Pelvic Exam - Wikispaces：盆腔检查- wiki空间.ppt

Spread both sides of the spatula onto the slide. Place immediately into the fixative for between 10 – 90 mins. High-risk specimens should be left in for a minimum of 1 hour. Inform the patient how long the results will take and how they will be delivered. 3-Bimanual examination Separate labia with gloved left hand Inserted index finger into vagina then slowly insert middle finger to palpate cervix Left hand then palpates uterus abdominally Tips of the vaginal fingers placed into each lateral fornix and the adnexae are examined on each side The uterosacral ligaments can be felt in posterior fornix 4-Examination during labor Palpate uterine contractions Assessment of the cervix dilatation 1 finger ? 1-2 cm dilated 2 fingers ? 3-4 cms dilated 3 fingers ? 5-6 cms dilated 4 fingers ? 7-10 cms dilates 3. Effacement of the cervix: thinning of the cervix (%) or length (cm). The cervix is normally 3-5 cms. If cervix is about 2 cm from external to internal os ? 50% effaced 50% effaced 100% effaced 4. Consistency of the cervix: soft vs. hard. During labor the cervix becomes soft. 5. Position of the cervix: posterior vs. anterior. During labor the cervix changes from posterior to anterior. 6. Membrane is intact or ruptured: assessed by fluid collection in the vagina * Hair extending towards umbilicus and onto inner thigh can be associated with disorders of androgen excess and clitoromegaly. Vulva can be a site of chronic skin conditions such as eczema, psoriasis, Lichen sclerosis and warts, cysts of the Bartholin’s gland and cancers. Ulceration may imply herpes, syphilis, trauma or malignancy. Perineal scars maybe secondary to childbirth. Modified by: Dr/Amaal Rayan To know the indication for pelvic examination To know the technique and value of speculum examination. To know the technique and value of bimanual examination. To know how to do a pap smear and what is its value. To know how to examine the vagina during labor. Check the health of the reproductive organs