Examination of female genitalia Flashcards
What equipment do you need?
Couch (with sheets and covering), manusept, water based lubricating gel, light source, screen
What should you do before starting the examination?
Introduce yourself, check patient details, explain procedure and gain consent
Chaperone
Ask if they have emptied their bladder
Wash hands and glove up
What position should they be placed in?
Supine position, hips and knees flexed with ankles close together
Only expose as much is necessary
What should be covered in inspection?
Inspect outer genitalia and hair
Gently separate labia minora to assess clitoris, urethra, vaginal orifice
Ask patient to strain down and look for bulging/prolapse
Ask patient to cough
What do you do during the internal exam?
Lubricate middle and index fingers
Insert R index finger, followed by R middle finger
Feel for cervix
Assess fornices
What do you do during bimanual examination?
Apply upwards pressure on the cervix and uterus
Apply fingers of left hand flat to abdominal wall under the umbilicus
Move left fingers towards the pubic bone gradually
How should you palpate the adenexae?
Place abdominal hand over the iliac fossa
Place vaginal fingers into the lateral fornix
Oppose the fingers (vaginal go upwards and laterally, abdominal go downwards and medially)