Uterus, uterine tubes and cervix

Question 1

What do maternal steroids do to the uterus?

Answer 1

Maternal steroids increase the size of newborn uterus

Question 2

What happens to the cervix and uterus during infancy?

Answer 2

Grows with height during infancy

Question 3

What is the myometrium dependent on?

Answer 3

Myometrium dependent on oestradiol

Question 4

Which grows greater in size, the corpus of uterus or the cervix?

Answer 4

Corpus of uterus undergoes greater increase in size than cervix

Question 5

What happens to myometrium throughout childhood?

Answer 5

The outer muscular myometrium grows rapidly throughout childhood

Question 6

What happens to the myometrium during puberty?

Answer 6

Increases rapidly in size and configuration during puberty

Question 7

What is the myometrium capable of during pregnancy?

Answer 7

Capable of vast expansion during pregnancy

Question 8

Structure of myometrium

Answer 8

• Inner layer has circular fibres
• Middle layer has a figure of 8 or spiral fibres
• Outer layer has longitudinal fibres

Question 9

How is the endometrium during childhood and what happens to it during puberty?

Answer 9

• Very thin in childhood

- Thickens at puberty

Question 10

What can the endometrium be seen and measured on?

Answer 10

Can be seen and measured on an ultrasound scan

Question 11

What changes happen to the endometrium throughout the cycle?

Answer 11

There are changes in glandular and epithelial cells throughout the cycle

Question 12

What happens to the endometrium at menstruation?

Answer 12

At menstruation, most of the endometrium is lost

Question 13

What happens to the endometrium after menstruation?

Answer 13

After menstruation, we’re left with the stromal matrix with small columnar cell with glandular extensions

Question 14

What is the endometrial proliferative phase stimulated by?

Answer 14

Stimulated by oestradiol from the dominant follicle

Question 15

What happens when the endometrium is >4mm in the endometrial proliferative phase?

Answer 15

When the endometrium is >4mm, there’s the induction of progesterone receptors on the endometrium and small muscular contractions of the myometrium

Question 16

What is the endometrial secretory phase during?

Answer 16

Is during the luteal phase of the ovary

Question 17

When does the endometrial secretory phase occur?

Answer 17

Occurs 2-3 days after ovulation

Question 18

What does the gradual rise in progesterone cause during the endometrial secretory phase?

Answer 18

The gradual rise in progesterone causes a reduction in cell division

Question 19

What happens to the glands during the endometrial secretory phase?

Answer 19

Glands increase in tortuosity and distend

Question 20

What secretions commence during the endometrial secretory phase?

Answer 20

Secretions of glycoproteins and lipids commence

Question 21

What happens to the myometrial cells during the endometrial secretory phase?

Answer 21

Myometrial cells enlarge and movement is suppressed

Question 22

What happens to the blood supply during the endometrial secretory phase?

Answer 22

Blood supply increases

Question 23

What happens when the endometrium is lost during menstruation?

Answer 23

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

Question 24

What percentage of endometrium is lost in 24 hours during menstruation?

Answer 24

50% of endometrium lost in 24 hrs

Question 25

How many ml of bleeding is considered normal during menstruation?

Answer 25

80ml bleeding is considered normal

Question 26

What layer remains during menstruation?

Answer 26

Basal layer remains and is then covered by extension of glandular epithelium

Question 27

What are the 2 cells lining the uterine tube that undergo change during different phases of the cycle?

Answer 27

The 2 cells are ciliated and secretory cells

Question 28

What happens to the cells lining the uterine tube during the follicular phase of the cycle ?

Answer 28

Epithelial cells express high numbers of oestrogen receptors and undergo differentiation in response to oestradiol causing an increase in height midcycle

Question 29

What happens to the cells lining the uterine tubes during ovulation?

Answer 29

Cilia beat and secretory cells are active along with muscular layer contractions, which are all in response to oestrogen

Question 30

What happens to the cells lining the uterine tubes during luteal/secretory phase?

Answer 30

Exposure of progesterone causes the oestrogen receptors to be suppressed and oestrogen effects are overcome causing decrease in height mid-luteal onwards

Question 31

For approximately how long does the egg remain in the uterine tubes after fertilisation?

Answer 31

Eggs remain in the uterine tubes for approximately 5 days

Question 32

What can damage to the lining of the uterine tubes cause and result in?

Answer 32

Damage to the lining of the tube may cause blockage or damage to the ciliated epithelium resulting in:

• Pain
• Infertility
• Ectopic pregnancy

Question 33

What are the steps involved in a laparoscopy and dye?

Answer 33

• 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

Question 34

What are the steps involved in hystero salpingo-contrast sonography(HyCOSy)

Answer 34

• A cannula is put through the cervix

- We then inject an ultrasound dye in order to monitor the progress of the dye

Question 35

What is the cervix?

Answer 35

Is a muscular structure capable of great contraction?

Question 36

How thick is the endocervical mucosa?

Answer 36

About 3mm thick

Question 37

What are the endocervical mucosa lined with and what do they do?

Answer 37

Lined with a single layer of columnar mucous cells containing numerous tubular mucous glands which empty viscous alkaline mucous into lumen

Question 38

What is the endocervical mucosa?

Answer 38

It’s a protective barrier to infection

Question 39

What is the ectocervix covered with?

Answer 39

Covered with non-keratinized stratified squamous epithelium

Question 40

What does oestrogen in the follicular phase cause to the cervix?

Answer 40

Oestrogen in the follicular phase causes change in vascularity of cervix and oedema

Question 41

What do mid-cycle oestrogen levels cause in the cervix?

Answer 41

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

Question 42

What does progesterone cause during the luteal phase to the cervix?

Answer 42

• Reduced secretion and viscous mucous

- Glycoproteins now form mesh like structure which acts as a barrier

Question 43

What is the vagina?

Answer 43

Thick walled tube, approx 10 cm

Question 44

What is the vagina lined by?

Answer 44

Lined by specialised squamous epithelial cells

Question 45

What is the vaginal environment like?

Answer 45

Warm damp environment containing glycoproteins

Question 46

The vagina is susceptible to infection therefore how is this prevented?

Answer 46

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

Question 47

Where are the bartholin’s glands located in the vagina?

Answer 47

Located slightly posterior and to the left and right of the opening of the vagina

Question 48

What do the bartholin’s glands secrete in the vagina?

Answer 48

Secrete mucus to lubricate the vagina

Question 49

What are the bartholin’s glands homologous to in males?

Answer 49

Are homologous to bulbourethral glands in males