CERVICAL SMEAR TEST
C
has overdeveloped to form an extra
rib
that lies parallel to and above the first
normal rib. The abnormality can vary
from a small, bony swelling to a fully
developed rib and it may occur on only
one or on both sides.
SYMPTOMS
In many cases, there are no symptoms.
I f the rib presses on the lower
brachial
plexus
(the
group
of nerves passing
from the spinal cord into the arm ),
however, there may be pain, numbness,
and
pins-and-needles
affecting
both
the forearm and hand.
DIAGNOSIS AND TREATMENT
An
X-ray
w ill show the presence of a
cervical rib, but other possible causes
o f pain and tingling in the hand or arm
(such as
carpal tunnel syndrome
or a
disc
prolapse
) still need to be excluded.
Exercises designed to strengthen the
shoulder muscles and improve posture
may bring relief. Severe or persistent
symptoms may, however, require surgery
in order to remove the rib.
cervical smear test
A test that is used to detect
cervical dys-
plasia
(abnormal changes in the cells of
the
cervix
,
the neck of the uterus) that
could develop into cancer (see
cervix,
cancer of
) .
A cervical smear test can also
detect viral infections o f the cervix,
such as
herpes simplex
,
papilloma (see
warts, genital
) ,
and C
hlamydia trachomatis.
WHEN IT IS DONE
A cervical smear test should be carried
out w ithin six months after a woman
first starts to have sexual intercourse. A
repeat test may be carried out between
six and twelve months later. I f no
abnorm ality
is
detected
on
these
smears, tests should subsequently be
perform ed
at
approxim ately
three-
yearly intervals until the age of
6 5
.
HOW IT IS DONE
Cervical smear tests are usually per-
formed by doctors or nurses in general
practice clinics
or at sexual health
clinics. A small sample o f cells is taken
from the surface o f the cervix using a
spatula or special brush and is exam-
ined under a microscope. If all the cells
appear normal, nothing further needs
to be done. If any cells show dysplasia,
this
w ill
be
graded
according
to
severity, and repeat smear tests and
further
investigations,
such
as
col-
poscopy
(inspection of the cervix w ith a
viewing instrument), may be required.
cervical spondylosis
An
alternative
name
for
the
neck
disorder
cervical osteoarthritis.
cervicitis
Inflammation of the
cervix
(the neck of
the uterus). The condition is usually
due to a sexually transmitted infection,
such as
gonorrhoea
,
chlamydial infections
,
or genital herpes (see
herpes, genital
).
However, cervical infection may also
result from injury to the cervix during
childbirth or surgery.
SYMPTOMS
Cervicitis
often
does
not
produce
symptoms, although there may be a
vaginal
discharge,
irregular
vaginal
bleeding, and lower abdominal pain.
COMPLICATIONS
If it is left untreated,
cervicitis can
spread to cause
endometritis
(inflamma-
tion
o f the
lining
o f the
uterus),
salpingitis
(inflammation of the fallopi-
an tubes), or
pelvic inflammatory disease.
I f a pregnant woman has cervicitis,
her baby may be infected during deliv-
ery, resulting in
neonatal ophthalmia
(eye
infection) or, less commonly,
pneumo-
nia
due to chlamydial infection.
DIAGNOSIS AND TREATMENT
The condition is diagnosed by means
o f internal examination and by taking
swabs o f the vaginal discharge, w hich
CERVICAL SMEAR
Regular cervical smear tests should begin within six months of a woman first
having sexual intercourse, then be done every three years as a matter of routine.
The procedure is risk-free, although it may be slightly uncomfortable, and the
actual collection of the cells from the cervix takes only a few seconds.
N o r m a l c e l l
n u c l e u s
Normal cells
as seen
under the
microscope
S p e c u l u m
B l a d d e r .
C e r v ix
Procedure for cervical smear
The woman lies on her backwith her legs bent
and relaxed so thattheyfall open atthe knees.
The vagina is held open with a speculum. Cells
are collected with a spatula or a special brush
and either smeared on to a glass slide or put in
a preservative for later microscopic examination.
l a r g e d a r k -
s t a i n e d n u c l e u s
o f a b n o r m a l c e ll
Abnormal
cells as seen
under the
microscope
158
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