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A pelvic examination is the physical examination of the external and internal female pelvic organs. [1] It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract , such as pain, bleeding, discharge, urinary incontinence , or trauma (e.g. sexual assault).
The vagina is attached to the pelvic walls by endopelvic fascia. The peritoneum is the external layer of skin that covers the fascia. This tissue provides additional support to the pelvic floor. The endopelvic fascia is one continuous sheet of tissue and varies in thickness. It permits some shifting of the pelvic structures.
The lower portion is the pelvic cavity, and it contains the urinary bladder, the rest of the large intestine (the lower portion), and the internal reproductive organs. [2] [3] There is no membrane that separates out the abdominal cavity from the pelvic cavity, so the terms abdominal pelvis and peritoneal cavity are sometimes used.
The coccygeus muscle completes the pelvic floor, which is also called the pelvic diaphragm. It supports the viscera in the pelvic cavity, and surrounds the various structures that pass through it. The levator ani is the main pelvic floor muscle and contracts rhythmically during female orgasm, and painfully during vaginismus. [4]
It exits the pelvic cavity through the lesser sciatic foramen. The internal obturator is situated partly within the lesser pelvis, and partly at the back of the hip-joint. It functions to help laterally rotate femur with hip extension and abduct femur with hip flexion, as well as to steady the femoral head in the acetabulum.
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The diagnosis can be made in the typical setting of pain or limp in a young child who is not generally unwell and has no recent trauma. There is a limited range of motion of the hip joint. Nevertheless, children with transient synovitis of the hip can usually weight bear.
Though pelvic floor dysfunction is thought to more commonly affect women, 16% of men have been identified with pelvic floor dysfunction. [13] Pelvic floor dysfunction and its multiple consequences, including urinary incontinence, is a concerning health issue becoming more evident as the population of advancing age individuals rises.