[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:02.20,0:00:05.20,Default,,0000,0000,0000,,Narrator: Now stand to perform a bimanual examination.
Dialogue: 0,0:00:13.07,0:00:15.23,Default,,0000,0000,0000,,Lubricate the index and middle fingers
Dialogue: 0,0:00:15.23,0:00:16.44,Default,,0000,0000,0000,,of your examining hand.
Dialogue: 0,0:00:19.88,0:00:22.90,Default,,0000,0000,0000,,Practitioner: Okay, I'm going to continue the internal exam now.
Dialogue: 0,0:00:23.82,0:00:27.73,Default,,0000,0000,0000,,You're going to feel me insert two fingers into your vagina.
Dialogue: 0,0:00:27.73,0:00:30.33,Default,,0000,0000,0000,,Narrator: And insert them into the vagina,
Dialogue: 0,0:00:30.33,0:00:31.95,Default,,0000,0000,0000,,exerting pressure posteriorly.
Dialogue: 0,0:00:33.81,0:00:35.90,Default,,0000,0000,0000,,Palpate the vaginal wall,
Dialogue: 0,0:00:35.90,0:00:37.27,Default,,0000,0000,0000,,posteriorly,
Dialogue: 0,0:00:42.60,0:00:43.10,Default,,0000,0000,0000,,laterally,
Dialogue: 0,0:00:54.40,0:00:58.27,Default,,0000,0000,0000,,and anteriorly, including the urethra and bladder region.
Dialogue: 0,0:00:59.35,0:01:01.53,Default,,0000,0000,0000,,Note any nodularity or tenderness.
Dialogue: 0,0:01:03.53,0:01:07.20,Default,,0000,0000,0000,,Palpate the cervix, noting its position, size, shape,
Dialogue: 0,0:01:07.20,0:01:11.61,Default,,0000,0000,0000,,consistency, regularity, mobility, and tenderness.
Dialogue: 0,0:01:15.00,0:01:17.28,Default,,0000,0000,0000,,The cervix is normally rounded and firm
Dialogue: 0,0:01:17.28,0:01:19.67,Default,,0000,0000,0000,,with the consistency similar to the cartilage
Dialogue: 0,0:01:19.67,0:01:20.73,Default,,0000,0000,0000,,at the tip of the nose.
Dialogue: 0,0:01:21.55,0:01:23.64,Default,,0000,0000,0000,,It should be nontender and mobile.
Dialogue: 0,0:01:24.89,0:01:26.61,Default,,0000,0000,0000,,Feel the fornix around the cervix.
Dialogue: 0,0:01:28.80,0:01:30.88,Default,,0000,0000,0000,,Press down toward the intravaginal hand
Dialogue: 0,0:01:30.88,0:01:32.93,Default,,0000,0000,0000,,as it raises the uterus upward.
Dialogue: 0,0:01:34.13,0:01:37.00,Default,,0000,0000,0000,,Note the size, shape, consistency, and mobility
Dialogue: 0,0:01:37.00,0:01:37.93,Default,,0000,0000,0000,,of the uterus.
Dialogue: 0,0:01:38.80,0:01:40.73,Default,,0000,0000,0000,,Identify any masses or tenderness.
Dialogue: 0,0:01:43.67,0:01:45.65,Default,,0000,0000,0000,,In a nonpregnant woman, you may feel
Dialogue: 0,0:01:45.65,0:01:48.00,Default,,0000,0000,0000,,an anteverted uterus above the symphysis.
Dialogue: 0,0:01:49.23,0:01:50.81,Default,,0000,0000,0000,,It is normally firm and mobile.
Dialogue: 0,0:01:54.07,0:01:55.40,Default,,0000,0000,0000,,To palpate the right ovary,
Dialogue: 0,0:01:55.40,0:01:58.67,Default,,0000,0000,0000,,place your abdominal hand on the right lower quadrant,
Dialogue: 0,0:01:58.67,0:02:02.53,Default,,0000,0000,0000,,and your intravaginal hand in the right lateral fornix.
Dialogue: 0,0:02:04.40,0:02:06.74,Default,,0000,0000,0000,,Press your abdominal hand in and down
Dialogue: 0,0:02:06.74,0:02:10.73,Default,,0000,0000,0000,,to move the ovary within reach of the intravaginal hand.
Dialogue: 0,0:02:12.53,0:02:15.65,Default,,0000,0000,0000,,Palpate the right ovary, or any adnexal mass
Dialogue: 0,0:02:15.65,0:02:17.04,Default,,0000,0000,0000,,between your hands.
Dialogue: 0,0:02:17.97,0:02:21.27,Default,,0000,0000,0000,,If possible, note its size, shape and consistency,
Dialogue: 0,0:02:21.27,0:02:23.08,Default,,0000,0000,0000,,mobility, and tenderness.
Dialogue: 0,0:02:24.53,0:02:27.40,Default,,0000,0000,0000,,Repeat the bimanual examination on the left side.
Dialogue: 0,0:02:29.03,0:02:32.56,Default,,0000,0000,0000,,Ovaries are palpable in women with active ovarian function.
Dialogue: 0,0:02:33.60,0:02:35.67,Default,,0000,0000,0000,,They may be somewhat tender normally.
Dialogue: 0,0:02:36.41,9:59:59.99,Default,,0000,0000,0000,,Palpation is often difficult in obese or poorly relaxed women.