Pelvic Exam

Question 1

What is the superior border of the breast exam?

Answer 1

clavicle

Question 2

What is the inferior border of the breast exam?

Answer 2

6th rib

Question 3

What is the lateral border of the breast exam?

Answer 3

Midaxillary line

Question 4

What is the medial border of the breast exam?

Answer 4

sternum

Question 5

What are the 4 components of the breast examination?

Answer 5

1. Introduction (eg. explain exam, wash hands, etc..)
2. Breast inspection
3. Lymph node palpation
4. Breast palpation

Question 6

What is the name for thickening of the tissue with “orange peel” appearance
?

Answer 6

Peau d’orange

Question 7

What are the 6 features to inspect on a breast examination?

Answer 7

Size
Symmetry
Shape
Contour (flattening, masses, and dimpling)
Skin (color, edema, rashes, lesions, thickening, and venous pattern)
Scars (previous surgery, injuries)

Question 8

Recent onset of unilateral nipple inversion is suggestive of?

Answer 8

underlying malignancy

Question 9

What lymph nodes need to be examined during the breast examination?

Answer 9

1. Supraclavicular lymph nodes

2. Axillary lymph nodes (anterior axial, mid-axillary and post axiallary)

Question 10

Where does secondary drainage of breast lymph drain?

Answer 10

internal mammary (can also drain to supraclavicular and jugular nodes

Question 11

What is the name for the extension of the breast tissue that extends into the axilla?

Answer 11

Tail of Spence

Question 12

Name three types of tissue being examined with breast palpation?

Answer 12

1. Adipose
2. Glandular tissue
3. Ductal tissue

Question 13

How long should a Bra size B breast take to examine?

Answer 13

3 minutes per breast (total of 6 minutes)

Question 14

Where is a common area of recurrence of breast cancer?

Answer 14

the scar from a previous surgery

Question 15

How is earlier menarche related to breast cancer?

Answer 15

Earlier menarche = higher risk for breast cancer

Question 16

Name the 4 parts of the pelvic exam?

Answer 16

1. External exam: Inspection of the vulva and introitus
2. Internal exam: speculum, obtaining samples - pap and HPV, cultures, biopsy
3. Bimanual exam (palpation)
4. Rectal/Rectovaginal exam

Question 17

Are skene’s glands to the sides of the urethra inspected or palpated?

Answer 17

inspected (can be inflamed with chlamydia)

Question 18

Which 4 structures are palpated during the pelvic exam?

Answer 18

1. Mons pubis
2. Labia majora and minora
3. Prepuce
4. Bartholin’s duct

Question 19

Which 4 structures are inspected during the pelvice exam?

Answer 19

1. Clitoris
2. Urethral meatus
3. Introitus and hymen
4. Paraurethral (Skene’s) gland

Question 20

Name 5 types of vulvar lesions

Answer 20

1. Apthous ulcers
2. Genital herpes
   3 Epidermal inclusion cysts (common and normal finding)
3. Warts
4. Vulvar neoplasia

Question 21

What is a caruncle?

Answer 21

Caruncle- lesion around the urethra (nothing medical needs to be done)

Question 22

What is a cystocele?

Answer 22

prolapse of the bladder into the vagina

Question 23

At what angle should the speculum be inserted into the vagina?

Answer 23

45 degrees

Question 24

Should you be applying upward pressure or downward pressure when inserting the speculum?

Answer 24

Apply downward pressure

Question 25

In what type of cervix would you expect to see "large external os, transverse with stellate slit"

Answer 25

Normal parous cervix (has had children)

Question 26

What is the significance of the squamo-columnar junction?

Answer 26

This is the junction between the cervical skin (pink) and endocervical canal (red)

Question 27

What is the most likely site of dysplasia (abnormal cell changes)?

Answer 27

Squamo-columnar junction (opening of the cervix)

Question 28

Are unilateral transverse, bilateral transverse and stellate normal changes of cervical os?

Answer 28

yes, unilateral transverse, bilateral transverse and stellate are variations of normal (lacerations from delivery)

Question 29

What type of disease is a strawberry cervix associated with?

Answer 29

STI

Question 30

Are nabothian cysts normal or abnormal finding of the cervix?

Answer 30

normal

Question 31

Name two pap smear sampling devices

Answer 31

1. Broom | 2. Cytobrush/spatula

Question 32

Where should the dominate hand go during the bimanual exam?

Answer 32

internally

Question 33

Where should the non dominate hand go during the bimanual exam?

Answer 33

on abdomen

Question 34

What are the expected finding of palpating the uterus?

Answer 34

- Pear-shaped - Rounded - Firm - Smooth

Question 35

What are the expected findings of palpating the ovaries?

Answer 35

- smooth - ovoid - mildly tender to palpation notes: - may not be palpable - similar to an almond

Question 36

What is the most common type of urterine position?

Answer 36

anteverted

Question 37

Which uterine position variation is hardest to palpate?

Answer 37

retroflexed

Question 38

Which exam will be helpful in palpating a retroverted or retroflexed uterus?

Answer 38

Retovaginal exam

Question 39

What are 5 purposes of a rectovaginal exam?

Answer 39

1. palpate retroverted or retroflexed uterus 2. Palpate uterosacral ligaments 3. Palpate the cul-de-sac and adnexa (fallopian and ovarian area) 4. Screen for colorectal cancer 5. Asses pelvic pathology

Question 40

What is the name for infection or inflammation of the ovarian tubes?

Answer 40

salpingitis

Question 41

What is the term for painful sexual intercourse?

Answer 41

Dyspareunia

Question 42

What is the word for number of pregnancies?

Answer 42

Gravidity

Question 43

What is the word for births?

Answer 43

Parity

Question 44

What does TPAL stand for?

Answer 44

T-erm births P-remature births A-bortions (spontaneous or induced) L-ive births

Question 45

What does G3P1112 stand for?

Answer 45

3 pregnancies 1 term birth 1 premature birth 1 abortion 2 live births