OSCE
Test Vibration sense in the leg and arm of given subject
5 Marks
• [Link] the subject .Explains the procedure and assures him
that no pain is caused.(1)
• [Link] a tuning fork of 128 Hz, strike one prong against
edge of ones hand to set into vibration.(1)
• [Link] the vibrating tuning fork on subjects head of
radius ,elbow and medial malleolus.(1)
• [Link] the response in each case with a YES , NO or Don’t
know.(1)
• [Link] the response to opposite side. (1)
Test the sensation of fine touch on Fore arm of given subject
5 Marks
• [Link] the subject .Makes the subject to sit on a stool and
explains the procedure.(1)
• [Link] her to put forearms on the table .Tells her to close her
eyes.(1)
• [Link] a piece of cotton and twists into a pointed wisp.(1)
• 4. lightly touches the skin on the finger tips , palms and fore
arm and asks now and the subject responds with yes , no or
don’t know.(1)
• [Link] the responses on the opposite forearm.(1)
Assess the muscle tone in the Upper limb of given subject
5 marks
• [Link] the subject, explains the procedure to the subject
and seats him comfortably.(1)
• [Link] the upper arm of the subject and alternately flexes
and extends the elbow with other hand.(1)
• [Link] doing this he feels the tension in the upper arm
muscles.(1)
• [Link] similar passive movements at the fingers and
wrist.(1)
• [Link] the muscle tone on the opposite arm.(1)
Test the Vocal Resonance in the infra scapular
region of given subject. 5 Marks
[Link] the subject .Explains the procedure to the subject.(1)
[Link] the stethoscope to ears and checks the diaphragm.(1)
[Link] the diaphragm on the infrascapular region on the
back.(1)
[Link] the subject to say 1,2,3 or 99 in a normal clear voice and
listens to the sound.(1)
[Link] the process on the other side of the chest.(1)
Elicit the Direct light reflex in the subject
provided
• [Link] the subject. Explains the procedure to the subject.(1)
• [Link] the patient to fix his gaze by looking at a far wall to
overcome the accommodation reflex.(1)
• [Link] the subject to cover one eye and shines a bright light
into the other eye with a torch coming sideways. (1)
• [Link] for the constriction of pupil in the eye in which light
has been shown. (1)
• [Link] the procedure on the other eye.(1)
Elicit triceps jerk in the subject provided.
5 Marks
[Link] the subject. Explains the procedure to the subject.(1)
2. Positions the patient’s arm so that the triceps tendon is
relaxed .
[Link] the triceps tendon.
[Link] triceps [Link] for contraction triceps
muscle.
[Link] the response with the opposite side.(1)
Auscultate the breath sounds of given subject .5 Marks
• [Link] the subject. Explains the procedure to the subject.(1)
• [Link] the subject to relax and breathe deeply in and out
through their mouth.(1)
• [Link] the stethoscope to her ears and checks the
diaphragm.(1)
• [Link] the diaphragm of the stethoscope over each of the
relevant locations on the chest wall to ensure all lung regions
have been assessed.(1)
• [Link] to the breathing sounds during inspiration
and expiration. Assess the type,intensity of breath sounds and
note any added sounds.(1)
Tie blood pressure cuff on the given subject.5
marks
• [Link] the subject, explains the procedure to the subject.
• [Link] him comfortably with their arm comfortably placed at
an approximately heart level .(1)
• [Link] that the blood pressure cuff size is appropriate for
subject’s arm and it is fully deflated.(1)
• [Link] the location of the brachial artery by palpating
medial to the biceps brachii tendon and lateral to the medial
epicondyle of the humerus.(1)
• [Link] the BP cuff smoothly and snugly around the patient’s
upper arm 3cm above the cubital fossa, its middle lying over the
brachial artery, and the tubes lying anterolaterally. (1)
•
To elicit Biceps jerk in the subject provided.
• [Link] the subject. Explains the procedure and gains
consent to proceed. – 1 mark
• [Link] subject to relax his arm and assures the hammer
will not cause any pain. – 1 mark
• [Link] the biceps brachii tendon and places thumb
over it. – 1 mark
• [Link] the tendon with hammer and observes for
contraction of biceps (flexion at elbow). – 1 mark
• [Link] the response with the opposite side. – 1
mark
To elicit conjugate eye movements in the subject provided.
• [Link] the subject. Explains the procedure and gains
consent to proceed. – 1 mark
• [Link] finger at around 30cm in front of patient’s eyes in
midline and asks subject to focus on it. – 1 mark
• [Link] subject to keep his head still while following the finger
with his eyes. – 1 mark
• [Link] his finger through various eye axes in a “H” pattern. –
1 mark
• [Link] for any deviation or abnormal movements or
nystagmus. – 1 mark
To elicit Knee jerk in the subject provided.
• [Link] the subject. Explains the procedure and gains
consent to proceed. – 1 mark
• [Link] subject to relax his lower extremity (supports it in
supine position or sits cross-legged) and assures the
hammer will not cause any pain. – 1 mark
• [Link] patellar tendon and taps with hammer – 1 mark
• [Link] reflex appears absent, performs reinforcement
manoeuvre– 1 mark
• [Link] the response with the opposite side. – 1
mark
To elicit Rinnie’s test in the subject provided.
• [Link] the subject. Explains the procedure and gains
consent to proceed. – 1 mark
• [Link] 512 Hz tuning fork and sets it into vibration by
striking on heel of hand. – 1 mark
• [Link] a vibrating 512 Hz tuning fork on mastoid process
and confirms with patient about hearing of sound. Asks him to
tell when he no longer hears it.
• [Link] moves the tuning fork in front of external
auditory meatus . Asks him to tell when he no longer hears it.
– 1 mark
• [Link] same on the opposite side. – 1 mark
To elicit Romberg’s sign in the subject provided.
• [Link] the subject. Explains the procedure and gains
consent to proceed. – 1 mark
• [Link] subject to remove shoes and keep feet bare. – 1 mark
• [Link] himself within arms enough to reach patient and
intervene if subject begin to fall. – 1 mark
• [Link] the subject to keep their bare feet together and arms
by their side, eyes open. Observes for any postural swaying. –
1 mark
• [Link] the subject to close his eyes and observes for any
postural swaying. – 1 mark
To elicit Finger-to-nose test in the subject provided.
• [Link] the subject. Explains the procedure and gains
consent to proceed. – 1 mark
• [Link] his finger so that patient can outstretch his
arm to reach it. – 1 mark
• [Link] subject to touch their nose with the tip of index
finger and touch examiner’s fingertip and continue this
as fast as possible with eyes open. – 1 mark
• [Link] to continue same with eyes close. – 1 mark
• [Link] the procedure on the opposite arm. – 1
mark
To elicit Diadochokinesia in the subject provided.
• [Link] the subject. Explains the procedure and gains
consent to proceed. – 1 mark
• [Link] the subject to place their left palm over right palm and
then turn over to touch the back of it onto their right palm. –
1 mark
• [Link] the patient to repeat this sequence of movements as
fast as possible with eyes open. – 1 mark
• [Link] the patient to repeat this sequence of movements as
fast as possible with eyes close. – 1 mark
• [Link] the procedure on the opposite arm. – 1 mark