Uniformed Services University Obstetrics and Gynecology Core ...

IX. Obstetric and Gynecologic Examination:An accurate examination compliments the history, provides additional information, and helpsdetermine diagnosis and guide management. It also provides an opportunity to educate andreassure the patient.1. Mental Status Examination: Evaluate mood, affect, behavior, and dress. Endogenousdepression is commonly encountered in women, and the earliest manifestations ofserious depressive illnesses are often overlooked due to inattention to this part of theevaluation. Postpartum depression is also a significant problem.2. Blood Pressure: Note position of the patient and indicate in which arm the pressureis measured.3. Breast Examination:• size• shape• nipple – e.g. inverted, crusted, reddened• presence of nodules - describe- location- size- shape- consistency- mobility- presence of overlying skin changes• presence of galactorrhea - spontaneous or elicited by manual expression4. Abdominal Examination:• shape• consistency• bowel Sounds• presence of “guarding” (voluntary)• rigidity (involuntary)• tenderness (direct or rebound)• ascites• hepatosplenomegaly• presence of mass5. Pelvic Examination:• external genitalia- hair distribution- development of labia- clitoral size• Bartholin’s gland (greater vestibular)• urethra• Skene’s glands (paraurethral)• vagina