ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3c.org/TR/1999/REC-html401-19991224/loose.dtd"> <html xmlns="http://www.w3.org/1999/xhtml" xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:(null)0="http://www.w3.org/TR/REC-html40"><head><title>Rocky Mountain OB-GYN .::. Riverton, Wyoming</title> <meta content="text/html; charset=unicode" http-equiv="Content-Type"> <meta name="description" content=""> <meta name="keywords" content=""> <script language="JavaScript" type="text/javascript"> <!-- function clickmail(domain,mailto) { var url = "mailto:" + mailto + "@" + domain; self.location.href = url; return; } //--> </script> <link rel="stylesheet" type="text/css" href="styles.css"> <meta name="GENERATOR" content="Microsoft FrontPage 5.0"> </head> <body> <!-- DHTML Menu Builder Loader Code START --> <div style="POSITION: absolute" id="dmbri"> <img name="dmbif" alt="" src="layout/dmb_i.gif" width="1" height="1"> <img name="dmbjs" alt="" src="layout/dmb_m.gif" width="1" height="1"> </div> <!-- <script type="text/javascript"> var rimPath=null;var rjsPath=null;var rPath2Root=null;function InitRelCode(){var iImg;var jImg;var tObj;if(!document.layers){iImg=document.images['dmbif'];jImg=document.images['dmbjs'];tObj=jImg;}else{tObj=document.layers['dmbri'];if(tObj){iImg=tObj.document.images['dmbif'];jImg=tObj.document.images['dmbjs'];}}if(!tObj){window.setTimeout("InitRelCode()",700);return false;}rimPath=_gp(iImg.src);rjsPath=_gp(jImg.src);rPath2Root=rjsPath+"../";return true;}function _purl(u){return xrep(xrep(u,"%%REP%%",rPath2Root),"\\","/");}function _fip(img){if(img.src.indexOf("%%REL%%")!=-1) img.src=rimPath+img.src.split("%%REL%%")[1];return img.src;}function _gp(p){return p.substr(0,p.lastIndexOf("/")+1);}function xrep(s,f,n){if(s) s=s.split(f).join(n);return s;}InitRelCode(); </script> <script type="text/javascript"> /* <![CDATA[ */function LoadMenus() {if(!rjsPath){window.setTimeout("LoadMenus()", 10);return false;}var navVer = navigator.appVersion; if(navVer.substr(0,3) >= 4) if((navigator.appName=="Netscape") && (parseInt(navigator.appVersion)==4)) { document.write('<' + 'script type="text/javascript" src="' + rjsPath + 'nsmenu.js"><\/script\>'); } else { document.write('<' + 'script type="text/javascript" src="' + rjsPath + 'iemenu.js"><\/script\>'); }return true;}LoadMenus();/* ]]> */</script> DHTML Menu Builder Loader Code END --> <div align="center"> <table border="0" cellspacing="0" cellpadding="0" width="800"> <tbody> <tr> <td height="171" valign="top" width="449" align="left"> <img id="MenuSpacer" name=MenuSpacer alt=MenuSpacer src="layout/spacer.gif" width=413 height=64><img border=0 alt="Rocky Mountain OB-GYN" src="layout/logo.jpg" useMap=#Map align="left" width="339" height="77"></td> <td height="171" valign="top" width="351" align="left" bgcolor="#8DB2CD"> <p align="center"><br> <font size="5" face="Verdana"><br> <font color="#005591">ANATOMY OF THE UTERUS,<br> CERVIX and VAGINA</font></font></td> </tr></tbody></table> <table class="body-table-right-bottom" border="0" cellspacing="0" cellpadding="0" width=800> <tbody> <tr> <td valign="top" background="layout/body-bg-left.jpg" width="8" align="left" bgcolor="#A75F5F"> <img alt="Rocky Mountain OBGYN" src="layout/body-top-left.jpg" width="8" height="27"><img alt="Rocky Mountain OBGYN" src="layout/spacer.gif" width=8 height=400></td> <td class="body-bg" valign="top" colspan="2" align="left"> <table border="0" cellspacing="0" cellpadding="10" width="790"> <tbody> <tr> <td valign="top" align="left" width="427" colspan="2"> <p align="right"><img border="0" src="images/female%20anatomy.jpg" width="400" height="320"><font size="1"><br> image from medlineplus</font></td> <td valign="top" width="323" align="left" bgcolor="#C9DAE7"> The VAGINA is lined by <b>SKIN</b> (squamous) cells.<br> <br> The inside of the CERVIX CANAL (from vagina to uterine opening) is lined by <b>GLAND</b> cells, called <u>endocervical glandular cells</u>.&nbsp; Girls and young women frequently have these cells on the outside of the cervix (the portion within the vagina.)<br> <br> The inside of the uterine body is also lined by GLAND cells, called <u>endometrial glandular cells</u>.&nbsp; There are differences between the two gland cells which sometimes can be detected when both are present on the pap smear.<p>By the time women are in their 30's and 40's, most of them have only skin -- or squamous cells -- on the outside of the cervix, and the endocervical cells are within the canal going up to the uterus.</td></tr> <tr> <td valign="top" align="left" width="427" colspan="2"> <img border="0" src="images/cervix.gif" width="365" height="359"></td> <td valign="top" width="323" align="left"> <hr> <p>The area where the skin cells and the gland cells meet is called the &quot;transformation zone&quot;.&nbsp; Typically this is on the outside of the cervix in younger women.&nbsp; The process by which the gland cells become skin cells is called &quot;metaplasia.&quot;&nbsp; This process is influenced by numerous factors, including age, infection, vaginal health, hormones, and medical treatments.<p>HPV viruses like to invade the cells at this transformation zone and begin to reproduce themselves, causing the cells to take on an abnormal appearance.&nbsp; Because younger women do not have a strong immune response to the virus, we allow them more time to clear up an abnormal pap smear.&nbsp; That may take 24 to 36 months.<hr><p>&nbsp;</td></tr> <tr> <td valign="top" align="left" width="427" colspan="2"> <img border="0" src="images/Benign_superficial_squamous_cells.jpg" width="207" height="154"><img border="0" src="images/pap%20smear%20cells.jpg" width="189" height="143"></td> <td valign="top" width="323" align="left" bgcolor="#C9DAE7"> In women over 20, high risk types of HPV may persist in the tissues of the cervix, giving rise to changes in the appearance of cells that are picked up by the Pap smear.&nbsp; In the two adjacent pictures, notice how the nuclei (dark centers) and shape of the abnormal cells on the right differ from those of the normal cells on the left.&nbsp; Changes such as these are what the pathologists classify as Pap smear abnormalities.</td></tr> <tr> <td valign="top" align="left" width="375"> When High Risk HPV is present, the abnormalities tend to be more pronounced (Pap results are ASC-H, LGSIL and HGSIL) and we recommend further evaluation.&nbsp; Similarly, if the Pap was ASCUS but the High Risk HPV-DNA test is positive, further evaluation is performed.</td> <td valign="top" align="left" width="375" colspan="2"> <p align="right"> <font size="4">What does that evaluation involve?&nbsp; <br> Click here to find out more about <br> <a href="colpo-bx.htm">COLPOSCOPY and BIOPSY</a>.</font><p align="right"> <font size="4"><a href="pap-central.htm">Return to Pap Smear Central</a></font></td> </tr> </tbody></table></td></tr></tbody></table> <table border="0" cellspacing="0" cellpadding="0" width="798"> <tbody> <tr> <td colspan="3" align="middle"><br><br><a href="./"><span class=footer-links>HOME</span></a> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 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