Okay. So, we’ll start off by washing my
hands. Hello. My name is Sasha, one of the
doctors. Can I just check your name, please?
What’s your date of birth?
Great! I’ve got the right person. I was
just wondering if there’s any chance I could
do an examination of you, Tommy? Would that
be all right? This could involve you lying
flat. I’m going to have a look and then
I’m going to have a look at your hands and
your face, then I would have a feel of your
tummy if that’s all right? Can I get you
to lie flat for me, please? So ideally, I
don’t expose the patient. I’d say nipple
to knees, but as long as you got
So I’m just going to start by having a look
from the end of the bed. I’m kind of looking
around the bed for any signs of sick bowls
or any lines or tubes or anything else like
that. I can’t see anything obvious. Also,
just in the end of that examination of the
abdomen, I can’t see any obvious scars or
any hernias. Can I get you to have, if you
lift your head up so that you’re looking
towards your feet? That would make any hernias
a little bit more obvious. That’s fine.
You can relax for me.
So I’m going to move on to inspection of the
hands. Can I borrow both of your hands first?
So I’m just feeling the temperature, a little
bit cold. I’m checking capillary refill.
That’s fine. I’m looking for any nail
signs. So there’s no signs have clubbing
or oncholysis. Can I feel your pulses there?
That’s fine. So pulse is irregular and symmetrical.
I’m just going to have a look at your hands
as well. There is no palmar erythema and I’m
just going to feel across your palms, and
there are no contractures or anything else
like that. That’s fine. As I move up the
arm, I’m just having a look for any signs,
excoriation, if there are any skin lesions,
if there’s any trap marks, all of those
things could tie with liver disease.
Now, I’m coming up to your face. Can I get you
just to take your specs off for me? That’s
great. Would you be able to look up? And I’m
just going to draw your low eyelids down.
That’s fine if you look down for me. That’s
fine. You can put your specs back on again.
Wonderful! Can you open your mouth for me?
Stick your tongue out. That’s fine. So I
couldn’t see any signs in the eyes such
as anaemia, and I’m looking in the mouth
as well for any signs of aphthous ulcers or
a big tongue which might indicate a deficiency
of some sort. Do you have any pain in your
neck at all?
No. That’s fine. So I’m just going
just specifically for a node called Virchow’s
node which is associated with gastric malignancies.
Ideally I’d want to do full lymph node exam.
Okay. So I’m going to move on to have a