Uterus Flashcards
What are the three layers of the uterus and 2 layers of innermost layer?
Perimetrium, Myometrium, Endometrium -(basalis(regeneraltive cells), functionalis (shed in menses))
What are the 2 types of cells in mucosa of uterus
glandular and stromal(support the glands) - both hormone responsive and both can get tumors
Describe timing in menstrual cycle
day 1 - first day of menses
follicular (menstrual/proliferative)phase (14-21 days) -menses to day before LH surge
luteal (secretory)phase - (14 days)
What can be tested for proof of ovulation?
subnuclear vacuoles in the glandular epithelium (2-3 days post ovulation) - early secretory phase
What happens histologically in the menstrual phase
stromal breakdown - fragmented glands, with lots of blood
What is dysfunctional uterine bleeding
unscheduled bleeding - presumed to be hormonal abnormality - must rule out structural causes first
oligomenorrhea defintion
intervals > 35 days
polymenorrhea definiton
intervals <24 days
menorrhagia definiton
excessive bleeding with normal intervals
metrorrhagia definiton
excessive flow and duration at irregular intervals
menometrorrhagia definiton
irregular menses
withdrawal bleeding definiton
bleeding following the withdrawal of hormones
cause of abnormal uterine bleeding prepuberty
precocious puberty
cause of abnormal uterine bleeding reproductive age
Pregnancy complications organic lesions (leiomyoma, adenomyosis, polyps, endometrial hyperplasia, carcinoma) Dysfunctional uterine bleeding(anovulotory cycle, ovulatory dysfunctional bleeding(inadequate luteal phase
cause of abnormal uterine bleeding - adolescence
anovulatory cycle
coagulation disorders
cause of abnormal uterine bleeding - perimenopausal
Dysfunctional uterine bleeding
Organic lesions - biopsy
cause of abnormal uterine bleeding - post menopausal
endometrial atrophy
organic lesions - biopsy
what is an anovulatory cycle
dysfunctional uterine bleeding - no known cause
increased prolonged, unopposed estrogen stimulation
->unstable endometrium
common around menarch/perimenopausal
what is inadequate luteal phase?
dysfunctional uterine bleeding
abnormal corpus luteum fxn -> low progesterone
presents as infertility w/ menorrhagia or amenorrhea
biopsy shows histology >2 days behind clincal date of menses
Why do oral contraceptives cause dysfunctional uterine bleeding
effects on endometrium depending on E-P ratio and sequence of ingestion (hypoactive endometrial mucosa)
What is acute endometritis
inflammation of endometrium caused by vaginal bacteria like strep group A or Staph - retained products of conception(remove and treat w/ ABs)
What is chronic endometritis
chronic inflammation of endometrium due to chronic PID Retained products of conception IUDs TB
What would a biopsy of chronic endometritis show
plasma cells - not normal in endometrium
How can chronic endometritis present
metromenorrhagia
dysmenorrhea
pain
infertility
