we have a series of tests to get through and as we go along i'll be taking some written notes
in my little medical journal here okay so looking at the list so we have about eight
tests to perform this evening the first one is using the little pen torch here
a little tongue depressor we're going to have a little look in your mouth and to let you
know there's going to be a lot of bright lights tonight to perform the tests okay so open wide
i'll place this under the tongue i'm going to be bringing the light in from different angles
to look inside the mouth i'll check the lower portion first see how we're looking there
okay the upper part of the tongue good just raise the tongue now please
press that out
under the tongue there lovely okay open the mouth again how to look at the
superior portion of the mouth look at the teeth and the tissue
sides of the mouth looking at the tissue there
okay
looks fine let me take some notes there
okay i have a new piece of equipment here recently purchased this is the green otoscope
protective green pack
the otoscope is going to perform two roles tonight
i just need to get a specular out of the tube here
magnification window there i'm going to view through here
the first thing we're going to use the other scope for
is to look inside your nose a little bit closer
there we go so as we look at the right nostril
we're actually looking at the openness of the airway there
looking at the fine vessels underneath the very fine tissue it's good i'm going to go left left
looking for any haemorrhaging
but it's going to carry out its traditional function inside the ears
okay we're going to look inside your right here first
turn to your left side
bottom to top through the ear canal there
the tympanic membrane
and that's looking fine also judging the level of wax
looking for any inflammation
any deposits scarring
okay turn to you right hand side for me please
there we go the left
external ear
okay so i will provide all the magnification you require
just to make your way from top to bottom please
reading out loud i'll bring it a little bit closer for you
thank you just continue
so we're providing magnification and illumination to enhance your near vision there
and we have the smaller sets of print here
to the bottom portion there let's try and get the light correct
like so
just have a little read for me and let's go to the smallest print at the bottom
how do you feel the print is there?
is that good enough to read at this distance here?
okay is the clarity of the map of London there
can you see the airport? can you see the little green markings of the roads?
lovely can you follow the course of the red paths?
good okay what number do you see on this first plate please?
and the second plate? and the third plate? good
are the circles and print clearer on the red or the green side there? and how is
this little puzzle looking to you is that clear with magnification and illumination?
i'm going to be using a very bright burton lamp to look at the front of the eye so just look straight
through the window
i just want to observe the lids and lashes and the surrounding skin of the orbit
look right look to the left looking up and looking down straight ahead again
now for the left
looking straight take a very quick blink look to your right to your left up to the ceiling down
to the floor straight ahead through the window blink again just see the level of corneal staining
in the right looking for any punctate staining any tracking looking at the amount of staining
good trace amount of inferior punctate staining there okay looking up
we are reviewing any conjunctival staining
and looking down straight ahead probably grade one conjunctival standing there fairly normal
about the ripples just to follow the light with the eyes now to observe the corneal reflexes
don't worry about any double vision just follow the light with the eyes and please
in these positions of gaze
keep going keep going and i'm going to start on the white beam
we're going to use the ophthalmoscope to look inside the eyes in the dark room
let's get the focus right i just want to focus on the crystalline lens
i'm going to come a little bit closer
focus on the optic nerve
okay peripheral time looking up
to the right
to the left
down to the floor looking at the macula and now look into the light
to look at the nerve fibers and the blood vessels there with the green line
mid peripherals in the left eye
start at this distance first just to focus on the crystalline lens
looks normal
okay with peripheral scan good now look to the right and try left
and up
and down to the floor
just look into the light for a little bit
focus on the macula and the fovea look straight a quick look with the green light
and the nerve fibers and blood vessels all looking clear and normal within normal limits