GYNECOLOGIC EXAMINATION

Student________________________ Date____________ Examiner

TOTAL POINTS

(26)

Time

(30 min)

Pass Repeat

Correctly
Completed

1.

Wash hands.

2.

Wear gloves.

3.

Pain assessment

External Genitalia
Inspect the following structures:

4.

Mons pubis.

5.

Pubic area, noting hair distribution, excoriation, inflammation and nits or lice.

6.

Labia majora, noting swelling, bruises or varicosities.

7.

Labia minora.

8.

Clitoris.

9.

Urethral meatus.

10.

Vaginal opening, noting inflammation, discharge, ulceration, swelling or nodules.

If there is swelling or a history of swelling in the area of the Bartholins glands, palpate
between thumb and forefinger at 8 oclock and 4 oclock positions. If urethritis is
suspected, milk the urethra and culture any discharge.
Speculum Examination
Assess support of vaginal walls:

11.

Ask the patient to bear down, noting any bulging of the vaginal walls into the
vagina.

12.

With one finger determine the position of the cervix.

13.

Insert the speculum.

Ask the patient to bear down, push down on the posterior wall of the vaginal
opening with one finger and insert the speculum at an oblique angle and rotate.

14.

Inspect the cervix and os, noting color, position, shape, discharge, surface
character, and any abnormalities (bleeding, ulceration, masses, cysts, nodules).

15.

Obtain endocervical and ectocervical specimens for Pap test. (Include

squamocolumnar junction.)

16.

Inspect the vagina as the speculum is removed, noting color and any discharge,
odor, masses and ulceration.

Bimanual Examination

17.

Insert lubricated fingers into the vagina.

18.

Palpate the vaginal walls posteriorly, laterally and anteriorly, noting tenderness
and nodularity.

19.

Palpate the cervix, noting position, size, shape, consistency, mobility, masses
and tenderness.

20.

Palpate the fornix.

21.

Palpate the uterus, noting size, shape, consistency, mobility, masses and
tenderness.

22.

Palpate for both ovaries.

Student
Correctly
Completed
Rectovaginal Examination to be done if uterus is retroverted, if there is pelvic
pathology, or in a woman over age 50 to assess for colorectal cancer.

23.

Ask the patient to bear down, while inserting index finger into the vagina and
middle finger into the rectum.

24.

Palpate the uterus.

25.

Palpate the right and left adnexa.

26.

Palpate the region behind the uterus.

PRESENTATION

COMMUNICATION SKILLS

COMMENTS: