Physical examination maneuver
Physical Exam
Pelvic Bimanual Exam
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Video coming September 2026
How to Perform
With the patient in the dorsal lithotomy position, appropriately draped, and with the bladder empty, insert the lubricated gloved index and middle fingers of one hand into the vagina while placing the other hand on the lower abdomen. Palpate the cervix and assess its consistency, mobility, and tenderness with motion. Elevate the cervix and uterus with the vaginal fingers while pressing downward with the abdominal hand to palpate the uterus between the two hands and assess its size, position, contour, mobility, and tenderness. Then move the vaginal fingers into each lateral fornix while the abdominal hand presses downward over the corresponding lower quadrant to palpate each adnexa for masses or tenderness.
How to Interpret
Showing 3 of 13 findings
Ovarian Cancer
Adnexal abnormality in an asymptomatic woman
Rule in
Very helpful
Rule out
Minimally helpful
Evidence:Limited
Pelvic Inflammatory Disease
Cervical motion tenderness (chandelier sign)
Rule in
Minimally helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Strong
Adnexal tenderness
Rule in
Not helpful
Rule out
InconclusiveWide CI
Evidence:Strong