Examination

Question 1

Vaginal Specula

Identify

Indications

Advantage

Disadvantage

Answer 1

Identify:
Cusco’s non-fenestrated bi-Valvular self-retaining vaginal speculum.
——
1. Expose the cervix (mainly) & the vaginal wall in examination.
2. Visualize the cervix or obtaining swaps.
3. Introduction of the uterine sound, insertion of IUD, performing Hysterosalpingography, taking a premenstrual endometrial biopsy & taking a surface biopsy scraping of the cervix.
4. Expose the 2 sides of a septate vagina, when a blade is inserted in both sides.
——
1. easy to introduce. 2.Self-retaining. 3.Can be adjusted to the size of the vagina
——
1. hides the anterior & posterior vaginal walls

Question 2

Sim’s vaginal speculum

Indication

Advantages

Disadvantages

Answer 2

1.Exposes the anterior vaginal wall especially in cases of vesicovaginal Wstulas.
2. diagnosis of prolapsed and for operative repairs like episiotomies.
———

1. exposes the anterior vaginal wall. It’s the only and best one for the vaginal wall visualization
2. The grooved blade directs the blood or the urine outside when it’s used in the lithotomic position & provides a space for the operative work.
3. Provides a space for operative work.
   ——
   1.Assistance is required especially when it’s used to expose the cervix or during surgical procedures because it’s not a self-retaining specula.
4. In the presence of a large cystocele, exposure of the cervix is often diAicult

Question 3

Uterine instruments

Indications

Complications

Contraindications

Answer 3

To measure uterine cavity length in order for D&C so we avoid uterine perforation.
——

1.Disturbance of an undiagnosed pregnancy. 2. Perforation of the cervix or body of the uterus. 3. Ascending infection.
——

1.Suspicion of pregnancy.
2. Soft uterus (malignancy, infection or molar pregnancy )

Question 4

Hegar’s uterine dilator
Indication

Diagnostic

Therapeutic

Contraindications

Complications

Answer 4

Gradually dilated the uterus
Range 0-14

1.Cervical incompetence. 2. Diagnose intrauterine lesions & septa. 3. Prior to insuZations or Hysterosalpingography in cases with a narrow external cervical os. 4. Diagnose Spasmodic dysmenorrheal
——

1.Cervical stenosis. 2.Dysmenorrhea 3.Drainage of a hematometra or pyometra. 4.Cervical abortion. c) As a step in the course of other operations (iucd,d/c)
——
Active Genital infection. -Normally pregnant uterus. – -Never in labor or OB only gyn cases
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1.Perforation of the cervix or body of the uterus. 2. Ascending infection (cervicitis, endometritis, salpingitis, peritonitis & parametritis). 3. Laceration of the cervix