Cervical exam/bimanual exam question

[Woman_in_love]

Hi everyone,

I am currently training to become a Women's Health Nurse Practitioner. My background is antepartum/postpartum patients. So I never got to check cervixes or do a bimanual exam. I am having a hard time checking cervix (if it is closed, thick, etc).

It all feels sort of soft, and I can't tell exactly what I am feeling and how it should feel.

Any tips or suggestions how to be able to feel cervix and know what are you feeling?

Thanks

[MJB2010]

Maybe try posting in the specialty forums?

[Sprocket36]

Hi there- I've worked in sexual health for a number of years (and am also an NP student!) so hopefully I can help a bit...

In a well-woman check the pelvic exam generally had 3 components: assessing the external genitalia, speculum exam and bimanual exam. Before you are feeling the cervix, you are visualizing the cervix with the speculum. At this point you can see the os and gauge whether it is open or closed (slit-like or a dot), and take your swabs. After that, you insert your fingers to do the bimanual- at this point you are simply assessing whether or not there is any cervical motion tenderness, assessing the size/position/tenderness of the uterus, and assessing the adenexa for any masses or tenderness.

So based on that, I guess I'm not really sure why you're trying to feel if the cervix is closed or thick- that seems reserved for pregnant women who are about to labour, and the delivery process (something I have no idea about!). If you're just trying to find the cervix during a bimanual exam, it will feel smooth, circular and firm (like the tip of your nose) and usually be located near the "back ceiling" of the lady parts.

Hope that helps a bit, let me know if you have any more questions.

[RNBelle]

For lack of better terms. The cervical opening (when closed) feels like a nub.