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17 Cards in this Set
- Front
- Back
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Mrs. Brown is a 34 year old woman who has come to your clinic. What will you inquire about prior to a genital examination? |
Age of menarche, last menstrual period Any discharge that is abnormal Regularity, duration, amount and pain associated with menses Is she sexually active? Is there pain during intercourse? Has she ever had an STI? Does she now? Has she ever given birth? How did that go? How was it for her? Frequency, pain, or blood in the urine. |
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What will you notice during inspection and palpation of Mrs. Browns External genitals? |
Pubic Hair (is it present, is it even?), pubic skin (inflammation, swelling, lesions). Separate the labia to inspect the inner labia. Palpate inguinal nodes. |
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Lifespan considerations assessing the genitals of female infants? |
Hold in a supine position with the knees flexed. Mothers estrogen from delivery may cause genitals to appear edematous and enlarged. Some white/bloody discharge is normal after delivery Check the mons pubis for an inguinal hernia. |
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Lifespan considerations for assessing the genitals of female children? |
Get parent approval. Use tanner staging. Clitoris is the site for syphillitic chancres |
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Lifespan considerations for assessing the genitals of older adult females? |
Labia is flat and may atrophy. Vulva may atrophy. Fallopian tubes and ovaries atrophy as well. Ovulation and estrogen production stop. Cervix and uterus decrease in size. Prolapse may occur. Vaginal bleeding is abnormal. |
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Mr. White is a 44 year old client who has come to your clinic for a physical exam. What will you inquire about prior to a genital exam? |
Voiding patterns and changes, bladder control, incontinence, urgency, abdominal pain STI's Hernias Family history of nephritis, malignancy of prostate and kidneys |
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When inspecting the genitals of a male, what are normal? |
Normal hair patterns and thickness. Skin is intact, may be wrinkled. The foreskin is easily retractable. The meatus is pink, slitlike, without discharge. Scrotum is darker, asymmetric, and loose Inguinal areas is without swelling and buldges |
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What are normal findings during the palpation of external genitals? |
No swelling buldges that are palpable. Scrotum has no masses, is not edematic or abnormally wrinkled. Skin is intact |
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You are going to verbally teach the TSE to a teenage boy. What are the key points you want to make? |
Cancer is rare at this age, but it's good to familiarize yourself with your body. Do it after a warm shower or bath or relax the skin, and do it consistently. Feel your testicles one at a time. It's fine that one is larger than the other. The epididymis is a normal lump to feel within the testicles. Pain, aches, strange skin, etc. are abnormal. |
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What are normal observations for the genitals of male infants? |
Foreskin may not retract until 2-3 y/o Assess placement of urethral meatus Palpation for descension of testes Assess inguinal area for hernia |
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What are normal observations for the genitals of male children? |
Have parent permission Be aware of shyness of body Note tanner staging Have boys sit cross legged to decrease cremaster reflex |
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What are normal observations for the genitals of older adult males? |
Penis may decrease in size; size and firmness of testes may also decrease The amount of testosterone decreases May experience premature ejaculation and need more stimulation to reach climax. Seminal fluid and viscosity of semen decreases Urinary frequency may change, nocturia and dribbling may occur - prostatic enlargement may occur. |
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Prior to a breast exam, what shall you inquire about? |
Are you pregnant, breastfeeding? Hx of breast masses Pain, tenderness associated with menses Nipple discharge? Meds (birth control, steroids, diuretics, estrogen therapy) Risk factors (alcohol, high fat diet, obesity, birth control, family history, menopause after 55, menses before 12) |
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When assessing breasts and lymph nodes, what would you assess and expect to see? |
Females: Round, fairly symmetrical breats Males: flat, even chest wall. Skin is smooth and uniform, striae may occur due to breast growth. Nipples are symmetrical to one another bilaterally. They are round, similar colour, no discharge, face the same direction. No tenderness in axillary, subclavicular lymph node areas. Palpate the breasts in a supine position Palpation of the areolas should not produce discharge |
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When performing the breast exam on a male client, what technique is used? |
Palpate the chest area, around the nipple, up to the tail of spence Palpate the axillae. |
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How often should screening for breast cancer be done? |
BC Cancer Society - Women 40-74 w/ first degree relative with BC - yearly Women 40-49 without FHx - every 2 years Women 50-79 w/o Family Hx - every 2 years 75+ w/o FHx - 2-3 years |
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Who would you recommend a BSE to? What are the key points you should make? |
Women aged 50-74 with increased risk of breast cancer Women of any age with increased breast cancer risk Men with a family history of breast cancer Points to make Be familiar with your breasts, notice changes Some changes/tenderness may be due to menses Clinical breast exams are more effective |
