Pelvic Exam Flashcards
What is the superior border of the breast exam?
clavicle
What is the inferior border of the breast exam?
6th rib
What is the lateral border of the breast exam?
Midaxillary line
What is the medial border of the breast exam?
sternum
What are the 4 components of the breast examination?
- Introduction (eg. explain exam, wash hands, etc..)
- Breast inspection
- Lymph node palpation
- Breast palpation
What is the name for thickening of the tissue with “orange peel” appearance
?
Peau d’orange
What are the 6 features to inspect on a breast examination?
Size
Symmetry
Shape
Contour (flattening, masses, and dimpling)
Skin (color, edema, rashes, lesions, thickening, and venous pattern)
Scars (previous surgery, injuries)
Recent onset of unilateral nipple inversion is suggestive of?
underlying malignancy
What lymph nodes need to be examined during the breast examination?
- Supraclavicular lymph nodes
2. Axillary lymph nodes (anterior axial, mid-axillary and post axiallary)
Where does secondary drainage of breast lymph drain?
internal mammary (can also drain to supraclavicular and jugular nodes
What is the name for the extension of the breast tissue that extends into the axilla?
Tail of Spence
Name three types of tissue being examined with breast palpation?
- Adipose
- Glandular tissue
- Ductal tissue
How long should a Bra size B breast take to examine?
3 minutes per breast (total of 6 minutes)
Where is a common area of recurrence of breast cancer?
the scar from a previous surgery
How is earlier menarche related to breast cancer?
Earlier menarche = higher risk for breast cancer
Name the 4 parts of the pelvic exam?
- External exam: Inspection of the vulva and introitus
- Internal exam: speculum, obtaining samples - pap and HPV, cultures, biopsy
- Bimanual exam (palpation)
- Rectal/Rectovaginal exam
Are skene’s glands to the sides of the urethra inspected or palpated?
inspected (can be inflamed with chlamydia)
Which 4 structures are palpated during the pelvic exam?
- Mons pubis
- Labia majora and minora
- Prepuce
- Bartholin’s duct
Which 4 structures are inspected during the pelvice exam?
- Clitoris
- Urethral meatus
- Introitus and hymen
- Paraurethral (Skene’s) gland
Name 5 types of vulvar lesions
- Apthous ulcers
- Genital herpes
3 Epidermal inclusion cysts (common and normal finding) - Warts
- Vulvar neoplasia
What is a caruncle?
Caruncle- lesion around the urethra (nothing medical needs to be done)
What is a cystocele?
prolapse of the bladder into the vagina
At what angle should the speculum be inserted into the vagina?
45 degrees
Should you be applying upward pressure or downward pressure when inserting the speculum?
Apply downward pressure
In what type of cervix would you expect to see “large external os, transverse with stellate slit”
Normal parous cervix (has had children)
What is the significance of the squamo-columnar junction?
This is the junction between the cervical skin (pink) and endocervical canal (red)
What is the most likely site of dysplasia (abnormal cell changes)?
Squamo-columnar junction (opening of the cervix)
Are unilateral transverse, bilateral transverse and stellate normal changes of cervical os?
yes, unilateral transverse, bilateral transverse and stellate are variations of normal (lacerations from delivery)
What type of disease is a strawberry cervix associated with?
STI
Are nabothian cysts normal or abnormal finding of the cervix?
normal
Name two pap smear sampling devices
- Broom
2. Cytobrush/spatula
Where should the dominate hand go during the bimanual exam?
internally
Where should the non dominate hand go during the bimanual exam?
on abdomen
What are the expected finding of palpating the uterus?
- Pear-shaped
- Rounded
- Firm
- Smooth
What are the expected findings of palpating the ovaries?
- smooth
- ovoid
- mildly tender to palpation
notes:
- may not be palpable
- similar to an almond
What is the most common type of urterine position?
anteverted
Which uterine position variation is hardest to palpate?
retroflexed
Which exam will be helpful in palpating a retroverted or retroflexed uterus?
Retovaginal exam
What are 5 purposes of a rectovaginal exam?
- palpate retroverted or retroflexed uterus
- Palpate uterosacral ligaments
- Palpate the cul-de-sac and adnexa (fallopian and ovarian area)
- Screen for colorectal cancer
- Asses pelvic pathology
What is the name for infection or inflammation of the ovarian tubes?
salpingitis
What is the term for painful sexual intercourse?
Dyspareunia
What is the word for number of pregnancies?
Gravidity
What is the word for births?
Parity
What does TPAL stand for?
T-erm births
P-remature births
A-bortions (spontaneous or induced)
L-ive births
What does G3P1112 stand for?
3 pregnancies
1 term birth
1 premature birth
1 abortion
2 live births
