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DeGowin's Diagnostic Examination, 9e
Physical Examination of the Female Genitalia and Reproductive System
Sections: The Female Pelvic Examination, Bimanual pelvic examination, Rectovaginal examination.
Topics Discussed: bartholin's glands; bimanual examination; female genitalia; gynecological examination; manual pelvic examination; rectovaginal examination; reproductive function, female; reproductive system; uterus; vaginal speculum.
Excerpt:"Inspection and palpation of the female pelvis can reveal many disorders of the reproductive organs, the lower urinary tract, and the lower abdomen. The pelvic examination is an extension of abdominal palpation and is mandatory for every female. Neglect of the pelvic examination often leads to serious errors in diagnosis. Routine Papanicolaou smear is effective in detecting early cervical cancer.The pelvic examination should be at the end of the physical examination because it requires special positioning, equipment, and attendance of a female chaperone to assist. After emptying her bladder, the patient is placed in the lithotomy position on the examination table. Cover her body with a sheet, place her feet in stirrups attached to the table, and wrap the lower corners of the sheet around her legs, leaving considerable slack for the cloth to envelope the thighs and lower abdomen (Fig. 11–2A). When the patient is too weak to be examined on the table, have her assume the lithotomy position in bed elevating her pelvis on an inverted bedpan.Always use the same hand for vaginal palpation. The invariable use of the same hand permits each hand to become accustomed to its role. In the following directions, the right hand is arbitrarily assigned..."
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