A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Skin and mucous membranes [due todifferential diagnosis of hyperandrogenemia (acne; alopecia androgentica/plant-related hair loss)]
- Abdominal wall and inguinal region (groin area).
- Inspection (viewing).
- Gynecological examination
- Inspection
- Vulva (external, primary female sexual organs).
- Vagina (vagina)
- Cervix uteri (cervix), or portio (cervix; transition from the cervix (cervix uteri) to the vagina (vagina)), taking a Pap smear (for early detection of cervical cancer).
- Palpation (bimanual; palpation with both hands) of the internal genital organs.
- Cervix uteri (cervix).
- Uterus (uterus) [Normal: anteflexed/angled anteriorly, normal size, no tenderness].
- Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [Normal: free]
- Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free].
- Pelvic walls [Normal: free]
- Douglas space (pocket-like bulge of the peritoneum (abdominal wall) between the rectum (rectum) at the back and the uterus (uterus) at the front) [Normal: clear].
- Digital rectal examination (DRU): examination of the rectum (rectum) [Normal: unremarkable mucosa].
- Inspection of the mammae (breasts), right and left; nipple (breast), right and left; and skin [Normal: unremarkable; furthermore, note the following:
- Galactorrhea/diseased breast milk discharge (due todifferential diagnosis of hyperprolactinemia/elevation of blood prolactin levels);
- Palpation of the mammae, both supraclavicular pits (upper clavicular pits) and axillae (axillae) [Normal: unremarkable].
- Inspection
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.