Shadowing Practice: Gynaecological Examination - Learn English Speaking with Video

The gynecological examination.

So continuing on our examination series, we're going to be taking a look at the gynae examination.

So when performing any examination on the patient, we always need to have a discussion prior, explain what we're going to be doing and obtain verbal consent.

We need to inform her that she will need to get undressed from the waist down, therefore we need to have an appropriate room where the patient will be able to get undressed in privacy

and we should provide the sheet so that she can cover herself.

We can ask her if she would like to empty her bladder

and also perform a pregnancy test before proceeding with the examination.

For this examination we will need to have a chaperone present with us.

Finally we need to ensure we have all our equipment prepared for the examination including a Cusco speculum,

lubricant gel, swabs used to assess for any infections and possibly a cervical smear brush.

Now we also need to prepare the couch.

This time we need to position the couch completely flat.

Then we need to make sure we wear disposable gloves as you can see here.

And then we would always start with the abdominal examination.

So here we will assess for tenderness, rebound guarding and any masses.

If you would like to see a detailed video on the abdominal examination, let me know in the comments.

Okay, so now we can start off the proper gynae examination.

So we start off by asking the patient to bend her legs and bring her heels to her buttocks, and allow her knees to fall to the sides.

This is called the modified litotomy position, and is preferred nowadays to placing the patient's legs in stirrups.

Now we can uncover the patient, and start off with inspection of the vulva.

So, here we are looking for any scars,

erythema, discoloration, masses, warts or ulcers and discharge or bleeding from the entroitis.

We can also part the labia a bit to improve our inspection.

At this point, we can also ask the patient to cough to assess for any prolapse.

Again, if you'd like to see a video from me about vaginal prolapse, leave a comment down below.

next up we've got the speculum examination

so first let's take a look at the instrument

so this is a cusco's speculum over here we have the blades the fixation screw and the handles

i like to hold the speculum as you can see here with my thumb

and index finger above the anterior blade

and my third finger below the posterior blade this gives me good stability

when handling the speculum and prevents the blades from opening before I want them to.

So next we'll look at how to insert the speculum, so of course on an actual patient we'll need to lubricate the blades of the speculum.

Then part the labia, insert the speculum on its side slowly with the blades closed

and then rotate the speculum with the handles positioned at the top.

I prefer this approach rather than having the handles facing downwards and having to fiddle with them close to the anus.

Once the speculum has been inserted all the way in, we start to open the blades under direct vision until the cervix has come into view.

Of course you must have some form of light available to see properly.

When we are happy, we can use a fixation screw to keep the speculum in place.

Once we have done this, we can inspect the cervix and the vaginal walls.

First of all, looking at the cervix, we want to identify any cervical ectropion,

any obvious masses any discharge or bleeding then we want to look at the vaginal walls

and inspect for any vaginal tears or lacerations

that is one advantage of using these transparent speculums as you

can still inspect all vaginal walls during the examination now here

i've also shown how to take a high vaginal swab

so essentially we are guiding the swab into the posterior fornix

which is location underneath the cervix and here we're taking a cervical smear

so here we are using a cervical broom the tip is inserted into the cervical loss

and is brushed in a circular motion over the cervix by

360 degrees for five turns some pressure should be applied to make sure

that the cells are sticking to your cervical broom for more

information on smears i have created a video all about this subject next we need to remove the speculum

so first we will retract the speculum slightly keeping the blades

open until we have passed the cervix then we can close the blades

and then we draw the speculum gently in the same position or rotate it again and withdraw it completely.

To perform the bimanual vaginal examination, we first lubricate two fingers.

Again, part the labia using our left hand and insert the fingers of our right hand gently into the vagina.

Now, our left hand will be placed on the abdomen so that we can bellow the structures between our two hands.

Starting off with the uterus, we want to assess the position, size and mobility of the uterus.

so back to some revision here so

when we talk about the position of the uterus we refer to version

and flexion of the uterus but what are these

so these refer to angles created by the curvature of the uterus

so the first is how the long axis of the uterus

is bent over the long axis of the vagina this refers

to version then we've got the angle created by the long axis of uterus, bent over the long axis of the cervix,

and this is referred to as flexion.

So keeping these two diagrams in mind, here we have got an antiverted uterus, with the uterus bent forwards over the vagina.

Then we have a retroverted uterus, with the uterus bent backwards over the vagina.

an anti -flexed uterus with the uterus bent forwards over the cervix

and a retroflexed uterus with the uterus bent backwards over the cervix.

So during a bimanual examination from these two images, you can appreciate how the cervix will be positioned in a different direction

and the uterus will be much harder to palpate when in a retroverted position.

now we also want to assess ferny masses

or cervical excitation cervical excitation refers to acute tenderness on palpation

of the cervix these patients might literally jump off the couch

so be careful when listing this sign some causes include pelvic inflammatory disease

or ectopic pregnancy we will then move over to the right at nexa again feeling ferny masses or adnexal tenderness,

a normal ovary will not be palpable in examination and will repeat the same on the left.

When talking about adnexal tenderness, this could be secondary to an ovarian cyst accident, such as ovarian cyst structure or ovarian torsion.

I hope you found this helpful.

If you haven't watched my previous video on the obstetric examination, you can have a look at it here.

Let me know what you think in the comments, like and subscribe.

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Vocabulario y notas de pronunciación para esta lección

Esta lección de conversación se basa en el vídeo “Gynaecological Examination”. Las palabras que más se repiten: uterus, examination, speculum, cervix, blade. Este vídeo tiene 84 frases y 1203 palabras para practicar shadowing. La parte hablada dura 7:37. El hablante habla a un ritmo natural de unas 158 palabras por minuto, cercano a una conversación cotidiana. Solo el 74 % de las palabras está entre las 3.000 más comunes del inglés, por lo que el vocabulario es exigente.

Vocabulario clave de este vídeo

15 palabras del vídeo que vale la pena aprender, con su pronunciación y significado:

Palabra	Pronunciación	Significado
examination sustantivo	/ɪɡˌzæm.ɪˈneɪ.ʃən/	examen, examinación
blade sustantivo	/bleɪd/	cuchilla, hoja
bend verbo	/bɛnd/	cimbrar, cimbrear
refer verbo	/ɹɪˈfɜː/	referir, remitir
assess verbo	/əˈsɛs/	evaluar, estimar
insert verbo	/ɪnˈsɝt/	insertar, enserir
finger sustantivo	/ˈfɪŋɡɚ/	dedo, alambres
axis sustantivo	/ˈæksɪs/	eje
vagina sustantivo	/vəˈdʒaɪ.nə/	vagina
couch sustantivo	/ˈkaʊ̯t͡ʃ/	sofá, sillón
inspect verbo	/ɪnˈspɛkt/	inspeccionar
angle sustantivo	/ˈæŋ.ɡəl/	ángulo
pregnancy sustantivo	/ˈpɹɛɡnənsi/	embarazo, gravidez
brush sustantivo	/bɹʌʃ/	pincel, cepillo
inspection sustantivo	/ɪnˈspɛkʃən/	inspección

Gramática en este vídeo

Las estructuras que más usa el hablante, con las palabras exactas del vídeo:

Estructura	En el vídeo
Voz pasiva be + participio pasado — importa lo que ocurre, no quién lo hace	is called · has been inserted · is inserted
Present perfect have/has + participio pasado — una acción pasada que sigue importando ahora	has been inserted · have done · i've also shown

Pronunciación a tener en cuenta

El hablante usa 10 contracciones y formas reducidas, como we're, we'll, we've. Dilas en su forma corta, tal como las oyes.

Los sonidos de “th”: underneath /ˌʌndɚˈniθ/, withdraw /wɪðˈdɹɔ/, thumb /ˈθʌm/, erythema /ˌɛɹɪˈθiːmə/
Los sonidos de “sh” y “zh”: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, brush /bɹʌʃ/, inspection /ɪnˈspɛkʃən/, essentially /ɪˈsɛnʃəli/, sheet /ʃit/
Palabras largas — cuida el acento: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, essentially /ɪˈsɛnʃəli/, stability /stəˈbɪlɪti/, mobility /mə(ʊ)ˈbɪlɪti/, inflammatory /ɪnˈflæmət(ə)ɹi/

Sonidos difíciles para hispanohablantes:

s + consonante al inicio — sin añadir una “e” delante: stability /stəˈbɪlɪti/, scar /skɑɹ/, speculum /ˈspɛk.jə.ləm/, smear /smiɚ/, swab /swɒb/
/v/ — no es /b/: los dientes tocan el labio inferior: vagina /vəˈdʒaɪ.nə/, privacy /ˈpɹaɪ.və.si/, verbal /ˈvɜː.bəl/, revision /ɹəˈvɪʒ.ən/, glove /ɡlʌv/
/z/ — sonora, no /s/: examination /ɪɡˌzæm.ɪˈneɪ.ʃən/, nowadays /ˈnaʊ.ə.deɪz/, disposable /dɪsˈpoʊzəbl̩/, downwards /ˈdaʊnwɚdz/

Cómo practicar con este vídeo

Escucha el vídeo entero una vez sin hablar y anota las palabras que no conoces.
Empieza a velocidad 0,75×, haz shadowing frase por frase y vuelve a la velocidad normal cuando te resulte fácil.
Grábate y compara con el original, prestando atención a palabras como examination, blade, bend.

¿Qué es la Técnica de Shadowing?

Shadowing es una técnica de aprendizaje de idiomas respaldada por la ciencia, desarrollada originalmente para la formación de intérpretes profesionales y popularizada por el políglota Dr. Alexander Arguelles. El método es simple pero poderoso: escuchas audio en inglés nativo y lo repites en voz alta de inmediato, como una sombra que sigue al hablante con solo 1-2 segundos de retraso. A diferencia de la escucha pasiva o los ejercicios de gramática, el shadowing obliga a tu cerebro y músculos de la boca a procesar y reproducir simultáneamente patrones de habla reales. Las investigaciones muestran que mejora significativamente la precisión de la pronunciación, la entonación, el ritmo, el habla conectada, la comprensión auditiva y la fluidez al hablar, convirtiéndola en una de las metodologías más efectivas para la preparación del IELTS Speaking y la comunicación en inglés en el mundo real.

Técnica de shadowing: lee la guía completa paso a paso →

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