Method Of Exam

• Palpate vagina and Cervix
  • Technique
    • Introduce the middle and index fingers of your gloved and lubricated hand into the vagina.
    • The thumb should be abducted and the ring and little fingers flexed into the palm.
  • Feel: Identify the cervix, noting its position, shape, consistency, regularity, mobility and tenderness.
• Palpate uterus via bimanual exam
  • Technique
    • Place your other hand midway between the umbilicus and the symphysis pubis and press downward toward the pelvic hand.
    • Using the palmar surface of your fingers, palpate for the uterine fundus while gently pushing the cervix anteriorly with the pelvic hand.
  • Feel the uterus and note
    • Size
    • Position
    • Consistency
    • Mobility
    • Tenderness
• Palpate adnexa via bimanual exam.
  • Technique
    • Gently slide the vaginal fingers into the lateral vaginal fornix while pushing inferiorly with the abdominal hand.
    • An attempt should be made to entrap the adnexa between the abdominal and vaginal hand.
  • Feel:

  Normal:

  • Normal uterus
    • is the size of a small orange. When enlarged often described in size corresponding to weeks of Pregnancy
    • Upside down Pear shaped
    • firm
    • smooth surface
    • anteverted (80%) and anteflexed.
    • freely movable.
    • not tender
  • Adnexa.
    • Ovary 2x2 cms
    • Almond shaped
    • slightly tender to palpation
    • very mobile

    .