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
- Abdominal wall and inguinal region (groin area).
- Inspection (viewing).
- Gynecological examination
- Inspection
- Vulva (external, primary female sex organs) [atrophic changes? Fluorine/discharge?, color?, foetor/odor?, inflammation?, vesicles?, coating?, scratch marks?, tumor?, injury?]
- Speculum setting:
- Vagina (vaginal) [blood?, fluor? (color?, foetor?), mucus?]
- Cervix uteri (cervix), or portio (cervix; transition from cervix uteri to vagina (vagina)) [blood?, ectopy?, fluor ? (color?, fetor?), mucus ?], if necessary, taking a Pap smear (for early detection of cervical cancer).
- Palpation (bimanual; palpation with both hands) of the internal genital organs.
- Cervix uteri (cervix) [dolence/pain on movement?, cervical sliding, wiggling, venting pain? ]
- Uterus (uterus) [normal size?, difficult to move?, fixed?, displaced?, pressure dolent? ]
- Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [free?,palpable resistances in the lesser pelvis in the adnexal area or Douglas, separable from the uterus? Pressure dolence?]
- Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [free ?, pressure dolence ?, resistance?]
- Pelvic walls [free ?, resistance ?]
- Douglas space (pocket-like bulge of peritoneum (abdominal membrane) between rectum (rectum) posteriorly and uterus (uterus) anteriorly) [free ?, palpable resistance?]
- If necessary, rectal examination [free ?, mucus ?, blood ?, tumor ?]
- Inspection
Square brackets [ ] indicate possible pathological (pathological) physical findings.
