A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
- Inspection (viewing).
- Skin and mucous membranes
- Abdomen (abdomen):
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Inspection (viewing).
- Gynecological examination
- Inspection
- Vulva (external, primary female reproductive organs) [fluorine/discharge?, blood?]
- Vagina (vagina) [blood?, fluor? (color?, foetor/odor?), mucus]
- Cervix uteri (cervix) or portio (cervix; transition from cervix uteri to vagina (vagina)) [shortened?, consistency soft?, opened? fingering?, aborted material visible in cervical canal/cervical orifice?; purulent fluorine/discharge indicative of infection?; if purulent fluorine and fever present, then abortus febrilis likely.
- Palpation (bimanual; palpation with both hands) of internal genital organs:
- Cervix uteri (cervix) [shortened?, consistency soft?, opened?, palpable?]
- Uterus (uterus) [assessment of size and consistency; pressure-dolent/painful?; in endometritis/uterine inflammation: extremely pressure-dolent (so-called edge pain), indicating involvement of the myometrium (wall of smooth muscle)]
- Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [Normal case: free; in case of ascending infection pressure dolence of the tubes/fallopian tubes]
- Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [normal case: free]
- Pelvic walls [normal case: free?; pressure-dolent/pressure-painful?]
- Douglas space (pocket-like bulge of the peritoneum (abdominal membrane) between the rectum (rectum) at the back and the uterus (uterus) at the front) [normal case: free; in case of infection, there may be a painful bulge]
- Inspection
Square brackets [ ] indicate possible pathological (pathological) physical findings.