music It's a typical day. A patient has noticedsome itching, or maybe an unpleasant vaginal odor. During her exam, the ian willcheck vaginal pH, examine any discharge that's present, and collect a sample. Then, it'son to the microscope. music This is where you'll gather more specificinformationabout what's causing those vaginal symptoms. We'll show you how to prepare andexamine vaginal wet preps and how to do a whiff test. The results, combined with the patient's vaginal pH test, will aidthe diagnosis.
Under the microscope, you'll be looking for trichomonads, yeast, and the clue cells associated with bacterial vaginosis. We'll show you how to recognize them. music First, the microscope itself: This is a compoundlight microscope. It has several objective lenses on a rotating mount. For our purpose,one of these has to be a 10x low power objective, and one has to be a 40x for greater magnifiion.This flat part, under the objectives, is the stage. Under the stage is the condenser. Belowthat, at the base of the microscope, is the light source. There are two knobs that controlfocus; one for coarse adjustment and one for
fine adjustment. And these are the oculars,or eyepieces. We'll come back to the microscopea minute, but first, let's look at how to prepare wet mount slides. The complete vaginal wet mount involves botha saline prep and a potassium hyoxide, or KOH, prep. When the vaginal sample was collected,the swab was placeda test tube with approximately half a milliliter of saline. So, for the salineprep, you only have to take a op of the suspension and place it on a slide. Add acoverslip, being careful to avoid trapping air bubbles. Your saline slide is ready.Place a second op of the vaginal sample on another slide and add one op of 10 percentKOH. Sniff the preparation immediately, using
your hand to waft any odor toward your nose.This is the whiff test. Note if there's a fishy or amine odor. Then add a coverslip,avoiding air bubbles. Keepmind that you must work quickly to prepare and examine thewet mounts. That's because trichomonads may lose their characteristic motility within15 to 20 minutes. Before we move on now, though, let's lookat the cast of characters you may discover. These are normal squamous epithelial cellsfoundthe vagina. They're large, flat cells with a small nucleus and a large area of cytoplasm.Note that there is some granularitythe cytoplasm.
Polymorphonuclear leukocytes are known asPolys, or PMNs. They may also be called white blood cells, or WBCs. These are small roundcells. Several lobes of the nucleus are visible within the surrounding cell cytoplasm. Findingmany PMNs may indie infection. Trichomonads are pearshaped protozoa whichmove by means of flagella. Trichomonads are similarsize to PMNs and are identifiedby their characteristic jerking movement. The actual flagella may be too thin and toorapidlymoving to be seen. A clue cell is a squamous epithelial cellcoated with enough small bacteria that at least 75 percent of the cell's border is obliterated.It may look as if someone has spread glue
over the cell and pressed itsand. Cluecells are associated with bacterial vaginosis, a conditionwhich the normal microbialflora of the vagina is disrupted. Yeast may be foundtwo forms. Pseudohyphaeare the long, tubular, branching forms. Budding yeast are paired yeast cells that resemblea shoe print. The larger part is the sole and the smaller bud is the heel of the shoe. The saline prep will allow you to see epithelialcells, PMNs, trichomonads, and clue cells. You can also see yeastsaline, but sometimesit's hidden by epithelial cells or by PMNs. Red blood cells, sperm, and bacteria can alsobe seen.
How to Wash Your Vagina by Daily Washing Routine
1.Lather up a washcloth or sponge with some mild natural soap and warm water. Avoid usingsoaps with heavy perfumes, or gels or antiseptics, which may throw off the balance of healthybacteria and irritate the sensitive skin around your vagina. The actual vagina (the inner canal) is quot;selfcleaningquot;and doesn't require washing; soap is likely to irritate the vagina if you try to use iton the vagina itself. You don't need to wash the vagina, just the area around the vagina(the vulva), using a plain, unperfumed soap, using the steps that follow.2.
Clean the folds around your clitoris. Useyour fingers to pull your labia away from your clitoris. Gently wipe the skin on bothsides of your clitoris with the washcloth. 3.Wash your vulva and your vaginal opening. Also, clean around your bikini line.4. Wash your perineum. The perineum is the areabetween your vagina and your anus. 5.Wash your anal area last. Keep your washcloth from touching your vaginal area after you'vewashed your anus. Doing this will ensure that you don't ag rectal germs toward your vaginalarea. These germs can cause you to get urinary
tract infections.6. Wash your vagina at least once per day. Ifyou have sex, you may want to wash it a second time to feel fresh and clean, although washingafter sex will not prevent pregnancy on its own.
Laci Ladies, what's up, ladiesé Actually, this doesn'tjust apply to ladies. I've gotten so muchemail the past few years of people asking me howto shave their pubes and have basically always just said, quot;Yeah, no, not gonna do that.quot; Reason being that I don'twant to be another one of those forces that pressures people
to shave off their pubic hair. I know when I was younger I felt a lot of pressure to get rid of that shit. And on one occasion, Igot such bad razor burn that I (mumbling) myself at the gynecologist worried that I had herpes. These days I kinda like pubic hair. I get excited by bushes thesize of mount kilimanjaro.
Yeah, I said it, haters gonna hate. And we all know what you gottado about the haters, righté Ignore the shit out of them. Which means that if deepdown if you don't want to shave your pubes, if itjust doesn't interest you, or you get really bad razor burn, or you're lazy, don't do it. I haven't shaved for months but maybe
a few weeks I'll decide, quot;Hey, I want a different hairstyle.quot; In which case, here are some things that I've found to helpyou shave your pubes and avoid the bumpy burnyitchy red nasty horribleness. (gentle music) And before you ever pull out a razor the first thing you wanna dois give yourself a little trim.
Get the hair nice and short. Then hopthe shower with a bath. And soak for five to ten minutes. Then take an exfoliator ora luffa and gently remove the dead skin cells fromthe triangle patch on top. Close shave is the keyto avoid irritation. So, removing all thosedead skin cells first it's gonna help you get a little closer.
So,terms of shaving cream, I like to use the kindthat's a gel to foam. You want something that's not too thin and something that's not too thick. And then your razor. So, your razor shouldbe sharper than mine. And this is where you don't wanna skimp. You wanna have somethingthat's really, really sharp.