Speculum (medical)
Encyclopedia
A speculum (plural specula or speculums) is a medical tool for investigating body cavities, with a form dependent on the body cavity for which it is designed. In old texts, the speculum may also be referred to as a diopter or dioptra. Like an endoscope, a speculum allows entry into a body cavity; endoscopes, however, tend to have optics
Optics
Optics is the branch of physics which involves the behavior and properties of light, including its interactions with matter and the construction of instruments that use or detect it. Optics usually describes the behavior of visible, ultraviolet, and infrared light...

 while a speculum is intended for direct vision.

History

Vaginal and anal specula were used by the ancient Greeks
Ancient Greece
Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...

 and Romans
Ancient Rome
Ancient Rome was a thriving civilization that grew on the Italian Peninsula as early as the 8th century BC. Located along the Mediterranean Sea and centered on the city of Rome, it expanded to one of the largest empires in the ancient world....

, and speculum artifacts
Artifact (archaeology)
An artifact or artefact is "something made or given shape by man, such as a tool or a work of art, esp an object of archaeological interest"...

 have been found in Pompeii
Pompeii
The city of Pompeii is a partially buried Roman town-city near modern Naples in the Italian region of Campania, in the territory of the comune of Pompei. Along with Herculaneum, Pompeii was destroyed and completely buried during a long catastrophic eruption of the volcano Mount Vesuvius spanning...

. A vaginal speculum, developed by J. Marion Sims
J. Marion Sims
J. Marion Sims, born James Marion Sims was a surgical pioneer, considered the father of American gynecology. Modern historians argue about his legacy as Sims used slaves as experimental subjects.-Early career:...

, consists of a hollow cylinder with a rounded end that is divided into two hinged parts, somewhat like the beak
Beak
The beak, bill or rostrum is an external anatomical structure of birds which is used for eating and for grooming, manipulating objects, killing prey, fighting, probing for food, courtship and feeding young...

 of a duck. The speculum is inserted into the vagina to dilate it for examination of the vagina
Vagina
The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...

 and cervix
Cervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...

.

Construction

All specula were formerly made of metal, and sterilized after use. However, many, especially those used in emergency departments and doctor's offices, are now made of plastic, and are sterile, disposable, single-use items. Those used in surgical suites are still commonly made of metal.

Types of specula

Specula come in a variety of shapes based on their purpose, in any case the tube or blade(s) of the instrument allow the operator a direct vision of the area of interest and the possibility to introduce instruments for further interventions such as a biopsy.

The best-known specula are the bivalved vaginal specula; the two blades are hinged and are "closed" when the speculum is inserted to facilitate its entry and "opened" in its final position where they can be arrested by a screw mechanism, so that the operator is freed from keeping the blades apart.

Vaginal use

A specialized form of vaginal speculum is the weighted speculum, which consists of a broad half tube which is bent at about a 90 degree angle, with the channel of the tube on the exterior side of the angle. One end of the tube has a roughly spherical metal weight surrounding the channel of the speculum. A weighted speculum is placed in the vagina during vaginal surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 with the patient in the lithotomy position
Lithotomy position
The lithotomy position is a medical term referring to a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen, as well as a common position for childbirth in Western nations...

. The weight holds the speculum in place and frees the surgeon's hands for other tasks.

Tubal shape
  • Fergusson
  • Glass speculum


One blade
  • Auvard
  • Breisky
  • Doyen
  • Eastman
  • Jackson
  • Kallmorgen
  • Kristeller
  • Landau
  • Martin
  • Mathieu
  • Samuel
  • Scherbak
  • Sims
  • Weissbarth


  • Two blades (bivalved)
    • Collin
    • Cusco
    • DeVilbiss
    • Grave
  • Pederson
  • Semm
  • Seyffert
  • Trelat
  • Winterton


  • Three blades
    • Guttmann
    • Nott
  • O´Sullivan-O´Connor
  • Polansky (veterinary use)

  • Rectal use

    Vaginal specula are also used for anal
    Anus
    The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest,...

     surgery, although several other forms of anal specula exist. One form, the anoscope
    Anoscopy
    An anoscopy is an examination using a small, rigid, tubular instrument called an anoscope . This is inserted a few inches into to the anus in order to evaluate problems of the anal canal. Anoscopy is used to diagnose hemorrhoids, anal fissures , and some cancers.-Process:This test is usually done...

    , resembles a tube that has a removable bullet
    Bullet
    A bullet is a projectile propelled by a firearm, sling, or air gun. Bullets do not normally contain explosives, but damage the intended target by impact and penetration...

    -shaped insert. When the anoscope is inserted into the anus, the insert dilates the anus to the diameter of the tube. The insert is then removed, leaving the tube to allow examination of the lower rectum and anus.

    This style of anal speculum is one of the oldest designs for surgical instruments still in use, with examples dating back many centuries. The sigmoidoscope can be further advanced into the lower intestinal tract and requires an endoscopic set-up.

    Tubal shape
    • Aniscope


    One blade
    • Czerny


    Two blades
    • Barr
    • Bodenhammer
    • Killian
    • Pratt
  • Ricord
  • Roschke
  • Sims
  • Smith-Buie

  • Three blades
    • Alan Park
    • Cook
    • Mathieu

    Nasal use

    Nasal
    Human nose
    The visible part of the human nose is the protruding part of the face that bears the nostrils. The shape of the nose is determined by the ethmoid bone and the nasal septum, which consists mostly of cartilage and which separates the nostrils...

     specula have two relatively flat blades with handle. The instrument is hinged so that when the handles are squeezed together the blades spread laterally, allowing examination.
    • Killian
    • Vienna
  • Voltolini
  • Yankauer

  • Aural use

    Ear
    Ear
    The ear is the organ that detects sound. It not only receives sound, but also aids in balance and body position. The ear is part of the auditory system....

     or aural specula resemble a funnel
    Funnel
    A funnel is a pipe with a wide, often conical mouth and a narrow stem. It is used to channel liquid or fine-grained substances into containers with a small opening. Without a funnel, spillage would occur....

    , and come in a variety of sizes.
    • Aural speculum

    Oral use

    In veterinary medicine, a McPherson Speculum can be used for oral examination. The speculum helps keep the mouth open during the exam and helps avoid biting injuries.

    Non-medical uses

    Some health centers and feminist organizations sell plain specula, to allow women to better understand their body and improve how they view their vulva and vagina.

    Vaginal and anal specula are also sometimes used as sex toy
    Sex toy
    A sex toy is an object or device that is primarily used to facilitate human sexual pleasure. The most popular sex toys are designed to resemble human genitals and may be vibrating or non-vibrating...

    s.
    The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
     
    x
    OK