Author: A. Chandrasekhar, MD

Consultant: P. Tomich, MD

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: