Female Pelvic Exam Flashcards
What is the equipment involved? 5
- Drapes
- Speculum (plastic versus metal)
- Gloves
- Water soluble lubricant
- Lamp (standing lamp versus local lighting)
Specimen collection equipment such as what?
7
- Sterile cotton swabs
- Glass slides
- Wooden or plastic spatula
- Cervical brush devices
- Cytologic fixative
- Culture plates or media
- DNA probe kits for chlamydia and gonorrhea,
if needed
How can we minimize pt apprehension?
Talk before touch
Tell the woman what you are doing with each part of the exam
Preparing for the Pelvic Exam
3
- Empty bladder (Have your medical assistant remind the patient ahead of time. Consider offering patient another opportunity)
- Warm speculum (but not too warm)
- Appropriate position
The more abducted the hips, the easier the examination… NEVER force the legs apart!!
What is the position the pt should be in for the exam called?
Lithotomy Position
hip flexion and abduction
What structures are we looking at for the external examination in the pelvic exam?
8
Always orient the patient to your hand on a location separate from what?
- Labia majora
- Labia minora
- Clitoris
- Urethral meatus
- Vaginal introitus
- Perineum
- Anus
- Skene and Bartholin glands
the genitalia initially!
What are we looking for when examing the labia majora?
6
- Symmetry
- Redness or swelling
- Excoriation, rashes, ulcers or other lesions
- Discoloration or thinned white appearance
- Varicosities or angiomas
- Trauma
What are we looking for when examing the labia minora?
8
- Symmetry
- Moisture
- Color
- Inflammation
- Excoriation
- Discharge
- Ulcers
- Verrucous changes
What are we looking for with the clitoris? 3
Urethral meatus? 3
Clitoris
- Size
- Atrophy/hypertrophy
- Adhesions or inflammation of prepuce/hood
Urethral meatus
- Discharge
- Polyps, carbuncles, or fistulas
- Irritation or inflammation
What are we looking for when examing the vaginal introitus?
5
- Moisture
- Swelling
- Discoloration
- Discharge
- Lesions, fistulas, or fissures
What are we looking for when examing the Perineum? 3
Anus? 4
Perineum
- Scarring
- Inflammation
- Fistulas, lesions, or growths
Anus
- Color
- Scarring or skin tags
- Excoriation
- Fissures or lesions
What are we looking for when examing the Skene and Bartholin glands?
5
- Discharge
- Tenderness
- Swelling
- Masses
- Temperature
Three critical items with placing the speculum?
1) Retract the labia minora laterally
2) Avoid the urethra by downward pressure on posterior vaginal introitus
3) Angle the speculum about 30-45° downward towards sacral promontory. (to “scoop” the cervix)
What structures are we looking at for the internal examination in the pelvic exam?
2
- Cervix
2. Cervical os
What are we looking for when examing the cervix? 5
What are we looking for when examing the cervical os?
Cervix
- Color
- Position
- Size
- Surface characteristics (location of SCJ, presence of nabothian cysts)
- Discharge
- Size
- Shape