FRS - Cervix

Question 1

What is the cervix?

Answer 1

It consists of the lower portion of the uterus.

It is a gateway between the vagina and the body of the uterus.

Question 2

Anatomical structure of the uterus

Answer 2

It composed of two regions: ectocervix and endocervical canal.

The ectocervix is a portion of the cervix that projects into the vagina. It is lined with non-keratinised stratified squamous epithelium. The opening of the ectocervix, the external os marks the transition from ectocervix to the endocervical canal.

The endocervical canal is the ‘inner part’ of the cervix. It is lined with mucous-secreting simple columnar epithelium. The endocervical canal ends and the uterine cavity begins, at an opening called the internal os.

Question 3

Functions of the cervix?

Answer 3

There are two main functions of the cervix:

1) Facilitates the passageway of sperm into the uterine cavity - this is done by dilatation of the external and internal os.
2) Maintains sterility of the upper female reproductive tract. The cervix and all the structures superior to it, are sterile. This protects the uterine cavity and the upper genital tract from bacterial infection. The environment is maintained by shedding of the endometrium, thick cervical mucous, and a narrow external os.

Question 4

Vascular supply and lymphatics?

Answer 4

Arterial supply to the cervix is via the uterine artery.

Venous drainage - uterine veins.

Lymphatic drainage - iliac, sacral, aortic and inguinal lymph nodes.

Question 5

Clinical relevance: cervicitis

Answer 5

Chronic inflammation of the cervix.

Commonly caused by chlamydia trachomatis and Neisseria gonnorrheae.

Usually asymptomatic, however there could be pelvic pain, vaginal discharge, post-coital bleeding, dyspareunia may be present.

Complications may include pelvic inflammatory disease and the potential blockage of ducts, increasing the risk of infertility by increasing hostility of the environment for sperm.

Question 6

Clinical relevance: cervical cancer

Answer 6

There are two main classifications of the cervical cancer:

1) Squamous cell carcinomas - cancer of the epithelial line of the ectocervix
2) Adenocarcinoma - cancer of glands found within the lining of the cervix.

Infection of the female genitalia with human papilloma virus (HPV) is widely known as the cause of the majority of cervical cancers. Latest vaccinations of against cervical cancers are, in essence, a vaccination against HPV.