Inspection and Examination of the External Genitalia

INSPECTION AND EXAMINATION OF THE EXTERNAL GENITALIA

The pelvic examination begins with the inspection and exam-ination of the external genitalia. Inspection should includethe mons pubis, labia majora and labia minora, per-ineum, and perianal area. Inspection continues as palpa-tion is performed in an orderly sequence, starting with the clitoral hood, which may be pulled back to inspect the glans proper. The labia are spread laterally to allow inspection of the introitus and outer vagina. The urethral meatus and the areas of the urethra and Skene glands should be inspected. The forefinger is placed an inch or so into the vagina to gently milk the urethra. A culture should be taken of any discharge from the urethral open-ing. The forefinger is then rotated posteriorly to palpate the area of the Bartholin glands between that finger and the thumb (Fig. 1.5).