Breast Exam Techniques and Protocols

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Questions and Answers

What type of student is the person performing the breast exam?

PA Student

What is the purpose of the breast exam?

Inspecting and palpating the breasts in various positions, performing a pelvic examination, and obtaining a pap smear.

The patient is asked to change before the breast exam.

True

What should be gathered before the breast exam begins?

Supplies and a chaperone Signup and view all the answers

What are the three positions the patient is asked to assume during the breast exam?

standing, sitting, lying down Signup and view all the answers

When inspecting the breasts, what characteristics are evaluated?

size, shape, contour, dimpling, skin color, edema, venous pattern, nipple size, shape, direction, rashes, ulceration Signup and view all the answers

The patient is asked to keep their hands at their side during the breast exam while sitting?

True Signup and view all the answers

What is the purpose of using fingertips to evaluate a mass?

To describe the mass in terms of its location, size, shape, mobility, consistency, and tenderness. Signup and view all the answers

What is the purpose of palpating the nipples?

To assess their elasticity and any presence of discharge. Signup and view all the answers

The patient should wear their gown open in the front for the breast exam.

True Signup and view all the answers

What is the purpose of asking the patient to cough and bear down during the pelvic exam?

To check for cystocele, incontinence, or rectocele. Signup and view all the answers

Why is a chaperone required during the GU/PAP smear?

To assist with the exam, ensure patient privacy and confidentiality, and protect the healthcare provider. Signup and view all the answers

Why are patients asked to take deep breaths while the speculum is being inserted?

To help relax the muscles and make the insertion more comfortable. Signup and view all the answers

The transformation zone is the area where the squamous epithelium of the vagina meets the glandular epithelium of the cervix.

True Signup and view all the answers

What is the purpose of rotating the brush during the Pap smear collection?

To collect a sample from all areas of the cervical os and the transformation zone. Signup and view all the answers

What is the purpose of the bimanual examination?

To assess the cervix, uterus, and adnexa. Signup and view all the answers

The patient is asked to remove their gown during the GU/PAP smear.

False Signup and view all the answers

Study Notes

Breast Exam

Introduction: Introduce self, use preferred pronouns and ask how patient would like to be addressed.
Purpose & Consent: Explain the purpose of the exam (breast and pelvic exam, including pap smear) and obtain consent.
Patient Prep: Provide gown, allow patient privacy to change and gather necessary supplies, including chaperone.
Standing Exam: Assess breasts for size, shape, contour, dimpling, skin color, edema, and venous pattern; assess nipples for size, shape, direction, rashes, and ulceration. Patient should stand and lean forward.
Sitting Exam: Repeat steps from standing exam, with patient sitting, keeping hands by their side.
Lying Down Exam: Position patient lying down, right hand behind head, palpate breast in linear pattern with three fingers. Pay attention to tail of Spence, and all four quadrants.
Mass Identification: Use fingertips to evaluate masses; note location, size, shape, mobility, consistency, tenderness. Provide example of how to describe a mass.
Nipple Palpation: Palpate nipples using thumb and index finger; note any elasticity and discharge.

Pelvic Exam

Gather Supplies: List necessary supplies (e.g., gloves, vials, lubricant, speculum, tissues.)
Chaperone: Explain the need and role of the chaperone.
Patient Positioning: Position patient; place patient in lithotomy position, drape properly.
External Genitalia Inspection: Visualize mons pubis, labia majora/minora, urethra, clitoris, vaginal introitus, and perineum. Palpate Bartholin's and Skene's glands.
Internal Examination: Inspect visually for cystocele, incontinence, and rectocele. Obtain the sample in the proper orientation.
Pap Smear Procedure: Explain the procedure and rationale for the pap smear. Grasp the swab, insert parallel with cervix, rotating 3-5 times before sample collection in vial.
Cervical Abnormalities: Identify cervical abnormalities and transformation zone.
Cervical Motion Tenderness: Palpate for cervical motion tenderness.
Ovaries, Adnexa, Uterus: Palpate ovaries, adnexa, and uterus in appropriate positions, while palpating the lower abdomen while palpating the uterus.
Discard Materials: Properly discard materials.
Post-Examination: Provide tissue for patient to clean themselves.

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Description

This quiz covers essential techniques and protocols for performing breast exams, including the introduction, patient preparation, and various examination positions. It emphasizes the importance of consent, privacy, and thorough assessment in patient care.