Question

_Discuss the techniques and assessment of an adult female external genital and include one usual abnormal finding

_Discuss the techniques and assessment of an adult female external genital and include one usual abnormal finding

Answer 1

PMH: Menstrual history

Menarche

Last menstrual period

Days in cycle

Character of flow

Dysmenorrhea

Intermenstrual bleeding or pain

Premenstrual symptoms

PMH: Obstetric history

Gravidity

Term pregnancies

Preterm pregnancies

Abortions: spontaneous or induced

Living children

Complications of pregnancy, delivery, abortion, or with fetus or neonate

PMH: Menopausal history

Age of menopause

Associated symptoms

Postmenopausal bleeding

Birth control during menopause

Feelings about menopause

Mother's experience with menopause

Medications

Use of complementary and/or alternative therapies

PMH: Gynecologic history

Prior Pap smears, human papillomavirus (HPV) testing and results

Past and recent gynecologic procedures or surgery

Sexually transmitted infections

Pelvic inflammatory disease

Vaginal infections

Diabetes

Cancer of reproductive organn

FH

Diabetes

Cancer of reproductive organs

Mother received diethylstilbestrol (DES) while pregnant

Multiple pregnancies

Congenital anomalies

PSH

Contraceptive history

Douching history

Use of alcohol, drugs

Sexual history

Current sexual activity

Contraception

Barrier protection

Prior sexually transmitted infections

Satisfaction with relationship

Specimen collection equipment

Sterile cotton swabs

Cervical brush devices

Cytologic fixative

Culture plates or media

DNA probe kits for Chlamydia and gonorrhea, if needed

Preparation for examination

Minimize patient apprehension

Comfortable temperature

Privacy

Empty bladder

Warm speculum

positioning for examination

Assist the patient into the lithotomy position on the examining table.

Help the woman stabilize her feet in the stirrups and slide her buttocks down to the edge of the examining table.

draping & gloving

Drape in such a way that minimizes exposure.

Cover her knees and symphysis, depressing the drape between her knees.

Allows you to see the woman's face (and she, yours).

Equipment is nearby and in easy reach.

Examining lamp so that the external genitalia are clearly visible

Wash hands and put gloves on both hands

External Examination: Labia majora

Symmetry

Redness, swelling, or tenderness

Excoriation, rashes, or lesions

Discoloration

Varicosities

Stretching

Trauma or scarring

External Examination: Labia minora

Symmetry

Moisture

Color

Soft, homogeneous, and without tenderness

Inflammation

Excoriation

Discharge

Ulcers

External Examination: clitoris, urethral orifice & Vaginal introitus

Clitoris-

Inflammation

Urethral orifice-

Discharge

Polyps, carbuncles, or fistulae

Irritation or inflammation

Vaginal introitus-

Moisture

Swelling

Discoloration

Discharge

Lesions, fistulae, or fissures

external examination Bartholin glands & Skene glands

Bartholin glands

Posterolateral portion of the labia majora

Discharge

Masses

Tenderness or swelling

Skene glands-

Periurethral location

Discharge

external examination: Elimentary canal , Muscle tone and Perineum

Elimentary canal

Color

Scarring or skin tags

Excoriation

Fissures or lesions

Muscle tone:

Observe for urinary incontinence or uterine prolapse.

Perineum:

Tenderness

Inflammation

Fistulae

Lesions or growths

Internal Examination: cervix

Cervix:-

Color

Position

Surface characteristics

Discharge

Size and shape

Pap smear:

Endocervical cells

Examination of cervical cells and mucus for early detection of cervical cancer

Gonococcal culture:

test for gonorrhea

DNA probe:

test for gonorrhea or Chlamydia

Wet mount:

test for trichomonas, bacterial vaginosis, or candidiasis

Bimanual Examination

Cervix:

Size, length, and shape

Position

Consistency

Movement

Nodules

Hardness

Tenderness

Uterus:

Position

Size, shape, and contour

Mobility

Tenderness

Ovaries:-

Size

Shape

Location

Consistency

Tenderness

Nodularity

Adnexa :

Masses

Tenderness

Additional considerations for pregnant women:

Gestational age estimation

Uterine size and contour

Pelvic size estimates

Cervical dilation and length