ExternalexaminationThevaginalopeningisinspectedforposition,presenceofthehymen,andshape.Thepresenceofbruising,tearinginflammation and discharge.Pelvicexaminations areusuallyproceduresthataredesignedtoobtainobjective,measurabledescriptionsofwhatisobserved.Ifsexualabuseissuspected.questionsregardingthisisdiscussedaftertheexaminationandnot during it.Whenthewoman is requestedto'bear down',thepresenceofprolapsedstructuresaredocumented.Prolapsedstructurescanappearwhenabdominalpressureincreasesortheycanhangfreewithoutbearingdown
External examination ⚫ The vaginal opening is inspected for position, presence of the hymen, and shape. The presence of bruising, tearing, inflammation and discharge. Pelvic examinations are usually procedures that are designed to obtain objective, measurable descriptions of what is observed. If sexual abuse is suspected, questions regarding this is discussed after the examination and not during it. When the woman is requested to 'bear down', the presence of prolapsed structures are documented. Prolapsed structures can appear when abdominal pressure increases or they can hang free without bearing down
ExternalexaminationTheperineum,thespacebetweenthevaginaandtheanusis inspected.Itshouldbesmooth.firmandfree ofdisease.Scarsfromepisiotomies are visible on women who havehad the procedure during childbirth.[3][9]Theanus is assessed forlesions,inflammation or trauma.It should appeardark,continuous and moist. In an obesewomen,excoriationmaybepresentduetofecalincontinence
External examination ⚫ The perineum, the space between the vagina and the anus is inspected. It should be smooth, firm and free of disease. Scars from episiotomies are visible on women who have had the procedure during childbirth.[3][9] ⚫ The anus is assessed for lesions, inflammation or trauma. It should appear dark, continuous and moist. In an obese women, excoriation may be present due to fecal incontinence
InternalexaminationBeforeinsertingthespeculum,thevaginalwall,urethra,Skene's glands and Bartholin'sglands are palpated throughthevaginal wallDuring the internal exam,the examinerdescribes the procedure while doing theassessment,makingsurethatthewomancan anticipate where she will feel thepalpations
Internal examination ⚫ Before inserting the speculum, the vaginal wall, urethra, Skene's glands and Bartholin's glands are palpated through the vaginal wall. During the internal exam, the examiner describes the procedure while doing the assessment, making sure that the woman can anticipate where she will feel the palpations
gynecologic examinationSupinelithotomy
gynecologic examination
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