GYNECOLOGICAL Physical EXAMINATION

Question 1

ESTABLISHMENT OF RAPPORT & PREPARATION
OF SETTING

Answer 1

ESTABLISHMENT OF RAPPORT & PREPARATION
OF SETTING
1. Greeting
2. Introduction of self
3. Purpose
4. Permission
5. Positioning and exposure
6. Important point before
examination:
a. Ask if the patient wants to
urinate
b. Request for a chaperone
and screen
c. Offer to measure weight
and height of patient

** CUE: GIPPPI

Question 2

General inspection

Answer 2

GENERAL INSPECTION
1. General condition
a. Age
b. Position
c. General state of health
and comfort/distress
d. Obvious signs
e.g., abdominal distention, oedema, etc.
2. Environment
CUE: APGO Envi

Question 3

General examination

Answer 3

GENERAL EXAMINATION
1. Hand signs
a. Palmar pallor
b. Peripheral cyanosis
c. Finger clubbing
d. Capillary refill time
e. Pulse: rate, rhythm,
volume, and character
f. Blood pressure
2. Head and Neck signs
a. Hair texture and
distribution
b. Scleral icterus/jaundice
c. Conjunctival pallor
d. Dental and oral
hygiene
e. Central cyanosis
f. Differential warmth
g. Skin turgor (for
hydration)
h. Lymphadenopathy
3. Leg signs
a. Peripheral oedema

Answer 4

ABDOMINAL EXAMINATION (OF PELVIC MASS)
INSPECTION
1. Shape and symmetry e.g., distended
2. Movement with respiration (MWR)
3. Umbilical stump
4. Linear nigra (and its extent)
5. Striae
6. Scars: surgical scars, unspecific
scars, and scarifications
7. Other skin changes e.g.,
pigmentation, distended veins
8. Hair distribution
CUE: Note visual order in which the structures are arranged.

Answer 5

PALPATION
OF THE ABDOMEN:
1. Light palpation
a. Tenderness
b. Presence of a mass
2. Organ-specific palpation
a. Enlarged liver
(hepatomegaly)
b. Enlarged spleen
(splenomegaly)
c. Ballotable (or
bimanually palpable) kidneys

Question 6

Examination OF THE PELVIC MASS:

Answer 6

Differential warmth
Tenderness*
Site*
Size
Shape
Surface
Edges
Consistency Attachment (mobility)
a. To skin
b. To surrounding structures
c. To overlying abdominal
muscle CUE: DT 4SECA.
*These would have already been elicited during light palpation

Answer 7

PERCUSSION
Shifting dullness
Fluid thrill (if indicated)
CONCLUDING REMARKS
Thank patient
Ask patient to cover herself To complete the examination
a. Pelvic examination

Question 8

PELVIC EXAMINATION (OF PELVIC MASS)

Answer 8

PELVIC EXAMINATION (OF PELVIC MASS)
EXAMINATION OF THE VULVA
1. Inspection
a. Hair distribution
b. Swellings
c. Scars
d. Ulcerations
e. Lesions
f. Atrophy or enlargement of labia or clitoris
g. Discharge – vaginal and urethral
CUE: HaS SULAEDis
2. Palpation
a. Bartholin’s gland
b. Skene’s gland
SPECULUM EXAMINATION OF THE VAGINA
1. Discharge
2. Discolouration 3. Ulcerations
4. Lesions
5. Swellings
CUE: DDULS
BIMANUAL PALPATION OF THE UTERUS
CERVIX
1. Position
2. Length
3. Consistency
4. Regularity
5. Cervical motion tenderness
CUE: PoLe CoReCt
UTERINE CORPUS
1. Tenderness 2. Size
3. Shape
4. Position
5. Consistency 6. Mobility
CUE: TSS PoCoMo
ADNEXAE
1. Mass
2. Tenderness
CONCLUDING REMARKS
1. Thank patient
2. Ask patient to cover herself
3. To complete examination
a. DRE