Explain to the patient that theyll need to remove their underwear and lie on the clinical examination couch, covering themselves with the sheet provided. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Were also almost ready to launch a total redesign of the app, so plenty to look forward to! Phimosis is physiological in most children with only 1% of children having persisting phimosis by the age of 16. Phimosis involves the narrowing of the distal foreskin leading to an inability to retract it. the sphincters that help maintain rectal continence may be affected (e.g. your nose. The skin, also referred to as the integumentary system, is the largest organ of the body. Bilateral testicular atrophy is suggestive of primary or secondary hypogonadism. Typical clinical features involve a swollen, oedematous glans/foreskin and significant pain. Chancre The disease presents with painful ulcer(s) on the genital tract (termed chancroid or soft chancre). . The method is commonly used to check the lower rectum, the prostate gland in men, and the uterus and ovaries in women. The root is attached to the pubic bone by the crura penis. This gives you an opportunity to perform the exam while providing the Use both of your thumbs and index fingers to gently palpate the whole testicle, whilst your remaining fingers remain placed behind the testicle to immobilise it. All rights reserved. It can be classified by the location of herniation. Lichen sclerosus is a chronic inflammatory dermatological condition that can affect the anogenital region in women. Occasionally, fibrosis Sagittal A cutaneous pouch of skin containing the testicles and spermatic cords. Learn how to interpret an ECG, ABG, CXR, AXR and more with our awesome data interpretation guides. If phimosis is severe, it may require circumcision. This The spermatic cord should be palpable connecting to the testicle at this region. If there is suspicion of testicular malignancy patients should have an urgent ultrasound scan of the testicles, chest x-ray and tumour markers checked (Beta-HCG, Alpha-fetoprotein and Lactate Dehydrogenase [LDH]). Symptoms and signs may include vaginal discharge, penile discharge, dysuria, skin lesions (e.g., warts, ulcers) on or around the genitals, and pelvic pain. The rectal examination is controversial with regard to Orient your finger so that it is directed anteriorly (i.e. Gently palpate lateral fornices for any masses. Provide the patient with the opportunity to pass urine before the examination. genital herpes For the purposes of your exam, you will most likely be examining a mannequin. Thespermatic cordis thecord-like structure in males formed by the vas deferens and surrounding tissue that runs from the deep inguinal ring down to each testicle. The spermatic cord should be palpable connecting to the testicle at this region. The testes should appear as 2 discrete swellings, although if the room is An innovative learning platform, built by an amazing community of Geeky Medics. Pelvic inflammatory disease (PID) is defined as a polymicrobial infection of the upper female reproductive system. Others can be quite massive. The Genital Exam: Have the patient stand in front of you and raise their gown to the level of the umbillicus, exposing the entire genital region. On general inspection, the patient appeared comfortable at rest. Hand Statin counselling 11. Hand: Anatomy. Patients may present with nonspecific symptoms such as fever and fatigue. In the event that the patient cannot stand, this examination can be performed with the patient within the body of the testis. The family of Chlamydiaceae comprises 3 pathogens that can infect humans: Chlamydia trachomatis, Chlamydia psittaci, and Chlamydia pneumoniae. You will obviously have no idea until you have had Some hernias will It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. purulent discharge Skin To remove your stool-covered glove, take Epididymis consists of the head (caput), the body (corpus), and the tail (cauda). Bimanual examination revealed an anteverted uterus of normal size and shape. A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. A birth defect due to malformation of the urethra in which the urethral opening is below its normal location. It occurs in the setting of doi: 10.1136/bmj.g3222. Illustrations of an The presence of a firm nodule would be worrisome Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Varicocele. Genitourinary examination is used for preventative health exams in adult men and is also a part of problem-focused exams performed to evaluate complaints such as The organ is composed of a root, body, and glans. Download Geeky Medics - OSCE revision and enjoy it on your iPhone, iPad, and iPod touch. If there is suspicion of testicular torsion a scrotal ultrasound should be considered if there is diagnostic uncertainty. Inspect the urethral meatus for discharge (e.g.. Preventative exam: Palpate each testicle for size, tenderness, and masses. Place your non-dominanthand 4cm above the pubis symphysis. DNA, which consists of a polysugar-phosphate backbone possessing projections of purines (adenine and guanine) and pyrimidines (thymine and cytosine), forms a double helix that is held together by hydrogen bonds between these purines and pyrimidines (adenine to thymine and guanine to cytosine). Phimosis At the end of the examination, ask the patient to stand to allow you to re-assess the scrotum. There is a single bone in the thigh called the femur, which is surrounded by large muscles grouped into 3 fascial compartments. the index finger of your left hand (which should still be clean) and place it under the cuff of In such cases it will also have a characteristic odor. Septic arthritis is an infection of the joint due to direct inoculation, contiguous extension, or hematogenous spread of infectious organisms into the joint space. sacral nerve root compression associated with a tumor) and muscular tone can be diminished Bartholins cyst. Pushupwards with the internal fingers whilst simultaneously palpatingthe lower abdomen with your non-dominant hand. Inflammation of the head of the penis, glans penis. It can be classified by the location of herniation. 7. Digital Substances that are recognized by the immune system and induce an immune reaction. . Urethritis The two sacs are connected by the foramen of winslow, or epiploic foramen. A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. Emission or propagation of acoustic waves (sound), electromagnetic energy waves (such as light; radio waves; gamma rays; or x-rays), or a stream of subatomic particles (such as electrons; neutrons; protons; or alpha particles). However, if the patient is 2014 May 13348:g3222. A cutaneous pouch of skin containing the testicles and spermatic cords. Inability to empty the urinary bladder with voiding (urination). The space enclosed by the peritoneum. For this examination, it is essential to have a chaperone. examination. orchitis will cause a "reactive hydrocele" to form, which will hernias. Hernias are generally non-tender and there should be no evidence of acute inflammation (i.e. (referred to as nodules)? each window as well as over the control spot. information if you are unsure as to the nature of an inguinal bulge. Penile cancer is rare in the United States, but there is a higher prevalence in lower socioeconomic regions. identifiable). Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. an opportunity to examine many to get a sense of the range of normal. of exam is rather difficult and not clinically important as both should generally be over the area in question. The rectum and anal canal are the most terminal parts of the lower GI tract/large intestine that form a functional unit and control defecation. The reader should review the techniques described in Chapter 97, Rectal Examination. A collection of surgery revision notes covering key surgical topics. Check out our NEW & IMPROVED quiz platform at geekyquiz.com, To be the first to know about our latest videos, subscribe to our YouTube channel . In certain diseases of the central or peripheral nervous system, innervation of The next step of the rectal examination involves the assessment of neuromuscular integrity. If you'd like to support us and get something great in return, check out our awesome products: You don't need to tell us which article this feedback relates to, as we automatically capture that information for you. While it may cause the Some infections can lead to infertility and chronic debilitating disease. Primary infection often presents with systemic, prodromal symptoms followed by clusters of painful, fluid-filled vesicles on an erythematous base, dysuria, and painful lymphadenopathy. Nevus is a non-specific medical term because it encompasses both congenital and acquired lesions, hyper- and hypopigmented lesions, and raised or flat lesions. Inguinal hernia Acromegaly examination text guide3. Briefly explain what the examination will involve using patient-friendly language: Today I need to carry out an examination of your genitals, this will involve me examining your penis, testicles and the surrounding region., Explain the need for achaperone:One of the ward staff members will be present throughout the examination, acting as a chaperone, would that be ok?, Gain consentto proceed with the examination:Do you understand everything Ive said? Sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) are infections that spread either by vaginal intercourse, anal sex, or oral sex. Penile Anomalies and Conditions, and masses that may need further evaluation to confirm Again, this is a very subjective finding which is only You should be able to feel the uterus between your hands. Gonorrhea may be asymptomatic but commonly manifests as cervicitis or urethritis with less common presentations such as proctitis, conjunctivitis, or pharyngitis. that the bleeding site is close to the anus? The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). Methotrexate counselling12. intra-abdominal pressure, forcing intestines/omentum/peritoneal fluid through any defect The body consists of the 2 parallel corpora cavernosa and the corpus spongiosum. Inguinal lymph nodes & inguinal hernia examples, Palpate the other testicle and epididymis, Inspect the scrotum with the patient standing, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LkhoUVlsVHNZMDJR, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LlJiVEF0NnE3aGxJ, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LmVsa0gtdG5pQzY0, Start typing to see results or hit ESC to close, Deep Vein Thrombosis (DVT) Examination OSCE Guide, Rash & Non-Pigmented Skin Lesion Examination OSCE Guide, Arterial Line Insertion (Arterial Cannulation) OSCE Guide, Chest Drain Insertion (a.k.a. This will allow me to assess the vagina, womb and ovaries. Peyronie disease This spirochete contains endoflagella, which allow for a characteristic corkscrew movement. Scrotum Explain to the patient that you need to perform a genital examination and ask permission to do so Offer a chaperone Expose patient: from waist down Position patient lying flat to begin with Ask if patient has any pain/is comfortable as they are Don gloves Inspection emerges from the external ring of the inguinal canal. Genetic changes in a malignancy, such as gene mutations or patterns of gene expression, are also being used as tumor markers, and are often referred to as cellular tumor markers.. Protrusion of tissue, structure, or part of an organ through the bone, muscular tissue, or the membrane by which it is normally contained. If present, it suggests incarceration/strangulation of the entrapped Palpatethe walls of the vagina for any irregularities or masses. Owing to its very thin structure, it is not easily seen on Gram stain, but can be visualized using dark-field microscopy. would be consistent with a hernia. Ask the patient to cough and inspect for vaginal prolapse, Gently insert lubricated fingers into the vagina, Rotate your hand 90 so your palm faces upwards, Withdraw fingers and inspect for discharge or blood, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LkhoUVlsVHNZMDJR, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LlJiVEF0NnE3aGxJ, YouTube Video VVVram5yRUhROGJRUW1sZk5kQVFDXzV3LmVsa0gtdG5pQzY0, Start typing to see results or hit ESC to close, Deep Vein Thrombosis (DVT) Examination OSCE Guide, Rash & Non-Pigmented Skin Lesion Examination OSCE Guide, Arterial Line Insertion (Arterial Cannulation) OSCE Guide, Chest Drain Insertion (a.k.a. Hernias may be internal, external, congenital, or acquired. Thank you for your effort. Both of these maneuvers increase Genital herpes infections are common sexually transmitted infections caused by herpes simplex virus (HSV) type 1 or 2. The prostate is a gland in the male reproductive system. Geeky Medics is a medical education platform that provides high-quality resources that anyone can access including:- OSCE guides: https://geekymedics.com/. digested blood as described above. Withdraw your fingers and inspect the glove for blood or abnormal discharge. spermatocele) and tenderness. the patient is supine. Gently insert the gloved index and middle finger of your dominant hand into the vagina. However, there is a problem with videos. Any pain on palpation, which is suggestive of prostatic infection? Identify any discrete swellings within this collection of tissues. Guaiac Positive (Note blue coloration in boxes), Cord Structures and Ensure that the subject is comfortable and only expose those parts of the body that are being examined. 3. Typical clinical findings include a fluctuant mass, separate from the testicle that transilluminates. Patients often present with rectal bleeding of bright red blood, or they may have pain, perianal pruritus, or a palpable mass. It presents with pruritis and clinical examination typically reveals white thickened patches. infection. or Digital DDx: Testicular Mass or Pain. Hepatitis B serology interpretation2. QUESTIONS TO CONSIDER. suspected undescended testicle. New abnormal growth of tissue. If you detect a diffuse swelling amidst the cord structures or note the inguinal canal area Paraphimosis. Hernia Fecal continence is maintained by several important anatomic structures including rectal folds, anal valves, the sling-like puborectalis muscle, and internal and external anal sphincters. This process causes an acute, inflammatory, monoarticular arthritis. Dispose of the used equipment into a clinical waste bin. Gently insert thegloved index andmiddle finger of your dominant hand into the vagina. The following examination, It is due to tightness or narrowing of the foreskin opening. chancre Symptoms and signs may include vaginal discharge, penile discharge, dysuria, skin lesions (e.g., warts, ulcers) on or around the genitals, and pelvic pain. This is most commonly caused by a hydrocele, which is a collection of fluid Penis Testicular examination video + text guide2. Carefully separate the labia using the thumb and index finger of your non-dominant hand. Thx! Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. with the left. Procedure Steps Step 01. If the patient is Prostatitis is inflammation or an irritative condition of the prostate that presents as different syndromes: acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain, and asymptomatic. Rectum and Anal Canal: Anatomy, Illustrations of Sexually Transmitted Infections (STIs), Explain the procedure and rationale to the subject. Privacy practices may vary, for example, based on the features you use or your age. Lubricate the gloved index and middle fingers of your dominant hand. Begin palpation of the spermatic cord from the superior aspect of the testicle using your thumb and index finger. the lights in the exam room and place a flash light on the scrotum, directly This condition may result from a variety of disease processes. Any fluid-filled closed cavity or sac that is lined by an epithelium. The tip of the index finger is placed at the most dependent part of the, Left-lateral (side-lying) position on the exam table, Standing and bending with elbows on the exam table. Accumulation of serous fluid between the layers of membrane (tunica vaginalis) covering the testis in the scrotum. The cystic fluid contains sperm (unlike an epididymal cyst). Make note of any Chlamydiae are obligate intracellular gram-negative bacteria. ), will be palpable throughout the length of the cord of an undescended testis. Candida is a genus of dimorphic, opportunistic fungi. is referred to as checking for occult blood (i.e. Note if there are any bulges or scars in the inguinal region, consistent with current or Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Place them on their side, with knees tucked up towards their chest. In subjects with urologic emergencies, such as paraphimosis What you encounter will vary with the clinical situation. It shouldnt be painful, but it will feel a little uncomfortable. Adapted by Geeky Medics. The examination mode makes assessment easy with built-in checklist mark schemes and customisable timer functionality. position covering head of penis. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Hernias may be internal, external, congenital, or acquired. Redness of the skin produced by congestion of the capillaries. There is usually some stool in the rectal vault that will coat your Provide paper towels for the patient to clean themselves. right and then directly backwards (i.e. Available from: [, Erskine K; Collecting data on female genital mutilation. There is a certain subjective tightness that you will notice when you enter the If the hydrocele is large, the testicle may be difficult to palpate. make up the spermatic cord, a structure that runs from the epididymis up through the FBC interpretation3. The organ is composed of a root, body, and glans. Cover the patient with the sheet, explain that the examination is now complete and provide the patient with privacy so they can get dressed. If you'd like to support us and get something great in return, check out our awesome products: You don't need to tell us which article this feedback relates to, as we automatically capture that information for you. gonorrhea Gently palpate the whole testicular body. SOCRATES overview8. It is faster and more organized than before. Normal prostatic tissue feels more or less like the tip of Inflammation involving the urethra. Explain the structures that will be examined (e.g., I will be examining your. with resulting edema causing fewer skin folds over the right testicle compared Gonorrhea is a sexually transmitted infection (STI) caused by the gram-negative bacteria Neisseria gonorrhoeae (N. gonorrhoeae). The etiologies are numerous but can include irritation, allergens, infections, or inflammatory conditions. pelvis An abdominal hernia with an external bulge in the groin region. Syphilis is a bacterial infection caused by the spirochete Treponema pallidum pallidum (T. p. pallidum), which is usually spread through sexual contact. Inflammation involving the urethra. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. along the spermatic cord, inverting the scrotal skin as you trace the cord to where it Suggest further assessments and investigations to the examiner: A quick overview of key clinical signs you might expect to find when performing a respiratory examination on a patient with chronic obstructive pulmonary disease (COPD). Geeky Medics is a medical education platform that provides high-quality resources that anyone can access including:- OSCE guides: https://geekymedics.com/. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. Suneja, M., Szot, J.F., LeBlond, R.F., Brown, D.D. The skin, also referred to as the integumentary system, is the largest organ of the body. Some infections can lead to infertility and chronic debilitating disease. rectum Please be advised: This clip may contain sensitive content. They may Introduce yourself to the patient including your name and role. 6. as close to you) as possible. a large rectal tumor) will not move. The classical agents (freunds adjuvant, bcg, corynebacterium parvum, et al.) finger at the end of the exam. . Licence: Mikael Hggstrm. Generalized lymphadenopathy often indicates underlying systemic disease. STIs A birth defect due to malformation of the urethra in which the urethral opening is above its normal location. chlamydia The prostate is a gland in the male reproductive system. hand. You should then assess the various characteristics of the uterus: The position of the uterus can be described as: The term adnexa refers to the area that includes the ovaries and fallopian tubes. Provide the patient withprivacyto undress andcheck it is ok to re-enter the room before doing so. quite vulnerable. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). Condylomata acuminata are described as raised, pearly, flesh-colored, papular, cauliflower-like lesions seen in the anogenital region that may cause itching, pain, or bleeding. The digital rectal exam can provide information about several important organ genital warts The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Most of the testicular cancers are of the germ cell tumor type, and they can be classified as seminomas and nonseminomas. Deep inguinal ring phimosis A spermatocele is a benign, smooth, extra-testicular, spherical cyst in the head of the epididymis or spermatic cord (there is no way to clinically differentiate a spermatocele from an epididymal cyst). Ask the patient to bear down as if they are trying to have a bowel movement. 2. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. structures or testis from the contents of the hernia, though give it a try. Testicular malignancy most commonly affects males aged between 20-40 years old. Enter the vagina with yourpalm facing laterally andthen rotate 90 degrees so that your palm is facing upwards. There were no objects or medical equipment around the bed of relevance., Abdominal examination was unremarkable and there were no abnormalities noted on inspection of the vulva. This allows us to get in touch for more details if required. Application of fingers with light pressure to the surface of the body to determine consistency of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. Exudates are fluids, cells, or other cellular substances that are slowly discharged from blood vessels usually from inflamed tissues. Position your external hand onto the left iliac fossa. prostate inguinal canal if you are concerned that it may contain a discrete mass, as in the case of a Today, were REALLY excited to announce Geeky AI; an intelligent assistant to help you write flashcards. Chancre. Prescribing at the end of life2. This condition is the 2nd most common skin malignancy and usually affects sun-exposed areas of fair-skinned patients. skin abnormalities, bleeding sites, fissures or hemerrhoids. 4. A varicocele is an abnormal dilatation of the testicular veins in the pampiniform venous plexus, caused by venous reflux. Distinguishing direct from indirect hernias on the basis A cutaneous pouch of skin containing the testicles and spermatic cords. Pay attention to the following: As your finger enters, make note if you hit any resistance. McGraw Hill. If if: the patient is obese/has large glutteal cheeks. at the tip of the penis, on the top-side (known as epispadias) or on the bottom-side The inflammation has spread from the testis to the skin of the scrotum, For additional information see: hernia 4. Geeky Medics is a medical education platform that provides high-quality resources that anyone can access including:- OSCE guides: https://geekymedics.com/. Put a lot of lubricant (a.k.a. The body consists of the 2 parallel corpora cavernosa and the corpus spongiosum. Occasionally, the entire testis feels enlarged. Sexually transmitted infections (STIs) are infections that spread either by vaginal intercourse, anal sex, or oral sex. should be located at the bottom of the scrotum. Surgical exploration is commonly warranted. Human papillomavirus (HPV) is a nonenveloped, circular, double-stranded DNA virus belonging to the Papillomaviridae family. masses. In the early phase of the disease, there are few, if any, systemic symptoms with the only clinical feature being a solitary solid testicular mass. 2. Labial and Genital HerpesLower left: ulcer/ leading to necrosis of the head of the penis, a condition referred to as paraphymosis. The gloves do not have to be sterile. pain specifically produced by pushing on the prostate. Licence: Pygmalion. Although this test can provide some clinical value it is inferior to Doppler ultrasound when trying to rule out testicular torsion. Pelvic inflammatory disease is closely linked with sexually transmitted diseases, most commonly caused by Chlamydia trachomatis, Neisseria gonorrhoeae, and Gardnerella vaginalis. Acne counsellingIf you find the app helpful, I'd really appreciate it if you could leave a rating or even a review. Ask the patient to report any pain or discomfort they experience during the examination. If there is a significant size discrepancy (or complete absence of one Make sure that you return the foreskin to its normal position has become trapped behind Carefully separate the labia using the thumb and index finger of your non-dominant hand. 3. Female Genitalia Examination Documentation 1 Read Free Female Genitalia Examination Documentation Thank you categorically much for downloading Female Genitalia Examination Documentation.Most likely you have knowledge that, people have see numerous times for their favorite books afterward this Female Genitalia Examination Documentation, but stop going on in harmful downloads. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! of each testis. Male Genital Exam. In this position, it is easier to examine the (hypospadias). them from the body of the testis by trans-illumination. The glans is ensheathed by the prepuce or foreskin. Primary infection often presents with systemic, prodromal symptoms followed by clusters of painful, fluid-filled vesicles on an erythematous base, dysuria, and painful lymphadenopathy. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. Available from: [, Farage MA, Miller KW, Tzeghai GE, et al; Female genital cutting: confronting cultural challenges and health complications across the lifespan. while testicular tissue will not. Available from: [, FGM mandatory reporting duty; Dept of Health and NHS England, 2015. chlamydia). Check out the male genital The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps. A physician, nurse practitioner, physician assistant, or another health professional who is directly involved in patient care and has a professional relationship with patients. The therapeutic efficacy of many biological response modifiers is related to their antigen-specific immunoadjuvanticity. Thanks for making the guides, I was wondering whether it will be possible for you to make a collection of normal and abnormal heart sounds, lung sounds, and bowel sounds heard at different places on the body (for example, how would systolic stenosis sound differently if heard at aortic, pulmonic, tricuspid, and mitral points) using diaphragm and bell of stethoscope? Check for any obvious milky discharge suggestive of urethritis, Testicular torsion involves the twisting of the spermatic cord resulting in a sudden loss of testicular blood supply. not have to be sterile. valsalva) or cough (though have them turn their heads first so they don't expectorate into Explain to the patient that the examination is now finished and provide them with privacy to get dressed. The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. the right glove. An orchidopexy is an operation performed in children for undescended testicles where the testicle is brought down from the inguinal canal into the scrotum. Up to 50% of patients will develop painful inguinal lymphadenopathy. although it can be from anywhere in the GI tract. + Examination of the Kidneys. Digital DDx: Anorectal Symptoms. You might also be interested in our awesome bank of 700+ OSCE Stations. Learn on the go with our comprehensive collection of high-quality OSCE guides covering a wide range of clinical skills.Our video demonstrations make clinical skills easier to understand.In need of a refresher? rectum. Have the patient repeat the above maneuvers that increase Breaking bad news (video demonstration)5. We make it easy to identify areas you need to focus on to perform better in your exam. inserted. Genital herpes infections are common sexually transmitted infections caused by herpes simplex virus (HSV) type 1 or 2. If present, note their Adapted by Geeky Medics. malignancy Normal appearing A physical examination in which the qualified health care worker inserts a lubricated, gloved finger of one hand into the rectum and may use the other hand to press on the lower abdomen or pelvic area to palpate for abnormalities in the lower rectum, and nearby organs or tissues. BMJ. Similar to cystitis, clinical symptoms range from vague discomfort to painful urination (dysuria), urethral discharge, or both. Copyright 2022 Apple Inc. All rights reserved. patient with something to lean against for support. Are there any underlying firm areas? Some infections can lead to infertility and chronic debilitating disease. The feeling-tone accompaniment of an idea or mental representation. (2020). of problem in pediatric then adult medicine). An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. LearnMore. Patients typically present with gradually worsening testicular pain and scrotal swelling along with systemic symptoms such as fever, depending on severity. Examination of urine by chemical, physical, or microscopic means. Testicles: Anatomy through the Licence. It is the causative agent of gonorrhea. Testicular torsion is the sudden rotation of the testicle, specifically the spermatic cord, around its axis in the inguinal canal or below. This clip demonstrates a male genital exam. the cheeks of the buttocks and look at the peri-anal area. Do you have any questions? A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Does the stool appear black/tarry, which occurs You can learn more about respiratory examination here: https://geekymedics.com/respiratory-examination-2/, Respiratory Examination Signs in COPD - OSCE Guide. Try This allows us to get in touch for more details if required. Lecturio Premium gives you full access to all contents and featuresincluding Lecturios Qbank with up-to-date board-style questions. should be able to get you finger over the top of the gland. or absent. Occasionally you will be unable to retract the foreskin from the head of the . Intercostal Drain) OSCE Guide, Ascitic Drain (Therapeutic Paracentesis) OSCE Guide, Nasopharyngeal Airway Insertion OSCE Guide, Parkinsons Disease Examination OSCE Guide. information and should not be skipped. inguinal hernia This is an intimate examination and therefore extra attention should be paid to the communication aspect to ensure the patient feels as comfortable as possible. Destructive scarring and adhesions develop causing distortion of the normal vaginal architecture (shrinking of the labia, narrowing of the introitus, obscuration of the clitoris). stool should be tested with a special agent designed to detect hemoglobin (see below). Diagram of First, each side of the buttocks is scratched with the gloved finger to elicit the superficial anal reflex (the anal "wink"), a function of L 1 and L 2. The testicles, also known as the testes or the male gonads, are a pair of egg-shaped glands suspended within the scrotum. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. DDx: Penile Mass, Ulcer or Discharge. If this condition persists, it can lead to painful constriction of glans penis, swelling, and impaired blood flow to the penis. Make careful note of any discrete lumps or bumps The primary sore of syphilis, a painless indurated, eroded papule, occurring at the site of entry of the infection. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. Vesicles Medimage. can use for cleaning themselves at the end of the exam. Subscription automatically renews unless auto-renew is turned off at least 24-hours before the end of the current period. If the patient consents to the continuation of the examination: 1. Nevi (singular nevus), also known as moles, are benign neoplasms of the skin. peritoneal cavity Stroking of the skin causes the cremaster muscle to contract and pull up the ipsilateral testicle toward the inguinal canal. Based on known statistical data, the number of years which any person of a given age may reasonably expected to live. For more information, see the developers privacy policy. The primary sore of syphilis, a painless indurated, eroded papule, occurring at the site of entry of the infection. skin repaired and the final determination can be made at the time of surgery. 1. Peyronie Disease Testicular cancer is the most common solid malignancy affecting men 15-35 years of age. Genitourinary examination is an integral part of the male physical examination that provides important information on the normal development in infants and children. lobe distinctly? It is usually related to infections in the urinary tract, which likely spread to the epididymis and then the testis through either the vas deferens or the lymphatics of the spermatic cord. within the anal canal. request), allowing you to feel the contraction of this muscle. If indicated, the doctor will also examine the rectum/anal area, and . You can also distinguish Inspect and palpate the posterior scrotum for evidence of varicocele (a palpable mass that feels like a bag of worms) or a hernia (a mass which you cannot get above). Thus, it's a good idea to talk them through each step. A glycoprotein that is a kallikrein-like serine proteinase and an esterase, produced by epithelial cells of both normal and malignant prostate tissue. Exam of the left inguinal area is done in the same way, though hand positioning is reversed. You can further assess external sphincter tone by asking the Pelvic exam is a important part of the exam for female patients and important towards making various diagnoses such as yeast vulvovaginitis, bacterial vaginosis, lichen sclerosis, cancers such as cervical cancer, anal/rectal cancer, sexually-transmitted infections (gonorrhea, chlamydia, trichomonas, syphilis, herpes and human papillomavirus) and many other diagnoses. Male Genital Examination - OSCE Guide | Geeky Medics This male genital examination OSCE guide provides a structured approach to examining the penis and testicles. Picture on right demonstrates appearance in same patient after manual reduction. Formation and development of a thrombus or blood clot in the blood vessel. Generalized rashes occur diffusely throughout the body. Etiologies include malignancy, infection, and autoimmune disorders, as well as iatrogenic causes such as the use of certain medications. pigmented areas, ulcers, vessicles etc.). Inflammation of a testis. In the male, the malformed urethra generally opens on the ventral surface of the penis or on the perineum. A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. There are several causes of abnormal vaginal discharge including: Warn the patient you are going to examine the vagina and ask if theyre still ok for you to do so. Confirm the patients name and date of birth. Access over 5000 free MCQs, 2500 flashcards & 700 OSCE stations. Asking the patient to cough as you inspect can exacerbate the lump and help confirm the presence of prolapse. The 8. Gonorrhea may be asymptomatic but commonly manifests as cervicitis or urethritis with less common presentations such as proctitis, conjunctivitis, or pharyngitis. Typical clinical features include the sudden onset of severe testicular pain, scrotal erythema and a swollen retracted testicle. By gently rotating your hand, you can use the pad of your index finger to feel to the left, Dispose of PPE appropriately and wash your hands. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! The developer, Geeky Medics LTD, indicated that the apps privacy practices may include handling of data as described below. spermatocele) and tenderness. Penile Anomalies and Conditions (left) and Licence: Fisch12. Condylomata Acuminata (Genital Warts)Upper right: penis, referred to as phymosis. Endocarditis is an inflammatory disease involving the inner lining (endometrium) of the heart, most commonly affecting the cardiac valves. at the end of the exam, else it can cause severe venous and arterial obstruction, Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Before palpating this region, have the patient bear down (i.e. Forced expiratory effort against a closed glottis. Female Genital Mutilation. As they bears down, gently push forward until you have placed the entire finger Inspectfor evidence of vaginal prolapse (a bulge visible protruding from the vagina). be barely palpable by the index finger placed in the external ring of the inguinal canal. Pain that you made available to them earlier. Genital Herpes You can ask me to stop at any point., Explain the need for achaperone:One of the female ward staff members will be present throughout the examination, acting as a chaperone, would that be ok?, Gain consent to proceed with the examination: Do you understand everything Ive said? The causes of meningitis are varied, with the most common being bacterial or viral infection. The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. via direct STIs Then turn the card over and open the back. Some infections can lead to infertility and chronic debilitating disease. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. Available from: [. The two sacs are connected by the foramen of winslow, or epiploic foramen. 5. The patient should be able to relate whether he was ever able to feel This will involve me using one hand to feel your tummy and the other hand to place two fingers into your vagina. male genital anatomy. (2018). In this setting, it may be difficult to distinguish the cord NEW CLINICAL EXAMINATION GUIDES1. The pelvic girdle, composed of 2 hip bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column with the lower extremities. If there appears to be a single testis, carefully examine the inguinal canal above, which readily conducts light). Exam of the stool. No authors listed. (e.g. The prostate is an exocrine gland that produces a weakly acidic secretion, which accounts for roughly 20% of the seminal fluid. which may exist and making a hernia more apparent. It is a rare cause of cerebral infarction resulting from thromboembolic occlusion of cerebral veins and sinuses. NCLEX, NCLEX-RN, and NCLEX-PN are registered trademarks of the National Council of State Boards of Nursing, Inc (NCSBN). You may be able to put the tip of your scrotum Explain to the patient what you are going to do (and why) screening Video. Eukaryotic and prokaryotic organisms normally contain DNA in a double-stranded state, yet several important biological processes transiently involve single-stranded regions. Herpes simplex virus (HSV) is a double-stranded DNA virus belonging to the family Herpesviridae. The convoluted cordlike structure attached to the posterior of the testis. testes, evaluate for inguinal hernias and perform the rectal exam. This may be less thorough than a full abdominal examination, but should at least include inspection and palpation of the abdomen. when blood released from an upper intestinal source is digested and passed thru the entire alimentary canal? As this is an intimate examination it is pertinent to gain a good rapport with your patient, maintain good communication and ensure the patient's dignity at all times. Some are endogenous (e.g., histamine, interferon, transfer factor, tuftsin, interleukin-1). structures. Paraphymosis: Picture on left demonstrates edematous foreskin which In the female, the malformed urethral opening is often between the clitoris and the labia, or in the abdomen. Adapted by Geeky Medics. In DeGowins Diagnostic Examination, 11e. Sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) are infections that spread either by vaginal intercourse, anal sex, or oral sex. First examine the glans (i.e. Please write a single word answer in lowercase (this is an anti-spam measure). On general inspection, the patient appeared comfortable at rest and there were no objects or medical equipment around the bed of relevance., On inspection, there were no abnormalities identified, however, on palpation, there was a 1cm smooth solid mass noted in the left side of the scrotum, separate from the testicle. Palpate and compare the head, body, and tail on each side. Glottis consists of the vocal folds and an opening (rima glottidis) between the folds. Are you happy for me to carry out the examination?. In the female, the malformed urethral opening is in the vagina. Bacterial prostatitis is easier to identify clinically and the management (antibiotics) is better established. urethritis Before proceeding, provide the patient with a box of tissue paper that they The hand constitutes the distal part of the upper limb and provides the fine, precise movements needed in activities of daily living. Look at the opening of the urethra. Next, using a generous amount of water-soluble gel for lubrication, the gloved index finger is . of the testes) ask the patient if this has always been the case. If the patient is aged under 35, it is likely due to a sexually transmitted infection (e.g. The glans is ensheathed by the prepuce or foreskin. Palpation of the testicle involves a gentle rubbing motion between your thumb and index finger to methodically examine the whole body of the testicle. missed testicular torsion) or surgery (e.g. Humans are the only reservoir, and transmission occurs through close skin-to-skin or sexual contact. Penile Anomalies and Conditions (right), Physical examination findings with Separate Read reviews, compare customer ratings, see screenshots, and learn more about Geeky Medics - OSCE revision. Blood transfusion counselling14. They do not cause issues unless they are enlarged, inflamed, thrombosed, or prolapsed. Pain: Types and Pathways, infection, Are you happy for me to carry out the examination?. Womens Health (Lond Engl). transilluminate. its entirety. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. lying on the exam table. The testicle should be palpable within the hydrocele sac and the mass should transilluminate. Inspect it after you withdraw your hand, looking for red or Penis: Anatomy anatomy Right: Abnormal curvature is seen with . table prior to beginning the exam and put a small smear of stool in each of the windows. Remember, this is a delicate aspect of the exam, and the patient often feels If a scrotal mass is identified, assess the following characteristics: Palpate the epididymis which is located at the posterior aspect of the testicle: tenderness is indicative of epididymitis (e.g. 3. Ask the patient if they have any pain before proceeding with the clinical examination. Dermatologic Examination of the anal orifice: Notice that the examiner retracts the buttocks with the back of the Syphilis has 4 clinical stages: primary, secondary, latent, and tertiary. Further investigations involve assessment of secondary sexual characteristics and hormonal abnormalities as well as ruling out anabolic steroid use. Symptoms and signs may include vaginal discharge, penile discharge, dysuria, skin lesions (e.g., warts, ulcers) on or around the genitals, and pelvic pain. Glaucoma counselling13. If they have not already done so, ask the patient to remove their underwear. relationship to the testes and inguinal canal. The testicles are composed of testicular lobules and seminiferous tubules. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. skin texture that is different from that of testicular tissue. 4. Check out our NEW & IMPROVED quiz platform at geekyquiz.com, To be the first to know about our latest videos, subscribe to our YouTube channel . Do they feel symmetric? Patient Introduction and Review of Anatomy of the Male Genitourinary System, Examination of the Male Genitourinary System, Quick Review: Examination of the Male Genitourinary System. Their mode of action is either non-specific, resulting in increased immune responsiveness to a wide variety of antigens, or antigen-specific, i.e., affecting a restricted type of immune response to a narrow group of antigens. Human papillomaviruses infect basal epithelial cells and can affect cell-regulatory proteins to result in cell proliferation. The gloves do Screening for Prostate Cancer: Recommendation Statement. It consists of 5 metacarpal bones and 14 phalanges, as well as numerous muscles innervated by the median and ulnar nerves. I wanted to offer users the ability to try the app, prior to committing to . Palpate along the cord assessing for masses (e.g. Typical clinical findings include a posterior scrotal mass that feels like a bag of worms which is more apparent when the patient is standing. Direct inguinal hernias occur through defects in the abdominal wall (transversalis fascia) in hesselbachs triangle. Infrequent/Mild Medical/Treatment Information. Inspection gland feel swollen? Condylomata acuminata are a clinical manifestation of genital HPV infection. Observation: Note if there are any bulges or scars in the inguinal region, consistent with current or past hernias. Anything firmer is suspicious for malignancy. The root is attached to the pubic bone by the crura penis. Testicles: Anatomy, and inguinal area (groin). Gonorrhea Female genital mutilation (FGM) is defined by the WHO as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.5Over 140 million girls and women worldwide have undergone FGM.6Women attending maternity, family planning, gynaecology, and urology clinics (among others) should be asked routinely about the practice of FGM.7 Cases of FGM in girls under the age of 18 should be reported to the police.8. A musculomembranous sac along the urinary tract. You might also be interested in our awesome bank of 700+ OSCE Stations. Similar to cystitis, clinical symptoms range from vague discomfort to painful urination (dysuria), urethral discharge, or both. Adapted by Geeky Medics. For additional information see:
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