15.11.2014 1 [email protected]Tevfik Yoldemir, MD, BBA Marmara University Department of Obstetrics and Gynecology Division of Reproductive Endocrinology and Infertility PELVIC EXAM [email protected]Positioning Positioning Move the pillow down to her head Move the pillow down to her head Help her place her heels into the stirrups Help her place her heels into the stirrups Buttocks are on the edge of the table Buttocks are on the edge of the table Ask her to relax her legs to the side Ask her to relax her legs to the side [email protected][email protected]Lithotomy Position Lithotomy Position [email protected][email protected]External Genitalia External Genitalia Mons pubis Mons pubis Tanner’s pubic hair distribution Tanner’s pubic hair distribution Excoriations or papules (lice) Excoriations or papules (lice) Labia minora and majora Labia minora and majora Bartholin’s glands Bartholin’s glands Inflammation Inflammation Ulceration Ulceration Nodules Nodules
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Bimanual ExamBimanual Exam�� Palpate the ovariesPalpate the ovaries
�� Place your vaginal Place your vaginal hand to the side of hand to the side of the cervix, your the cervix, your opposite hand in the opposite hand in the same side lower same side lower
�� Insert the index finger into Insert the index finger into the vagina and the middle the vagina and the middle finger into the rectumfinger into the rectum
�� Ask the patient to bear Ask the patient to bear downdown
�� Palpate the posterior cervixPalpate the posterior cervix
�� Palpate the uterosacral Palpate the uterosacral ligamentsligaments
�� Palpate the rectovaginal Palpate the rectovaginal septumseptum