Disclaimer: These images contain sensitive material. They are to be used for medical and educational purposes only.

 

 

Female Genitalia, Pubis (1:10 Horizontal)

Patient position: The patient stands upright with the arms positioned out of view.

Background: A uniform background is desired. A black, blue, or gray color is ideal; however, white is acceptable.

Film: ASA 100 or 200 Ektachrome.

Exposure setting: Aperture priority mode with an aperture setting of f11 or smaller (f16 or f22).

Reproduction ratio: 1:10.

Camera position: The camera is held in the horizontal format on a plane parallel to the pubis.

Flash position: The flash is held off-camera along the top of the barrel of the lens directed at the pubis.

Plane of focus: At the level of the pubis or pathology. The center of the frame is at the level of the pubic bone.

Tips: A precise reproduction ratio of 1:10 is obtained by placing the camera on manual focus, moving the focus ring to a reproduction ratio of 1:10, moving the camera closer to or farther from the subject until the pubis is in sharp focus, and shooting the photograph. Ensure that the camera is level with the pubis. With the camera held on a plane parallel to the pubis, a 1:10 reproduction ratio is difficult to obtain when the patient is supine on the gurney. Have the patient stand whenever possible to photograph the pubis.

Common mistakes: Leaving the flash in the hot shoe does not evenly illuminate the pubis if a 60-mm macro lens or less is used. Remove distractions such as clothing patient gown, and jewelry from the field of view unless they are part of the pathology or injury. 

 

 

Female Genitalia, Perineum (1:4 Horizontal)

Patient position: The patient is placed in the semilithotomy position, appropriately draped.

Background: The inner thighs are the background for the perineum view.

Film: ASA 100 or 200 Ektachrome.

Exposure setting: Aperture priority mode with an aperture setting of f11 or smaller (f16 or f22).

Reproduction ratio: 1:4.

Camera position: The camera is held in the horizontal format on a plane parallel to the perineum.

Flash position: The flash is held off-camera along the top of the barrel of the lens directed at the perineum. A ring flash may be used to illuminate the irregular surfaces of the perineum uniformly.

Plane of focus: At the level of the perineum or pathology. The center of the frame is at the level of the introitus.

Tips: A precise reproduction ratio of 1:4 is obtained by placing the camera on manual focus, moving the focus ring to a reproduction ratio of 1:4, moving the camera closer to or farther from the subject until the perineum is in sharp focus, and shooting the photograph. Ensure that the camera is level with the perineum. If retraction of labial folds is required, make sure that the retracting hands are gloved.

Common mistakes: Leaving the flash in the hot shoe does not evenly illuminate the perineum.

 

 

Female Genitalia, Cervix (1:2 Vertical)

Patient position: The patient is placed in the semilithotomy position, appropriately draped.

Background: The ispeculum is the background for the cervical view.

Film: ASA 100 or 200 Ektachrome.

Exposure setting: Aperture priority mode with an aperture setting of f11 or smaller (f16 or f22).

Reproduction ratio: 1:2.

Camera position: The camera is held in the vertical format on a plane parallel to the cervix.

Flash position: A ring flash is used to illuminate the cervix and vaginal vault.

Plane of focus: At the level of the cervix or pathology. The center of the frame is the cervical os.

Tips: A precise reproduction ratio of 1:2 is obtained by placing the camera on manual focus, moving the focus ring to a reproduction ratio of 1:2, moving the camera closer to or farther from the subject until the cervix is in sharp focus, and shooting the photograph. If retraction of any tissues is required, make sure that the retracting hands are gloved. The Welch-Allen plastic speculum has a built-in illumination source that allows excellent visualization and focus of the cervix.

Common mistakes: Attempting to illuminate the cervix with a point flash is difficult, and results are frequently suboptimal.