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Module 203 Reproduction & endocrinology > T3 L5 Cervix in health and disease > Flashcards

T3 L5 Cervix in health and disease Flashcards

1
Q

When does the development of the female genital system start?

A

Week 8

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2
Q

Describe the development of the female genital system

A

Paramesonephros tube joins in midline and then with sinovaginal bulb to form a solid vaginal plate which later canalises to form the vagina

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3
Q

What is agenesis of the cervix?

A

Complete absence of the cervix?

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4
Q

What is partial agenesis of the cervix?

A

Obstructed cervix

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5
Q

What is dysgenesis of the cervix?

A

Abnormal development and growth of the cervix

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6
Q

What is the endocervix?

A

Inner part of the cervix

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7
Q

What is the ectocervix?

A

Portio vaginalis and external os

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8
Q

What is the transformation zone?

A

Area between original SCJ and new SCJ

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9
Q

Describe the cervix in a nulliparous female

A

Cervix is barrel shaped

External os is small and circular at the centre of the cervix

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10
Q

Describe the cervix in a parous female

A

Cervix is bulky

External os becomes slit-like

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11
Q

Describe the stroma of the cervix?

A

Collagenous connective tissue

15% smooth muscle fibre

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12
Q

Why does the cervix often bleed when you take a biopsy?

A

Lack of muscle fibres meaning vasoconstriction is limited

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13
Q

What can be used to stop bleeding during a biopsy of the cervix?

A

Silver nitrate

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14
Q

What is the blood supply to the cervix?

A

Descending branch of uterine artery

Venous drainage follows the arteries

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15
Q

What is the lymphatic drainage of the cervix?

A

Parametrium nodes to obturator nodes into internal and external iliacs to the common iliacs

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16
Q

What is the nerve supply of the cervix?

A

Pain fibres with parasympathetic to S2, S3, S4

Uterine to T11 and T12

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17
Q

What is the histology of the ectocervix?

A

Non-keratinising stratified squamous epithelium

Native of metaplastic in continuity with vaginal epithelium

18
Q

What are the multiple layers of squamous epithelium of the ectocervix?

A

Basal
Parabasal
Intermediate
Superficial

19
Q

What is the histology of the endocervix?

A

Simple columnar epithelium that secretes mucus

Mucinous columnar epithelium lines the surface and the underlying glands

20
Q

What are the functions of the cervix?

A

Produces mucus to facilitate sperm migration
Barrier to ascending infection
Holds developing pregnancy in place
Effaces and dilates to enable vaginal birth

21
Q

What are the physiological changes of the cervix in pregnancy?

A 
Hypertrophies
Softens
Increased vascularity / venous congestion
Glands become distended with mucus
Prominent ectropion
Remains elongated until onset of labour
22
Q

What causes cervical ectopy ‘‘erosion’’?

A

Effect of oestrogen

23
Q

What causes atrophic cervicitis?

A

Lack of oestrogen

24
Q

What is atrophic vaginitis?

A

Inflammation of the vagina due to tissue thinning caused by a lack of oestrogen

25
Q

What are some examples of cervical infections?

A 
Chlamydia
Gonorrhoea
Trichomonas vaginalis
HPV
Thrush
Genital warts
26
Q

What does the cervix look like in trichomonas vaginalis?

A

Ulcers on the cervix (leopard cervix)

27
Q

How many cases of cervical cancer are there each year?

A

430,000

28
Q

What does the cervix look like in CIN III?

A

Increased vascularisation
Contact bleeding
Sharp, white edges
Spots with halo around them (HPV)

29
Q

What are the predisposing factors of cervical cancer from HPV?

A

Smoking
Multiple sexual partners
Immune compromise
Low socio-economic status

30
Q

How is HPV transmitted?

A

Through close sexual contact not via bodily fluids

31
Q

What percentage of sexually active women will be infected with HPV?

A

95%

32
Q

Why aren’t condoms fully protective against HPV?

A

Don’t cover all areas of the genitals

Close sexual contact may occur before condom is put on

33
Q

How often are women invited for cytology?

A

Every 3 years if aged between 25 and 49 years

Every 5 years if aged between 50 and 65 years

34
Q

What are the normal findings in a cytology test?

A

Endocervical cells
Squamous cells
Metaplastic cells from transformation zone

35
Q

What are the dyskaryosis findings in a cytology?

A

Nucleus is larger
Increased nucleoli
Nuclear cytoplasm is reduced
Looks more purple

36
Q

Why is acetic acid added in a colposcopy?

A

Makes abnormal cells more white

37
Q

Why is iodine added in a colposcopy?

A

Pre-cancerous / cancerous cells will look yellow instead of dark brown.

38
Q

How is cervical cancer treated?

A

Ablation or excision

39
Q

What is the treatment in stage 1a?

A

Cone biopsy / loop excision

40
Q

What is the treatment in 1b?

A

Radical hysterectomy / trachelectomy

41
Q

What is the treatment in 2a?

A

Chemo-radiotherapy

Module 203 Reproduction & endocrinology (52 decks)

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