To know the length of uterine cavity and its position, the instrument used is

UPPSC 2017

Obstetrics & Gynaecology

Easy

Appeared in: UPPSC 2017

Explanation

A uterine sound is a slender, malleable, graduated instrument specifically designed to be inserted through the cervix into the uterine cavity.
Its primary function is to measure the depth (length) of the uterocervical canal and to assess the position and flexion of the uterus (e.g., anteverted or retroverted).
This measurement is a crucial safety step before procedures like IUD insertion or dilation and curettage (D&C) to prevent uterine perforation.

Option A: A vaginal speculum is used to open and hold the vaginal walls apart for visualization of the cervix and vagina. It does not enter the uterine cavity and cannot be used for measurement.
Option B: A vulsellum is a type of forceps with sharp hooks used to grasp and hold the cervix firmly. Its purpose is stabilization, not measurement.
Option C: A tenaculum is very similar to a vulsellum. It is a surgical clamp with a sharp hook used to seize and hold the cervix to steady the uterus. It is a grasping instrument, not a measuring one.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification and use of gynecological instruments as background academic context rather than a clinical decision trigger.
Accurate measurement of the uterine cavity with a sound is a critical patient safety step before many gynecological procedures to minimize the risk of uterine perforation, a serious complication.
The measurement helps ensure that instruments like an IUD inserter or curette are not advanced too far, which could cause injury.
What if? If a patient has a severely stenotic (narrowed) cervix that prevents the passage of a uterine sound, a physician might need to use cervical dilators first or opt for a hysteroscopy, which allows for direct visualization of the cavity instead of blind measurement.

How to Approach the Question

First, identify the key actions required by the question: 'to know the length' (measure) and 'position' of the 'uterine cavity'.
Next, evaluate each option based on its primary function in gynecology.
A 'Vaginal speculum' is for visualization of the vagina and cervix, not for entering or measuring the uterus. Eliminate this option.
A 'Vulsellum' and 'Tenaculum' are forceps used for grasping and holding the cervix to provide traction or stability. They are not measuring devices. Eliminate these options.
A 'Uterine sound' is a probe specifically designed and marked (graduated) to measure the depth and assess the angle of the uterine cavity.
Conclude that the uterine sound is the only instrument listed that fits the description of measuring the uterine cavity's length and position.

Concept Tested & Keywords

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E6 Gynecology Williams p. 102-130

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 50-60