Histology of Uterus

#anatomy 2nd year mbbs

1. ANATOMY PRESENTATION HISTOLOGY OF UTERUS

2. PRESENTED BY : HASSAN MEHDI SHAYAAN PARVEZ WALEED ABDULLAH NAYYARA MUSHTAQ DANIYAL SABIR AQSA FAROOQ JUNAID SAEED NABIRA LATIF IDREES KARWAN FARAH FAROOQ

3. OUTLINES INTRODUCTION HISTOLOGY HISTOPATHOLOGY

4. INTRODUCTION Part of female reproductive system . It consists of two main parts: Body Cervix It has three layers : Perimetrium Myometrium Endometrium

5. HISTOLOGY

6. PERIMETRIUM: Outer most layer of uterus It is either serosa or adventitia. Most of the part is serosa. Serosa consist of single layer of simple squamous epithelium underlined by loose connective tissue . Lower anterior part is covered by adventitia (loose CT). It remains unchanged throughout the menstrual cycle .

7. MYOMETRIUM : It is middle of the uterus . It consists of three layers of smooth muscles : Thin outer longitudinal layer . Middle layer of circularly disposed muscle fibres called STRATUM VASCULARE. Inner longitudinal layer . During pregnancy this layer undergoes hypertrophy under the effect of progesterone .

8. ENDOMETRIUM : It consists of two layers : Epithelium (Simple columnar) Lamina propria. EPITHELIUM :- It consists of two types of cells : Ciliated cells with kinocilia (20%) Secretory cells (Non-ciliated )which produce secretions ; glycogen and glycoproteins. .

9. LAMINA PROPRIA : It is also called Endometrial stroma . It is highly cellular . It lodges uterine glands . In secretory phase of menstrual cycle it is divided into two zones :- Stratum functionalis Stratum basalis (It consists of distal part of uterine glands and proximal part of spiral arteries )

10. MENSTRUAL CYCLE :- Beginning with puberty and ending at menopause , the endometrium of the body of uterus passes through cyclic structural modifications which constitute the menstrual cycle . The duration of a menstrual cycle is variable but averages 28 days .

11. PHASES: Proliferative phase . Secretory phase . Premenstrual phase. Menstrual phase .

12. CHANGES IN MENSTRUAL CYCLE

13. PROLIFERATIVE PHASE : Regenerative phase . In this phase, epithelial cells of the basal part of glands in stratum basale proliferates and forms the uterine glands Uterine glands still appear narrow and straight . Stratum basale also contains basal arteries and proximal portion of spiral arteries.

14. Spiral arteries gradually lengthen but do not extend into the superficial 1/3 of the endometrium . Endometrium attains a thickness of 3mm.

15. SECRETORY PHASE : Also called as Luteal phase. Endometrial glands elongates and become dilated and tortuous . Glands give corkscrew shaped appearance and secretions can be seen in their lumen. Spiral arteries become highly coiled and grow nearly to the surface of the endometrium .

16. Stratum functionale is now characterized by the presence of vascular lacunae . Endometrium attains thickness of 6mm.

17. PREMENSTRUAL PHASE : It is also called Ischemic phase . In this phase ,hormones level declines and cause dramatic changes in the blood supply of st. functionale . Uterine glands ceased to secrete and the endometrium decreases in height. Spiral arteries become completely constricted leading to necrosis of st. functionale .

18. MENSTRUAL PHASE : In this phase, spiral arteries dilates once again and distal portion ruptures due to prolonged ischemia . Rapidly escaping blood causes sloughing of patches of necrotic st. functionale . Stratum functionale (patches) sloughed from the uterine wall for many days .

19. HISTOPATHOLOGY : ECTOPIC PREGNANCY : Fertilized ovum implants other than uterus for example in ovary , uterine tube or abdomen . Management :- 1. Methotrexate . 2. Surgery .