pelvic genitals and groin
TRANSCRIPT
Introduction to Clinical Skills
Pelvic, Genitalia and Groin Exam
Universidad Iberoamericana UNIBE
Introduction to Clinical Skills
Teaching Staff Dra Elizabeth Peralta Dr Marcos Núñez Dra Cristina Páez C Dr Juan Carlos Mariñez Dra Wayna Greo Dra Yun Pey Lee
Introduction to Clinical Skills
Pelvic Examination Sacrococcigeal area Perineum Rectum
Inspection External Internal (anoscopy)
Palpation RDE
Introduction to Clinical Skills
Pelvic Examination Sacrococcigeal area
Inspection Palpation
Introduction to Clinical Skills
Pelvic Examination Perineum
Inspection Palpation
Introduction to Clinical Skills
Pelvic Examination The Rectum. The Health History
Change in bowel habits Blood in the stools Pain with defecation, rectal bleeding or tenderness Anal warts or fissures Weak stream of urine Burning with urination
Introduction to Clinical Skills
Pelvic Examination The Rectum. Health Promotion and Counseling
Screening for prostate cancer Screening for polyps and colorectal cancer Counseling for sexually transmitted diseases
Introduction to Clinical Skills
Pelvic Examination The Rectum. Techniques for examination
Sims position Lithotomy position Jacknife position
Introduction to Clinical Skills
Pelvic Examination Rectum
Inspection External Internal (anoscopy)
Palpation RDE
Male Female
Introduction to Clinical Skills
Pelvic Examination Rectum. Recording your findings:
“No perirectal lesions or fissures. External sphincter tone intact. Rectal vault without masses.Prostate smooth and non tender with palpable median sulcus.(or in female, uterine cervix non tender.) Stool brown and hemoccult negative”
Introduction to Clinical Skills
Introduction to Clinical Skills
Genitalia Exam Embriology Male
External Internal
Female External Internal
Introduction to Clinical Skills
Male Genitalia
Introduction to Clinical Skills
Male Genitalia Common or concerning Symptoms
Sexual preference Penile discharge or lesions Scrotal pain, swelling or lesions
Introduction to Clinical Skills
Male Genitalia Tips for taking the Sexual History
Explain why you are taking the sexual history Note that you realice this information is highly personal,and
encourage the patient to be open and direct Relate that you gather this history on all your patients Affirm that your conversation is confidential
Introduction to Clinical Skills
Male Genitalia Health Promotion and Counseling
Prevention of STD´s and HIV Testicular self examination
Introduction to Clinical Skills
Male Genitalia Physical Exam requirements
Privacy (drapes) Chaperone Gloves Culturette
Introduction to Clinical Skills
Male Genitalia Physical Exam techniques Secondary Male development
Penis Shape Gland Prepuce
Scrotum Testicles
Shape Epididimus Vas deferens
Prostate (RDE)
Introduction to Clinical Skills
Male Genitalia. Recording your findings “Circumcized male. No penile discharge or lesions. No scrotal
swelling or discoloration.Tested descended bilaterally, smooth, without masses. Epididymis nontender. No inguinal or femoral hernias.”
Introduction to Clinical Skills
Female Genitalia
Introduction to Clinical Skills
Female Genitalia. The Health History Menarche, menstruation, menopause, postmenopausal bleeding Pregnancy Vulvovaginal symptoms Sexual preference and sexual response
Introduction to Clinical Skills
Female Genitalia. The Menstrual History: definitions Menarche Menopause Postmenopausal bleeding Amenorrhea Dysmenorrhea Premenstrual syndrome Abnormal uterine bleeding
Introduction to Clinical Skills
Female Genitalia. Health Promotion and Counseling Cervical cancer screening. Pap smear and HPV infection Options for family planning Sexually transmitted diseases and HIV Changes in menopause
Introduction to Clinical Skills
Female Genitalia Physical Exam requirements
Privacy (drapes) Chaperone Gloves Culturette
Introduction to Clinical Skills
External Examination Mons pubis Labia majora and minora Urethral meatus, clitoris Vaginal introitus Perineum
Internal Examination Vagina, vaginal walls Cervix Uterus, ovaries Pelvic muscles Rectovaginal wall
Introduction to Clinical Skills
Female Genitalia Physical Exam techniques Secondary Female development
External genitalia Internal genitalia
Introduction to Clinical Skills
Female Genitalia. Recording your findings “No inguinal adenopathy. External genitalia without erythema,
lesions or masses. Vaginal mucosa pink. Cervix parous, pink and without discharge. Uterus anterior, midline, smooth, and not enlarged. No adnexal tenderness. Pap smear obtained. Rectovaginal wall intact. Rectal vault without masses. Stool brown and hemoccult negative.”
Introduction to Clinical Skills
Introduction to Clinical Skills
Groin ExamExamen de la Ingle Inguinal Region
Inguinal canal Inguinal rings
Femoral Region N A V E L
Introduction to Clinical Skills