Supplies: Vaginal speculum, plastic extended-tip spatula,
cytobrush and fixative (spray fixative or bottle of 95% ethanol),
clean glass slide (single end frosted), black lead pencil and
test request form. Pap kits are available from PLA.
a) Label one (1) slide with patients first and last name
and specimen source.
b) Use an un-lubricated speculum (saline or warm water may be
c) After visualization of the cervix is accomplished insert the
spatula into the cervix. Rotate the spatula 360 degrees to perform
a scraping. This will allow a specimen to be obtained from the
transformation zone where neoplasia occurs. In post menopausal
patients, it is desirable to obtain a sample from the vaginal
pool (posterior fornix) with the rounded end of the spatula.
d) Make a smear lengthwise along
one side of a previously labeled glass slide. Smear slide thinly
e) If a cytobrush is used, insert the cervical brush into the
cervical os with gentle pressure and rotate only 90 to 180 degrees
to minimize bleeding.
f) Quickly make an adjacent lengthwise smear on the same slide
spreading material quickly and evenly. The endocervical mucus
will prevent air-drying during collection of the subsequent cervical
g) Broom, another collection instrument for taking
Pap smears, is a plastic broom-like brush which simultaneously
samples the endocervix and ectocervix at the same time. To use
the broom insert the long central bristles into the cervical
os until the lateral bristles bend against the ectocervix and
rotate in a clockwise direction 360° in the same direction
five (5) times while maintaining gentle pressure. The broom is
removed and with a single paint stroke motion the cellular sample
is transferred down the long axis of the labeled slide surface.
The broom is turned over the paint stroke motion is repeated
over the same area.
h) Fix immediately (spray with fixative holding the spray bottle
approximately 10-12 inches from the slide or drop slide into
95% ethanol fixative).
i) Complete the Cytology test request form, including relevant
clinical information. Submit the specimen to the Cytopathology
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