Download - OSCE PELVIC EXAM AND PAP SMEAR
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OSCE PELVIC EXAM AND PAP
SMEARIna S. Irabon, MD, FPOGS, FPSRM, FPSGE
Obstetrics and GynecologyReproductive Endocrinology and Infertility
Laparoscopy and Hysteroscopy
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Steps:1. Explain the purpose and conduct
of the pelvic examination
2. Use language/vocabulary that is appropriate and understandable
3. Provide adequate privacy
4. Inspect the external genital organs
photo credit: www.dreamstime.com
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5. Speculum examination• Prepare all materials needed
• Glove the examining hand to be used for internal examination
• Grasp the handle of the speculum using the ungloved hand
• Lubricate the speculum with water
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5. Speculum examination
• Separate the labia minor using the thumb and middle finger of the examining hand
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5. Speculum examination• Insert the speculum in a
diagonal manner to avoid the urethra and rectum
• Once inside the vagina, swing the speculum into mid position until the cervix is reached
• Open the speculum gently and adjust it until it cups and brings the cervix into full view
• Lock the speculum
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5. Speculum examination• Examine the cervix and
vaginal walls
• Report any visualized vaginal discharge (color, consistency, adherence to walls, odor, presence of erythema)
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6. Proceeds to collect sample forPAP SMEAR
USING THE “3-cotton pledget technique”, obtain specimens from:
• the endocervix
• the exocervix
• Lateral vaginal walls
• Place the collected sample on the appropriate glass slide and apply appropriate diluent/fixative to the the sample
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6. Proceeds to collect sample forPAP SMEAR
• Unlock the speculum and gently closed the speculum
• Remove the speculum in the reverse sequence
• Label the slide
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7. Proceeds with internal examination• Perform the gynecological exam in an organized and
orderly manner
• Gently separate the labia major with thumb and fourth finger
• Gently introduce the examining fingers into introitus
• Place non dominant hand over suprapubic area and proceed to examine the cervix and corpus then both adnexal areas in a gentle , unhurried manner
• Gently withdraw middle finger and gently introduces it into anal opening and conduct a rectovaginal exam
Upon completion of the rectovaginal exam, gently withdraw examining fingers and informs the patient that the examination has been concluded
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Concluding the visit
8. Entertain questions from the patient 9. Answer patient’s questions adequately 10. Thank the patient
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