Method Of Exam
Author: A. Chandrasekhar, MD
Consultant: P. Tomich, MD
To prepare for an adequate examination, the patient should be given an opportunity to empty her bladder and should be draped appropriately.
The examiner should use warm gloved hands and a warm speculum.
Each step of the examination should be explained in advance to the patient.
Always do pelvic exam chaperoned.
Ask the patient to assume the lithotomy position.
Select an appropriately sized speculum, warmed with water.
Do not lubricate your gloved fingers, as this may intefere with papsmear.
Place two fingers just inside or at the introitus and gently press down on the perineal body.
With your other hand, introduce the closed speculum past your fingers at a 45
The blades should be held up obliquely and the pressure exerted towards the posterior vaginal wall, avoiding the more sensitive anterior wall and urethra.
After the speculum has entered the vagina, remove your fingers from the introitus.
Rotate the blades of the speculum into a horizontal position.
Open the blades after full insertion and maneuver the speculum gently so that the cervix comes into full view.
Note the color of the cervix
Describe the mucous membrane
Position of Cervix
Appearnce and location
note the nature of discharge.
Cervical os is small and round in nulliparous and slit like after child birth.
The cervix is covered by smooth pink epithelium.