill]

I think we’ll certainly be doing more

[@thomasperez4412]

You are a good clinician and explain the steps very well. Thank you and your volunteer.

[@DrJamesGill]

👍

[@adultperson9255]

the dumpy though

[@AlbithJoelColon]

Excellent video! Very informative. Thank you.

[@CosmoQueen2900]

Okay his voice is so lovely to listen to. And he talks so calm and nice 😊

[@finnyoak]

I'm trying to get into nursing school and this is super informative. Much more effective for a visual learner like me!

[@DrJamesGill]

I honestly feel I’m a visual learner too

[@justsam100]

This is great. Free (real!) education for the masses. Thanks Doc. I find that having a basic idea of the anatomy and the standard tests that professionals perform could actually prove useful in cooperating with your doc/specialist when going in for a check up. Either way this is very interesting. Given the broad adience these videos, maybe some videos explaining first aid techniques and checks would be useful. For one, I would love to know how to do CPR, check the pulse (properly) and blood pressure.

[@Fab-tx9hz]

0:10 Doc Gilly spitting bars

[@MeegsMcK]

Found this very informative and relaxing, please make more!

[@gunaymirzayeva3466]

Good idea! I loved it and please keep going to make videos with explanations 🥰

[@pedrovilchez1688]

Dr you give guys like me non medical people a better understanding of the functions and abnormalities of the body..best wishes

[@abbiedoc97]

videos just keep getting better and better, loving the content!

[@DrJamesGill]

We’re trying 😊!

[@souldrinkerducy]

Thank you for the additional comments and descriptions. Makes for easier following. Highly educational for review and explination.

[@DrJamesGill]

I’m only about 60% happy with this one, there were some things I didn’t expand on - sciatic stretch and femoral as examples I should have explained more there

[@christianburke3545]

why is patient so thik

[@Medchat]

Good work as always, fellow doctor. Cheers from Brazil!

[@DrJamesGill]

Thank you. It’s always gratifying to get feedback from colleagues (I can get imposter syndrome from time to time 😊)

[@brocos]

One of the best asmr videos I have seen

[@simplychaotic1029]

Love this format! So easy to follow and understand.

[@DrJamesGill]

Great. I’m glad it has worked for you 😊

[@cheerry4679]

great video doc!! i can see all the work you put in here

[@DrJamesGill]

Thank you. I was quite pleased with this one

[@thomasperez4412]

Very good demonstration during the exam . Great partner too, your subject was very good looking. Thank you.

[@Billy-dj8zw]

I love the smooth voice and british accent of the doctor, and the silky skin of the patient.

[@mosquibeebarradin4138]

Nice video, thanks ! I was longing for the next video for a long time :)

[@MrLIVdDREAM]

Your voice is so relaxing! Instant tingles! Just a bonus we get some education as well

[@MarkMcQueen515]

So there I was watching the Island with Bear Grylls and guess who pops up ... Dr Gill. Bloody good effort. I had no idea and I've been watching your videos for years! Ha!

[@DrJamesGill]

There is a video on the channel here of a lecture I gave on it. Not the best quality as it was lecture capture at work, but it does give some background and info not shown in the broadcast

[@KnightEntertainmentNetwork_]

Does nobody else see ALL that back there.. sweet lord 🤤 lol ha

[@JazmeenHamid]

thought i was the only one that noticed it

[@alexstuarthoffmann267]

Excelente trabalho! Preciso desse tratamento sou todo torto. Kkk

[@user-pg4gl2ey2v]

Iam a chiropractic, my grandfather has teach me to fix knee, elbow, legs, arms, neck, ears and nose also pressure points like every disk from head to ass and l dont have any kind of papier but still people come to me to do them.. I did enjoy in your video pretty much. Wish you all the best and more.videos ❤

[@benjaylehman]

This is far and above my favorite format and video of yours, thank you! Happy holidays :)

[@DrJamesGill]

Merry Christmas. Thank you 😊

[@Andrew-pl8kz]

Great video,both to learn from and for ASMR… so with that in mind Let me learn whilst I fall asleep

[@ArianaGramsci]

I hope you take no offense but I'm actually listening to this video to relax. The way you speak is very soothing and I could listen to you for hours (but I have zero medical knowledge hahaha)

[@Lacrymosai]

0:55 Happy Birthday David :) its the 16th of October today

[@Ultravonder]

I learned more from this blended format and liked that the patient came in with potential issues to rule out

[@DrJamesGill]

🤣 the issue wasn’t really planned unfortunately

[@Ultravonder]

@@DrJamesGill unplanned moments make the best memories 😋

[@AndresMorenov]

Besides asmr (why I'm here) this is great content. Greetings

[@adulaide]

I am not a medical student (far from it!), and i watch these without sound for the visual ASMR of, idk, watching someone doing medical exams to someone else with their consent the same as if the cameras weren't on. But, i don't know what it is about Dr. Gill (and this specific person as a patient, for some reason)... maybe it's my past medical trauma with bad / dismissive / incompetent doctors... but these videos deeply relaxe me and my soul, because they make me feel safe for some reason. So, Dr. Gill, thank you for that, really. :'))

[@franciscosolimanhernandez8541]

Good work Doc, hope David gets better

[@ed7258]

Perfect video!

[@TristanLackey]

Even though I first started watching for the calming effect of your videos, I'm actually thinking of becoming a doctor now!

[@DrJamesGill]

yes! give it a go! follow that dream!

[@willsimpson6829]

Love it, very informative

[@RiqueUliven]

Brilliant!

[@thomasmuir5653]

I have to admit I wasn’t looking for this, but I’m not disappointed. I not qualified in this any fashion and nor did I sleep in a Holliday inn express. But your presentation was excellent. Well done.