Uterus, Uterine tubes and Cervix

Question 1

Where does fertilisation occur?

Answer 1

Ampulla

Question 2

What is the myometrium?

Answer 2

It is the middle layer of the uterine wall.

Question 3

How long does the embryo stay in the uterine tube?

And where would it implant?

Answer 3

The embryo stays in the uterine tube for the first 5 days.

Then it would implant into the receptive wall of the endometrium.

Question 4

What is the changes in size a uterus goes through its life?

Answer 4

It starts off quite big at birth from a large amount of maternal oestrogen. Post birth those oestrogens no longer exist so it shrinks until puberty. When pregnant it gets even bigger due to the extra oestrogen released.

Question 5

What do nulliparous and parous mean?

Answer 5

never given birth and someone who has given birth.

Question 6

What is menopause?

Answer 6

menopause is when the menstrual cycles stop due to very little oestrogen production. So the uterus shrinks to pubertal size.

Question 7

What are the two layers of the myometrium?

Answer 7

Outer muscular layer and inner fibrous layer.

Question 8

what is the structure of the muscle inside the myometrium?

Answer 8

The muscle in the middle is spiral, whereas the muscle in the outer layer is longitudinal.

Question 9

What part of the uterus can go away and regrow during the menstrual cycle?

Answer 9

The endometrium.

Question 10

What do you have in the endometrium that aid implantation?

Answer 10

glands that secrete adhesion molecules, growth factors etc.

Question 11

Which hormone cause the proliferation of the endometrium?

Which hormone cause differentiation of the endometrium?

Answer 11

oestrogen.

The progesterone cause it to provide convoluted artery nad maturation of secretory gland.

Question 12

What stimulates the proliferative phase of the endometrium?

Answer 12

The high oestrogen production during LH surge stimulates it.

Question 13

What happens during the proliferative phase?

Answer 13

Stromal cell division, ciliated surface, gland expansion., and neoangiogenesis.

Question 14

What happens when the endometrium is greater than 4mm?

Answer 14

Induction of progesterone receptor starts and small muscular contraction of the myometrium start.

Question 15

When does endometrium secretory phase start? And what does it involve?

Answer 15

Secretory phase starts 2-3 days after ovulation when the CL secrete progesterone.

After a gradual rise in progesterone which causes a reduction in cell division. Adhesive molecules, GF and cytokines secreted.

Question 16

Prostaglandin is released from endometrial cells when progesterone levels drops. What does it do?

Answer 16

Prostaglandin release cause constriction of spiral arterioles which lead to hypoxia and necrosis of the endometrium.

Question 17

what happens when prostaglandin release stops?

Answer 17

the resulting arterioles dilate and bleeding starts.

proteolytic enzyme is released to help.

Question 18

after prostaglandin release, most of the endometrium is lost, what remains?

Answer 18

1-2 mm of the basal stroma remains.

Question 19

the outer 50% of endometrium is shed in about 24 hours, up to 80ml of blood loss is considered normal, how long do bleedings normally last?

Answer 19

4+ days.

Question 20

The uterine tube also has 2 layers, what are they like?

Answer 20

the outer layer is made up of longitudinal muscle fibres which are used to contract the tube, the inner layer has circular muscle fibres which squeeze the tube producing peristalsis.

Question 21

what is the name for the structure where the uterine tube meet the uterus?

Answer 21

the intramural section.

Question 22

What are the different types of mucosa cells found in the uterine tube?

Answer 22

secretory cells secrete all nutrients for the early embryo.

the columnar ciliated cell which can wipe the egg down the tube.

Question 23

Where are there more mucosal cells, the isthmus or the intramural?

Answer 23

isthmus.

Question 24

What is the role of secretory mucosa in ampulla?

Answer 24

provide a large surface area.

Question 25

What is the role of oestrogen to the mucosal cells?

Answer 25

differentiation, because you need the cell to be ready after ovulation.

Question 26

Why do the epithelial cells increase in height half way through the cycle?

Answer 26

So the oocyte can pass during mid cycle only.

Question 27

What is the role of progesterone to the mucosal cells?

Answer 27

it overcomes the oestrogen effects, so height is decreased, the epithelium is undifferentiated and the secretions stop.

Question 28

What does the fimbrae do?

Answer 28

it grabs the ovary and the egg and transfers into the uterine tube.

Question 29

how does the egg gets moved along the uterine tube?

Answer 29

The beating of the cilia and rapid contraction of the muscular layer. both are caused by oestrogen.

Question 30

how do the beating of cilia and the contraction of uterine tube muscles stop?

Answer 30

high levels of progesterone suppress the oestrogen receptor.

Question 31

What can cause blockage or damage to the ciliated epithelial?

What can result from this?

Answer 31

infection, endometriosis, surgery or adhesion.

Pain, infertility and ectopic pregnancy.

Question 32

What is endometriosis?

Answer 32

this is when the endometrium grows outside if the uterus and implant itself on the peritoneal wall, or on the bowl, or fallopian tube.

Question 33

does the endometrium in endometriosis function properly?

Answer 33

they still respond to oestrogen and progesterone and grow in the first half of the cycle, differentiate and secrete in the second half.

Question 34

what happens during menses with endometriosis?

Answer 34

bleeding occurs, and blood remains in the peritoneal cavity, which leads to inflammation.

Question 35

what happens when the fallopian tube is blocked?

Answer 35

pain and infertility.

Question 36

does ectopic pregnancy cause permanent damage to the uterine tube?

Answer 36

yes?

Question 37

How do you check is the fallopian tube is blocked?

Answer 37

laparoscopy and dye. insert a uterine cannula through the cervix and introduce a dye to the uterus.. then you have a laparoscopy through the abdominal wall and pelvic. If you can see the dye emerging from the fimbrae of both side then no blockage.

fill up the uterus with dye via the same cannula, this time use ultrasound to see the progression.

Question 38

What is the cervix?

Answer 38

it is a muscular structure capable of great expansion. It has an inner mucosal layer with many secretory glands producing mucus.

Question 39

What is the role of the mucus of the cervix?

Answer 39

It acts as a protective barrier to infection, its consistency determines whether sperm can get through.

Question 40

What does oestrogen do to cervix?

Answer 40

It changes the vascularity, it can allow more blood into it, causing oedema to make the mucus thin and runny.

Question 41

what causes the cervical mucus to be thin and runny?

Answer 41

mid-cycle oestrogen.

Question 42

what happens at the molecular level to the cervical mucus which allows the sperm to swim through?

Answer 42

glycoprotein align and form microscopic channels.

Question 43

What does progesterone do to the cervix?

Answer 43

It reduces secretion so it is more viscous, the glycoprotein is more meshy.

Question 44

what can the groove in the endocervical canal be useful for?

Answer 44

collecting sperm and forming a reservoir.

Question 45

how does the vagina prevent infections?

Answer 45

layers of epithelial cells shed consistently and flow out.

secretion of the cervix is also flown out.

Secretions are generally acidic.