Uterus, uterine tubes and cervix Flashcards
What do maternal steroids do to the uterus?
Maternal steroids increase the size of newborn uterus
What happens to the cervix and uterus during infancy?
Grows with height during infancy
What is the myometrium dependent on?
Myometrium dependent on oestradiol
Which grows greater in size, the corpus of uterus or the cervix?
Corpus of uterus undergoes greater increase in size than cervix
What happens to myometrium throughout childhood?
The outer muscular myometrium grows rapidly throughout childhood
What happens to the myometrium during puberty?
Increases rapidly in size and configuration during puberty
What is the myometrium capable of during pregnancy?
Capable of vast expansion during pregnancy
Structure of myometrium
- Inner layer has circular fibres
- Middle layer has a figure of 8 or spiral fibres
- Outer layer has longitudinal fibres
How is the endometrium during childhood and what happens to it during puberty?
- Very thin in childhood
- Thickens at puberty
What can the endometrium be seen and measured on?
Can be seen and measured on an ultrasound scan
What changes happen to the endometrium throughout the cycle?
There are changes in glandular and epithelial cells throughout the cycle
What happens to the endometrium at menstruation?
At menstruation, most of the endometrium is lost
What happens to the endometrium after menstruation?
After menstruation, we’re left with the stromal matrix with small columnar cell with glandular extensions
What is the endometrial proliferative phase stimulated by?
Stimulated by oestradiol from the dominant follicle
What happens when the endometrium is >4mm in the endometrial proliferative phase?
When the endometrium is >4mm, there’s the induction of progesterone receptors on the endometrium and small muscular contractions of the myometrium
What is the endometrial secretory phase during?
Is during the luteal phase of the ovary
When does the endometrial secretory phase occur?
Occurs 2-3 days after ovulation
What does the gradual rise in progesterone cause during the endometrial secretory phase?
The gradual rise in progesterone causes a reduction in cell division
What happens to the glands during the endometrial secretory phase?
Glands increase in tortuosity and distend
What secretions commence during the endometrial secretory phase?
Secretions of glycoproteins and lipids commence
What happens to the myometrial cells during the endometrial secretory phase?
Myometrial cells enlarge and movement is suppressed
What happens to the blood supply during the endometrial secretory phase?
Blood supply increases
What happens when the endometrium is lost during menstruation?
Prostaglandins are released causing constriction of spiral arterioles
-Hypoxia causes necrosis
The vessels then dilate and bleeding ensues
Proteolytic enzymes are released from the dying tissue
What percentage of endometrium is lost in 24 hours during menstruation?
50% of endometrium lost in 24 hrs
How many ml of bleeding is considered normal during menstruation?
80ml bleeding is considered normal
What layer remains during menstruation?
Basal layer remains and is then covered by extension of glandular epithelium
What are the 2 cells lining the uterine tube that undergo change during different phases of the cycle?
The 2 cells are ciliated and secretory cells
What happens to the cells lining the uterine tube during the follicular phase of the cycle ?
Epithelial cells express high numbers of oestrogen receptors and undergo differentiation in response to oestradiol causing an increase in height midcycle
What happens to the cells lining the uterine tubes during ovulation?
Cilia beat and secretory cells are active along with muscular layer contractions, which are all in response to oestrogen
What happens to the cells lining the uterine tubes during luteal/secretory phase?
Exposure of progesterone causes the oestrogen receptors to be suppressed and oestrogen effects are overcome causing decrease in height mid-luteal onwards
For approximately how long does the egg remain in the uterine tubes after fertilisation?
Eggs remain in the uterine tubes for approximately 5 days
What can damage to the lining of the uterine tubes cause and result in?
Damage to the lining of the tube may cause blockage or damage to the ciliated epithelium resulting in:
- Pain
- Infertility
- Ectopic pregnancy
What are the steps involved in a laparoscopy and dye?
- Uterine cannula inserted through vagina
- Incision made on abdomen to insert the operating laparoscope
- Dye is injected into the uterine tubes and if the blue dye is collected by the uterine cannula, then there’s no blockage in the tubes
What are the steps involved in hystero salpingo-contrast sonography(HyCOSy)
- A cannula is put through the cervix
- We then inject an ultrasound dye in order to monitor the progress of the dye
What is the cervix?
Is a muscular structure capable of great contraction?
How thick is the endocervical mucosa?
About 3mm thick
What are the endocervical mucosa lined with and what do they do?
Lined with a single layer of columnar mucous cells containing numerous tubular mucous glands which empty viscous alkaline mucous into lumen
What is the endocervical mucosa?
It’s a protective barrier to infection
What is the ectocervix covered with?
Covered with non-keratinized stratified squamous epithelium
What does oestrogen in the follicular phase cause to the cervix?
Oestrogen in the follicular phase causes change in vascularity of cervix and oedema
What do mid-cycle oestrogen levels cause in the cervix?
Mid cycle oestrogen levels cause change in mucous to become less viscous
-Change in mucous composition
-Contain glycoprotein which become aligned and form
channels that allow sperm to swim up the channels
What does progesterone cause during the luteal phase to the cervix?
- Reduced secretion and viscous mucous
- Glycoproteins now form mesh like structure which acts as a barrier
What is the vagina?
Thick walled tube, approx 10 cm
What is the vagina lined by?
Lined by specialised squamous epithelial cells
What is the vaginal environment like?
Warm damp environment containing glycoproteins
The vagina is susceptible to infection therefore how is this prevented?
Prevented by:
- Layers of epithelial cells shed constantly and flow downwards with secretions
- Secretions that are from cervix transudates vaginal epithelium
- Secretions change with cycle and are generally acidic providing anti-microbial properties
Where are the bartholin’s glands located in the vagina?
Located slightly posterior and to the left and right of the opening of the vagina
What do the bartholin’s glands secrete in the vagina?
Secrete mucus to lubricate the vagina
What are the bartholin’s glands homologous to in males?
Are homologous to bulbourethral glands in males
