414:(structures adjacent to the uterus, which include the ovaries and any adnexal masses). The bimanual exam traditionally occurs after the speculum is removed. The examiner explains this part of the exam. From a standing position, the examiner typically applies lubricant to the fingers of the glove of their dominant hand, and the index finger or index finger and middle finger are gently inserted into the vagina. The examiner's opposite hand is place on the patient's abdomen to allow palpation of the pelvic structures; thus the exam is termed a "bimanual: examination". A systematic exam of the pelvic structures allows an assessment of the vaginal introitus (opening), pelvic floor muscles, bladder, rectum, cervix, and the area posterior to the uterus; this portion of the exam is particularly helpful for individuals with pelvic pain, as it allows an assessment of tenderness and an anatomic source of pain. In assessing the uterus, elevation of cervix with the vaginal hand allows palpation of the uterus above the pubic symphysis with the opposite hand, and the size, shape, mobility, contour, consistency, and position of the uterus can be determined. Observing the patient's face during this exam can provide information about the additional characteristic of uterine tenderness, and the patient can also provide verbal feedback. The adnexal structures are similarly palpated, noting any enlargement of the ovaries and if present, the size, shape, mobility, consistency, and tenderness of ovarian/adnexal masses. Normally Fallopian tubes are not palpable.
433:
can be assessed on bimanual examination. Subsequently, beyond the 12th week of gestation, the uterus can be felt above the pubic bone, and abdominal examinations assess growth. Attention is given to the vulva to assess any perineal abnormalities. A speculum exam is typically performed at the initial visit; the cervix typically appears bluish, which is a sign of increased blood flow. A Pap test may be performed according to guidelines, and testing for
Neisseria gonorrhea and Chlamydia trachomatis may be performed as indicated. A bimanual examination during early pregnancy will reveal that the uterus is enlarged, softened and globular; the external os may be dilated, but the internal os is typically closed. The structures adjacent to the uterus will be assessed, along with the size and shape of the bony pelvis. As the due date approaches, assessment of the cervix with bimanual examwill indicate whether the cervix has begun to dilate and soften.
220:
the examination of sensitive areas of the body. They may have experienced sexual assault or negative experiences with pelvic examination in the past, which may lead to the exam triggering strong emotional and physical symptoms. Additionally, patients may have concern about odor or menstruation during exam, neither of which should impact the examiner's ability to perform a thorough, respectful exam. Patients generally prefer to be asked about past experiences and are often helpful in suggesting ways to mitigate the discomfort of the exam. Prior to the exam, the examiner should offer to show the patient models or diagrams of the pelvic anatomy and any instruments that will be used during the exam.
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clinician to do a visual examination. A pelvic exam begins with an assessment of the reproductive organs that can be seen without the use of a speculum. Many women may want to 'prepare' for the procedure. One possible reason for delaying an exam is if it is to be done during menstruation, but this is a preference of some patients and not a requirement of the clinician. The clinician may want to perform pelvic examination and assessment of the vagina because there are unexplained symptoms of
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190:
recommendations and an assessment of harms vs benefits as reviewed by the US Preventive
Services Task Force, re-evaluation of routine screening pelvic examination for asymptomatic, non-pregnant women with average risk for gynecologic disease was indicated. A 2020 update of the literature by the US Preventive Services Task Force concluded that the evidence remained insufficient to assess the balance of benefits and harms of screening pelvic examinations in asymptomatic women.
185:. The ACP guideline concluded that there was no evidence that the exam in asymptomatic adult women reduced morbidity or mortality, and that there were no studies that addressed the exam's diagnostic accuracy for identifying specific gynecologic conditions. The guideline concluded that there was evidence of harm, including fear, embarrassment, pain, discomfort and unnecessary surgery. This was a strong recommendation, based on moderate-quality evidence. In 2018, the
181:(ACP) published a review of the benefits and the risks of the exam and issued a guideline that recommended against performing this examination to screen for conditions in asymptomatic, nonpregnant, adult women, concluding that the potential harms outweighed the demonstrated benefits and that screening pelvic exams in asymptomatic women did not reduce mortality or morbidity rates. The guideline did not consider the necessity or frequency of
418:
such as hemorrhoids, anal fissures, rectal polyps, or masses including carcinoma. It also allows palpation of the recto-vaginal septum, the intra-abdominal area posterior to the uterus (the cul-de-sac or pouch of
Douglas), and the adnexal. Nodularity posterior to the uterus along the uterosacral ligaments has been associated with pelvic endometriosis as well as implants of ovarian cancer.
314:
If sexual abuse is suspected, questions regarding this are discussed after the examination and not during it. When the patient is requested to 'bear down', the presence of prolapsed structures such as the bladder (cystocele), rectum (rectocele) or uterus are documented. Prolapsed structures can appear when abdominal pressure increases or they can protrude without bearing down.
228:, light source, lubricant, gloves, drapes, and specimen collection media. Warming the speculum with warm tap water or keeping the speculum in a warmer will also increase comfort. The patient should be given the opportunity to have a chaperone or support person in the room during the exam. In general, male examiners should always be accompanied by a female chaperone.
232:
possible during the exam. Relaxation of the pelvic muscles can reduce discomfort during the exam. Rather than telling the patient to "relax", which can trigger strong emotions for women who are survivors of assault, patients can be told to breathe slowly and deeply into their abdomens, or which is a more instructive way of describing how to relax the pelvic muscles.
117:, or trauma (e.g. sexual assault). It can also be used to assess a woman's anatomy in preparation for procedures. The exam can be done awake in the clinic and emergency department, or under anesthesia in the operating room. The most commonly performed components of the exam are 1) the external exam, to evaluate the
417:
An additional component of the pelvic examination may include recto-vaginal examination. The examiner puts on a clean glove, and using sufficient lubricant, places the index finger within the vagina and the middle finger within the rectum. This component of the exam assesses rectal tone and lesions
193:
Annual "well-woman visits" are an occasion for gynecologists to identify health risks for women; ACOG has noted that these visits may also include clinical breast examinations, immunizations, contraceptive care discussions, and preventive health care counseling. ACOG reinforced the potential value
235:
The patient should be informed that she can stop the procedure at any time. If the patient does not want to continue the exam, the examiner should stop, speak with the patient about her concerns and how to mitigate them, and only continue when the patient is ready to do so. However, in all but seven
313:
The vaginal opening is inspected for position, presence of the hymen, and shape. The examiner should look for the presence of bruising, tearing, inflammation and discharge. Pelvic examinations are usually procedures that are designed to obtain objective, measurable descriptions of what is observed.
265:
The pelvic exam begins with a discussion as described above, and an explanation of the procedure. The patient is asked to put on an examination gown, get on the examination table, and lie on her back with her feet in footrests. Sliding down toward the end of the table is the best position for the
219:
Prior to the exam, before the patient is undressed and lying on the examination table or chair, examiners should ask the patient if she has had a pelvic exam in the past and whether she has any questions or concerns about the exam. Women may be concerned about pain, or they may be embarrassed about
432:
The pelvic exam during pregnancy is similar to the exam for non-pregnant women; however, more attention is give to the uterus and cervix. The size of the uterus is assessed at the initial visit, and the growth of the uterus is assessed at subsequent visits. In the first trimester the uterine size
309:
The urethral opening is inspected. No urine should leak when the patient is asked to cough. Urine leakage may indicate stress incontinence and the weakening of pelvic structures. The opening should be midline, pink, and smooth. The presence of inflammation or discharge may indicate an infection.
189:
issued a committee opinion that pelvic exams should be performed for 1) symptoms of gynecologic disease, 2) screening for cervical dysplasia, or 3) management of gynecologic disorders or malignancy, using shared decision-making with the patient. ACOG acknowledged that given changes in screening
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The examiner should explain each step of the exam and its purpose, should address and normalize any concerns, should assert that the patient has full control over the exam, and should ask permission before each step of the exam. The examiner should keep as much of the patient's body covered as
347:
Before inserting the speculum, the vaginal wall, urethra, Skene's glands and
Bartholin's glands are palpated through the vaginal wall. During the internal exam, the examiner describes the procedure while doing the assessment, making sure that the patient can anticipate where she will feel the
260:
are displaced by the individual's own fingers. Individual structures include: 1. Clitoral hood 2. Clitoral glans (clitoris) 3. Urethra 4. Vaginal opening 5. Labia majora 6. Labia minora 7.
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The appropriate sized speculum is selected. The speculum is slowly inserted in its collapsed state at a 45-degree angle to match the slope of the vagina. The blades are then expanded until the cervix comes into view. If the speculum is transparent, the vaginal walls can be
223:
Careful preparation is helpful for an efficient and comfortable exam. Prior to asking the patient to position herself on the exam table or chair for examination, the examiner should collect all the instruments needed for the exam and any planned procedures, including the
352:
The patient is first informed that the examiner will insert their finger into the vagina. The palpation of the vagina is done by evaluating the condition of the vaginal walls. These should feel smooth, consistent and soft. The rugae can also be assessed by
176:
Traditionally in the field of gynecology, the benefits of routine pelvic examinations were assumed, and the exam was a recommended part of the initial gynecology visit, annual visits, and as needed for treatment. In 2014, the
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The cervix is then assessed. It should look moist, round, pink, and centered to the middle. The secretions of the cervix should be clear or whitish with no odor. The presence or absence of polyps, ulcers, and inflammation are
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The labia minora are then evaluated. They should appear moist, smooth in texture and pink. The presence of tearing, inflammation and swelling is noted. Thinner and smaller labia minora are an expected finding in older
194:
of pelvic examinations in allowing clinicians to explain a patient's anatomy, reassure her of normalcy, and answer specific questions, thus establishing open communication between patient and clinician.
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The labia majora are evaluated. Their position and symmetry are assessed. The expected finding in older patients is that the labia majora can be thinner and smaller. The examiner is looking for
216:
The examination can be emotionally and physically uncomfortable for women. Preparation, good communication, thoughtful technique, and trauma-informed care can help mitigate this discomfort.
667:
Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD (July 2014). "Screening pelvic examination in adult women: a clinical practice guideline from the
American College of Physicians".
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The bimanual component of the pelvic examination allows the examiner to feel ("palpate" in medical terms) the structures of the pelvis, including the vagina, cervix, uterus, and
421:
After completion of the exam, the examiner discards their gloves, washes their hands, assists the patient in sitting up, and describes their findings on the examination.
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will be used to collect or scrape cervical cells off of the surface of the cervix to be evaluated for changes. Other vaginal swabs can be taken at this time to test for
381:, uterus, and ovaries. If this is the first pelvic exam of the patient, the examiner will show the speculum to the patient, explain its use and answer any questions.
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299:. If drainage is present from these structures, its color, location and other characteristics are noted. Infection control is accomplished by frequent glove changes.
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are also assessed internally by gently squeezing them with one finger placed externally, on the posterior labia majora and the other finger in the vagina.
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1002:"Consent for the Pelvic Examination Under Anesthesia by Medical Students: Recommendations by the Association of Professors of Gynecology and Obstetrics"
1318:
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Cunningham, F. Gary; Leveno, Kenneth J.; Dashe, Jodi S.; Hoffman, Barbara L.; Spong, Catherine Y.; Casey, Brian M. (2022). "10. Prenatal care".
64:
1001:
809:"Recommendation: Gynecological Conditions: Periodic Screening With the Pelvic Examination | United States Preventive Services Taskforce"
711:"Don't perform pelvic exams on asymptomatic nonpregnant women, unless necessary for guideline-appropriate screening for cervical cancer"
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The pubic hair is inspected for pubic lice and hair growth patterns. Sparse hair patterns can exist in older and in some Asian patients.
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The patient is again asked to bear down while the examiner continues the internal examination. The presence of bulging is assessed.
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In some instances, different positioning and assistance may be required to keep tissue from blocking the view of the perineal area.
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The perineum, the space between the vagina and the anus, is inspected. It should be smooth, firm, and free of disease. Scars from
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The typical external examination begins with making sure that the patient is in a comfortable position and her privacy respected.
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887:"Society of Family Planning clinical guidelines pain control in surgical abortion part 1 - local anesthesia and minimal sedation"
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The anus is assessed for lesions, inflammation or trauma. It should appear dark, continuous and moist. In some patients,
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At this point of the pelvic exam, the examiner will insert the speculum to visualize other internal structures: the
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Hammoud, Maya M.; Spector-Bagdady, Kayte; O'Reilly, Meg; Major, Carol; Baecher-Lind, Laura (December 2019).
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765:"ACOG Committee Opinion No. 754 Summary: The Utility of and Indications for Routine Pelvic Examination".
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593:"Current Procedural Terminology - Pelvic examination under anesthesia (other than local) - Classes"
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The position of the urethra is assessed by palpation with a finger through the vaginal wall.
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739:(15th ed.). Philadelphia, PA: Lippincott, Williams, and Wilkins. 2012. p. 11.
629:(11th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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Chair for gynaecological examinations. Next to the chair a sonography device and screen.
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Hoffman BL, Bradshaw KD, Cunningham FG, Halvorson LM, Schaffer JI, Schorge JO (2012).
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ACOG Practice
Advisory on Annual Pelvic Examination Recommendations (30 June 2014).
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141:. During the pelvic exam, sample of cells and fluids may be collected to screen for
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published guidelines against routine pelvic examination in adult women who are not
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256:(the opening of the vagina) in relation to its surrounding structures, when the
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A speculum exam showing the ectocervix of a postmenarchal, nulliparous woman
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928:"Women's attitudes and expectations regarding gynaecological examination"
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Excoriation can be present in obese patients due to urinary incontinence.
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Yanikkerem E, Ozdemir M, Bingol H, Tatar A, Karadeniz G (October 2009).
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The clitoris is assessed for size, position, symmetry, and inflammation.
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504:. American Congress of Obstetricians and Gynecologists. Archived from
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pelvic exams to be done under anesthesia without the patient's consent
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and lack symptoms, with the exception of pelvic exams done as part of
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1248:(13th ed.). Philadelphia Baltimore New York: Wolters Kluwer.
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are visible on women who have had the procedure during childbirth.
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1197:. American College of Obstetricians and Gynecologists. May 2017.
1094:. American College of Obstetricians and Gynecologists. May 2017.
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502:"The Utility of and Indications for Routine Pelvic Examination"
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530:(2nd ed.). New York: McGraw-Hill Medical. pp. 2–6.
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976:"Sexual Trauma: Information for Women's Medical Providers"
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Prenatal care includes pelvic exams during the pregnancy.
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American
College of Obstetricians and Gynecologists (ACOG)
270:, pelvic pain, unexpected bleeding, or urinary problems.
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may be present, and can be a sign of fecal incontinence.
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Bates' guide to physical examination and history taking
717:. American Academy of Family Physicians. August 8, 2018
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Bates' guide to physical examination and history-taking
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Preparation, communication, and trauma-informed care
862:"Trauma-Informed Pelvic Exam - Contraceptive Pearl"
152:Some clinicians perform a pelvic exam as part of
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1223:(16th ed.). Philadelphia: Wolters Kluwer.
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236:states in the United States, it is legal for
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625:Bickley LS, Szilagyi PG, Bates B (2013).
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113:, such as pain, bleeding, discharge,
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1858:Tests and procedures involving the
1713:Upper limb neurological examination
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1065:"Pelvic exam - About - Mayo Clinic"
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904:10.1016/j.contraception.2018.01.014
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559:Emery JD, Paraiso MF (2014-10-07).
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137:to visualize the vaginal walls and
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1201:
866:Reproductive Health Access Project
609:
473:"Examination of the Female Pelvis"
14:
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833:"Stanford 25: Pelvic Examination"
133:and 3) the internal exam using a
1219:Berek, Jonathan S., ed. (2020).
1150:. Boston: Pearson. p. 665.
1734:Ballard Maturational Assessment
1594:Peripheral vascular examination
1237:
993:
968:
919:
885:Allen RH, Singh R (June 2018).
878:
825:
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399:sexually transmitted infections
143:sexually transmitted infections
1360:History of the present illness
1286:(27th ed.). McGraw Hill.
1244:Bickley, Lynn S., ed. (2021).
1221:Berek & Novak's gynecology
1192:"Your First Gynecologic Visit"
1172:"Pelvic exam - MayoClinic.com"
1089:"Your First Gynecologic Visit"
773:(4): 1080–1083. October 2018.
729:
703:
585:
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179:American College of Physicians
158:American College of Physicians
33:Line drawing showing bimanual
1:
1701:Mini–mental state examination
1612:Ankle–brachial pressure index
458:
91:of the external and internal
1018:10.1097/AOG.0000000000003560
779:10.1097/aog.0000000000002896
737:Berek and Novak's Gynecology
16:Physical medical examination
7:
2247:Gynecologic ultrasonography
1977:Uterine artery embolization
1006:Obstetrics & Gynecology
669:Annals of Internal Medicine
436:
101:. It is frequently used in
10:
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1860:female reproductive system
982:. National Center for PTSD
944:10.1016/j.midw.2007.08.006
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121:2) the internal exam with
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2214:Female genital mutilation
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2018:
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1708:Cranial nerve examination
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767:Obstetrics and Gynecology
166:cervical cancer screening
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252:An image that shows the
156:. However, in 2014, the
37:as part of a pelvic exam
2224:Clitoral hood reduction
2191:Vaginal transplantation
1780:Athletic heart syndrome
154:routine preventive care
1817:Differential diagnosis
1752:Well-woman examination
443:Well-woman examination
344:
262:
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2252:Hysterosalpingography
1869:Gynecological surgery
342:
251:
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125:(commonly called the
2038:Endometrial ablation
1785:Sudden cardiac death
1668:Shoulder examination
1607:Abdominojugular test
1440:Physical examination
1387:Past medical history
1284:William's Obstetrics
453:Trauma-Informed Care
406:Bimanual examination
333:Internal examination
244:External examination
115:urinary incontinence
89:physical examination
2089:Cervical conization
1972:Pelvic exenteration
1890:Salpingoophorectomy
1804:Assessment and plan
1589:Cardiac examination
1534:Swinging light test
1402:Psychiatric history
1335:Medical examination
528:Williams gynecology
107:female reproductive
2106:Cervical screening
2061:Uterine myomectomy
2033:Endometrial biopsy
1762:Breast examination
1637:Rectal examination
1571:Respiratory sounds
1370:Nursing assessment
1069:www.mayoclinic.org
345:
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172:Medical guidelines
85:pelvic examination
22:Pelvic examination
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2186:Vaginal wet mount
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2101:Cervical cerclage
2010:Vacuum aspiration
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1812:Medical diagnosis
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1673:Elbow examination
1293:978-1-260-46273-9
1255:978-1-4963-9817-8
1230:978-1-4963-8033-3
1157:978-0-13-387640-6
1146:Damico D (2016).
746:978-1-4511-1433-1
636:978-1-60913-762-5
570:978-1-4939-1414-2
537:978-0-07-171672-7
508:on 2 August 2014.
268:vaginal discharge
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475:. Archived from
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371:Bartholin glands
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2281:
2279:
2278:
2277:
2263:
2262:
2261:
2256:
2239:Medical imaging
2233:
2195:
2126:
2070:
2065:
2047:
2042:
2019:
2014:
1991:
1986:
1982:Transplantation
1946:
1932:
1900:Fallopian tubes
1894:
1871:
1862:
1856:
1826:
1821:
1794:
1766:
1738:
1717:
1682:
1663:Hip examination
1651:Musculoskeletal
1646:
1618:
1575:
1557:
1524:Eye examination
1510:
1477:
1434:
1355:Chief complaint
1347:Medical history
1341:
1332:
1302:
1301:
1294:
1280:
1263:
1256:
1242:
1238:
1231:
1217:
1202:
1194:
1190:
1189:
1185:
1176:
1174:
1170:
1169:
1165:
1158:
1144:
1099:
1091:
1087:
1086:
1082:
1073:
1071:
1063:
1062:
1051:
998:
994:
985:
983:
980:www.ptsd.va.gov
974:
973:
969:
924:
920:
883:
879:
870:
868:
860:
859:
846:
831:
830:
826:
817:
815:
807:
806:
802:
764:
763:
754:
747:
735:
734:
730:
720:
718:
715:Choosing Wisely
709:
708:
704:
665:
652:
637:
623:
610:
601:
599:
591:
590:
586:
571:
557:
553:
538:
524:
513:
498:
491:
482:
480:
471:
470:
466:
461:
439:
427:
408:
335:
246:
206:
200:
174:
145:or cancer (the
77:
49:
48:
38:
17:
12:
11:
5:
2286:
2276:
2275:
2258:
2257:
2255:
2254:
2249:
2243:
2241:
2235:
2234:
2232:
2231:
2229:Vestibulectomy
2226:
2221:
2216:
2211:
2205:
2203:
2197:
2196:
2194:
2193:
2188:
2183:
2178:
2173:
2168:
2167:
2166:
2164:husband stitch
2156:
2151:
2146:
2140:
2138:
2132:
2131:
2128:
2127:
2125:
2124:
2118:
2113:
2103:
2098:
2097:
2096:
2086:
2080:
2078:
2067:
2066:
2064:
2063:
2057:
2055:
2044:
2043:
2041:
2040:
2035:
2029:
2027:
2016:
2015:
2013:
2012:
2007:
2001:
1999:
1994:Uterine cavity
1988:
1987:
1985:
1984:
1979:
1974:
1969:
1964:
1959:
1953:
1951:
1940:
1934:
1933:
1931:
1930:
1928:Tubal reversal
1925:
1920:
1918:Tubal ligation
1915:
1910:
1904:
1902:
1896:
1895:
1893:
1892:
1887:
1881:
1879:
1873:
1872:
1867:
1864:
1863:
1855:
1854:
1847:
1840:
1832:
1823:
1822:
1820:
1819:
1814:
1808:
1806:
1800:
1799:
1796:
1795:
1793:
1792:
1787:
1782:
1776:
1774:
1768:
1767:
1765:
1764:
1759:
1754:
1748:
1746:
1740:
1739:
1737:
1736:
1731:
1725:
1723:
1719:
1718:
1716:
1715:
1710:
1705:
1704:
1703:
1692:
1690:
1684:
1683:
1681:
1680:
1675:
1670:
1665:
1660:
1654:
1652:
1648:
1647:
1645:
1644:
1639:
1634:
1628:
1626:
1620:
1619:
1617:
1616:
1615:
1614:
1609:
1601:
1596:
1591:
1585:
1583:
1581:Cardiovascular
1577:
1576:
1574:
1573:
1567:
1565:
1559:
1558:
1556:
1555:
1554:
1553:
1548:
1538:
1537:
1536:
1531:
1529:Ophthalmoscopy
1520:
1518:
1512:
1511:
1509:
1508:
1503:
1501:Blood pressure
1498:
1493:
1487:
1485:
1479:
1478:
1476:
1475:
1470:
1465:
1460:
1454:
1452:
1442:
1436:
1435:
1433:
1432:
1431:
1430:
1427:
1422:
1417:
1409:
1407:Progress notes
1404:
1399:
1397:Social history
1394:
1392:Family history
1389:
1384:
1383:
1382:
1372:
1367:
1365:Systems review
1362:
1357:
1351:
1349:
1343:
1342:
1339:history taking
1331:
1330:
1323:
1316:
1308:
1300:
1299:
1292:
1261:
1254:
1236:
1229:
1200:
1183:
1163:
1156:
1097:
1080:
1049:
992:
967:
918:
897:(6): 471–477.
877:
844:
824:
800:
752:
745:
728:
702:
650:
635:
608:
597:NCBO BioPortal
584:
569:
551:
536:
511:
489:
463:
462:
460:
457:
456:
455:
450:
445:
438:
435:
426:
423:
407:
404:
403:
402:
391:
387:
375:
374:
367:
364:Skene's glands
360:
357:
354:
334:
331:
330:
329:
322:
315:
311:
307:
304:
300:
281:
278:
245:
242:
199:
196:
173:
170:
79:
78:
71:
68:
67:
62:
56:
55:
46:
40:
39:
32:
24:
23:
15:
9:
6:
4:
3:
2:
2285:
2274:
2271:
2270:
2268:
2253:
2250:
2248:
2245:
2244:
2242:
2240:
2236:
2230:
2227:
2225:
2222:
2220:
2217:
2215:
2212:
2210:
2207:
2206:
2204:
2202:
2198:
2192:
2189:
2187:
2184:
2182:
2181:Hymenorrhaphy
2179:
2177:
2174:
2172:
2169:
2165:
2162:
2161:
2160:
2157:
2155:
2154:Culdocentesis
2152:
2150:
2147:
2145:
2142:
2141:
2139:
2137:
2133:
2122:
2119:
2117:
2114:
2111:
2107:
2104:
2102:
2099:
2095:
2092:
2091:
2090:
2087:
2085:
2082:
2081:
2079:
2076:
2074:
2068:
2062:
2059:
2058:
2056:
2053:
2051:
2045:
2039:
2036:
2034:
2031:
2030:
2028:
2025:
2023:
2017:
2011:
2008:
2006:
2003:
2002:
2000:
1997:
1995:
1989:
1983:
1980:
1978:
1975:
1973:
1970:
1968:
1965:
1963:
1960:
1958:
1955:
1954:
1952:
1949:
1944:
1941:
1939:
1935:
1929:
1926:
1924:
1921:
1919:
1916:
1914:
1913:Salpingectomy
1911:
1909:
1906:
1905:
1903:
1901:
1897:
1891:
1888:
1886:
1883:
1882:
1880:
1878:
1874:
1870:
1865:
1861:
1853:
1848:
1846:
1841:
1839:
1834:
1833:
1830:
1818:
1815:
1813:
1810:
1809:
1807:
1805:
1801:
1791:
1788:
1786:
1783:
1781:
1778:
1777:
1775:
1773:
1769:
1763:
1760:
1758:
1755:
1753:
1750:
1749:
1747:
1745:
1744:Gynecological
1741:
1735:
1732:
1730:
1727:
1726:
1724:
1720:
1714:
1711:
1709:
1706:
1702:
1699:
1698:
1697:
1696:Mental status
1694:
1693:
1691:
1689:
1685:
1679:
1676:
1674:
1671:
1669:
1666:
1664:
1661:
1659:
1656:
1655:
1653:
1649:
1643:
1640:
1638:
1635:
1633:
1630:
1629:
1627:
1625:
1621:
1613:
1610:
1608:
1605:
1604:
1602:
1600:
1597:
1595:
1592:
1590:
1587:
1586:
1584:
1582:
1578:
1572:
1569:
1568:
1566:
1564:
1560:
1552:
1549:
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1543:
1542:
1539:
1535:
1532:
1530:
1527:
1526:
1525:
1522:
1521:
1519:
1517:
1513:
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1502:
1499:
1497:
1494:
1492:
1489:
1488:
1486:
1484:
1480:
1474:
1471:
1469:
1466:
1464:
1461:
1459:
1456:
1455:
1453:
1451:
1446:
1443:
1441:
1437:
1428:
1426:
1423:
1421:
1418:
1416:
1413:
1412:
1410:
1408:
1405:
1403:
1400:
1398:
1395:
1393:
1390:
1388:
1385:
1381:
1378:
1377:
1376:
1373:
1371:
1368:
1366:
1363:
1361:
1358:
1356:
1353:
1352:
1350:
1348:
1344:
1340:
1336:
1329:
1324:
1322:
1317:
1315:
1310:
1309:
1306:
1295:
1289:
1285:
1278:
1276:
1274:
1272:
1270:
1268:
1266:
1257:
1251:
1247:
1240:
1232:
1226:
1222:
1215:
1213:
1211:
1209:
1207:
1205:
1193:
1187:
1173:
1167:
1159:
1153:
1149:
1142:
1140:
1138:
1136:
1134:
1132:
1130:
1128:
1126:
1124:
1122:
1120:
1118:
1116:
1114:
1112:
1110:
1108:
1106:
1104:
1102:
1090:
1084:
1070:
1066:
1060:
1058:
1056:
1054:
1045:
1041:
1036:
1031:
1027:
1023:
1019:
1015:
1011:
1007:
1003:
996:
981:
977:
971:
963:
959:
954:
949:
945:
941:
937:
933:
929:
922:
914:
910:
905:
900:
896:
892:
891:Contraception
888:
881:
867:
863:
857:
855:
853:
851:
849:
841:. 2017-09-27.
840:
839:
834:
828:
814:
810:
804:
796:
792:
788:
784:
780:
776:
772:
768:
761:
759:
757:
748:
742:
738:
732:
716:
712:
706:
698:
694:
690:
686:
682:
678:
674:
670:
663:
661:
659:
657:
655:
646:
642:
638:
632:
628:
621:
619:
617:
615:
613:
598:
594:
588:
580:
576:
572:
566:
562:
555:
547:
543:
539:
533:
529:
522:
520:
518:
516:
507:
503:
496:
494:
479:on 2001-11-15
478:
474:
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454:
451:
449:
446:
444:
441:
440:
434:
430:
422:
419:
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400:
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388:
384:
383:
382:
380:
372:
368:
365:
361:
358:
355:
351:
350:
349:
341:
337:
327:
323:
320:
316:
312:
308:
305:
301:
298:
294:
290:
286:
282:
279:
276:
275:
274:
271:
269:
259:
255:
250:
241:
239:
233:
229:
227:
221:
217:
210:
205:
195:
191:
188:
184:
180:
169:
167:
163:
159:
155:
150:
148:
144:
140:
136:
132:
128:
127:bimanual exam
124:
120:
116:
112:
111:urinary tract
108:
104:
100:
97:
94:
90:
86:
75:
69:
66:
63:
61:
57:
52:
47:
45:
41:
36:
30:
25:
20:
2176:Colpocleisis
2116:Cervicectomy
2071:
2048:
2020:
2005:Hysteroscopy
1992:
1962:Hysterectomy
1957:Genitoplasty
1947:
1908:Falloposcopy
1885:Oophorectomy
1743:
1688:Neurological
1642:Bowel sounds
1599:Heart sounds
1463:Auscultation
1283:
1245:
1239:
1220:
1186:
1175:. Retrieved
1166:
1147:
1083:
1072:. Retrieved
1068:
1009:
1005:
995:
984:. Retrieved
979:
970:
938:(5): 500–8.
935:
931:
921:
894:
890:
880:
869:. Retrieved
865:
836:
827:
816:. Retrieved
812:
803:
770:
766:
736:
731:
719:. Retrieved
714:
705:
675:(1): 67–72.
672:
668:
626:
600:. Retrieved
596:
587:
563:. Springer.
560:
554:
527:
506:the original
481:. Retrieved
477:the original
467:
431:
428:
420:
416:
409:
376:
348:palpations.
346:
336:
319:episiotomies
289:inflammation
272:
264:
234:
230:
222:
218:
215:
192:
175:
151:
126:
84:
82:
2219:Labiaplasty
2144:Vaginectomy
2022:Endometrium
1967:Hysterotomy
1729:Apgar score
1678:GALS screen
1563:Respiratory
1491:Temperature
1483:Vital signs
1380:Medications
326:excoriation
51:gynaecology
2209:Vulvectomy
2171:Hymenotomy
2159:Episiotomy
2149:Culdoscopy
2084:Colposcopy
2050:Myometrium
1632:Liver span
1496:Heart rate
1473:Percussion
1458:Inspection
1411:Mnemonics
1177:2007-12-09
1074:2018-01-04
986:2019-12-20
871:2019-12-05
818:2024-02-07
721:5 December
602:2018-03-02
483:2007-12-09
459:References
393:A swab or
353:palpation.
202:See also:
183:Pap smears
103:gynecology
2123:insertion
1624:Abdominal
1468:Palpation
1375:Allergies
1026:0029-7844
932:Midwifery
645:801810287
579:893426765
546:779244257
395:cytobrush
303:patients.
254:introitus
123:palpation
44:Specialty
35:palpation
2267:Category
2110:pap test
1948:General:
1757:Pap test
1722:Neonatal
1448:General/
1429:COASTMAP
1044:31764743
962:18086509
913:29407363
795:52342353
787:30247359
697:12370761
689:24979451
448:Pap test
437:See also
226:speculum
162:pregnant
147:Pap test
135:speculum
60:ICD-9-CM
2121:Pessary
1877:Ovaries
1541:Hearing
1035:6882529
953:2801597
838:YouTube
412:adnexae
87:is the
2136:Vagina
2073:Cervix
1938:Uterus
1923:Essure
1772:Sports
1603:Other
1420:OPQRST
1415:SAMPLE
1290:
1252:
1227:
1154:
1042:
1032:
1024:
960:
950:
911:
793:
785:
743:
695:
687:
643:
633:
577:
567:
544:
534:
390:noted.
379:cervix
297:rashes
285:ulcers
139:cervix
99:organs
96:pelvic
93:female
2201:Vulva
1790:RED-S
1551:Rinne
1546:Weber
1516:HEENT
1195:(PDF)
1092:(PDF)
791:S2CID
693:S2CID
386:seen.
293:warts
258:labia
119:vulva
72:[
65:89.26
2094:LEEP
1450:IPPA
1425:SOAP
1337:and
1288:ISBN
1250:ISBN
1225:ISBN
1152:ISBN
1040:PMID
1022:ISSN
958:PMID
909:PMID
783:PMID
741:ISBN
723:2019
685:PMID
641:OCLC
631:ISBN
575:OCLC
565:ISBN
542:OCLC
532:ISBN
369:The
362:The
295:and
261:Anus
109:and
1030:PMC
1014:doi
1010:134
948:PMC
940:doi
899:doi
775:doi
771:132
677:doi
673:161
149:).
2269::
1264:^
1203:^
1100:^
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1052:^
1038:.
1028:.
1020:.
1008:.
1004:.
978:.
956:.
946:.
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907:.
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864:.
847:^
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2024::
1996::
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1258:.
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1180:.
1160:.
1077:.
1046:.
1016::
989:.
964:.
942::
915:.
901::
874:.
821:.
797:.
777::
749:.
725:.
699:.
679::
647:.
605:.
581:.
548:.
486:.
401:.
76:]
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
