Female Exam Flashcards
Where does the primary lymphatic drainage of the breast go to?
Axillae (secondary to internal mammary nodes)
Where is the most common segment for breast cancer?
Upper outer quadrant (leads to the tail of spence)
Concerning symptoms of the breast
Breast lump or mass
Breast discomfort or pain
Nipple discharge
What does p’eau d’orange symbolize?
Inflammatory breast cancer
What is the best to say to the patient after the exam?
Everything appears healthy and normal
What are the 4 motions you do when inspecting the breast?
Arms overhead with palms together
Hands on hips and press down
Shrug shoulders
Lean forward
What do you think of first with dimpling?
Malignancy
What does nipple inversion indicate?
Recent onset of unilateral nipple inversion suggests underlying malignancy
Where are supernumerary nipples?
Usually along the mammary line
3 patterns for breast exam
Vertical, concentric or radial
What nipple discharge is abnormal?
Serous or bloody discharge
4 sweeps of axillary nodes
1: anterior axillary region, to include under pec muscle
2: mid axillary high into apex
3: posterior axillary region beneath teres minor muscle
4: down medial aspect under arm
Common sight of pathology in pelvis
Rectouterine pouch
2 components of external pelvic exam
Palpate inguinal nodes and inspect pubic region
What is atrophic vaginitis?
Fusion of the labia sometimes seen in menopausal women
What size is a Pederson speculum?
Smallest (ped)
What do you check for when you ask the patient to bear down (Valsalva)?
Cystocele (bladder protrude superiorly)
Rectocele (bulge into posterior vaginal wall)
When you can’t find the cervix, what do you do first?
Bimanual exam to find the cervix
Parous and nonparous cervix
Nonparous is with no vaginal delivery
Parous is after vaginal delivery when external os is a transverse slit
2 different pap smear techniques
Broom cervical sampling device and cytobrush/spatula cervical sampling device
What does the pap test for?
HPV, GC/chlamydia, trichomona vaginalis and mycoplasma genitalium
What should the cervix NOT feel like?
Soft and boggy
What does the chandelier sign indicate?
Pelvic inflammatory disease (pt reaches up to ceiling for relief)
Expected findings of uterus
Pear-shaped, rounded, firm and smooth (similar in shape and consistency as a fist)
