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; further:
- Inspection (viewing).
- Skin and mucous membranes
- Abdominal wall and inguinal region (groin area).
- Inspection (viewing).
- Gynecological examination
- Inspection (speculum)
- Vulva (external, primary female sex organs) [fluorine discharge)?, color?, foetor?, inflammation?, vesicle?, coating?, kraurosis vulvae?, tumor?]
- Vagina (vagina), if necessary vaginal cytology to assess the hormonal status [blood?, fluor vaginalis / discharge?, color?, foetor?, mucus?, vaginal dryness (vaginal dryness)?; if pressed, if necessary incontinence problems (in about 60-70% of cases there is a stress incontinence (formerly: stress incontinence))]
- Cervix uteri (cervix), or portio (cervix; transition from the cervix (cervix uteri) into the vagina (vagina), if necessary, taking a Pap smear (for early detection of cervical cancer) [blood?, ectopy (easily injured cylinder epithelium on the surface of the cervix)?, fluorine?, color?, foetor?, mucus?]
- Palpation (bimanual; palpation with both hands) of the internal genital organs.
- Cervix uteri (cervix) [dolence on movement?, cervical sliding, wiggling, venting pain?]
- Uterus (uterus) [normal: anteflexed/angled forward, normal size, no tenderness, difficult to move?, fixed?, displaced?]
- Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tube (fallopian tube)). [Normal: free, [free?, palpable resistance in the small pelvis in the adnexal area?]
- Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free, pressure difference? Resistance?]
- Pelvic walls [Normal: free, resistance?]
- Douglas space (pocket-like bulge of peritoneum (abdominal wall) between rectum (rectum) posteriorly and uterus (uterus) anteriorly) [Normal: free, resistance?]
- Digital rectal examination (DRU) [free?, mucus?, blood?, tumor?]
- Examination of the mammae (breasts)
- Inspection of mammae (breasts), right and left; nipple (breast), right and left, and skin [Normal: unremarkable, skin retractions (esp. when arms are raised)?, redness?, swelling?]
- Palpation of the mammae, both supraclavicular pits (upper clavicle pits) and axillae (axillae) [Normal: unremarkable, resistance/tumor/nodes?, dolence?,orange peel?) secretion/blood secretion from the nipple? Lymph nodes palpable (palpable)?]]
- Inspection (speculum)
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.