3 - Gynae - The Uterus and its abnormalities - Anatomy and Physiology of the Uterus

Question 1

howis uterus supported ? anteversion and retroversion? what is wall made of? what, therefore, can originate from wall?

Answer 1

predominantly at inf end by uterosacral and cardinal ligament
20% retroverted, 80% anteverted
wall = SM - origin of fibroids

Question 2

what is uterus lined with? what is outside coat/serosa?

Answer 2

glandular epithelium - endometrium

peritoneum posteriorly and anteriorly down to bladder
laterally peritoneum continuous with broad ligaments > run between uterus and pelvic side wall > continuous with tubes and round ligs superiorly

Question 3

Blood and lymph - uterine blood supply is from? crosses ureters where? then go where?

Answer 3

uterine arteries, cross ureters lateral to cervix and pass inf and sup supplying myometrium and endometrium

Question 4

Blood and lymph - what happens at cornu (meeting of tubes and uterus) ?
lymph drainage?

Answer 4

arterial anastomosis with vessels of upper vagina

drainage > via internal and external iliac nodes

Question 5

Endometrium - supply? which is important for menstruation and nourishment of growing fetus? endometrium responds to? what lead to IMB?

Answer 5

spiral and basal arterioles
spiral
oestrogen and progesterone

poor hormonal control

Question 6

Endometrium - describe normal cycle

Answer 6

first 14 d :
-proliferates, under influence of oestrogen
after ovulation:
-progesterone influence > gland swell and bl supply incr
towards end of luteal phase:
-prog levels drop
-disintegration as bl supply can no longer support it

> menstruation