1. Reproductive System History and Examination
Female Breast and Pelvic Exam
Male Genitourinary and Rectal Exam
Dr. Lanice Jones 2008

2. Breast Examination History: Common Concerns or Symptoms
Breast lump or mass
Breast pain or discomfort
Nipple Discharge
Risk Factors for Breast Cancer
Age - > 50 years old
Family History
Menstrual History

3. Risk Factors For Breast Cancer
Age – greater than 50
Family History
First degree relative
Pre or Post Menopausal
Unilateral or Bilateral
Menstrual History
Menarche < 12 years old
Age at menopause > 55
Pregnancy History
First live birth after 30 years of age or no pregnancy
Not Breast Feeding or short time breast feeding

4. Breast Anatomy

5. Breast Exam: Inspection
Arms at sides
Hands pressed against hips
Arms overhead
Look for skin color,
Skin retraction, dimpling
Nipple shape, asymmetry

6. Palpation Axillary Palpation Sitting
Check anterior, medial, lateral and posterior quadrant of axilla

7. Palpation Lying Expose one breast at a time
3 different Palpation techniques
Wedge (clock hours)
Vertical strip
circular

8. Palpation techniques Move fingers in small circles One hand
Two hands for larger breasts – stabilize the tissue

9. Nipple exam
Check for nipple discharge

10. Pelvic Examination History Menarche, Menstruation, Menopause Pregnancy
Pain
Vulvovaginal symptoms
Discharge
Itching
Sores, lumps
Sexual activity

11. Female Pelvic Anatomy

12. Inspection Inspection: Labia Clitoris Vaginal opening Discharge
Lesions

13. Inspection: Speculum Exam
Inspect vaginal opening
Vaginal walls
Cervix

14. Palpation: Bimanual Examination
Use lubrication
Palpate cervix
Gently move cervix – test for pain with movement
Palpate uterus
Palpate each ovary

15. Male Genitourinary Hx and Exam
History
Pain
Swelling
Discharge
Sexual Problems: Pain or Erectile Dysfunction

16. Pelvic Anatomy Male

17. Inspection 1. Testicles 2. Epididymis 3. Corpus cavernosis 4. Foreskin
5. Frenulum
6. uretheral meatus
7. Glans penis
8. corpu8s spongiosum
9. Penis
10. scrotum

18. Palpation Palpate each testis and epididymis
Size, shape, consistency, tenderness, nodules
Palpate each spermatic cord and vas deferens
Palpate for Inguinal Hernias

19. Digital Rectal Examination
Position
Lying on left side
Standing
Inspect perianal area
Examine anus and rectum
Use lubrication, wait for sphincter to relax
Note sphincter tone, tenderness, irregularities or nodules