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Sometimes in isolated settings, vaginal specula are not available. In such cases, good use can be made of bent spoons to examine the vagina and cervix.

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If the bowl of the spoon is too large for the patient, the narrower handle of the spoon can be used instead. Ultrasound is a very useful tool. It can reveal the presence of endometrial polyps, or ovarian cysts, or other gynecologic abnormalities.

Ultrasound can also be used dynamically during a pelvic exam, providing more information than either alone. Using the vaginal ultrasound probe as though it were the examining fingers, the probe can mechanically lift structures toward the abdominal hand.

Alternatively, the abdominal probe can be used to identify structures coming in contact with the vaginal fingers.

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Show Transcript The dorsal lithotomy position is generally used for pelvic exams, because it provides for good access to pelvis while inspecting the vulva, inserting a vaginal speculum, and performing a bimanual exam. A frog-leg position can provide for a very satisfactory exam.

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Elevating the buttocks with a pillow, rolled-up blanket, or bedpan facilitates the conventional placement of the speculum. When the buttocks cannot be raised, turning the speculum upside down can still allow for a good exam.

The knee-chest position can be very useful, particularly with children.

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While the orientation of the pelvic structures is reversed, this is a manageable issue. The bimanual examination can also be performed in this position.

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5 Minute Pelvic Exam Video. Show Transcript. Position the patient at the very edge of the exam table, with her feet in stirrups, knees bent and relaxed out to the side. If she is not down far enough, the exam will be more difficult for you and more uncomfortable for her. Pad the stirrups to Exam of the Vagina and Cervix. A disposable speculum can be used to examine the vagina and cervix for poor conformation, infections, injuries, persistent hymen, varicose veins, adhesions and cervical injuries. The procedure is described below and in a video Pelvic Exam Variations Video. The dorsal lithotomy position is generally used for pelvic exams, because it provides for good access to pelvis while inspecting the vulva, inserting a vaginal speculum, and performing a bimanual exam. Because of illness or injury, some individuals cannot be examined in the conventional dorsal lithotomy position

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