Physical examination maneuver

Physical Exam

Pelvic Speculum Exam

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How to Perform

With the patient in the dorsal lithotomy position and appropriately draped, select and warm an appropriately sized speculum and lubricate it with a small amount of water-based gel compatible with any planned testing. Separate the labia and gently insert the closed speculum, directing it posteriorly toward the sacrum. Once inserted, open the blades until the cervix is fully visualized and lock the speculum in place. Inspect the cervix for color, discharge, and lesions, and obtain any indicated samples, such as cervical cytology or swabs. Unlock and slowly withdraw the speculum, inspecting the vaginal walls for color, discharge, and lesions as the blades are withdrawn.

How to Interpret

Showing 2 of 5 findings

Bacterial Vaginosis

Appearance of vaginal discharge as an isolated sign
Rule in
Not helpfulDerived CI
Rule out
HelpfulWide CI
Evidence:Moderate

Trichomoniasis

Strawberry cervix (punctate cervical hemorrhages / colpitis macularis)
Rule in
Very helpfulWide CI
Rule out
Not helpfulDerived CI
Evidence:Moderate

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How-ToFreeHow to Drape a Patient
How to Drape a Patient

Related Systems / Regions

PelvisReproductive

Related Diagnoses

Bacterial VaginosisCervical CancerCervicitisTrichomoniasis

Related Chief Complaints

Vaginal BleedingVaginal DischargeVaginal ItchingVaginal Odor

References

  • Simões JA, Discacciati MG, Brolazo EM, Portugal PM, Dini DV, Dantas MC. Clinical diagnosis of bacterial vaginosis. Int J Gynaecol Obstet. 2006;94(1):28-32. doi:10.1016/j.ijgo.2006.04.013. PMID: 16756982.
  • Brunham RC, Paavonen J, Stevens CE, Kiviat N, Kuo CC, Critchlow CW, Holmes KK. Mucopurulent cervicitis — the ignored counterpart in women of urethritis in men. N Engl J Med. 1984;311(1):1-6. PMID: 6427611.
  • Wolner-Hanssen P, Krieger JN, Stevens CE, Kiviat NB, Koutsky L, Critchlow C, DeRouen T, Hillier S, Holmes KK. Clinical manifestations of vaginal trichomoniasis. JAMA. 1989;261(4):571-576. doi:10.1001/jama.1989.03420040109029. PMID: 2783346.
  • Wesley R, Sankaranarayanan R, Mathew B, Chandralekha B, Aysha Beegum A, Amma NS, Nair MK. Evaluation of visual inspection as a screening test for cervical cancer. Br J Cancer. 1997;75(3):436-440. doi:10.1038/bjc.1997.72. PMID: 9020493. PMCID: PMC2063368.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.