via
tu
ss
lu
Ap
@
,Product Description
Advanced Health Assessment of Women Clinical Skills and Procedures 4th Edition Carcio
Secor Test Bank
ISBN-10:0826124240
ISBN-13:9780826124241
Table of Contents
Chapter 1. Anatomy and Physiology of the Urinary and Reproductive Systems
Chapter 2. The Reproductive Cycle
Chapter 3. The Health History
Chapter 4. The Physical Examination
Chapter 5. Assessment of the Skin
Chapter 6. Assessment of the Female Breast
Chapter 7. Assessment of the Pregnant Woman
Chapter 8. Assessment and Clinical Evaluation of Obesity in Women
Chapter 9. Lesbian Health (Don’t Ask . . . Won’t Tell: Lesbian Women and Women Who Have
Sex With Women)
Chapter 10. Gynecological Examination of the Transgender Patient
Chapter 11. Assessment of Menopausal Status
Chapter 12. Osteoporosis and Evaluation of Fracture Risk
Chapter 13. Genitourinary Syndrome of Menopause (GSM) and Vulvovaginal Atrophy
Chapter 14. Assessment of Pelvic Pain
@
Chapter 15. Assessment of Vulvar Pain and Vulvodynia
Chapter 16. Polycystic Ovarian Syndrome
Chapter 17. Abnormal Uterine Bleeding
Chapter 18. Pelvic Organ Prolapse
Ap
Chapter 19. Urinary Incontinence
Chapter 20. The Female Sexual-Assault Victim
Chapter 21. Intimate Partner Violence
Chapter 22. Sexually Transmitted Infections
Chapter 23. Initial Evaluation of Infertility
lu
Chapter 24. Methods to Detect Ovulation
Chapter 25. Donor Insemination
ss
Chapter 26. Medical Eligibility Criteria for Contraceptive Use
Chapter 27. The FemCap
Chapter 28. Intrauterine Contraception
Chapter 29. Contraceptive Implants
tu
Chapter 30. Cervical Cancer Prevention
Chapter 31. Vaginal Microscopy
Chapter 32. Maturation Index
v ia
,Chapter 33. Sonohysteroscopy (Fluid Contrast Ultrasound)
Chapter 34. Genetic Testing for Hereditary Breast and Ovarian Cancer
Chapter 35. Urinalysis
Chapter 36. The Simple Cystometrogram
Chapter 37. Pelvic Floor Electrical Stimulation
Chapter 38. Pelvic Floor Rehabilitation
Chapter 39. Vulvar Cancer and Biopsy
Chapter 30. Endometrial Biopsy
Chapter 41. Acrochordonectomy
Chapter 42. Cervical Polypectomy
Chapter 43. Incision and Drainage of Bartholin’s Abscess
Chapter 44. Intrauterine Insemination
Chapter 45. Percutaneous Tibial Nerve Stimulation
Chapter 46. Pessary Insertion
@
Ap
lu
ss
tu
v
ia
,3
1
Anatomy and
Physiology of
the Urinary and
Reproductive
Systems
Helen A. Carcio
@
I. General Overview
Ap
A. In females, the urinary and reproductive systems are completely
separate, unlike in males.
B. The internal female reproductive organs are located in the lower
pelvis and are safely tucked inside the bony pelvis, behind the
pubic bone.
C. External genitalia collectively include the mons pubis, the labia
lu
majora, the labia minora, the vestibule, the clitoris, and the vaginal orifice
(Figure 1.1).
D. The structures of the peritoneum are listed and compared in Table 1.1.
ss
II. Ovaries
A. Description
1. Each ovary lies in a depression in the lateral pelvic wall, on either
side of the uterus.
2. Ovaries are small and almond shaped.
tu
3. They vary considerably in size among women, but usually
measure between 3 and 5 cm long, 1.5 and 3 cm wide, and 1 and
1.5 cm thick—about the size of a thumbnail.
v
4. They are pinkish white to gray.
ia
Carcio_24241_R1_01_p1-16.indd 3 14-Aug-18 7:31:42 PM
,4
4 I: FEMALE REPRODUCTION
Mons veneris
Anterior commissure
Prepuce of clitoris
Frenulum of clitoris
Labia majora
Labia minora
Urethral orifice
Skene duct
Vestibule Vaginal orifice
Hymen
Posterior commissure Fossa navicularis
Anus
@
FIGURE 1.1 External female genitalia.
Ap
5. They are not directly attached to the uterus and fallopian tubes.
The ovaries lie suspended in a strong, flexible structure called the
round ligament, which anchors them to the uterus.
6. The uterine tubes, which consist of the oviducts and the fallopian
lu
tubes, are not directly connected to the ovaries. They open into the
peritoneal cavity, which is near the ovaries
B. Function
1. The ovaries house the female sex gametes.
ss
2. The ovaries are counterparts to the testes in the male, in that they
secrete sex hormones: estrogen, progesterone, and testosterone.
3. The ovaries produce an ovum (egg) during ovulation in response
to hormonal stimulation.
tu
III. Fallopian tubes
A. Description
1. The fallopian tubes extend outward from both sides of the
v
uterus and act as a connecting tunnel between the ovary and the
uterus.
ia
Carcio_24241_R1_01_p1-16.indd 4 14-Aug-18 7:31:42 PM
,5
1: URINARY AND REPRODUCTIVE SYSTEMS 5
TABLE 1.1 Structure, Functions, and Purposes of the Organs of Female Reproduction
STRUCTURE FUNCTION PURPOSE
External Sensitive to touch and external Sexual arousal and sensation of orgasm
genitalia stimulation
Vagina Passage for intercourse Organ of copulation
Provides space for containment of sperm
Excretory outlet for the uterus
Becomes birth canal during the birthing
process
Cervix Fibrous, muscular band that holds the Major source of mucus production
bottom of uterus closed and keeps fetus during the menstrual cycle
inside during pregnancy
Uterus Organ of menstruation Fertilized egg implants here
Maintains and protects developing fetus
until birth
Contracts during labor to birth the
neonate
Fallopian tubes Transport of sperm upward Location of fertilization of the egg
Transport of the egg downward Carries the egg to the uterus
@
Ovaries Maturation and development of eggs Produce eggs during ovulation
Ejection of eggs
Secrete hormones, including estrogen,
progesterone, and testosterone
Ap
2. They are approximately 13 cm (5 in.), rubbery, and less than half
the diameter of a pencil (0.05–1.0 cm).
3. They have two layers—inner and outer serous layers—that
surround the layers of involuntary muscle.
4. The fallopian tubes are narrow and muscular (acting as oviducts)
lu
and lined with cilia.
5. They consist of four sections:
a. Interstitial section, which lies within the uterine wall
b. Isthmus
ss
(1) The isthmus is the narrowest section closest to the uterus.
(2) It opens into the cavity of the uterus.
(3) It has a thick muscular wall.
c. Ampulla
tu
(1) The ampulla is the longest section, about two thirds of the
tube’s total length.
(2) It widens progressively to the wide distal opening in the
infundibulum.
v
(3) It is thin walled.
(4) It is the site of fertilization.
ia
Carcio_24241_R1_01_p1-16.indd 5 14-Aug-18 7:31:42 PM
,6
6 I: FEMALE REPRODUCTION
d. Infundibulum
(1) The infundibulum is the fimbriated end that lies in close
proximity to the ovary.
(2) Finger-like projections at the ends of the tubes are the
fimbriae, which sweep over the ovary, scoop up the egg, and
propel it toward the inner ampullae.
B. Function
1. Transports the sperm and the egg (Box 1.1).
a. The inner wall of the fallopian tubes is lined with cilia, which
are hair-like projections.
b. It is believed that the beating motion of these cilia transports
the fertilized egg along the tube to the uterus, where the egg is
implanted.
c. Muscle contractions in the fallopian tube assist in moving the
egg along its journey, much as in intestinal peristalsis.
d. Fallopian tubes have the unique ability to transport the egg in
one direction and the sperm in the opposite direction.
2. Collects the egg.
a. The cilia on the fimbriae have adhesive sites that help navigate
the egg into the fallopian tube.
b. Near the time of ovulation, the fimbriae bend down in
proximity to the ovaries.
@
c. The swooping motion of the petals sweeps up the egg.
Ap
BOX 1.1 Transport of the Egg by the Fallopian Tubes
Egg is released during ovulation
↓
Egg is scooped up by petals of fimbriae
↓
Egg enters the tube at the infundibulum
lu
↓
Fertilization occurs in the ampullae
↓
Ampullae transport fertilized egg (ovum) in the direction of the uterus
ss
(tube progressively narrows from the flared tips)
↓
Muscle contractions and ciliary action in the tube help propel the egg
↓
Egg enters the uterus from the isthmus
tu
↓
Implantation of the egg in the wall of the uterus
↓
Pregnancy
v ia
Carcio_24241_R1_01_p1-16.indd 6 14-Aug-18 7:31:43 PM
,7
1: URINARY AND REPRODUCTIVE SYSTEMS 7
IV. The uterus
A. Description of the uterine corpus, or uterine body
1. The uterus is shaped like an inverted pear.
2. The uterus is hollow, thick walled, and muscular, lying between
the bladder and the rectum.
3. The size and the shape of the uterus vary.
a. Length—7.5 cm (3 in.)
b. Width—5 cm (2 in.)
c. Depth—2.5 cm (1 in.)—a little smaller than a fist
4. The uterus consists of two sections, roughly divided in the middle
at the isthmus.
a. Upper portion
(1) The corpus—the main body
(2) The fundus—the dome-shaped portion located at the point
at which the fallopian tubes enter the uterus
b. Lower narrower portion—the cervix
5. The uterus is mobile and expands readily to accommodate a
developing fetus.
6. The uterine artery is the main source of blood for the uterus.
7. The uterus is supported by the levator ani muscle and eight
ligaments.
8. Major ligaments that help the uterus remain supported in
@
midposition are the elastic broad ligaments, which act as “guide wires.”
9. The position of the uterus within the pelvis varies (Figure 1.2).
a. Anteverted/anteflexed—tilted toward the bladder
b. Retroverted/retroflexed—tilted toward the rectum
c. Midposition—found less frequently
Ap
d. Positions do not affect fertility
10. Relationship of the uterine body to the cervix
a. Anteflexed—the anterior surface bends toward the cervix
b. Retroflexed—the posterior surface bends toward the cervix
11. Consequently, a uterus can commonly be anteverted (tilting
toward the front) and anteflexed (the anterior portion bent).
lu
12. The uterus is a freely movable organ suspended in the pelvic
cavity and actual placement varies as the woman changes position.
13. The wall of the uterus consists of three layers.
ss
a. Perimetrium—the serous external peritoneal covering
b. Myometrium—the middle muscular layer
c. Endometrium—the inner layer of the cavity
(1) The endometrium is controlled hormonally.
(2) It is involved with menstruation or development of the
tu
placenta.
B. Description of the uterine cervix
1. The uterine cervix is visible and palpable in the upper vagina and
is a knob-like structure.
v
2. It is smooth, shiny, and pink.
ia
Carcio_24241_R1_01_p1-16.indd 7 14-Aug-18 7:31:43 PM
,8
8 I: FEMALE REPRODUCTION
D
C
E
B
A
FIGURE 1.2 Positions of the uterus: (A) anteflexion; (B) anteversion, the normal position; (C) midposition;
(D) retroversion; (E) retroflexion.
@
3. It is firmer to palpation than the uterine corpus because it contains
more connective tissues. (It feels like the tip of the nose.)
Ap
4. It is covered by two types of epithelium:
a. Squamous epithelium
(1) The squamous epithelium is pink and shiny.
(2) It is contiguous with the vaginal lining.
b. Columnar epithelium
(1) The columnar epithelium is deep red.
lu
(2) It is an extension of the lining of the endocervical canal.
5. The cervical opening, the external os, connects the vagina to the
endocervical canal, which connects to the body of the uterus.
6. The size of the external os varies.
ss
a. The external os is a tiny, round opening in women who have not
given birth vaginally.
b. It is open, slitlike, and irregular in women who have had
children vaginally.
tu
c. It becomes tight and tiny in postmenopausal women because of
a decrease in estrogen levels.
C. Description of nabothian cysts
1. The surface of the external cervix normally has endocervical
v
glands that secrete mucus in response to hormonal stimulation.
2. The ducts can become obstructed and cystic.
ia
Carcio_24241_R1_01_p1-16.indd 8 14-Aug-18 7:31:43 PM
,9
1: URINARY AND REPRODUCTIVE SYSTEMS 9
3. The extent of obstruction varies from a few tiny cysts to large cysts
covering the entire cervix.
4. Nabothian cysts are common; however, infection may increase
their number.
D. Description of endocervical canal
1. The endocervical canal is open at both ends, connecting the
external os to the internal os.
2. It is about 2 to 2.5 cm (1 in.).
3. It is lined by columnar epithelium.
4. The ectocervix is the cervical portion extending outward from the
external cervical os.
a. Anterior lip—the portion above the cervical os
b. Posterior lip—the portion below the cervical os
5. The endocervix is a narrow column, extending upward from the
external os to the internal os of the uterine endometrium.
E. The cervical epithelium is composed of squamous and columnar
epithelia.
1. Squamous epithelium
a. The squamous epithelium is smooth, shiny, and pink.
b. It covers the ectocervix.
c. It has four main layers, similar to the skin (Figure 1.3).
(1) Basal layer—lies within the thin basement membrane. This
@
layer has one or two cell layers.
(2) Parabasal layer. This layer has three or four cell layers.
(3) Intermediate layer. This layer is thicker than the parabasal
and basal layers.
Ap
Superficial
squamous
cells (keratinized)
lu
Superficial
squamous
cells
ss
Parabasal
cells
tu
Basal
cells
v
FIGURE 1.3 Layers of squamous epithelium.
ia
Carcio_24241_R1_01_p1-16.indd 9 14-Aug-18 7:31:43 PM
tu
ss
lu
Ap
@
,Product Description
Advanced Health Assessment of Women Clinical Skills and Procedures 4th Edition Carcio
Secor Test Bank
ISBN-10:0826124240
ISBN-13:9780826124241
Table of Contents
Chapter 1. Anatomy and Physiology of the Urinary and Reproductive Systems
Chapter 2. The Reproductive Cycle
Chapter 3. The Health History
Chapter 4. The Physical Examination
Chapter 5. Assessment of the Skin
Chapter 6. Assessment of the Female Breast
Chapter 7. Assessment of the Pregnant Woman
Chapter 8. Assessment and Clinical Evaluation of Obesity in Women
Chapter 9. Lesbian Health (Don’t Ask . . . Won’t Tell: Lesbian Women and Women Who Have
Sex With Women)
Chapter 10. Gynecological Examination of the Transgender Patient
Chapter 11. Assessment of Menopausal Status
Chapter 12. Osteoporosis and Evaluation of Fracture Risk
Chapter 13. Genitourinary Syndrome of Menopause (GSM) and Vulvovaginal Atrophy
Chapter 14. Assessment of Pelvic Pain
@
Chapter 15. Assessment of Vulvar Pain and Vulvodynia
Chapter 16. Polycystic Ovarian Syndrome
Chapter 17. Abnormal Uterine Bleeding
Chapter 18. Pelvic Organ Prolapse
Ap
Chapter 19. Urinary Incontinence
Chapter 20. The Female Sexual-Assault Victim
Chapter 21. Intimate Partner Violence
Chapter 22. Sexually Transmitted Infections
Chapter 23. Initial Evaluation of Infertility
lu
Chapter 24. Methods to Detect Ovulation
Chapter 25. Donor Insemination
ss
Chapter 26. Medical Eligibility Criteria for Contraceptive Use
Chapter 27. The FemCap
Chapter 28. Intrauterine Contraception
Chapter 29. Contraceptive Implants
tu
Chapter 30. Cervical Cancer Prevention
Chapter 31. Vaginal Microscopy
Chapter 32. Maturation Index
v ia
,Chapter 33. Sonohysteroscopy (Fluid Contrast Ultrasound)
Chapter 34. Genetic Testing for Hereditary Breast and Ovarian Cancer
Chapter 35. Urinalysis
Chapter 36. The Simple Cystometrogram
Chapter 37. Pelvic Floor Electrical Stimulation
Chapter 38. Pelvic Floor Rehabilitation
Chapter 39. Vulvar Cancer and Biopsy
Chapter 30. Endometrial Biopsy
Chapter 41. Acrochordonectomy
Chapter 42. Cervical Polypectomy
Chapter 43. Incision and Drainage of Bartholin’s Abscess
Chapter 44. Intrauterine Insemination
Chapter 45. Percutaneous Tibial Nerve Stimulation
Chapter 46. Pessary Insertion
@
Ap
lu
ss
tu
v
ia
,3
1
Anatomy and
Physiology of
the Urinary and
Reproductive
Systems
Helen A. Carcio
@
I. General Overview
Ap
A. In females, the urinary and reproductive systems are completely
separate, unlike in males.
B. The internal female reproductive organs are located in the lower
pelvis and are safely tucked inside the bony pelvis, behind the
pubic bone.
C. External genitalia collectively include the mons pubis, the labia
lu
majora, the labia minora, the vestibule, the clitoris, and the vaginal orifice
(Figure 1.1).
D. The structures of the peritoneum are listed and compared in Table 1.1.
ss
II. Ovaries
A. Description
1. Each ovary lies in a depression in the lateral pelvic wall, on either
side of the uterus.
2. Ovaries are small and almond shaped.
tu
3. They vary considerably in size among women, but usually
measure between 3 and 5 cm long, 1.5 and 3 cm wide, and 1 and
1.5 cm thick—about the size of a thumbnail.
v
4. They are pinkish white to gray.
ia
Carcio_24241_R1_01_p1-16.indd 3 14-Aug-18 7:31:42 PM
,4
4 I: FEMALE REPRODUCTION
Mons veneris
Anterior commissure
Prepuce of clitoris
Frenulum of clitoris
Labia majora
Labia minora
Urethral orifice
Skene duct
Vestibule Vaginal orifice
Hymen
Posterior commissure Fossa navicularis
Anus
@
FIGURE 1.1 External female genitalia.
Ap
5. They are not directly attached to the uterus and fallopian tubes.
The ovaries lie suspended in a strong, flexible structure called the
round ligament, which anchors them to the uterus.
6. The uterine tubes, which consist of the oviducts and the fallopian
lu
tubes, are not directly connected to the ovaries. They open into the
peritoneal cavity, which is near the ovaries
B. Function
1. The ovaries house the female sex gametes.
ss
2. The ovaries are counterparts to the testes in the male, in that they
secrete sex hormones: estrogen, progesterone, and testosterone.
3. The ovaries produce an ovum (egg) during ovulation in response
to hormonal stimulation.
tu
III. Fallopian tubes
A. Description
1. The fallopian tubes extend outward from both sides of the
v
uterus and act as a connecting tunnel between the ovary and the
uterus.
ia
Carcio_24241_R1_01_p1-16.indd 4 14-Aug-18 7:31:42 PM
,5
1: URINARY AND REPRODUCTIVE SYSTEMS 5
TABLE 1.1 Structure, Functions, and Purposes of the Organs of Female Reproduction
STRUCTURE FUNCTION PURPOSE
External Sensitive to touch and external Sexual arousal and sensation of orgasm
genitalia stimulation
Vagina Passage for intercourse Organ of copulation
Provides space for containment of sperm
Excretory outlet for the uterus
Becomes birth canal during the birthing
process
Cervix Fibrous, muscular band that holds the Major source of mucus production
bottom of uterus closed and keeps fetus during the menstrual cycle
inside during pregnancy
Uterus Organ of menstruation Fertilized egg implants here
Maintains and protects developing fetus
until birth
Contracts during labor to birth the
neonate
Fallopian tubes Transport of sperm upward Location of fertilization of the egg
Transport of the egg downward Carries the egg to the uterus
@
Ovaries Maturation and development of eggs Produce eggs during ovulation
Ejection of eggs
Secrete hormones, including estrogen,
progesterone, and testosterone
Ap
2. They are approximately 13 cm (5 in.), rubbery, and less than half
the diameter of a pencil (0.05–1.0 cm).
3. They have two layers—inner and outer serous layers—that
surround the layers of involuntary muscle.
4. The fallopian tubes are narrow and muscular (acting as oviducts)
lu
and lined with cilia.
5. They consist of four sections:
a. Interstitial section, which lies within the uterine wall
b. Isthmus
ss
(1) The isthmus is the narrowest section closest to the uterus.
(2) It opens into the cavity of the uterus.
(3) It has a thick muscular wall.
c. Ampulla
tu
(1) The ampulla is the longest section, about two thirds of the
tube’s total length.
(2) It widens progressively to the wide distal opening in the
infundibulum.
v
(3) It is thin walled.
(4) It is the site of fertilization.
ia
Carcio_24241_R1_01_p1-16.indd 5 14-Aug-18 7:31:42 PM
,6
6 I: FEMALE REPRODUCTION
d. Infundibulum
(1) The infundibulum is the fimbriated end that lies in close
proximity to the ovary.
(2) Finger-like projections at the ends of the tubes are the
fimbriae, which sweep over the ovary, scoop up the egg, and
propel it toward the inner ampullae.
B. Function
1. Transports the sperm and the egg (Box 1.1).
a. The inner wall of the fallopian tubes is lined with cilia, which
are hair-like projections.
b. It is believed that the beating motion of these cilia transports
the fertilized egg along the tube to the uterus, where the egg is
implanted.
c. Muscle contractions in the fallopian tube assist in moving the
egg along its journey, much as in intestinal peristalsis.
d. Fallopian tubes have the unique ability to transport the egg in
one direction and the sperm in the opposite direction.
2. Collects the egg.
a. The cilia on the fimbriae have adhesive sites that help navigate
the egg into the fallopian tube.
b. Near the time of ovulation, the fimbriae bend down in
proximity to the ovaries.
@
c. The swooping motion of the petals sweeps up the egg.
Ap
BOX 1.1 Transport of the Egg by the Fallopian Tubes
Egg is released during ovulation
↓
Egg is scooped up by petals of fimbriae
↓
Egg enters the tube at the infundibulum
lu
↓
Fertilization occurs in the ampullae
↓
Ampullae transport fertilized egg (ovum) in the direction of the uterus
ss
(tube progressively narrows from the flared tips)
↓
Muscle contractions and ciliary action in the tube help propel the egg
↓
Egg enters the uterus from the isthmus
tu
↓
Implantation of the egg in the wall of the uterus
↓
Pregnancy
v ia
Carcio_24241_R1_01_p1-16.indd 6 14-Aug-18 7:31:43 PM
,7
1: URINARY AND REPRODUCTIVE SYSTEMS 7
IV. The uterus
A. Description of the uterine corpus, or uterine body
1. The uterus is shaped like an inverted pear.
2. The uterus is hollow, thick walled, and muscular, lying between
the bladder and the rectum.
3. The size and the shape of the uterus vary.
a. Length—7.5 cm (3 in.)
b. Width—5 cm (2 in.)
c. Depth—2.5 cm (1 in.)—a little smaller than a fist
4. The uterus consists of two sections, roughly divided in the middle
at the isthmus.
a. Upper portion
(1) The corpus—the main body
(2) The fundus—the dome-shaped portion located at the point
at which the fallopian tubes enter the uterus
b. Lower narrower portion—the cervix
5. The uterus is mobile and expands readily to accommodate a
developing fetus.
6. The uterine artery is the main source of blood for the uterus.
7. The uterus is supported by the levator ani muscle and eight
ligaments.
8. Major ligaments that help the uterus remain supported in
@
midposition are the elastic broad ligaments, which act as “guide wires.”
9. The position of the uterus within the pelvis varies (Figure 1.2).
a. Anteverted/anteflexed—tilted toward the bladder
b. Retroverted/retroflexed—tilted toward the rectum
c. Midposition—found less frequently
Ap
d. Positions do not affect fertility
10. Relationship of the uterine body to the cervix
a. Anteflexed—the anterior surface bends toward the cervix
b. Retroflexed—the posterior surface bends toward the cervix
11. Consequently, a uterus can commonly be anteverted (tilting
toward the front) and anteflexed (the anterior portion bent).
lu
12. The uterus is a freely movable organ suspended in the pelvic
cavity and actual placement varies as the woman changes position.
13. The wall of the uterus consists of three layers.
ss
a. Perimetrium—the serous external peritoneal covering
b. Myometrium—the middle muscular layer
c. Endometrium—the inner layer of the cavity
(1) The endometrium is controlled hormonally.
(2) It is involved with menstruation or development of the
tu
placenta.
B. Description of the uterine cervix
1. The uterine cervix is visible and palpable in the upper vagina and
is a knob-like structure.
v
2. It is smooth, shiny, and pink.
ia
Carcio_24241_R1_01_p1-16.indd 7 14-Aug-18 7:31:43 PM
,8
8 I: FEMALE REPRODUCTION
D
C
E
B
A
FIGURE 1.2 Positions of the uterus: (A) anteflexion; (B) anteversion, the normal position; (C) midposition;
(D) retroversion; (E) retroflexion.
@
3. It is firmer to palpation than the uterine corpus because it contains
more connective tissues. (It feels like the tip of the nose.)
Ap
4. It is covered by two types of epithelium:
a. Squamous epithelium
(1) The squamous epithelium is pink and shiny.
(2) It is contiguous with the vaginal lining.
b. Columnar epithelium
(1) The columnar epithelium is deep red.
lu
(2) It is an extension of the lining of the endocervical canal.
5. The cervical opening, the external os, connects the vagina to the
endocervical canal, which connects to the body of the uterus.
6. The size of the external os varies.
ss
a. The external os is a tiny, round opening in women who have not
given birth vaginally.
b. It is open, slitlike, and irregular in women who have had
children vaginally.
tu
c. It becomes tight and tiny in postmenopausal women because of
a decrease in estrogen levels.
C. Description of nabothian cysts
1. The surface of the external cervix normally has endocervical
v
glands that secrete mucus in response to hormonal stimulation.
2. The ducts can become obstructed and cystic.
ia
Carcio_24241_R1_01_p1-16.indd 8 14-Aug-18 7:31:43 PM
,9
1: URINARY AND REPRODUCTIVE SYSTEMS 9
3. The extent of obstruction varies from a few tiny cysts to large cysts
covering the entire cervix.
4. Nabothian cysts are common; however, infection may increase
their number.
D. Description of endocervical canal
1. The endocervical canal is open at both ends, connecting the
external os to the internal os.
2. It is about 2 to 2.5 cm (1 in.).
3. It is lined by columnar epithelium.
4. The ectocervix is the cervical portion extending outward from the
external cervical os.
a. Anterior lip—the portion above the cervical os
b. Posterior lip—the portion below the cervical os
5. The endocervix is a narrow column, extending upward from the
external os to the internal os of the uterine endometrium.
E. The cervical epithelium is composed of squamous and columnar
epithelia.
1. Squamous epithelium
a. The squamous epithelium is smooth, shiny, and pink.
b. It covers the ectocervix.
c. It has four main layers, similar to the skin (Figure 1.3).
(1) Basal layer—lies within the thin basement membrane. This
@
layer has one or two cell layers.
(2) Parabasal layer. This layer has three or four cell layers.
(3) Intermediate layer. This layer is thicker than the parabasal
and basal layers.
Ap
Superficial
squamous
cells (keratinized)
lu
Superficial
squamous
cells
ss
Parabasal
cells
tu
Basal
cells
v
FIGURE 1.3 Layers of squamous epithelium.
ia
Carcio_24241_R1_01_p1-16.indd 9 14-Aug-18 7:31:43 PM
