When examining an obese patient, to do a proper Pap smear, position the patient at the edge of the examination table. To identify the cervix while doing the Pap test, have the patient place her hands on her knees and pull her legs back toward her. The cervix will then be very nicely in the view of the speculum.

If the vaginal rugae are collapsing on the lateral walls of the vagina and are impeding your ability to see, a condom can be placed over the speculum before the examination. Simply cut the tip off the condom, and place the speculum in the vagina. When the speculum opens, the condom will prevent the vaginal walls bilaterally from obstructing your view. This technique can be used during colposcopy procedures as well.—TERRI FULLER, APRN, Lake Hopatcong, N. J. (207-5)

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