O &G Physical Examination

Question 1

Introduction

Answer 1

Wash 🧼 hands 🙌

GREETING AND
INTRO
PURPOSE AND
CONSENT

Position patient

Expose

6. Important points
   a. Voiding: Ask if the patient would want to urinate
   b. Chaperone and screen
   c. Hand hygiene
   d. BMI: Ask to measure the
   weight and height of the pregnant woman.

Question 2

GENERAL INSPECTION

Answer 2

GENERAL INSPECTION
1. General condition
a. Age group
b. Position/posture
c. General state of Health and
Comfort
i. Healthy/ill-looking
ii. Comfortable/in distress
d. Obvious signs
e.g., abdominal enlargement, oedema, etc.

2. Environment
   a. Cannula, IV infusion line
   b. Bedpan
   c. Medications
   d. Maternal and Child Health
   Record book

Question 3

GENERAL EXAMINATION

Answer 3

GENERAL EXAMINATION
1. Hand
a. Palmar pallor
b. Peripheral cyanosis
c. Capillary refill time
d. Finger clubbing
e. Pulse: rate, rhythm, volume
f. Blood pressure
2. Head
a. Hair texture and
distribution
b. Scleral icterus/jaundice
c. Conjunctival pallor
d. Periorbital oedema
e. Dentition and oral hygiene
f. Oral mucosa for hydration
and central cyanosis
g. Facial puffiness
3. Neck
a. Anterior neck swelling
b. Differential warmth
c. Skin turgor for hydration
d. Lymphadenopathy

4. Breast examination
   a. Skin and nipple changes
   b. Presence of mass
   c. Axillary lymphadenopathy
5. Leg signs
   a. Peripheral oedema

Question 4

ABDOMINAL EXAMINATION OF THE GRAVID PATIENT

Answer 4

ABDOMINAL EXAMINATION OF THE GRAVID PATIENT
INSPECTION OF THE ABDOMEN
1. Shape and symmetry
2. Movement with respiration
3. Foetal movement
4. Umbilical stump
5. Linea nigra (and its extent)
6. Striae gravidarum
7. Scars: surgical scars, unspecific
scars, and scarification
8. Other changes visible on skin:
pigmentation, distended veins, etc.
9. Hair distribution
CUE: Note visual order in which the structures are arranged.
PALPATION OF THE ABDOMEN
1. Light palpation
a. Tenderness
b. Presence of mass (presumed to be gravid uterus)
2. Organ-specific palpation a. Palpable
liver/hepatomegaly
b. Palpable spleen/splenomegaly
c. Ballotable (or bimanually palpable) kidneys

Question 5

EXAMINATION OF THE GRAVID UTERUS

Answer 5

EXAMINATION OF THE GRAVID UTERUS
1. Symphisiofundal height
2. Leopold manouvre:
a. Lie
b. Foetal back
c. Presentation
d. Descent
3. Foetal Heart Rate
Don’t forget to ask for a pinnard to check the FHR

Question 6

CONCLUDING REMARKS

Answer 6

CONCLUDING REMARKS

3. Thank patient
4. Ask patient to cover herself
5. For a gravid uterus that is more
   than 20 weeks, ask the patient to lie on the left for a while.

Question 7

OBSTETRICS EXAMINATION OSCE

Answer 7

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