Gals Exm

Year 3 OSCE Teaching Noor Jawad; Muslim Medics
The GALS Examination

Name:
Date:
Time taken to complete the examination:
Done
1. Introduces self and states role
2. Consent and obtains patients name
3. Offers a chaperone
4. Exposure of patient (giving them privacy to do so)
5. Asks the following questions: What is your occupation? Do you have any pain or stiffness in any joints, muscles
or your back? Do you have any difficulty climbing the stairs? Do you have any difficulty washing or dressing?
6. General inspection for obvious scars, deformities, abnormal posture or muscle wasting
7. GAIT: asks patient to walk away and turn and come back, checking for:
 Smoothness of movement, abnormalities in gait, normal heel-toe strike, normal turning speed, normal
posture and arm swing
8. SPINE: inspect from the back, looking for:
 Any deformities such as scoliosis
 Level shoulders and iliac crests
 Normal cervical and lumbar lordosis
9. Checks muscle bulk in the paraspinals, shoulder girdle, gluteals, calves
10. Inspects the popliteal fossa and Achilles tendon
11. Feels supraspinatus and lightly squeezes trapezius to test for fibromyalgia
12. Runs finger down back to check for tenderness
13. Movements:
 Side-to-side, rotate upper torso without moving hips
 Press ear to shoulder
 Open jaw and move side-to-side
 Flex and extend neck, rotate head
14. Places 2 fingers on vertebral processes and asks patient to bend over, distance should increase
15. ARMS: General inspection for muscle wasting, fasciculations, skin rashes, nodules (on elbows), swelling,
deformity or erythema over the joints, Dupuytren’s or thenar wasting in the hand, pitting psoriasis in the nails
16. Feels the temperature of the joints then squeezes across the metacarpals for tenderness
17. Movements:
 Put hands behind head and push elbows back, touch the small of back, ‘pray’ with hands together then
back to back
 Flex and extend elbows, pronation and supination, flex and extend wrists
18. Hands:
 Power grip
 Precision movements (thumb to each finger in turn)
 Paper test
19. LEGS: General inspection for muscle wasting, fasciculations, skin rashes, nodules, swelling, deformity or
erythema over the joints, calluses or ulcers on soles
20. Feels the temperature of the joints then squeezes across the metatarsals for tenderness
21. Movements:
 Flex and extend hips, knees and ankles
 Internal rotation at hips and knees
 Inversion and eversion at the ankle
 Crepitus and bulge test at the knee
22. Thanks patient, offers to help them dress
23. To complete my examination, would like to do a full neurological examination of the upper and lower limbs and
a full cranial nerve exam
24. Presents findings in a clear and fluent manner
Total (out of 24)
Any Other Comments:
Please note: these are not official mark schemes, and have just been made from our notes. Every effort has been made to ensure accuracy, but some errors may
remain. This is just our way of doing it, feel free to adapt it to what you feel comfortable doing!
Year 3 OSCE Teaching Noor Jawad; Muslim Medics
The Script
‘Thank you for letting me examine this 21-year old student. The patient doesn’t have any pain or stiffness in any of
his joints, muscles or back. He has no difficulty climbing stairs or washing and dressing. On general inspection, there
were no obvious scars, deformities, abnormal posture or muscle wasting. On examination of the patient’s gait, there
was smoothness of movement, no abnormalities in the gait, a normal heel-toe strike and normal turning speed.
Posture and arm swing were normal. On inspection of the spine, there were no obvious deformities such as
scoliosis. There was a normal cervical and lumbar lordosis, and the iliac crests were level. On inspection of the
muscle bulk, it was normal in the paraspinal, shoulder girdle, gluteal and calf muscles. There were no bulges in the
popliteal fossa and the Achilles tendon appeared to be normal. There was no evidence of fibromyalgia or vertebral
tenderness. All movements of the spine were normal. On bending over, the space between the lumbar vertebrae
increased as normal. On general inspection of the arms, there was no muscle wasting, fasciculations, skin rashes,
nodules. There was no swelling, deformity or erythema over the joints. There was no evidence of Dupuytren’s or
thenar wasting in the hand, or pitting psoriasis in the nails. The joints were cool in temperature and there was no
tenderness on squeezing the metacarpals. All movements of the arms were normal. On testing the small muscles of
the hand, the power grip, precision fine movement and the paper test were normal. On general inspection of the
legs, there was no muscle wasting, fasciculations, skin rashes, nodules. There was no swelling, deformity or
erythema over the joints. There were no calluses or ulcers on the soles. The joints were cool in temperature and
there was no tenderness on squeezing the metatarsals. All active movements of the legs were normal. There was
no evidence of crepitus at the knee or fluid. In summary, this patient had normal gait, arms, legs and spine. To
complete I would like to do a full neurological examination of the limbs and a full cranial nerve examination.’
Please note: these are not official mark schemes, and have just been made from our notes. Every effort has been made to ensure accuracy, but some errors may
remain. This is just our way of doing it, feel free to adapt it to what you feel comfortable doing!

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Year 3 OSCE Teaching Noor Jawad; Muslim Medics

The GALS Examination

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