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SGUL - Physiology 2 > Uterus, Uterine Tubes & Cervix > Flashcards

Uterus, Uterine Tubes & Cervix Flashcards

1
Q

Describe the changes in the uterus & Cervix

A
  • Maternal steroids increase size of new born uterus
  • Grows with height during infancy
  • Myometrium dependent on estradiol
  • Corpus of uterus undergoes greater increase in size than cervix
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2
Q

Describe how the myometrium grows

A
  • Outer muscular myoentrium grows gradually throughout childhood
  • Increases rapidly in size and configuration during puberty
  • Changes in size through the cycle. Capable of vast expansion during pregnancy
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3
Q

What is the endometrium dependent on?

A

Dependent on Steroids and responds cyclically to hormones changes

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4
Q

Describe the growth of the endometrium?

A
  • Very thin during childhood. Begins to thicken at puberty
  • Estrogen principally causes growth in proliferative phase.
  • Can be seen and measured on an ultrasound
  • Good bioassay of estradiol level (7-16 mm)
  • Changes in the grandular and epithelial cells through the cycle
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5
Q

What does progesterone mainly cause?

A

Differentiation in the secretory phase

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6
Q

Where is most of the endometrium lost?

A

During the menstruation phase

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7
Q

What happens after most of the endometrium is lost?

A

After menstruation
- Stromal matrix with small columnar cells with grandular extensions about 2-3mm thick glands are simple and straight

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8
Q

What are the two types of endometrial phases?

A
  • Proliferative phase
  • Secretory phase
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9
Q

What is the Endometrial Proliferative phase?

A
  • The Proliferative phase is “The follicular phase of ovary”
  • Occurs following the menses
  • Stimulated by estrogen from the growing follicle
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10
Q

What occurs during the Endometrial Proliferative phase?

A
  • Stromal cell division occurs on a ciliates surface
  • Causes glands to expand and become torturous
  • Increases Vascularity and neoangiogenesis
  • Maximal cell division by days 12-14
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11
Q

What happens when the endometrium is >4mm?

A
  • Induction of progesterone receptors
  • Small muscular contractions of myometrium
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12
Q

What is the Endometrial secretory phase?

A
  • Secretory phase is “Luteal phase of the Ovary”
  • Occurs 2-3 days after ovulation
  • The gradual rise in progesterone causes a reduction in cell division
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13
Q

What occurs in the Endometrial secretory phase?

A
  • Glands increase in tortuosity and distend
  • Causes secretions of glycoproteins and lipids to commence
  • Oedema increases vascular permeability, arterioles and grow tightly
  • Myometrial cells enlarge and movement is suppressed
  • Bloody supply increases
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14
Q

Describe the regression of the corpus luteum

A
  • The Corpus Luteum is stimulated by LH from the pituitary gland during the luteal phase
  • The fertilised Oocyte becomes a blastocyst and produces human chorionic gonadotrophin (hCG)
  • This acts like LH ie On LH receptor & rescues the ‘CL’
    In the absence of this, falling levels of steroid from the CL results in menstruation
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15
Q

What are the processes that occur during menstruation? (PART 1)

A

Prostaglandin release causes constriction of spiral arterioles
- Hypoxia causes Necrosis
- Vessels then dilate and bleeding ensues
- Proteolytic enzymes are released from the dying tissue

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16
Q

What are the processes that occur during menstruation? (PART 2)

A
  • Outer layer of endometrium shed, 50% lost in 24hrs, up to 80ml is considered normal.
  • Bleeding normally lasts 4+ days.
  • Basal layer remains and is then covered by extension of glandular epithelium
  • Estrogen from follicle in next follicular phase starts cycle off again
17
Q

What are the 3 different cross sections of the uterine tube?

A
  • Intramural
  • Isthmus
  • Ampullary
18
Q

What are the different type of cells in the mucosa of the uterine tubes?

A
  • Secretory
  • Columnar ciliates epithelial
  • Non ciliated Peg
19
Q

Describe the muscularis in the uterine tube

A
  • Inner circular & outer
  • Longitudinal layers
  • Blood vessels & lymphatics
20
Q

What happens to the epithelial cells during changes in cells lining the uterine tubes?

A

Epithelial cells express high numbers of estrogen receptors & undergo differentiation in response to estradiol increase in height mid-cycle

21
Q

What happens to the Oocytes during changes in cells lining the uterine tubes?

A
  • Oocyte can only pass down the tube during mid-cycle
  • Cilia beat and secretory cells are active along with muscle layer contractions, all in response to estrogen
22
Q

What happens to the estrogen receptors during changes in cells lining the uterine tubes?

A
  • After a few days of exposure to progesterone, the estrogen receptors become suppressed
  • Estrogen effects are overcome causing decrease in height mid luteal onwards
23
Q

Fertilisation & early embryo development
How long does the Egg remain in the tube for?

A

Approximately 5 days

24
Q

Where does fertilisation occur?

A

Occurs In the ampulla

25
Q

What could damage to the tube cause?

A
  • Damage to the lining of the tube by infection, endometriosis, surgery or adhesions
  • May cause blockage or damage to ciliated epithelial resulting in
  • Pain, Infertility, ectopic pregnancy
26
Q

Briefly describe the cervix

A

Muscular structure capable of great expansion

27
Q

Describe the structure of the cervix

A

The endocervical mucosa is about 3 mm thick
- Lined with a single layer of columnar mucous cells containing numerous tubular mucous glands which empty viscous alkaline mucus into the lumen

28
Q

What is the purpose of the viscous alkaline mucus?

A
  • Protective barrier to infection
  • However it has to allow passage of motile sperm
29
Q

Describe the ectocervix structure of the cervix

A

The ecto-cervix is covered with nonkeratinized stratified squamous epithelium, resembling the squamous epithelium lining the vagina

30
Q

What does Estrogen in the follicular phase cause?

A

Change in vascularity of cervix and oedema

31
Q

What does mid cycle estrogen levels cause?

A
  • They cause a change in mucous to become less viscous
  • Change in mucous composition
  • Mucus contains glycoproteins
  • These glycoproteins become aligned and form microscopic channels
  • Sperm swing up the channels
32
Q

What does progesterone in the luteal phase cause?

A
  • Reduced secretion and viscous mucous (reduced water content)
  • Glycoproteins now form mesh like structure: acts as barrier to sperm and microorganisms
  • One mechanism of action of oral contraceptives
33
Q

Describe the structure of the vagina

A
  • Thick walled tube approximately 10 cm
  • Lined by specialised ‘squamous epithelial’ cells
  • Warm damp environment containing glycoproteins
  • Susceptible to infection
34
Q

How is Vaginal infection prevented?

A
  • Layers of epithelial cells shed constantly and ‘flow’ downwards with the secretions.
    -Secretions are from cervix and transudation from vaginal epithelium
  • Secretions change with cycle and are generally acidic providing anti-microbial protection
35
Q

Where are Bartholins glands located?

A

Bartholins glands located slightly posterior and to the left and right of the opening of the vagina

36
Q

What do Bartholin glands do?

A
  • Secrete mucus to lubricate the vagina
  • And are homologous to bulbourethral glands in males.

SGUL - Physiology 2 (37 decks)

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