Female tract, oogenesis and endocrine control 2 Flashcards
The uterus expands during pregnancy to increase the volume it holds from 10 mls to over 5 L, what facilitates this increase?
This is due to cell stretch rather than proliferation. They can go from 50 um to 500 um.
What are the three layers of the uterus?
The serosa (perimetrium) The muscular myometrium The inner endometrium
What is the main function of the myometrium and how does it change during the menstrual cycle?
It is mostly for expulsion of the fetus and does not change much during the menstral cycle.
What part of the endometrium is lost and what part is retained during menstruation?
The basilar layer is retained and the functional layer is lost.
What is the name of the tissue that the fertilised embryo implants?
The decidua
What are the three endometrial phase of menstruation, how long does each phase last and what happens?
Menses - 5-6 days - the endometrial layer becomes necrotic and is shed along with 30 mls of blood.
Proliferative - the endometrium begins to regenerate over 14-20 days. The basilar layer remains behind and these cells and the blood vessels undergo rapid proliferation.
Secretory - The glands begin to secrete things that help embryo. This is induced by secretion of progesterone by the granulosa cells of the corpus luteum.
What happens to an embryo once it is in the uterine lumen?
Prior to implantation the endometrium under goes the decidual reaction: the stroma become oedematous, stromal fibroblasts expand and fill with glycogen.
The embryo inserts into the endometrial wall. It then sinks into the wall and is covered by the endometrium (no longer in the lumen). As the embryo implants, it is eating the glands in the endometrium and these contain stromal fibroblasts filled with glycogen (embryo energy source)
What are the names of the arteries that supply the uterine walls?
Uterine artery to the radial artery in the myometrium t the arcuate arteries to the radial arteries in the to the spiral arteries endoetrium
How does menses occur?
The spiral arteries clamp off and cutting off blood supply to the endometrium. This causes necrosis and inflammation and causes the tissue to be lost. The basilar region
What are the ways that you can date the endometrium?
Use ultrasound to look for proliferation of the endometrium (endometrial thickness).
Precise dating is done by a pipelle biopsy of the endometrium.
Different features duting different phases:
Proliferation: gland mitoses, pseudostratification of nuclei, some stromal edema, stromal mitoses (major part), some tortuosity.
Secretion: most tortuosity, basal vacuolation (around ovulation), secretion, most stromal edema, pseudodecidual reaction, some stromal mitoses, some leucocytic infiltration.
Menstration: Leucocytic infiltration
Can see mitosis because of rapid proliferation, secretion of glands, stromal edema, gland tortuosity (straightness), gland secretions. Use this data to get a precise date.
What are the detectable features of the early luteal phase?
This is the secretion phase.
Basal vacuolation, tortuosity of glands, glandular secretions
What is a identifying factor for menstruation microscopically?
Leukocytic infiltration - neutrophils
What does estrogen do in the uterus?
It stimulates epithelial and stromal cell proliferation.
It stimulates stromal oedema (seen in biopsy) and production of glandular secretions but not secretion.
It stimulates the synthesis of intracellular progestrone receptors. Stimulates myometral activity.
What does progesterone do in the uterus?
It stimulates the release of the glandual secretions in the luteal phase.
It cause the differentiation of the stromal cells (which are induced t proliferate by estrogen)
It drives the decidual reaction
It inhibits myometrial activity (smooth muscle relaxant; uterine quiescence during pregnancy)
What are the features of enometriosis?
Ectopic endometrium
Chronic pelvic pain
Associated with infertility
Endometrial tissue outside of the uterus, usually on the ovaries
