The cervix in health and disease

Question 1

What are the congenital abnormalities of the cervix?

Answer 1

cervical agenesis and dysgenesis

Question 2

How does menopause effect the transformation zone?

Answer 2

transformation zone recedes further into the canal

Question 3

What are the functions of the cervix?

Answer 3

Produces mucus to facilitate sperm migration
Acts as a barrier to ascending infection
Holds a developing pregnancy in place
Effaces and dilates to enable vaginal birth

Question 4

What are the physiological changes of the cervix during pregnancy?

Answer 4

Hypertrophies, but not as much as the uterus
Becomes softer
Increased vascularity
Glands distended with mucus
Prominent ectropion
Remains elongated until the onset of labour

Question 5

Which physiological change can arise due to the effect of oestrogen?

Answer 5

Cervical ectopy

Question 6

Which physiological change can arise due to the lack of oestrogen?

Answer 6

Atrophic cervicitis

Question 7

What are the cervical infections?

Answer 7

Chlamydia - pelvic adhesions 
gonorrhoea
trichomonas vaginalis - strawberry cervix
HPV - can appear as warts
candida - curdy white discharge

Question 8

What are the causes of cervical cancer?

Answer 8

HPV
Predisposing factors
Smoking
Multiple sexual partners
Immune compromise
Low socio-economic status

Question 9

How is cervical intraepithelial neoplasia (CIN) treated?

Answer 9

Cytology, colposcopy, histology, treatment by ablation or excision

Question 10

What is the current treatment for cervical cancer?

Answer 10

loop excision, radical hysterectomy/trachelectomy, chemo-radiotherapy

Question 11

Outline the histology of the normal cervix

Answer 11

ectocervix is covered by non-keratinising stratified squamous epithelium composed by basal, parabasal, intermediate and superficial layers.
endocervix is lined by simple columnar epithelium that secretes mucus.