Breast, Pelvic and Male GU Exam Flashcards
The female GU exam is an essential component of a woman’s _____ health care
annual
Presenting history questions for Female GU Exam
“Any concerns today?”
“Any abnormal discharge?”
Female GU History Items
Medical and surgical history
Allergies
Menstrual history and pattern
Obstetric history
Results of pap smears
Breast concerns
Sexual history
Intimate partner violence screen
Family history
Vaccine history
Urinary and rectal symptoms
Breast exam visual examination: inspect for _____ with the patient sitting
symmetry
Visual examination on the breast
- Inspect for symmetry with the patient sitting
- Ask the patient to sit with arms lifted overhead and then leaning forward while she places her hands on her waist
- Examine the anterior chest wall
- Assess pigmentation changes, surface irregularities
- Inspect for symmetry in the recumbent position
Palpation of the breast is performed using the base of the fingertips in small _____ with variable depth
circular motions
Three breast examination palpation techniques
Circles
Wedges
Lines
What you are looking for with breast examination
Irregular skin texture and tone
Changes to nipple shape
Discharge from the nipple
Irregular fullness or pluckering
_____ breast changes tend to be on both breasts
Fibrocystic
Why many women fear pelvic exams:
Fear
Embarrassment
Lack of information
Cultural or language barriers
Previous painful exams
PTSD related to sexual assault
Supplies for the female pelvic exam
Gloves
Light source
Speculum
Lubricant
Cervical cytology
Wet prep slides
pH paper
Swabs
STD testing
The typical position for a female pelvic exam is to have the patient in the _____ position
Lithotomy
T/F - you should Insert the speculum at an angle
T
Bimanual exam is meant to assess what
Cervix
Vaginal walls
Abdomen
If you need to examine the rectum only, the lateral position is satisfactory and affords a better view of the _____ and _____ areas
perianal; sacrococcygeal
Examples of male sexual dysfunction questions
“How do you feel about your ability to perform sexually?”
“Does your partner have any concerns regarding your sexual performance?”
“Can you achieve and maintain an erection?”
“Do you experience erections when you awake?”
“Do you climax too soon?”
“Do you find that you cannot have orgasm even though you can have an erection?”
“Any difficulty conceiving?”
Male GU Health history
Penile Disorders
Scrotum Disorders
Prostate Disorders
Scrotum disorder questions
“Do you have any scrotal pain?”
“Do you have any scrotal swelling?”
Prostate disorder questions
“Do you have difficulty initiating urination?”
“Is the flow weak?”
“How often are you getting up in the middle of the night to pee?”
Penile shaft inspection
Lesions
Carcinoma
Peyronie’s
Evaluate the base of the penis for excoriations, nits, or lice in the pubic hair
_____: foreskin cannot be retracted over the glans
Phimosis
_____: Foreskin once retracted cannot be returned.
Paraphimosis
Penis inspection for
Chancres
Carcinomas
Smegma: a cheesy white material that may accumulate normally under the foreskin
Scrotal examination
- Skin
Lift up the scrotum so you can see the posterior surface
Look for rashes, epidermoid cysts, rarely skin cancer - Scrotal contours
Swelling, lumps, veins
A poorly developed scrotum may suggest _____ (undescended testicle)
cryptorchidism
You can locate the ______ on the superior posterior surface of each testicle. (It feels nodular and cordlike)
epididymis
Painless nodules in the testis could be ____
testicular cancer
Tortuous veins in this area of the ______ typically indicate varicocele
spermatic cord
The serous fluid in hydroceles will light up when performing ______ to evaluate for scrotum swelling
Transillumination
Small testis are notable in _____ syndrome
Klinefelter’s
Inspection for hernia
Check the inguinal and femoral areas for bulges.
Ask the patient to bear down
invert the scrotal skin on each side and feel for any new pressure
If you suspect a possible scrotal hernia
Ask patient to lie down
If the scrotal mass returns to the abdomen = hernia
Can you get your finger above the mass? If yes, it is a hydrocele
Can you hear bowel sounds in the mass? If yes, it is a hernia
Palpation of the prostate
Note the size, shape ,and consistency of the prostate
Identify any nodules or tenderness
The normal prostate is rubbery and non-tender
In a Bimanual exam you are palpating these things
Cervix and cervical os
Uterine body and apex of fundus
Adnexa/overies
_____ refers to varicose veins of the spermatic cord, usually found on the left
Varicocele
A _____
