#anatomy 2nd year mbbs

1. ANATOMY
PRESENTATIO
N
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.
1. Most of the part is serosa.
2. Serosa consist of single layer of simple
squamous epithelium underlined by loose
connective tissue .
3. 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 :
1. Thin outer longitudinal layer .
2. Middle layer of circularly disposed muscle
fibres called STRATUM VASCULARE.
3. Inner longitudinal layer .
During pregnancy this layer undergoes
hypertrophy under the effect of progesterone .

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

9. LAMINA PROPRIA :
1. It is also called Endometrial stroma.
2. It is highly cellular .
3. It lodges uterine glands .
In secretory phase of menstrual cycle it is
divided into two zones :-
1. Stratum functionalis
2. 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 :
a) Fertilized ovum implants other than
uterus for example in ovary , uterine
tube or abdomen .
b) Management :-
1. Methotrexate .
2. Surgery .