Uterus, Uterine Tubes and Cervix Flashcards
What is the inner lining of the uterus called?
β Endometrium
What is the body of the uterus called?
β Myometrium
What do the uterine tubes end in?
β Fimbriae
What increases the size of a newborns uterus?
β Maternal steroids
What does the myometrium growth depend on?
β Estradiol
When does the myometrium grow rapidly?
β During puberty
Where do uterine fibroids originate?
β Myometrium
In what shape are myometrial fibres?
β Spiral fibres
When does the endometrium thicken?
β At puberty
What is a good bioassay of estradiol levels?
β 7-16mm
What is the stromal matrix?
β The smallest the endometrium can get
What does the stromal matrix look like after menstruation?
β Small columnar cells with glandular extensions 2-3mm thick
What is the proliferative phase stimulated by?
β Estradiol from the dominant follicle
What are the changes that occur in the proliferative phase?
β Stromal cell division, ciliated surface
β Glands expand and become tortuous
β Increased vascularity and neoangiogenesis
When are progesterone receptors expressed?
β when the endometrium gets to 4mm
When does the secretory phase start and why?
β 2-3 days after ovulation
β The gradual rise in progesterone causes a reduction in cell division
What are the changes that occur in the secretory phase?
β Glands increase tortuosity and distend β Secretion of glycoproteins and lipids β oedema β increased vascular permeability β arterioles contract and grow tightly wound
What happens to the myometrium during the secretory phase?
β Myometrial cells enlarge
β movement is suppressed to prevent contractions
β blood supply increases
What causes menstruation?
β Falling levels of steroid from the corpus luteum
Describe what happens during menstruation
1) Prostaglandin release causes constriction of the spiral arterioles
2) Hypoxia causes necrosis
3) Vessels then dilate and bleeding ensues
4) Proteolytic enzymes are released from the dying tissue
5) Outer layer of the endometrium is shed and 50% is lost in 24 hours
How long does bleeding last?
β 4 days
What happens to the basal layer after menstruation?
β It is covered by an extension of glandular epithelium
What are the three components of the mucosa?
β secretory
β columnar ciliated epithelial cell
β non ciliated peg cell
What does the muscularis layer consist of?
β inner circular and outer longitudinal layers
β blood vessels and lymphatics
What is the serosa?
β Outer layer of the uterine tubes
What do epithelial cells in the uterine tube express?
β High numbers of estrogen receptors
What happens to epithelial cells in the uterine tube mid cycle?
β They undergo differentiation and increase in height
When can the oocyte pass?
β Mid cycle
What happens to the epithelial cells of the uterine tube when progesterone starts being produced?
β The estrogen receptors are suppressed
β They decrease in height
What is the function of the cilia?
β They beat which moves the egg forward
How long does the egg remain in the tube for?
β 5 days
Where does fertilisation occur?
β in the ampulla
What does damage to the epithelial cells cause?
β Pain
β Infertility
β Ectopic pregnancy
What are the two ways to investigate tube patency?
β Laparoscopy
β Hystero-Salpingo-contrast sonography
How is laparoscopy done?
β A small incision is done on the anterior abdominal wall and a laparoscope is put through
β Uterine cannula passes through and some blue dye is injected into the uterus
β If you donβt see the dye the tube is blocked
How is a hystero-salpingo-contrast sonography done?
β Cannula is put through the cervix and instead of dye an ultrasound opaque dye is injected
β you ultrasound the abdomen and monitor the progress of the dye
What is endometriosis?
β The cells of the endometrium escape from the uterus and get into the body
β They implant in other places and still respond to progesterone and estrogen
What is the cervix?
β Muscular structure which is capable of great expansion
How thick is the endocervical mucosa?
β 3mm thick
What is the cervix lined with?
β A single layer of columnar mucous cells containing numerous tubular mucous glands
What do the mucous glands in the cervix do?
β empty viscous alkaline mucus into the lumen
What is the mucus in the cervix for?
β Protective barrier to infection
What is the ectocervix covered with?
β Monokeratinized stratified squamous epithelium
After ovulation what happens to the cervical mucus?
β it becomes more liquid and has channels through which sperm can swim
What does estrogen cause in the cervix?
β Changes in vascularity and oedema
How does the mucus change to allow sperm through?
β During early stages the glycoproteins form a mesh that the sperm canβt get through
β Glycoproteins then become aligned and form microscopic channels that sperm can swim through
What does progesterone do to the cervical secretions?
β Reduced secretion and viscous mucus
β Glycoproteins form a mesh structure
How long is the vaginal canal?
β approximately 10cm long
How is infection prevented in the vagina?
β Layers of epithelial cells shed constantly and flow downward with secretions
β secretions are acidic and provide anti-microbial protection
Where are Bartholins glands located?
β Slightly posterior and left and right of the opening to the vagina
What do Bartholins glands do?
β Secrete mucus to lubricate the vagina
What are Bartholins glands homologous to?
β Bulbourethral glands in males
