Sample Taker Sample Taker Training Training Anatomy & Physiology Anatomy & Physiology of Pelvic Organs of Pelvic Organs
Dec 19, 2015
Sample Taker Sample Taker TrainingTraining
Anatomy & Physiology Anatomy & Physiology
of Pelvic Organsof Pelvic Organs
Median Section Of Female PelvisMedian Section Of Female Pelvis
External Female Genitalia External Female Genitalia - vulva - vulva
Female Reproductive TractFemale Reproductive Tract- Anterior View- Anterior View
UTERUSUTERUS• Located centrally
within pelvic cavity• Hollow muscular organ• 7.5cm long• Consists of:
– Upper body– Lower neck (Cervix)
• Walls separated by slit like space (uterine cavity)
Body
CervixUterineCavity
Uterine cavityUterine cavity
• Lined by endometrial epithelium
• Undergoes cyclical changes in thickness
• Upper third of epithelium will shed during menstruation
CERVIXCERVIX• Neck of the womb• Has an internal and external os• Can be divided into 2 parts
– Endocervix– Ectocervix– These are lined by different types of cells
Endocervix
Ectocervix
EndocervixEndocervix
Tall columnar surface epithelium arranged into folds (crypts)
EctocervixEctocervix
•
Ectocervix: Covered by a multi-layered Squamous EpitheliumEctocervix: Covered by a multi-layered Squamous Epithelium
Squamo-columnar junctionSquamo-columnar junction
Endocervical cells - delicate
Squamous cells - protective
Squamo-columnar junction
EndocervixEndocervix EctocervixEctocervix
Squamo-columnar JunctionSquamo-columnar Junction
Squamo-columnar junctionSquamo-columnar junction
VAGINAVAGINA
• Covered by protective stratified squamous epithelium (epithelium is continuous with ectocervix)
The Menstrual CycleThe Menstrual Cycle• 28 days
• 4 phases:– Menstruation– Proliferative phase– Ovulation– Secretory phase
• Oestrogen & progesterone levels fluctuate
The menstrual cycleThe menstrual cycle
Squamous EpitheliumSquamous Epithelium
Fully mature if high levels of Oestrogen
Clinical dataClinical data
• Different cells may be seen depending on hormone levels (oestrogen & progesterone).
CervixCervix• Changes to the position of the
cervical epithelia occur especially at puberty and during pregnancy
• The uterus increases in size and this pushes down on the cervix
• Ectropion can occur at these times
• The endocervical cells are pushed out to lie on the ectocervix
EctropionEctropion
Normal Ectropion
Ectropion/’Erosion’Ectropion/’Erosion’
MetaplasiaMetaplasia• The endocervical cells are
transformed into squamous cells through the process of squamous metaplasia, a protective mechanism.
Squamous MetaplasiaSquamous Metaplasia
•Delicate endocervical epithelium is replaced by squamous epithelium through a process called metaplasia.
•The area where metaplasia takes place is called the transformation zone
Squamous MetaplasiaSquamous Metaplasia
New squamo-columnarjunction
Old squamo-columnar junction
Endocervical crypts remain beneath the ‘new’ squamous epithelium
Nabothian follicles can sometimes develop
Transformation ZoneTransformation Zone• The area where metaplasia occurs is
called the TRANSFORMATION ZONE• This is an unstable area where
Cervical Abnormalities can arises• The whole of the TZ must be
sampled when a cervical smear is taken
MetaplasiaMetaplasia
Squamous epithelium
Crypt openings in transformation zone
Squamo-columnar junction
Everted columnarepithelium (‘ectropion’)
Transformation zone
Transformation Zone CellsTransformation Zone Cells• Endocervical cells• Metaplastic cells
• Can be identified on cytology sample• Indicates good quality• Should be present in most samples
from women aged 25-50
Post-menopausal cervixPost-menopausal cervix
TransformationZone
SCJ
Transformation zone may not be visible in a post-menopausal cervix. Tip of broom may reach it in some cases.