Uterus, Uterine tubes and cervix

Question 1

In what region does the egg meet the sperm?

Answer 1

ampullary

Question 2

How long does the embryo spend in the uterine tube?

Answer 2

5-6 days

Question 3

What stage does the embryo need to be for it to be impanted into the uterus?

Answer 3

blastocyte

Question 4

Where does the embryo implant?

Answer 4

endometrium (wall of the uterus)

Question 5

What are the 3 layers of the uterus and the cervix?

Answer 5

• Endometrium is the mucosal lining of the uterus, it is shed every month
• Myometrium is the (smooth muscle fibres) muscular layer that makes up the body of the uterus
• Perimetrium surrounds uterus

Question 6

What is the size of the myometrium dependent on?

Answer 6

oestrogen

Question 7

What is nulliparous?

Answer 7

someone who has never given birth

Question 8

What is parous?

Answer 8

someone who has given birth

Question 9

How does the uterus size compare of a nulliparous and parous person?

Answer 9

nulliparous uterus is smaller bc high oestrogen exposure during pregnancy

Question 10

What happens to the uterus size during menopause?

Answer 10

shrinks

Question 11

Is uterus of a 4 year old bigger or a uterus of a new born baby?

Answer 11

newborn is larger bc in utero exposed to lots of maternal oestrogen

Question 12

What are the 3 layers of the muscular (myometrium) layer of the uterus?

Answer 12

inner layer fibres = circular direction (IC)
middle layer fibres = spiral direction (MS)
outer layer fibres = longitudinal direction (OL)

Question 13

What is the endometrial layer?

Answer 13

inner secretory layer of the uterus

Question 14

After menstruation, what does the endometrium consist of?

Answer 14

stromal matrix layer

small columnar cells

Question 15

What happens to the endometrium at the start (under oestrogen influence) of the menstrual cycle?

Answer 15

proliferation of the endometrium

Question 16

What happens on the 2nd half of the menstrual cyle, when progesterone is dominating?

Answer 16

differentiation of endometrium
twisted blood vessels develop= increase SA for nutrients
glandular secretions

Question 17

A week after ovulation, the endometrium reaches its max size. What is this?

Answer 17

10mm

Question 18

What happens to the endometrium at the end of the menstrual cycle?

Answer 18

endometrium is lost
bc corpus luteum dies
so less progesterone
so endometrium cant be maintained

Question 19

What are the 2 phases of the menstrual cycle called when talking about the ovary?

Answer 19

follicular and luteal phase

Question 20

What are the 2 phases of the menstrual cycle called when talking about the uterus?

Answer 20

proliferative and the secretory phase of the uterus

Question 21

What is the proliferative phase of the uterus influenced by?

Answer 21

endometrium under oestrogen influence

Question 22

What is the secretory phase of the menstrual cycle under the influence of?

Answer 22

the secretory phase of the menstrual cycle is when the endometrium is undergoing development and differentiation under the influence of progesterone

Question 23

What happens in the proliferative phase?

Answer 23

the stromal cells divide= form a ciliated surface
glands expand = become tortuous
increased vascularity
maximal cell division by day 12-14
the oestrogen levels keep increasing, until the negative feed back on the HPG turns into positive feedback, and there is an LH surge

Question 24

What happens because of LH surge?

Answer 24

the egg gets ovulated
leaving the corpus luteum
NOW there is increased progesterone secretion, and the negative feed back is reinstated

Question 25

What happens in the secretory phase?

Answer 25

``` cell division stops, endometrium differentiates glands become more tortuous glycoproteins and lipids secretions oedema myometrial cells enlarge blood supply increases ```

Question 26

What happens to the egg during the secretory phase?

Answer 26

it gets fertilised and spends 5-6 days in the tube

Question 27

If the embryo implants, the blastocyst released hCG. What does this do?

Answer 27

this is almost identical to LH binds to the LH receptor on the corpus luteum rescues the corpus luteum corpus luteum keep producing produce progesterone endometrial layer doesn't break down.

Question 28

What happens to the endometirum when progeterone is no longer released?

Answer 28

prostaglandidn is released in the endometrium

Question 29

What does prostaglandin in the endometirum cause?

Answer 29

constriction of all extended spiral arterioles hypoxia and necrosis in cells vessels then dilate and there is bleeding

Question 30

How many ml of blood is lost during menstruation?

Answer 30

80ml

Question 31

What part of the endometrium remains when the endometrium sheds?

Answer 31

basal layer (Stromal layer)

Question 32

What are the 3 parts of the uterine tube?

Answer 32

inramural, ampulary, isthmus

Question 33

Describe the intramural portion.

Answer 33

uterine tube meets the uterus very muscular and consists of a thick layer of inner circular and outer longitudinal muscles many blood vessels lymphatics

Question 34

Describe the ampullary region.

Answer 34

where the fimbria are where the tube meets the ovary has big secretory mucosa layer

Question 35

What are the cell types on the secretory mucosa?

Answer 35

secretory cell: this secretes growth factors, nutrients, adhesion molecules, cytokines etc (nutrients for early embryo) columnar ciliated epithelial cell: these gently move the embryo towards the uterus (waft embryo)

Question 36

What does the ampulla have that is a remnant of something?

Answer 36

ampulla also has something called the appendix vesiculosa-this is a remnant of the wolfian duct

Question 37

How do oestrogen and progesterone act in the uterine tubes?

Answer 37

opposite to endometrium | oestrogen leads to differentiation and progesterone causes de-differentiation and anti-growth

Question 38

How is the egg transpoted along the uterine tube?

Answer 38

cilia beat | muscular layer rapid contractions

Question 39

Why does the cilia beat and why does peristalsis take place?

Answer 39

influenced by oestrogen

Question 40

How can the uterine tube be damaged?

Answer 40

infection: chlamydia causes inflammation and blockage of the tube endometriosis: the cells of the endometrium attach themselves in other places in the pelvis or the uterine tube−if they enter the uterus, they will continue to respond to estrogen and progesterone in a normal way, they will proliferate and differentiate and shed −this will cause an inflammatory response in the uterine tube surgery adhesions these processes can lead to pain, fertility, and in some cases ectopic pregnancy

Question 41

What is tubal patency test?

Answer 41

checks if the tube is blocked or not

Question 42

What are tests to check for tubal patency?

Answer 42

laproscopy and dye | hysteron salpingo-contrast sonography (HyCoSy)

Question 43

What is the cervix?

Answer 43

muscular structure

Question 44

What is the endocervical mucosa and what does it do?

Answer 44

lines the cervix single layer or columnar mucus cells cels have lots of mucus glands= which empty viscous alkaline mucus into the lumen this makes mucus plug prevents infection, bacteria entering uterus plug allows sperm to enter

Question 45

How does oestrogen in the midcycle of follicular phase change the cervical mucus?

Answer 45

vascularity change more fluid mucus changes glycoprotein arrangement of mucus= form aligned channel

Question 46

How does progesterone change the cervical mucus?

Answer 46

``` more viscous (because less water content) glycoproteins form mesh ```

Question 47

What is the cervical canal?

Answer 47

between the external os and internal os

Question 48

What is the structure of the cervial canal and what happens here?

Answer 48

striations and grooves this area causes the sperm to get stuck here it takes a while for the sperm to get past this stage this forms a reservoir of sperm and thus there is constant release of sperm from the cervix

Question 49

What is the vagina?

Answer 49

thick walled tube (10cm long) warm damp susceptible to infection

Question 50

What glands are located in the vagina?

Answer 50

bartholin's= secrete mucus to lubricate the vagina

Question 51

What is the homologous to bartholin's gland in males?

Answer 51

bulbourethral glands

Question 52

In which layer of the uterus do fibroids grow and what are they responsive to?

Answer 52

It is the myometrium where uterine fibroids (benign smooth muscle tumours of the uterus) develop, they are responsive to oestrogen.

Question 53

What are the layers of the uterine tube?

Answer 53

serosa= outermost layer outer layer of smooth longitudinal fibres inner layer of circular muscle fibres.= PERISTALSIS

Question 54

How does laproscopy and dye work?

Answer 54

1. A uterine cannula goes through the cervix and introduces a dye into the uterus 2. A laproscope goes through the abdominal wall and you can look down it and see inside the pelvic cavity 3. Can see the dye emerge out the end of the uterine tube (out the fimbrial end) this means there is no blockage. But if it doesn't emerge it means there is something blocking it.