复旦大学上海医学院妇产科学系2009级六年制妇产科学课件 Obstetrics and Gynecological History and Physical examination.ppt

2 Please according to the following data to write present medical condition, to see what is needed for history collection: At the age of 28, amenorrhea for 2 months, irregular vaginal bleeding 40 years old, the vulva pruritus, leucorrhea is abnormal At the age of 26, 7+ months of pregnancy, vaginal bleeding Discussion Medical history collecting and writing Pelvic examination Check carefully, gentle movement Urine evacuated before check ( urine preserved for checkup ) Replace the one-time pad Bladder lithotomy position Q: To avoid the menstrual period, what should you do before check, if check is must while bleeding? Male doctor to check best with female physician presence to avoid unnecessary misunderstanding Basic Requirements of the Pelvic Examination Step 1 Vulval inspection Vulva development and its hair distribution New biological, skin lesion vulva Vaginal vestibule Hymen The vagina mouth Vaginal wall and uterine prolapse or not Step 2 Check up by speculum Speculum forbidden without agreement by virgin replacement and removal Step 3 Vaginal inspection deformity: vaginal septum, double vagina new biological, ulcer, cyst or not Vaginal discharge is normal, if necessary, check leucorrhea routine Step 4 Cervical inspection Size, color, mouth shape bleeding, erosion, gland cyst, polyps Cervical tube has hemorrhages or exudates or not Cervical smear Cervical scraping smear Step 5 Bimanual examination Check with two fingers or one finger into the vagina, while the other hand in the abdomen to help checking Vaginal, cervical, endometrial, attachment, palace and pelvic wall Step 6 Trimanual examination Rectal, vaginal, abdominal examination Rectal - abdominal diagnosis index finger into the rectum, with the other hand in the abdomen helping check Asexual life history, vaginal atresia or other reasons can not be performed bimanual examination. Check up Record The vulva: development, producti