VAGINAL EXAM

Inspection
Inspect the vagina for the following:
The presence of blood
Discharge. This should be studied to detect trichomoniasis, monilia, and
clue cells and to obtain cultures, primarily for gonococci and chlamydia.
Mucosal characteristics (i.e., color, lesions, superficial vascularity, and
edema)
The lesion may be:
1. Inflammatoryredness, swelling, exudates, ulcers, vesicles
2. Neoplastic
3. Vascular
4. Pigmentedbluish discoloration of pregnancy (Chadwicks sign)
5. Miscellaneous (e.g., endometriosis, traumatic lesions, and cysts)
Structural abnormalities (congenital and acquired)
Inspection
of the vagina and cervix using a speculum should
always precede palpation.
Introduce the instrument into the vaginal orifice
with the blades oblique, closed, and pressed
against the perineum. Carry the speculum along
the posterior vaginal wall, and after it is fully
inserted, rotate the blades into a horizontal
position and open them. Maneuver the speculum
until the cervix is exposed between the blades.
Gently rotate the speculum around its long axis
until all surfaces of the vagina and cervix are
visualized.
Palpation

Bimanual palpation
Test the strength of the perineum by pressing
downward on the perineum and asking the
patient to bear down. This procedure may
disclose a previously concealed cystocele or
rectocele and descensus of the uterus
Note any abnormalities of structure or
tenderness in the vagina
1.Partial or complete atresia
2. Transverse or longitudinal septa
3. Relaxation of walls
4. Inflammation and atrophy of the mucosa
5. Masss or nodularity of the vagina wall
6. Discharge
1. Partial or complete atresia
2.Transverse or longitudinal septa
3. Relaxation of walls
4. Inflammation and atrophy of the mucosa
5. Masss or nodularity of the vagina wall
6. Discharge
1. Partial or complete atresia
2. Transverse or longitudinal septa
3.Relaxation of walls
4. Inflammation and atrophy of the mucosa
5. Masss or nodularity of the vagina wall
6. Discharge
Vaginal Relaxation Syndrome
1. Partial or complete atresia
2. Transverse or longitudinal septa
3. Relaxation of walls
4.Inflammation and atrophy of the
mucosa
5. Masss or nodularity of the vagina wall
6. Discharge
image of
lymphoid
follicles on the
vaginal mucosa,
click here. These
are indicative of
non-specific
causes of long-
term
inflammation
1. Partial or complete atresia
2. Transverse or longitudinal septa
3. Relaxation of walls
4. Inflammation and atrophy of the mucosa
5.Masss or nodularity of the vagina wall
6. Discharge
1. Partial or complete atresia
2. Transverse or longitudinal septa
3. Relaxation of walls
4. Inflammation and atrophy of the mucosa
5. Masss or nodularity of the vagina wall
6.Discharge