7.2.0   UTERUS-CERVIX-VAGINA- FALLOPIAN TUBE: INTRODUCTION

1.  Uterus
The uterus is a pear-shaped hollow organ (5-8 cm long), consisting of three layers: endometrium (tunica mucosa), the myometrium (tunica muscularis) and the perimetrium (tunica serosa).Anatomically one discerns the fundus (upper end), body and cervix. A portion of the uterine cervix protrudes in to the vagina (portio vaginalis). The endometrium comprises columnar epithelium forming glands embedded in supporting stroma. Between the menarche and the menopause, the endometrium undergoes the monthly cycle of proliferation (early follicular phase-9th day- late follicular phase 16th day), secretion (secretory phase, luteal phase, 23th day), necrosis and shedding (desquamation phase, menstruation, 1st day). All stages of differentiation are present and described in our POJA collection.
By retrograde displacement endometrial cells can settle on other organs and cause endometriosis.

Macroscopy female reproductive organs: See: 7.2 POJA-L1894
Survey/scheme of the uterus: See: 7.2 POJA-L-L1222B+1431
Scheme endometrium menstrual cycle: See: 7.2 POJA-L1223
Comparative scheme of uterus-cervix-vagina structure: See: 7.2 POJA-L1226
Early proliferative and mid secretory period: See: 7.2 POJA-L1570+1411+1413
Secretory phase: See: 7.2 POJA-L1410+1649

 
2. Fallopian tubes or oviducts
The muscular tubes convey ova from the ovary to the body of the uterus. After fertilization, the ovum is implanted in the endometrial cavity of the uterus. Four parts of the oviducts are discerned: the infundibulum, nearby the ovary, stacked with fimbriae – the ampulla where fertilization takes place – the isthmus the narrow part – intramural part that opens into the uterus.The epithelial lining consists of ciliated columnar cells and secretory cells, their number being hormonally dependent. The lumen shows numerous longitudinal folds and plicae.

Survey of the oviduct: See: 7.2 POJA-L1221+1228 and 7.2 POJA-L1449+1583
Detail of the oviduct: See: 7.2 POJA-L1351+1354 and 7.2 POJA-L1451+1359
 
 
3. Cervix
The cervical canal is a continuation of the uterus structure, comprises an endocervix (mucus secreting epithelium) and an ectocervix part. The lining epithelium, however, does hardly undergo cyclic menstrual changes. There are cervical glands that can transform into retention cysts (ovula Nabothi or Nabothian follicles). The ectocervix part is covered with stratified squamous epithelium, while the endocervical part is lined by tall columnar epithelium. The part of the cervix that protrudes into the vagina is called portio vaginalis with glycogen-rich epithelial cells. The transformation zone of the cervical epithelium is a site where cervical carcinomas can arise, i.e. carcinoma-in-situ or cervical intraepithelial neoplasia (C.I.N.).

Survey scheme cervix-vagina: See: 7.2 POJA-L1226
Endocervix: See: 7.2 POJA-L1641+1726+1727
Ectocervix: See: 7.2 POJA-L1731+1523+1598
Survey of cervical canal and Nabothian cysts: See: 7.2 POJA-L1578+1599+1841

 
4. Vagina
The wall of the vagina consists of the tunica mucosa, tunica muscularis and tunica adventitia. It is a fibromuscular tube forming a cuff around the cervical portio. The mucosa has a stratified squamous epithelium rich in glycogen. Characteristic thin walled blood vessels are present in the elastin-rich lamina propria. The fibromuscular wall contains bundles of circular and longitudinal smooth muscles, and some skeletal muscles.

Survey vagina: See:  7.2 POJA-L1597+1364+1366
Vagina-PAS staining: See: 7.2 POJA-L1372+1373 and 7.2 POJA-L1613+1642

5. Female external genitalia or vulva.  See PDF file POJA-L1899  for description.

6. Pathology
Cervical intraepithelial neoplasm: See: 7.2 POJA-L1800B+1801B+1802B+1804B
Carcinoma in situ, cervix PAP cytology: See: 7.2 POJA-L1898
Endometriosis, colorectal: See: 7.2 POJA-L1675+1877+1585
Tubal pregnancy: See: 7.2 POJA-L1458+1459  and  POJA-L1460+1571+1572
Endometrioid adenocarcinoma, uterus: See: 7.2 POJA-L1545+1872  and POJA-L1579+1546+1682  and POJA-L1581+1766
Leiomyoma: See: 7.2 POJA-L1554+1557+1679  and POJA-L1552+1553
Clear cell carcinoma, vagina: See: 7.2 POJA-L1681  and POJA-L1689+1540+1691
Cervical small cell carcinoma: See: 7.2 POJA-L1823+1824+1827+1825
Squamous cell carcinoma cervix: See: 7.2 POJA-L1885B+1831+1889
Adenosis vaginae: See: 7.2 POJA-L1532+1531

COPYRIGHTS

​All rights reserves worldwide for the POJA collection are hold by L.G. Poels and P.H.K. Jap and Radboud University Medical Center (Radboud UMC  Nijmegen). No one may modify, copy, distribute, transmit, display, or publish any materials contained in the POJA collection without prior written permission of the authors Poels and Jap or the UMC St Radboud. Any commercial use of the POJA collection is forbidden. POJA images are partly deposited in the Health Education Assets Library (HEAL database) as well as in the MedEdPortal/AAMC database).
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