Atlas of Human Anatomy by Netter

FACTS & HINTS

High-Yield Facts

Clinical Points
page 184
page 185

The thickness of the endometrium (vascular mucosal lining) changes throughout the menstrual cycle, undergoing thickening and shedding.

Following menopause the uterus and vagina undergo atrophy

Because the upper two thirds of the vagina lie within the pelvic cavity, weakness of the pelvic floor muscles can lead to vaginal prolapse.

The lumen of fallopian tubes communicates with the peritoneal cavity at its distal (ovarian) end.

The ovary is covered only by a thin layer of mesothelium, an extension of the mesovarium, to permit ovulation of the mature ovum into the

peritoneal cavity.

Ectopic pregnancies are therefore possible within the peritoneum.

Fertilization of an ovum usually occurs within the fallopian tubes at the ampulla (the widest part)

Ectopic pregnancies-implantation of a blastocyst other than in the uterine wall-can occur in the uterine tube (tubal pregnancy-most common

ectopic pregnancy), into the ovary (ovarian pregnancy-rare) or into the abdominal wall (peritoneal pregnancy-very rare)

Blockage of the uterine tubes as the result of disease is a common cause of infertility

Clinical Points

Cervical Cancer

Common between age 40 and 60 years

Was the leading cause of death of women in the United States until 1940, when detection of malignancies and premalignant conditions

was made possible by the development of Pap (Papanicolaou) smears.

Risk factors include: early sexual activity, multiple sexual partners, human papillomavirus infection, and smoking

Eighty-five percent to 90% are squamous cell carcinomas; 10% to 15% are adenocarcinomas

Fibroids

Benign tumors of smooth muscle cells of uterine myometrium

Occur in 30% all women

Can occur in any location within the uterus

Growth stimulated by estrogen and oral contraceptive pill

Symptoms usually a result of compression effects