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Vy

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Basic gynecological examination 3rd Medical Faculty, Charles University Gynecological examination Non invasive: history, aspection, palpation, ultrasound, etc – PowerPoint PPT presentation

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Title: Vy


1
Basic gynecological examination
3rd Medical Faculty, Charles University
2
Gynecological examination
  • Non invasive history, aspection, palpation,
    ultrasound, etc
  • Pre-bioptic examination kolposcopy
  • Mikrobiological examination
  • Endoscopic methods cystoscopy, hysteroscopy,
    laparoscopy, etc

3
History
  • Family / genetic factors
  • Personal - blood pressure, BMI, etc
  • gynecological - obstetric
  • Menstruation cycle
  • Delivery spontaneus / S.C.
  • Gynecologicla disease
  • Contraception / hormonal therapy
  • Status present
  • Sexual life

4
Gynecological examination
  • palpation
  • cervix, uterus, adnexis, cavum Douglasi,
    abdominal wall, small pelvis, urinary bladder -
    pain, resistence, peritoneal irritation
  • In speculam
  • Pathology of introitus, vulva, cervix
    (speculae Simpsons, Scherbacks, Cuzks)
  • examination per rectum
  • Pediatric gynecology
  • cervix, uterus, adnexis, cavum Douglasi
  • Examination in anestasia / analgesia

5
  • Breast examination
  • shape, density, skin and nipple of the breast
  • palpation 4 quadrants, nipple discharge
  • recommandation
  • self examination once a months
  • Mamograph screening programme from 45 years
    every 24 months event. ultrasound

6
Pre-bioptic examination methods
  • Kolposcopy
  • Screening examination
  • 6 - 40x (magnification)
  • native kolposcopy
  • Cervical and vulvar patholgy
  • Change of the epithelium,
  • inflammation
  • angiogenesis
  • Pre-cancerosis, tumor proscess

7
Pre-bioptic examination methods
  • Expanded colposcopy
  • Acetic acid diferentiation of squamous and
    cylindric epithelium change of the colour
    andtransparence
  • Schillers examination Lugols dilution
    squamous epithelium is brown, cylindric
    epithelium or erosion are non-colured

8
Pre-bioptic examination methods
  • Expanded colposcopy
  • physiological status squamous epithelium,
    ektopium, ektropium, trnasformative zone
  • non-physiological status angiogenesis, glands,
    leukoplakia, white epithelium, mozaik,
    pre-carcinoma, carcinoma.
  • kondylomatas, papiloms etc

9
Pre-bioptic examination methods
  • Function cytology
  • changes of the epithelium during the menstruation
    cycle
  • diagnaotic of the mestrual cycle disorders
  • Oncological cytology
  • The most important screening methods for ca
    cervicis
  • Cytological critiria of the smear from the cervix
    exocervix / endocervix

10
Pre-bioptic examination methods
  • Classification of the oncological cytology
  • Bethesda
  • SIL - dlaždicobunecná intraeiteliální léze
  • LSIL
  • HSIL
  • ASCUS
  • HPV infection

11
Ultrasound
  • The most important diagnostic method
  • Abdominal ultrasound
  • Pediatric gynecology
  • Abdominal tumors, ascites
  • Vaginal ultrasound
  • Small pelvis pathology
  • GEU
  • Tumonrs ot the vary and uterus
  • doppler

12
Urogynecology
  • cystoskopy
  • urodynamics
  • uroflowmetry
  • Uretral pressure profile
  • uretrocystografy

13
Endoskopic methods
  • Vaginoscopy
  • Hysteroscopy
  • Rektoscopy
  • Laparoscopy

14
laparoscopy
15
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16
Invasive diagnostic and treatment methods
  • Dilatation of the cervix
  • curretage
  • Punction of the cavi Douglasi
  • Biopsia of the cervix
  • Biopsia of the vulva
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