Cervix Flashcards
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What is the cervix?
Part of uterus just below internal os, lined with mucous columnar epithelium on endocervix and squamous on vaginal portion
What is the transition zone and why is it important?
Squamo-columnar junction between endocervix and vaginal cervix
Predisposed to malignant change (during puberty and pregnancy, can get partial eversion of cervix; exposure to pH of vagina causes metaplasia - malignant potential here)
What is the function of the cervix?
Allows sperm in, menstrual flow out
In pregnancy, holds foetus in uterus, then dilates in labour
How is the cervix attached to surrounding structures?
Sacrum - uterosacral ligaments
Pelvic side wall - cardinal ligaments
What lies lateral to cervix?
Parametrium, containing connective tissue, uterine vessels, ureters
Blood supply and lymphatic drainage to the cervix?
Upper vaginal branches and uterine artery
Obturator and internal + external iliac nodes
What is cervical ectropion/erosion?
Red ring around os due to endocervical epithelium extending over to ectocervix
What causes ectropion?
Hormonal influence (puberty, COCP, pregnancy)
What causes the symptoms?
As columnar epithelium is soft and glandular, ectropion prone to bleeds, excess mucus production and infection
Treatment of ectropion?
None if asymptomatic, pregnant or pubertal
If on hormonal contraception - change to non-hormonal methods, cautery with diathermy if wished
What is cervicitis?
Inflammation which may be follicular or mucopurulent, presenting with discharge
Causes of cervicitis?
Chlamydia (up to 50%), gonococci or herpes (check for vesicles)
What is chronic cervicitis often a sign of?
Mixed infection
Why is cervicitis important to investigate?
Can mask neoplasia on smear
What can happen in severe cases of acute cervicitis?
Infection and ulceration found in severe degrees of prolapse when the cervix protrudes/held back with pessary
