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I'm working on the musculoskeletal portion of the physical exam. The very first thing dictated, after the MSK heading is "s/l fetalblocker. FROM of the bilateral shoulders, elbows, wrists. (s/l minimal or medial ulnaral) deviation. Enlargement of the 2nd and 3rd MCPs of the bilateral hands." I know ulnaral isn't a word, but that's what it sounds like she is saying. She is breathing heavily into the mic with both s/l, so the sounds are altered. Any ideas?