Ordinarily, the cervix will not be visible when the patient strains down. Similar articles in PubMed. This part of the examination allows for a better examination of the pelvis because the rectal finger can reach beyond the posterior vaginal fornix and can therefore palpate the uterosacral ligaments, the paracervical tissue, the broad ligaments, the ovaries, the pelvic side walls.
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The pelvic examination is performed to collect information about the lower abdomen and external genitalia, vagina, cervix including cervical cytologyuterus, adnexa, anus, and rectum. Sims' vaginal speculum is a double-bladed surgical instrument used for examining the vagina and cervix. Fig 1 — Types of speculum. In a thin, relaxed patient, it is usually possible to palpate speculum placed posteriorly in vagina ovaries in the adnexal region lateral and posterior to the uterus. This is true for every patient and for every examination, but is especially important for the patient having her first gynecologic examination.
The pelvic examination is not complete unless a bimanual examination has been done with the finger in the rectum. The left side of the pelvis is ordinarily more difficult to evaluate because the sigmoid colon is usually located on the left. Also, the strongest hand should be on the patient's lower abdomen, and for most people the strongest hand is the right hand.