Question

1a Discuss the techniques and assessment of an adult anal and perianal area and include one usual abnormal finding

2a Discuss the techniques and assessment of an adult female vagina (internal) and include one usual abnormal finding.

if necessary, remember to include gloves, lubricant, draping, etc…) The list must be complete, but make it brief.

3a)_Name ALL the instruments needed to assess each system above the waist in an adult male. Pick ONLY FOUR systems.

Answer 1

As all physical examination has four steps.

Inspection.

Palpation

Percussion

Auscultation.

Assessment of adult anus.

Technique. Wear clean gloves. Explain the procedure to the patient. Apply jelly. Slowly insert the finger from the lateral region. Encourage the patient to take deep breaths.

Anal inspection. Observe for any visual hemorrhoids or fissure

Palpation. The rectal sphincter is palpated for muscle tone, presence of any blood, tenderness, pain or nodules.

Abnormal findings. Enlarged prostrate gland, cancer of rectum, hemorrhoids and abscess.

Vaginal examination.

Inspection of the vulva. Inspect the mons pu is, labia majora, labia minor. Observe the perineum for any scars, lesions or tears. Observe the introitus.

Palpate to feel the bartholian gland(cysts).

Cervical examination can be done digitally, speculum and bimanual examination.

Cervical examination.

Type of cervical os. Round in nulliparous and oval in multiparous

Colour. Normal pink in colour. In pregnancy it turns bluish known as Chadwick sign.

Secretion. Observe the colour.

Yellow greenish indicates trichomoniasis infection.

Grey indicates bacterial vaginosis.

Presence of any growth. Bleeds on touch indicates malignancy.

All examinations should be followed using universal precautions. If the procedure is sterile follow surgical asepsis. In the current situation of covid 19 any kind of patient interaction should minimally have an N95 mask and goggles or visor.

Respiratory system.

Spatula, stethoscope, endoscpes, broncos copes.

Cardiovascular. Echocardiograms, sthescope,

Gastrointestinal endoscopes, sthescope