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can you mix hydrocodone and tramadol Speculum exam should focus on vaginal support in addition to routine elements. Inspect lateral vaginal fornices looking for obliteration of sulci indicating a paravaginal defect. Note presence or absence of vaginal rugae. Smooth vaginal epithelium points to a fascial defect in that area. Split speculum exam, using only the posterior blade, is very helpful in determining what compartment is prolapsing. Depression of the posterior wall aids inspection of the anterior compartment and splinting a prolapsed anterior vaginal wall will allow for visualization of a posterior defect.
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