Examination of female genitalia

Question 1

What equipment do you need?

Answer 1

Couch (with sheets and covering), manusept, water based lubricating gel, light source, screen

Question 2

What should you do before starting the examination?

Answer 2

Introduce yourself, check patient details, explain procedure and gain consent
Chaperone
Ask if they have emptied their bladder
Wash hands and glove up

Question 3

What position should they be placed in?

Answer 3

Supine position, hips and knees flexed with ankles close together
Only expose as much is necessary

Question 4

What should be covered in inspection?

Answer 4

Inspect outer genitalia and hair
Gently separate labia minora to assess clitoris, urethra, vaginal orifice
Ask patient to strain down and look for bulging/prolapse
Ask patient to cough

Question 5

What do you do during the internal exam?

Answer 5

Lubricate middle and index fingers
Insert R index finger, followed by R middle finger
Feel for cervix
Assess fornices

Question 6

What do you do during bimanual examination?

Answer 6

Apply upwards pressure on the cervix and uterus
Apply fingers of left hand flat to abdominal wall under the umbilicus
Move left fingers towards the pubic bone gradually

Question 7

How should you palpate the adenexae?

Answer 7

Place abdominal hand over the iliac fossa
Place vaginal fingers into the lateral fornix
Oppose the fingers (vaginal go upwards and laterally, abdominal go downwards and medially)