Female Reproductive System

Question 1

Why does the uterus change in preganancy

Answer 1

Get bigger to Provide support for growing fetus and expel fetus and placenta
Contract after birth to prevent haemorrhage
remodel back to prepregnancy shape by involution

Question 2

How does the uterus grow

Answer 2

Increased vascularity and fluid retention by progesterone and oestrogen
Plus stretches mechanically
changes from a pelvic organ to an abdominal organ

Question 3

Describe the endometrium during pregnancy

Answer 3

Following the attachment of the fertilised egg, it becomes the decidua

Question 4

describe decidualization

Answer 4

cells differentiate in the decidua to prepare for implantation, protect from the trophoblast and prepare to provide nutrition to the blastocyst

Question 5

Describe what happens to the muscle cells in myometrium during pregnancy

Answer 5

Comprised of three muscle layers: longitudinal, oblique and circular
undergoes hyperplasia where the number of muscle cells increase and hypertrophy where the size of the muscle cells get bigger

Question 6

Describe the involvement of the myometrium in uterine contraction during pregnancy

Answer 6

High levels of progesterone promote relaxation of myometrium, inhibits prostaglandins and oxytocin receptors (contractions)

Question 7

Describe the involvement of the myometrium in uterine contraction at established labour

Answer 7

oestrogen, oxytocin and prostagladins increase the density and permeability of the gap junctions between the myometrial cells, so contractions are more regular and stronger

Question 8

Describe the role of the myometrium in the cessation of bleeding

Answer 8

in the oblique layer, Each muscle cell is a figure of 8, and can constrict around a blood vessel to stop bleeding

Question 9

Describe the adaptation to the perimetrium

Answer 9

Layer of connective tissue around uterus expands to accommodate growth and more blood vessels

Question 10

Why does the perimetrium expands

Answer 10

Contractions squeeze some blood so the blood sits in the enlarged uterine veins, acting as a reservoir during uterine contractions

Question 11

what is the application of the isthmus

Answer 11

lower uterine segment is formed from the isthmus, which becomes increasingly thin (as no hypertrophy) and distensible and the muscle fibres are transverse so thats where LSCS

Question 12

What is the new blood flow to the uterus

Answer 12

From the heart it changes from 2% to 17%

Question 13

What is uterine vascular remodelling

Answer 13

Blood vessels in uterus change
Spiral arteries dilate and loss of muscle and so maternal blood pools into a site for gaseous exchange

Question 14

Describe ischaemia

Answer 14

Cutting of blood supply. Muscles retract to constrict blood vessels at placental site so blood stops

Question 15

Describe autolysis

Answer 15

Enzymes and macrophages break down the muscle fibres so size of myometrial cells is reduced

Question 16

Describe phagocytosis

Answer 16

Removes excess fibrous and elastic tissue, some remain

Question 17

Describe involution

Answer 17

Uterus contracts back down to its normal size

Question 18

Describe the cervical changes in labour

Answer 18

After remodelling, Tissue softens after conception so structure is disrupted and increases vascularity
Ripens becomes soft, thin
Effacement and dilation: muscle fibres pulls up to become lower uterine segment, so length shortens, external os opens
Then repair

Question 19

Describe the operculum

Answer 19

Cells undergo proliferation and secrete mucus that acts as a plug, protective seal against pathogens and has antibacterial properties

Question 20

Describe the operculum during labour

Answer 20

The operculum is released as blood streaked mucous known as show

Question 21

Describe vaginal changes in pregnancy

Answer 21

Mucosa thickens, connective tissue loosens and muscle cells increase in size
Increase in white vaginal discharge
Increase in blood vessels and blood flow in skin and muscles of perineum and vulva
Vulvar varicosities caused by vasodilation and reduced venous tone