COLLECTION AND SMEARING TECHNIQUES FOR PAP SMEARS

CERVICAL CYTOLOGY

1. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 1
Pap Smear Technique
Video

2. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 2
Positioning
•Privacy
•Buttocks just off table
•Good Lighting
•Drape
•Standby

3. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 3
Padded Stirrups
•Soft, padded stirrups
•Oven mitts
•Socks
•Battle dressings

4. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 4
Inspect
•Spread labia
•Discharge
•Ulcers
•Growths

5. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 5
Anatomy

6. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 6
Vaginal Speculum

7. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 7
Warm Speculum
•Warm water
•Not too hot
•Lubricates speculum
•Don’t use K-Y,
Surgilube or Vaseline to
lubricate speculum

8. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 8
Insert Speculum
•Spread labia
•Keep labia apart
•Blades remain closed
until fully inserted

9. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 9
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

10. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 10
Ayers Spatula
•Concave end to fit the
cervix
•Convex end for vaginal
wall and vaginal pool
scrapings

11. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 11
Sample Cervix
•Use concave end
•Rotate 360 degrees
•Don’t use too much force
(bleeding, pain)
•Don’t use too little force
(inadequate sample)

12. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 12
Cytobrush
•Insert ~ 2 cm (until brush
is fully inside canal)
•Rotate only 180 degrees
(otherwise will cause
bleeding)

13. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 13
Make Pap Smear
•As thin as possible
•Properly labeled

14. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 14
Spray with Fixative
•Within 10-15 seconds
•Allow to fully dry
before packaging
•Cytologic Fixative
(hairspray works
acceptably also)