OSCE Component Physicals
OSCE Component Physicals
OSCE Component Physicals
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Inspects for and comments on findings: scars, asymmetry, visible peristalsis etc.
Performs light palpation and comments on findings i.e. guarding, rigidity, etc.
6
7
8
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Inspects and comments on findings: distended, full flanks, everted umbilicus, etc.
Knowledge questions
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
3
4
Knowledge question
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
3
4
5
6
7
8
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Palpates lower border of spleen starts in RIF, asks pt to inhale deeply, bimanual,
roll patient to right
List at least three ways to differentiate an enlarged spleen from an enlarged kidney
Washes hands, appropriate dress and grooming. Introduces self and asks permission
Asks about comfort, coffee intake, cigarettes, etc.
Reports patients blood pressure and interprets per the JNC 8 guidelines
Knowledge question
Washes hands, appropriate dress and grooming. Introduces self and asks permission
Inspects for evidence of arterial insufficiency on upper and lower limbs: cool skin,
dry thin skin, pallor, etc.
Palpates radial pulse and determines rate and rhythm
Palpates radial and brachial arteries bilaterally and comments on symmetry. Checks
capillary refill
Palpates the carotid artery bilaterally and comments on symmetry. Determines the
character and volume. Auscultates for carotid bruits bilaterally
Palpates the dorsalis pedis and anterior tibial artery bilaterally and comments on
symmetry
Checks capillary refill
Compare and contrast at least 3 different findings on physical exam between arterial
insufficiency and venous insufficiency, i.e. trophic changes, color, temp, edema etc.
Knowledge questions
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Inspects scalp for shape, hair, infection, bruise, hematoma, and comments on
findings
Inspects oral cavity examination for hygiene, cavities, caries etc., and comments on
findings
Inspects and palpates neck for lymph nodes and thyroid swelling
Inspects hand for pallor, clubbing, koilonychia, splinter hemorrhages, etc., and
comments on findings
Knowledge questions
OSCE CVS
Examination of JVP
1
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Describe venous pulse: A & V waves, and lists at least 3 features which distinguish it
from the carotid
Measures vertical height with respect to sternal angle and reports in cm.
Knowledge question
OSCE CVS
Heart Auscultation
1
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
3
4
5
6
7
OSCE CVS
Inspection and palpation for the cardiac system
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Inspects for systematic findings relevant to the cardiac system, including malar
flush, cyanosis, respiratory distress, diaphoresis, neck vein distension etc. Comments
on findings
Examine the Hands and list signs related to cardiac including splinter hemorrhages,
clubbing, cyanosis, pallor, capillary refill etc. Comments on findings
Inspection the chest looking for scars, pacemaker, forceful PMI, chest deformity,
apical impulse etc. Comments on findings.
Palpate the 4 cardiac areas for thrills. Explain the significance of a thrill
Knowledge question
OSCE Neuro
Examine cranial nerves 1 -6 excluding 5
1
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Inspect the nasal cavities looking for blockage, discharge, etc. Inspect the eyes
looking for aniscoria, narrow angle glaucoma, conjunctivitis, subconjuctival
hemorrhage, strabismus, etc.
Tests direct and consensual pupillary reflexes and comment on finding. Describe
findings in Horners syndrome and Argyll Robertson pupils
Knowledge question
OSCE Neuro
Examine cranial nerves 5 and 7
1
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Test light touch in the three branches of the trigeminal nerve and comments on
findings. Describe how to test for the corneal reflex
6
7
8
Inspects the face for evidence of CN 7 paralysis and explains the different findings
for a central versus a peripheral lesion
Test strength of muscles innervated by the facial nerve including eye closure, cheek
puffing, smile, and wrinkling of forehead and comment on findings
Knowledge question
Neuro OSCE
Examine cranial nerves 8-12
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
2
3
4
5
CN 12: Ask patient to protrude tongue and comment on findings. Describe findings
in central CN 12 lesion
Knowledge question
OSCE Neuro
Motor system lower limb
1
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Explains procedure to patient, positions and drapes
3
4
Elicit reflexes bilaterally and comment on findings: patellar reflex, ankle reflex and
clonus bilaterally, demonstrates reinforcement techniques.
Check for a plantar response bilaterally and comment on findings. Describe a
positive response and its significance
Knowledge question
OSCE Neuro
Motor system upper limb
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Explains procedure to patient, positions and drapes
Knowledge question
3
4
5
6
OSCE Neuro
Sensory system lower limb
1
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
4
5
6
7
8
OSCE Neuro
Sensory system upper limb
1
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
4
5
6
7
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
Inspect the trachea for deviation. Describe what a tracheal deviation may indicate
Inspect the chest wall looking for deformities, scars, etc. Describe signs for
respiratory distress
Palpate for chest wall tenderness. Describe the significance of a positive finding
Check tactile vocal fremitus and describe the findings lobar pneumonia, pleural
effusion, pneumothorax, asthma and COPD
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
3
4
5
Percusses the anterior and posterior lung fields and comment on your findings.
Describe the percussion notes found in lobar pneumonia, pleural effusion,
pneumothorax, asthma and COPD
Auscultate the anterior and posterior lungs fields and comment on your findings.
Describe normal breath sounds
Check for Transmitted Voice Sounds (bronchophony, egophony or whispered
pictoriliquy) and comment on your findings. Describe what you would find in lobar
pneumonia, pleural effusion, pneumothorax, asthma and COPD
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
3
4
Inspects the knees for symmetry, swelling, scars, fasciculations etc. and comments
on findings
Palpates the knees for tenderness, swelling, warmth, crepitus, etc. and comments on
findings
Checks for joint effusion: bulge or balloon test, and patellar tap
7
8
9
Checks the stability of the anterior and posterior cruciate ligaments bilaterally via
the anterior and posterior drawer tests respectfully
Performs valgus and varus stress tests to evaluate the stability of the medial and
lateral collateral ligaments
Knowledge question
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
3
4
5
6
7
Washes hands, appropriate dress and grooming. Introduces self and asks for consent
3
4
5
6
7
8