operational obstetrics & gynecology · bureau of medicine and surgery · 2000 slide 1 pap smear...

Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 1

Pap Smear Technique

Video


Positioning

• Privacy• Buttocks just off table• Good Lighting• Drape• Standby


Padded Stirrups

• Soft, padded stirrups• Oven mitts• Socks• Battle dressings


Inspect

• Spread labia• Discharge• Ulcers• Growths


Anatomy


Vaginal Speculum


Warm Speculum

• Warm water• Not too hot• Lubricates speculum• Don’t use K-Y,

Surgilube or Vaseline to lubricate speculum


Insert Speculum• Spread labia• Keep labia apart• Blades remain closed

until fully inserted


Squamo-Columnar Junction

• Junction of pink cervical skin and red endocervical canal

• Inherently unstable • Key portion of the cervix to

sample• Most likely site of dysplasia


Ayers Spatula

• Concave end to fit the cervix

• Convex end for vaginal wall and vaginal pool scrapings


Sample Cervix

• Use concave end • Rotate 360 degrees• Don’t use too much force

(bleeding, pain)• Don’t use too little force

(inadequate sample)


Cytobrush

• Insert ~ 2 cm (until brush is fully inside canal)

• Rotate only 180 degrees (otherwise will cause bleeding)


Make Pap Smear• As thin as possible• Properly labeled


Spray with Fixative

• Within 10-15 seconds• Allow to fully dry

before packaging• Cytologic Fixative

(hairspray works acceptably also)

operational obstetrics & gynecology · bureau of medicine and surgery · 2000 slide 1 pap smear...

Documents

bleeding slide

inserted slide

anatomy slide

vaginal speculum slide

likely site of dysplasia

speculum dont use

sample cervix

warm speculum warm water