OSCE PELVIC EXAM AND PAP

SMEARIna S. Irabon, MD, FPOGS, FPSRM, FPSGE

Obstetrics and GynecologyReproductive Endocrinology and Infertility

Laparoscopy and Hysteroscopy

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

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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

5. Speculum examination

• Separate the labia minor using the thumb and middle finger of the examining hand

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

5. Speculum examination• Examine the cervix and

vaginal walls

• Report any visualized vaginal discharge (color, consistency, adherence to walls, odor, presence of erythema)

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

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

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

Concluding the visit

8. Entertain questions from the patient 9. Answer patient’s questions adequately 10. Thank the patient

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