Female Reproductive System Flashcards Preview

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Flashcards in Female Reproductive System Deck (140):
1

Menstrual Cycle

  • reproductive cycle
  • female organs undergo changes
  • averages 28 days
  • affects all reproductive organs

2

Female Internal reproductive organs

  • gonads=ovaries
  • accessory ducts
    • uterine tubes
    • uterus
    • vagina

3

Ovaries

  • paired
  • amond shaped
  • 3 cm by 1.3 cm by 1 cm
  • lie against the bony lateral wall of true pelvis
    • in the fork of iliac vessels
  • smooth in young girls
  • scarred and pitted after puberty from monthly release of ova
  • retroperitoneal but surrounded by peritoneal cavity

4

Mesovarium

  • mesentery of ovaries
  • horizontal
  • holds ovaries in place
  • part of broad ligament

5

Broad ligament of peritoneum

(ovaries)

  • large fold of peritoneum
  • hangs from uterus and uterine tube like a tent
  • contains mesovarium

6

suspensory ligament of the ovary

  • lateral continuation of broad ligament
  • attaches the ovary to the lateral pelvic wall

7

ovarian ligament

  • anchors ovary to uterus medially
  • distinct fibrous band enclosed within broad ligament

8

Veins, arteries and nerves of ovary

  • ovarian arteries
    • branches of abdominal aorta
  • ovarian branches of uterine arteries
    • arise from internal iliac artery
  • veins, nerves and arteries reach ovary through the suspensory ligament and then through mesovarium
  • innervated by both divisions of the autonomic nervous system

9

tunica albuginea

ovary

  • fibrous capsule that surrounds ovary
  • much thinner than tunica albuginea of testis
  • covered by germinal epithelium
    • simple cuboidal epithelium
    • does not germinate ova

10

ovarian cortex

  • houses the developing gametes (oocytes) while in the ovary

11

developing gametes in females

oocytes

12

follicles

  • little bags
  • saclike multistructure in which oocytes occur
  • enlarge substantially as they mature

13

ovarian medulla

  • loose connective tissue
  • containes the largest blood vessels, nerves, and lymphatic vessels of the ovary
    • enter through hilium
      • slit where mesovarium attaches

14

ovarian cycle

  • mestrual cycle in relation to ovary
  • Phases:
    1. Follicular phase (first 1/2)
    2. ovulation
    3. luteal phase

15

Follicular phase

(ovarian cycle)

  • the start of each ovarian cycle
  • 6-12 primordial follicles start to grow
  • lasts two weeks
  • growth is stimulated by follicle stimulating hormone (FSH)
    • ​from anterior part of pituitart gland

16

primordial follicles

(ovarian cycle)

  • the majority of follicles in the ovarian cortex
  • from which all follicle stages arise
  • consist of:
    • oocyte surrounded by follicular cells
      • ​a layer of flate supportive cells

17

primary follicle

(ovarian cycle)

  • primordial follicle starts to grow
  • flat cells become cuboidal
  • oocyte grows larger

18

granulosa cells

(ovarian  cycle)

  • follicular cells multiply to form a stratified epithelium around oocyte
  • follicular cells are now granulosa cells

19

zona pellucida

(ovarian cycle)

  • the oocyte's glycoprotein coat 
  • protective shell that a sperm must penetrate to fertilize

20

theca folliculi

(ovarian cycle)

  • "box around the follicle"
  • a layer of connective tissue that condenses around the exterior of the primary follicle
  • theca cells are stimulated by luteinizing hormones to secrete androgens

21

estrogens

  • female sex hormones
  • granulosa cells under the influence of FSH convert the theca cells' androgens into estrogen
  • stimulates growth and activity of all female sex organs
  • signal uterine mucosa to repair itself after each menstrual period

22

antrum

(ovarian cycle)

  • fluid filled cavity
  • a clear liquid gathers between granulosa cells and coalesces, forming this cave

23

secondary (antral) follicle

  • once antrum is formed, follicle is now this

24

corona radiata 

  • a surrounding coat of granulosa cells 
  • "radiating crown"
  • antrum expands with fluid until it isolates oocycte and this on a stalk at the periphery of the follicle

25

vesicular (graafian) follicle

(ovarian cycle)

  • a full-sized mature follicle
  • 2cm in diameter (almost 1 inch)
  • ready to be ovulated

26

ovulation

  • midpoint of ovarian cycle
  • one oocyte exits from one of the ovaries into peritoneal cavity
  • swept into uterine tube

27

Luteal Phase

(ovarian cycle)

  • second half of ovarian cycle
  • corpus luteum does not die
  • corpus luteum scretes estrogen and progesterone
    • signaling mucosa of uterus to prepare for implantation
  • if there is no implantation, corpus luteum dies and becomes a scar that is eventually phagocytized

28

corpus luteum

(ovarian cycle)

  • remaining granulosa and theca layers after ovulation
  • endocrine gland 
    • secretes estrogen and progesterone
    • signals uterus to prepare for implantation
  • dies after two weeks if there is no implantation

29

corpus albicans

(ovarian cycle)

  • "white body"
  • scar from corpus luteum
  • stays in ovary several months
  • shrinks until it is phagocytized by microphages

30

Oogenesis

  • process of ova production
  • "egg generation"
  • uses meiosis like spermatogenesis
  • takes many years to complete

31

oogonia

  • stem cells in the fetal period
  • give rise to females lifelong supply of oocytes
  • are arrested in an early stage of meiosis I around birth
    • turned to primary oocytes

32

primary oocytes

  • oocytes stalled in meiosis since birth
  • remain stalled for decades until ovulated by their follicle
  • Do not finish meiosis I and begin meiosis II until influence of LH that signals ovulation

33

secondary oocyte

  • oocyte entering meiosis II
  • arrested again until sperm penetrates its plasma membrane

34

Ovum

  • egg is called ovum after completion of meiosis II

35

polar bodies

  • three smaller cells produced by oogenesis (apart from large ovum)
  • contain primarily DNA
  • degenerate quickly without being fertilized or contributing to development of embryo

36

uterine tubes

  • aka oviducts
  • aka fallopian tubes
  • receive the ovulated oocyte
  • site for fertilization
  • begins laterally near ovary
  • ends medially, emptying into superior part of uterus
  • Contains: infundibulum, ampulla, and isthmus
  • little or no direct contact with the ovaries
  • most common place for ectopic pregnancies

37

infundibulum

  • lateral region of uterine tube
  • open funnel
  • opens into peritoneal cavity

38

fimbrae

  • surrounds the margin of the infundibulum
  • ciliated, fingerlike projections
  • drape over ovary

39

ampulla

  • medial to the infundibulum
  • forms half the length of the uterine tube 
  • site where fertilization occurs

40

isthmus

  • narrow passage
  • medial third of uterine tube

41

mesosalpinx

  • a short mesentery that covers the uterine tube
  • a part of the broad ligament

42

salpingectomy

  • surgical removal of the uterine tube

43

salpingitis

  • inflammation of uterine tube

44

pelvic inflammatory disease


PID

  • widespread infection that originates in vagina and uterus
  • spreads to uterine tubes, ovaries, and pelvic peritoneum
  • occurs in 10% of women in USA
  • caused by chlamydia or gonorrheal infection
  • symptoms: tenderness of lower abs, fever, vaginal discharge
  • A single episode can cause infertility if not halted
    • due to scarring that blocks uterine tubes
  • broad-spectrum antibiotics can stop

45

Uterus

  • womb
  • lies in pelvic cavity
  • anterior to rectum
  • posterosuperior to bladder
  • hollow, thick walled organ
  • shape and size of small inverted pear in women who havent been pregnant
  • Function:
    • receive, retain, and nourish a fertilized egg throughout pregnancy

46

Uterus positioning 

  • normally antiverted: tilted anteriorly at the superior part of vagina
  • in older women it is often retroverted.
    • inclined posteriorly

47

body of uterus

  • main portion of uterus

48

fundus of uterus

  • rounded region superior to entrance of uterine tubes

49

isthmus of uterus

  • slightly narrow region inferior to the body

50

cervix of uterus

  • beneath isthmus
  • narrow neck
  • the inferior tip that projects into the vagina
  • contains a lot of collagen
  • forms a tough, fibrous ring that keeps uterus closed and fetus within it during pregnancy

51

cervical canal

 

  • part of the central lumen of the uterus
  • communicates with the vagina inferiorly
  • mucosal lining of canal contains cervical glands that fill canal with muscus to block spread of bacteria and sperm entry

52

external os

of cervical canal

  • os=mouth
  • communication of cervical canal with vagina inferiorly

53

internal os

cervical canal

  • os=mouth
  • communication of cervical canal with the cavity of body (part of lumen of uterus) superiorly

54

Supports of the uterus

  • Main support provided by muscles of the pelvic floor
    • urogenital and pelvic diaphragms
  • mesomenterium
  • lateral cervical (cardinal) ligaments
  • round ligaments of uterus

55

mesomenterium

(uterine support)

  • anchors uterus to lateral pelvic walls
  • largest division of the broad ligament

56

lateral cervical (cardinal) ligaments

(uterine support)

  • run horizontally from uterine cervix and superior vagina to lateral pelvic walls
  • thickenings of the fascia of the pelvis

57

round ligaments of the uterus

(uterine support)

  • binds uterus to anterior body wall
  • each starts as a continuation of ovarian ligament of superolateral aspect of the uterus
  • descends through the mesomenterium and inguinal canal
  • anchors in one of the labia major of the external genitalia

58

Uterine Wall

  • inner endometrium
  • middle myometrium
  • outer perimetrium

59

Prolapse of Uterus

  • when supporting pelvic floor muscles are torn during childbirth
  • unsupported uterus sinks inferiorly
  • tip of cervix portrudes through the external vaginal opening

60

perimetrium

 

of uterine wall

  • outer serous membrane of uterine wall
  • the peritoneum

61

myometrium

of uterine wall

  • bulky middle layer of uterine wall
  • interlacing bundles of smooth muscle 
  • contract during childbirth to expel baby from body

62

endometrium

 

of uterine wall

  • mucosal lining of the uterine cavity
  • simple columnar epithelium
  • contains secretory and ciliated cells
  • underlain by lamina propria connective tissue
  • In fertilization the embryo burrows into endometrium and resides there during development
  • two layers:
    • stratum functionalis
    • stratum basalis
    • PLUS uterine glands

63

stratum functionalis

of endometrium 

of uterine tube

  • thick inner layer of endometrium
  • undergoes cyclic changes in response to varying levels of ovarian hormones in the blood 
  • is shed during menstruation (every 28 days)

64

stratum basalis

  • thin basal layer of endometrium
  • not shed
  • responsible for forming new functional later after menstruation ends

65

uterine glands 

of endometrium 

of uterine tube

  • tubular
  • change lengths as endometrium thins and thickens

66

blood supply of uterus

  • uterine arteries
  • arcuate arteriess
  • radial arteries
  • spiral (coiled) arteries

67

uterine arteries

(blood supply of uterus)

  • arise from the internal iliac arteries of pelvis
  • ascend along sides of uterine body
  • send branches into the uterine wall
  • divide into arcuate arteries

68

Arcuate Arteries

(blood supply of uterus)

  • branches of uterine arteries
  • course through the myometrium
  • give rise to radial arteries

69

Radial Arteries

(blood supply of uterus)

  • branch from aruate arteries
  • reach endometrium
  • give rise to straight arteries 

70

straight arteries

(blood supply of uterus)

  • Branch from radial arteries
  • AKA basal arteries
  •  

71

Uterine Cycle

  • the menstrual cycle as it involves the endmetrium
  • series of phases that endometrium undergoes month after month as it responds to changing levels of ovarian hormones in blood
  • closely coordinates with ovarian cycle
  • dictated by FSH and LH
  • 3 phases:
    1. menstrual phase (Days 1-5): Stratum functionalis is shed
    2. proliferative phase (days 6-14): functionalis rebuilds
    3. secretory phase (days 15-28): endometrium prepares for implantation of embryo

72

endometriosis

  • fragments of endometrial tissue are present in the uterine tubes, on the ovary, and in the peritoneum of pelvic cavity
  • probably spread by reflux of menstrual fluid
  • extreme pain is caused from fragments responding to ovarian hormones
  • blood accumulates in pelvic cavity, forms cysts, and exerts pressure
  • present in up to 10% of women of reproductive age
  • causes 1/3 of all infertility in females
    • endometrial tissue blocks uterine tubes or covers ovaries
  • Treatment involves
    • drugs that halt estrogen secretion and suppress menstruation
    • Lasers that vaporize endometrium
    • hysterectomy
  •  

73

Vagina

  • Sheath
  • thin walled tube
  • lies inferior to the uterus
  • anterior to rectum
  • posterior to urethra and bladder
  • aka birth canal
  • receives penis and semen during intercourse

74

histology of vagina

  • outer adventitia of fibrous connective tissue
  • muscularis of smooth muscle
  • inner mucosa marked by transverse folds (rugae)
    • lamina propria with elastic fibers that help vagina return to original shape after expanding
    • stratified squamous epithelium
      • can withstand intercourse friction and resist bacterial infection
  • Rugae
    • flatten as vagina expands during childbirth
    • stimulate penis during intercourse

75

vaginal orifice

  • the vagina's external opening

76

hymen

  • near vagina's external opening
  • incomplete diaphragm of mucous
  • vascular 
  • tends to bleed when ruptured during the first sexual intercourse
  • durability varies
    • in some it is delicate and can rupture:
      • during sports
      • inserting a tampon
      • pelvic exam
    • in some it is so tough that it must be breached surgically if intercourse is to occur

77

fornix

 

  • the recess formed where the widened superior part of the vagina encircles the tip of the cervix
  • posterior fornix is deepest part

78

external genitalia

 

  • aka vulva (covering)
  • aka pudendum 
  • the female reproductive organs that lie external to vagina
  • include:
    • mon pubis
    • labia
    • clitoris
    • vestibule structures

79

mons pubis

  • "mountain on pubis"
  • fatty, rounded pad overlying the pubic symphysis
  • pubic hair covers this after puberty

80

labia majora

  • extends posteriorly from mons pubis
  • two long fatty skin folds
  • covered in hair
  • female counterpart (homologue) of scrotum
    • derive from same embryonic structure

81

labia minora

  • enclosed within labia majora
  • two thin folds of skin
  • hairless
  • enclose the vestibule

82

vestibule 

 

external genitalia

  • "entrance hall"
  • houses the external openings of the urethra and vagina
  • vaginal orifices lie posterior to the urethral orifice
  • pea sized greater vestibular glands lie lateral to vaginal orifices
    • secrete lubricating mucous during sexual arousal to facilitate penis entry

83

fourchette

  • extreme posterior point of the vestibule
  • right and left labia minora form a ridge
  • aka frenulum of the labia 
    • ​"little bridle of the lips"

84

clitoris

  • just anterior to the vestibule
  • "hill"
  • a portruding structure composed largely of erectile tissue
  • sensitive to touch 
  • swells with blood during sexual stimulation
  • homologous (female counterpart) to penis
    • has both glans and body (no urethra within)

85

prepuce of the clitoris

  • a fold of skin that covers clitoris
  • formed by anterior junction of the labia minoras

86

corpora cavernosa

of clitoris

  • body of clitoris contains this
  • continue into the crura
    • extend along the bony pubic arch
  • contains no corpus spongiosum
    • homologous to bulbs of the vestibule

87

bulbs of the vestibule

  • homologous to corpora spongiosum in penis
  • lie along each side of the vaginal orifice
  • directly deep to bulbospongiosum muscle
  • engorge with blood during sexual stimulation
  • may help grip penis within vagina
  • this and the base of clitoris squeeze urethral orifice shut during intercourse
    • closes off urethra, perhaps to prevent infectious bacteria up to the bladder

88

perineum

  • diamond shaped region 
  • between pubic arch anteriorly
  • coccyx posteriorly
  • ischial tuberosities laterally
  • central tendon or perineal body lies at the exact center
    • knobby insertion tendon of most muscles that support pelvic floor

89

episiotomy

  • procedure to widen vaginal orifice during birth
  • 50-80% of deliveries in USA
  • avoids tearing of central tendon by babies head
  • widened by a posterior cut through the fourchette when baby's head appears in vestibule
  • After birth cut is sewed up

90

Mammary glands

  • Breasts
  • modified sweat glands
  • present in both sexes
  • only function in lactating females when they produce milk to nourish an infant in response to hormonal stimulation

91

nipple

  • the central protruding area from which an infant sucks milk
  • surrounded by areola

92

areola

 

  • a ring of pigmented skin surrounding the nipple
  • during nursing, large sebacious glands here produce oily sebum that minimizes chapping and cracking of nipple skin

93

lobes of mammary glands

  • 15-25
  • each is distinct compound alveolar gland
  • opening at the nipple
  • separate from each other by adipose tissue and interlobar connective tissue

94

suspensory ligaments of the breasts

  • large amounts of adipose tissure
  • strips of interlobar connective tissue
  • run from the underlying skeletal muscles to overlying dermis
  • provide support for the breasts

95

lobules of the mammary glands

  • smaller units in the lobes of the breast
  • tiny alveoli or acini clustered like grapes
    • simple cuboidal epithelium of milk-secreting cells

96

lactiferous ducts 

  • "Milk Carrying"
  • from alveoli, milk passes through progressively larger ducts
  • the largest of the ducts
  • lie within and deep to nipple
  • just deep to areola

97

lactiferous sinus

  • each lactiferous duct has one
  • where milk accumulates during nursing

98

acrosomal reaction

 

events leading to fertilization

  1. sperm reach oocyte
  2. sperm binds to receptors on zona pellucida around oocyte
  3. undergo acromosomal reaction
    1. digestive enzymes release from acromosomes
    2. enzymes digest a slit into zona
    3. sperm wriggles through slit to reach oocyte
    4. plasma membrane of sperm fuses w/ membrane of oocyte
    5. sperm nucleus is englufed by cytoplasm
    6. Fusion induces cortical reaction

99

cortical reaction

  • granules in the oocyte secrete enzymes into the extracellular space beneath the zona pellucida
  • enzymes in alter zona pellucida and destroy the sperm receptors
  • prevent any other sperm from binding to and entering the egg

100

fertilization

  • occurs the moment chromosomes from male and female come together within ovum (ampulla of uterine tube) 
  • fertilized egg, zygote, then ititiates cleavage

 

[image is implantation of blastocyst]

101

implantation

  • 6 days after fertilization the blastocysts begins implantation process
  • the act of burrowing into the endometrium
  • blastocyst consists of
    • inner cell mass (future embryo)
    • outer trophoblast 

102

trophoblast

  • "nourishment generator"
  • outer layer of blastocyst
  • will provide embryo with nourishment from uterus of mother

103

cytotrophoblast

  • "cellular part of trophoblast"
  • Inner layer of trophoblast when cells proliferate and form two distinct layers
  • where cell proliferation occurs

104

syncytiotropholast

  • outer layer of trophoblast
  • "the part of the trophoblast with fused cells"
  • where cells lose their plasma membranes
  • cells fuse into multinuclear mass of cytoplasm
  • projects invasively into endometrium
  • digests uterine cells it contacts

105

lacunae 

 

of syncytiotrophoblast

  • celftlike spaces
  • open within syncitiotrophoblast
  • quickly fill with maternal blood that leaks from degraded endometrial blood vessels

106

extraembryonic mesoderm

 

(formation of placenta)

  • rise from proliferating trophoblast on external surface

107

chorion

 

(formation of placenta)

  • formed from extraembryonic mesoderm and trophoblast layers
  • folds into fingerlike villi called chorionic villi

108

chorionic villi

 

(formation of placenta)

  • fingerlike villi
  • from folds in the chorion
  • contact lacunae containing maternal blood

109

body stalk

 

 

(formation of placenta)

  • connecting stalk
  • connects the embryo's body to the outside chorion
  • extraembryonic mesoderm
  • umbilical arteries and veins grow into it from embryo's body
  • forms the core of future umbilical cord

110

decidua basalis

 

(formation of placenta)

  • the part of the mother's endometrium adjacent to the complex chorionic villi and umbilical cord

111

Formation of placenta

  • completed during months 2 and 3
  • chorionic villi near umbilical cord grow in complexity
  • chorionic villi elsewhere ultimately disappear

112

decidua capsularis

 

(formation of placenta)

  • endometrium opposite of decidua basalis
  • on the uterine-luminal side of emplanted embryo
  • expands to accomodate growing embryo (fetus)
  • completely fills the uterine lumen by month 4

113

placenta

 

 

  • "cake"
  • at month 4 it is formed by the decidua basalis and chorionic villi 
  • thick, pancake-shaped disc at the end of umbilical cord
  • noruishes the fetus for 6 months until birth

114

placenta previa

  • "appearing in front of"
  • 1 in 200 pregnancies
  • embryo implants in the inferior part of the uterine wall (normally superior part)
  • placenta may cover internal os of cervix
  • bleeding the last 3 months of pregnancy
  • bed rest is prescribed
  • #1 reason for cesarean section

115

placental abruption

 

  • placenta is in normal position
  • placenta becomes partially separated from uterine wall before birth
  • 8 times more common than placenta previa
  • also produces vaginal bleeding during pregnancy
  • can interfere with fetal development by reducing delivery of nutrients and oxygen to fetus

116

parturition

 

(childbirth)

  • "bring forth young"
  • act of giving birth
  • avg 266 days after fertilization
  • 280 days after last menstrual period

117

labor

  • the events that expel the infant from the uterus
  • Three stages:
    1. Dilation
    2. expulsion
    3. placental stage

118

Stage 1: Dilation

 

Parturition

  • begins with first regular contractions of uterus
  • ends when cervix is fully dilated (10 cm in diameter) by baby's head
  • longest part of labor
    • 6-12 hours or more

119

Stage 2: Expulsion

 

Parturition

  • lasts from full dilation to delivery (actual childbirth)
  • uterine contractions become stronger and stronger
  • mother has urges to bear down with abdominal muscles
  • typically lasts 50 minutes in first birth and 20 minutes in subsequent births
  • can take up to 2 hours

120

Stage 3: Placental Stage

 

Parturition

  • delivery of placenta
  • within 15 minutes after birth of infant
  • Forceful contractions that continue after birth compress uterine blood vessels
    • limits bleeding 
    • causes pacenta to detach from uterine wall
  • remove placenta by slight tug on umbilical cord
  • umbilical arteries and veins counted as screen for cardiovascular disorders

121

Testicular Cancer

  • affect 1 of every 50,000 males
  • most often between ages 15 and 35
  • firm painless tumors
  • pain may be associated with swelling of testis
  • curable if detected early enough
  • men are advised to examine their testis regularly for lumps felt through scrotum
  • most lumps discovered are not cancer, but pockets of harmless fluid called varicoceles and hydroceles

122

Testicular cancer in USA

and treatment

  • becoming increasingly common
  • 95% cured in all cases
  • death rates are falling
  • treatment involves:
    • removal of affected testis
    • radiotherapy
    • chemotherapy

123

prostate cancer

  • slow growing cancer
  • arises from main gland in prostate
  • symptomless in early stages
  • can eventually grow sufficiently to impinge on the urethra and block urine flow
  • after growing large, metastasizes to bony pelvis, lower back, and bones

124

Commonality and risk factors Prostate Cancer

  • second most common cause of cancer death in men (after lung cancer)
  • kills 3% of all men in the US
  • twice as common in blacks than whites
  • half as common in asians
  • risk factors:
    • fatty diet
    • genetic predisposition
      • more hereditary components than most cancers

125

Detecting prostate cancer

  • Later stages:
    • digital rectal examination
    • ultrasound imaging with device inserted into rectum
  • PSA tests: Measuring blood levels of prostate-specific antigens (PSA)
    • detect prostate cancer in 70-80% of all cases
    • recommended to all men over 50

126

Therapy for Prostate Cancer

  • detected before metastasis:
    • radical prostatectomy (removal of prostate)
    • radiation therapy
  • After metastasis:
    • no effective control measures available
    • cancer grows slowly and rarely kills

127

Ovarian Cancer

  • arises from cells in germinal epithelium covering the ovary
  • affects 1.4% of women
  • 5th most common cause of cancer deaths in women
  • produces few symptoms until it enlarges sufficiently to produce:
    • feeling of pressure in pelvis
    • changes in bowel or bladder habits

128

Diagnosing and treating ovarian cancer

Diagnosing:

  • feeling a mass during a pelvic exam
  • visualizing it by using an ultrasound probe placed in the vagina
  • using a blood test for protein CA-125

Treatment:

  • surgical removal of ovary, uterine tubes, and uterus
  • radiotherapy
  • chemotherapy

Prognosis is poor if metastasis has occured

129

Endometrial Cancer

  • rises from endometrium of uterus/uterine glands
  • 4th most common cancer of women
  • 2% of all women develop it
  • sign=bleeding from vagina
  • Risk factors:
    • obesity
    • post menopausal estrogen-replacement therapy
  • Diagnosis involves ultrasound inserted into vagina to detect endometrial thickening, followed by endometrial biopsy
  • Treatment:
    • Removal of uterus
    • pelvis irradiation
  • high cure rate of 40-95%

130

Cervical Cancer

  • usually appears in ages 30 to 50
  • occurs in 1% of US women
  • slow growing cancer
  • starts at epithelium covering the tip of the cervix
  • 90% of cases are transferred sexually by spreading human papollomavirus

131

Papanicolaou (pap) smear

  • cervical smear test
  • most effective way to detect cervical cancer in earliest stage (precancerous)
  • cervical epithelial cells are scraped off and examined for abnormalities

132

treatment of cervical cancer

  • removed by freezing or laser if cancerous cells are confined to cervix
    • survival rate is over 95%
  • if cancer has spread throughout pelvic organs:
    • radiation + chemotherapy=5 year survival rate over 70%
  • women over 18/sexually active women are advised to have pap smear every 1-3 years

133

Cancers in women

From most deadly:

  1. Lung cancer
  2. breast cancer
  3. colorectal cancer
  4. Endometrial cancer

134

Breast Cancer

  • Arises from the smallest ducts in the lobules of the breast
  • 97% of cases occur in women over 55
  • 1/8 women will develop breast cancer
  • women should perform a monthly self eval for:
    • lumps
    • change in size/shape
    • scaling on nipple or or areola
    • discharge from nipple
    • orange peel dimpling 

135

Risk factors of breast cancer

  • Family history of breast cancer
  • late menopause
  • early onset puberty
  • first live birth after age of 30
  • postmenopausal estrogen-replacement therapy

All bust history reflect lifelong exposure to increased estrogen levels:

  • stimulates division of duct cells
  • promotes cancer

 

 

136

Path of breast cancer

  • metastasizes from breast through lymphatic vessels
  • to axillary and parasternal lymph nodes
  • to chest wall, lungs, liver, brain, and bones
  • if reaches lungs or liver, survival  is less than 6 months

137

Mammogram

  • Screening technique to enable early detection
  • greatly reduces morality rate
  • women over 50 get mammogram annually
  • suspicious masses are biopsied and examined microscopically to check for cancer

138

radical mastectomy

  • removal of entire affected breast
  • plus all underlying muscles, fascia and associated lymph nodes
  • performed only in most advanced cases

139

lumpectomy

  • standard treatment of breast cancer
  • removal of cancerous mass
  • plus small rim of surrounding tissue
  • followed by radiation therapy
  • then administration of hormones and chemotherapy

140

DEVELOPMENT OF HOMOLOGOUS STRUCTURES OF EXTERNAL GENITALIA IN BOTH SEXES

 

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