Reproductive System History and Examination Female Breast and Pelvic Exam Male Genitourinary and Rectal Exam Dr. Lanice Jones 2008
Breast Examination History: Common Concerns or Symptoms Breast lump or mass Breast pain or discomfort Nipple Discharge Risk Factors for Breast Cancer Age - > 50 years old Family History Menstrual History
Risk Factors For Breast Cancer Age – greater than 50 Family History First degree relative Pre or Post Menopausal Unilateral or Bilateral Menstrual History Menarche < 12 years old Age at menopause > 55 Pregnancy History First live birth after 30 years of age or no pregnancy Not Breast Feeding or short time breast feeding
Breast Anatomy
Breast Exam: Inspection Arms at sides Hands pressed against hips Arms overhead Look for skin color, Skin retraction, dimpling Nipple shape, asymmetry
Palpation Axillary Palpation Sitting Check anterior, medial, lateral and posterior quadrant of axilla
Palpation Lying Expose one breast at a time 3 different Palpation techniques Wedge (clock hours) Vertical strip circular
Palpation techniques Move fingers in small circles One hand Two hands for larger breasts – stabilize the tissue
Nipple exam Check for nipple discharge
Pelvic Examination History Menarche, Menstruation, Menopause Pregnancy Pain Vulvovaginal symptoms Discharge Itching Sores, lumps Sexual activity
Female Pelvic Anatomy
Inspection Inspection: Labia Clitoris Vaginal opening Discharge Lesions
Inspection: Speculum Exam Inspect vaginal opening Vaginal walls Cervix
Palpation: Bimanual Examination Use lubrication Palpate cervix Gently move cervix – test for pain with movement Palpate uterus Palpate each ovary
Male Genitourinary Hx and Exam History Pain Swelling Discharge Sexual Problems: Pain or Erectile Dysfunction
Pelvic Anatomy Male
Inspection 1. Testicles 2. Epididymis 3. Corpus cavernosis 4. Foreskin 5. Frenulum 6. uretheral meatus 7. Glans penis 8. corpu8s spongiosum 9. Penis 10. scrotum
Palpation Palpate each testis and epididymis Size, shape, consistency, tenderness, nodules Palpate each spermatic cord and vas deferens Palpate for Inguinal Hernias
Digital Rectal Examination Position Lying on left side Standing Inspect perianal area Examine anus and rectum Use lubrication, wait for sphincter to relax Note sphincter tone, tenderness, irregularities or nodules