In vaginal examination the vulva is first inspected to see evidence of infection, scarification and other lesions such as genital mutilations etc, then the finger is inserted through the introitus into the vagina to feel the walls. The posterior wall has the rectum and anus together with the central perineal tendon. The anterior wall contains the urinary bladder and inferiorly the urethra. The lateral walls contains the levator ani (pelvic floor) together with the ureter at the level of the infravaginal cervix. Superiorly you can feel the infravaginal cervix and the fornices of the vagina which include the posterior fornix (the deepest) directly related to the Douglas pouch and to the lateral fornices. Then a bimanual palpation can feel the adnexae which include the ovary, fallopian tubes and the uterus.

 

 
DIGITAL LOCATOR OF VAGINA FROM BELOW (PELVIS): DIGITAL LOCATOR OF FEMALE PELVIS: Layer 1, layer of skin of female pelvis. Layer 2, layer of pelvic fascia. Layer 3 layer of greater pelvis, Layer 4, layer of lesser pelvis. Roll over mouse to label; click to display page. Then click blinking end page to display vagina page. Vagina is localised at layer 4. Roll over to label
1 mons pubis 2 clitoris 3 labium majus 4 labium minus 5 introitus 6 anus
Speculum examination

 

 
Speculum examination of vagina and cervix

 
 

 

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