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:: Scoping the heart November 14, 2007

Posted by Minci 先生 in Medical School.
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Each medical student will eventually develop their own style in examining a patient. Most often it will be influenced by the consultant or other doctors in the team that they’ve been attached to, videos they’ve watched and a rare few, would just figure out what’s best for them and their patient all by themselves.

My first introduction with ‘style development’ was when I was taught the ‘scratch test’ in detecting hepatomegaly and splenomegaly (big liver and spleen).

The second was on how to examine the knee upon discovering how my physical limitations (strength & stature) could result in a less convincing result if not done right.

There were a few ‘style development lessons’  afterwards including on how to communicate with colleagues and patients. The most recent technique I’ve learnt for the benefit of myself is on how to listen for the heart on a woman’s chest.

Women have breast. (Ada yang tak tahu lagi ker?) And I’ve witnessed a few ways as to how a doctor may move the breast out of the way in enabling themselves to place the stethoscope well on the chest. These ways are not wrong, they just look a bit funny sometimes. So some people would; (with the patient lying down)

  1. Just push and slide the stethoscope under the breast. rodoklah sampai dapat, matilah kalau breast besar. I used to do this.😛

  2. Examining from the right side of the bed , lift the breast with one hand gaya angkat kucing atau pilih ikan di pasar, put the stethoscope on the chest and then tutup stethoscope with the breast again.

From my observation, Way 1 is quite popular but then I discovered a very slick method of ‘pushing the breast out of the way on Youtube and has used that technique ever since. I can’t find it now but you do it by either asking the patient to lift it up for you OR you pushing it up by using the back of the hand allowing the piece to be placed just in front of it. 

Then there is a question of ‘where you put your eyes’. One needs to concentrate as they listen to the very soft, almost inaudible heart sounds. To do this, some doctors/students have the habit of;

  1. Having their head bowed so close to the chest as though it would make a difference if their head were much higher.

  2. Stare and stare and stare and stare blankly at the patient’s chest. memang takde nafsu whatsoever but still.. it is kind of awkward.

  3. Stare and stare and stare at the patients face while smiling like a pervert.

Haha.. wanna know my style? Rahsia.:mrgreen:

Comments»

1. jet - November 14, 2007

‘makcik, tolong angkat breast leh..’

mekaseh..tolong jangan kasik sy wanita breast besa dikala exam..

2. Zy - November 14, 2007

eh eh..men have boobs too! hahaha.

tukar skrip jet.

“makcik/pakcik, tolong angkat breast leh…”

mekaseh..tolong jgn kasik sy wanita/lelaki breast besa dikala exam.

oh…sbb ni ke korang gelak kuat2 tgh hari tadi sampai kitaorg kat ruang tamu pun dapat dgr.

3. coops - November 15, 2007

haha, lucky i’m not a doctor, if not, i wud definitely rasa inferior most of the time sbb my chest is like an airport, uhuk. *pervert* soweeela minci, jd mcm tpt 18SX pulak :p

4. kaSyah - November 15, 2007

kerjaya doktor best juga upenya. masih tak terlambat nak tukar coz ni.

anatomy is vry interesting…haha

5. nautilusiv - November 15, 2007

Ni apa cerita breast breast ni…🙂.. cite le kombang terebang ke, ikan emas ke… eh.. blog orang, suka dia le!.

6. malimkundang - November 15, 2007

wah macam2 teknik ghupanya yer. ingat main letak jer mana2 stethoscope tuh

7. hafiz - November 15, 2007

For pendulous breast, I usually used the back of the left hand to move the breast upwards. Then, listen carefully to differentiate S1 and S2 sounds and to find out if there is any murmur.

There are different technique used in physical examination in every system of the body. I have seen different techniques used in gastrointestinal, neurological and breast exam as well. I guess with time, we will know which techniques best suit us….

8. Just A Lady~ - November 16, 2007

at least some part of our body is being discussed secara ilmiah….

9. nautilusiv - November 16, 2007

Hahahah.. angkat tanga tanda setuju sama Just A Lady

10. Minci - November 16, 2007

jet,
tak kot.. selama nih breast exam pun dia bagi patung jer kan.

Zy,
hahaha.. we laugh at everythng dear.. but this was not the topic.. dah sik ingat dah apa kenak kitorg tetak di dapur ari ya..

coops,
haha.. ‘airport’.. eishh.. kak coopsss nih..😉

kasyah,
oii.. niat tk baik harus dijauhi..

adiratna,
aku citer pasal testis kang.. berguling korang..

malimkundang,
oh mestilah.. kalo tak, enggak dengerin apa2..

hafiz,
same here.. hooray

kak syifa,
op coz kak..🙂


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