Cervix. Photo close-up inside, size, rate, anatomy, healthy structure, pregnancy, before delivery, before menstruation

Uterus - unpaired genital organ in females, which is located in the middle third of the pelvic cavity. In front of the uterus are the bladder and behind - the middle and the bottom of the ampoule of the rectum, as seen in the photo. uterine weight in females of reproductive age ranges from 40 to 70 g, at given birth - to '90

Body length - 04.08 cm, and the width - 5 cm. In pregnant women uterine size changing due to muscle hypertrophy wall. The uterus is composed of three parts (top to bottom): a bottom, body, and neck. The wall of each department consists of three layers: the endometrium, myometrium, perimeter.

What is the cervix, its anatomy and structure

The cervix is ​​the lower body segment and is a continuation of the body of the uterus. The isthmus is the boundary between the body and the neck.

wall

neck wall differs from uterine body wall to a greater extent by the presence of collagen connective fibers and less elastic fibers of smooth muscles. Cervical mucosa is located directly beneath the connective tissue membrane, represented by columnar epithelium.

Columnar epithelium consists of tall cells capable of secreting mucus. Nabothian gland are derived mucous membrane of the uterus. In place of entering the cervix into the vagina (vaginal cervical surface) area marked change columnar epithelium neorogovevayuschy multilayered epithelium.

Neck

The cervix (the photo is presented later in this article) is anatomically consists of: Isthmus supravaginal and vaginal parts.

1. Vaginal surface of the cervix.
2. Supravaginal cervical segment.
3. The external os uteri.
4. Internal os uteri.
5. Cervical canal.

Vaginal part - the bottom of the uterus department. On this site there is a transition zone epithelium, which is the diagnostic term is significant for the doctor at the time of the survey. Normally, the entire surface of the vaginal part of the cervix is ​​covered neorogovevayuschy multilayer epithelium as the surface of the vagina.

By moving the transition zone occupies a portion of the vaginal surfaces columnar epithelium, which is not the norm. In this case, we should talk about pathological changes - the formation of pseudo or erosions. On the vaginal surface marked outer mouth which is bounded by front and rear cervical lip.

there is a "pocket" between the lip and the back wall of the vagina - posterior fornix of the vagina, and between the front lip and front wall - the front arch. These anatomical structures are the puncture site by doctors for diagnostic purposes. Supravaginal part of the cervix is ​​its upper segment located between the vaginal department and neck.

Cervical Canal - vaginal message uterine cavity. Unit begins anatomical inner throat into the uterus body, passes in proper neck cervical canal and exits through the outer mouth of the vagina. The glands that produce large amounts of mucus, mucous plug formed in the channel, preventing ingress of foreign infection.

Ligaments and muscles

Ligaments presented complex muscles, ligaments and fascia, performing maintenance, fixing and hung function.

The composition of the ligamentous apparatus:

Function	Bundles, performing the function
hang (Uterine attachment to the pelvic wall ring)	Broad ligament of the uterus - 2. Ovarian ligament (on site and maintenance). Circular ligament.
Locking (Providing the required mobility of the pregnant uterus)	Ligament connecting the sacrum and the uterus. Ligament that connects the uterus and bladder. Own ligament of the uterus.
supportive (Demarcation and maintenance of the pelvic organs in their anatomical position)	Muscle and fascia, pelvic floor forming.

Cervical ligamentous apparatus 3 includes all functions, but not all the ligaments are involved in fixing it.

Cervical ensure normal functioning:

• a steam room and a wide circular ligament, suspensory performing the function;
• primary fallopian ligament fixation operate;
• muscle fascial fiber membrane as a supporting apparatus.

The dimensions of the cervix is ​​normal

The cervix, like the body of the uterus, can change shape depending on age, menstrual cycle, pregnancy, before and after pregnancy.

Based on the anatomical features of the cervix wall (predominance of collagen fibers of connective tissue), such is not able to fully separated to stretch and return to its original position. The main objective is to keep the neck of the fetus at the stage of pregnancy inside the uterus, preventing getting foreign infection in the uterus and preservation of the natural birth canal at the right moment.

adolescents

At puberty increases body of the uterus, and then the neck. The reason for this is the increase in level of ovarian hormone. At full formation of secondary sexual characteristics, ovarian hormones are no longer accumulate, which contributes to the cessation of growth of internal genitals. Cervix adolescents increases in length by 2 - 3 cm, and a width of 0.1 cm.

In adult women

cervical parameters in nulliparous women:

• length - 4.5-5 cm;
• width - 0.25-0.3 cm.

In the case of pathological inflection neck length may be increased by a few cm.

When pregnancy at different stages

Depending on the duration of pregnancy cervical length will vary in the longitudinal direction:

Period of weeks	The neck length in cm
1-30	4.8-3.4
31-36	3.3-2.5
36-40	2.4-1.8

Before and after childbirth

The cervix (neck of the size of photo changes during labor is given later in this article) will gradually shorten, and increase in diameter. Such changes will take place under the pressure of the fetus from the uterus, and then it passes by natural birth canal (cervical ripening).

Pictured process of passing through the fetal vaginal tract, including the cervix. Before birth, the lower uterine segment is rapidly shortened by 2 cm and fixed due to ligamentous apparatus exactly in the center of the pelvic cavity. Thus, there is the preparation of the female body to labor and the expulsion of the fetus.

After the baby is born, the uterus takes the form of "inverted pear" when the cervix becomes wider body. The process of restoring the lower uterine department long - up to 2 months. Within the first postnatal days, the neck diameter equal to 5.4-5.7 cm.

By the end of the second week of closed internal os and the external - to the end of the second month of postnatal period. If women who have not given birth, the outer mouth point form, then childbirth - slit shape (excessive tissue stretching). The shape of the neck before birth - conical, after childbirth - cylindrical.

Before, during and after menstruation, during ovulation

Cervix (photo from uterine shape description and characteristic changes in each period is arranged further in the article) is able to change shape and density, depending on the current cycle. The most favorable period for conception falls to the ovulatory period when the egg passes through the fallopian tubes.

The neck is pulled up and becomes softer, highlighting special secret through the outer mouth slightly open, contributing to the smooth passage of sperm into the uterus. Before ovulation and after ovulation, the outer and inner jaws are closed, and the very solid neck and lowered.

Features of development of cervical disease, the symptoms

At the moment, the problem of cervical disease is still relevant. Such diseases are more related to the girls of reproductive age.

Pathological changes often occur in the cervical vaginal surface, in the "transition zone" of one another epithelium. When changing the localization of this zone, there are background diseases: ectopia (pseudo) ectropion, leucoplakia, erythroplakia, polyps and as a consequence, malignant neoplasms of the uterine cervix.

cervical ectopia

Ectopic (pseudo) - cervical disease characterized yield columnar epithelium on vaginal surface of the cervix. Women with menstrual disorders are predisposed to the development of the disease.

The clinical picture is somewhat blurred. These women may complain about the selection of blood clots after intercourse and intercourse painful process itself. Can recognize the disease in the medical examination of the cervix in the mirrors: body surface will not pale pink and bright red hue.

Cervical ectropion

Ectropion - eversion cervical mucous membrane of the vagina, on the cervix to form hems and ectopia. This disease occurs as a result of a failed diagnostic or surgical intervention on the uterus, as well as after labor or abortion.

The clinical picture of quiet - women do not complain or point out a minor stomach discomfort pulling character at the bottom. No amount of bleeding.

cervical leukoplakia

Leukoplakia - a disease associated with the emergence of areas of keratinization at neorogovevayuschy epithelium. Leukoplakia is a simple and proliferative. Proliferative form is a precancerous condition, and the capture of biological material from that portion (biopsy) revealed abnormal cells.

A clear symptom of the disease is not present. Developing this disease is usually in women with impaired hormonal or immune system. When neck injuries likelihood of developing the disease is high.

Cervical erythroplakia

The cervix is ​​at erythroplakia affected locally, closer to the outer zevu. The pathogenesis of the disease is the thinning of stratified squamous epithelium, and as a consequence - atrophy of tissues. Etiology erythroplakia to them has not been studied. The photo clearly visible red spots in the area of ​​the ectocervix.

Cervical polyps

Polyps - different sized protuberances on the mucosa of the cervical canal. In its structure, the polyps are epidermizirovannye and glandular. When viewed in the mirrors polyps oblong, leaf-shaped. Diagnose and differentiate these polyps can be achieved only by ultrasound pelvic area.

cervical endometriosis

Endometriosis neck - a disease in which the fabric, similar in structure to the endometrium, located on the vaginal surface of the cervix. Normally, such a fabric should be placed in the uterine cavity.

The main causes of this disease:

• neck injuries due to violence, labor or abortion, as well as medical interventions;
• genetic predisposition;
• hormonal disbalance.

Patients with cervical endometriosis usually do not show typical complaints. Noted discomfort during intercourse, vaginal bleeding after intercourse, as well as before and after menstruation.

Cervical cancer

Cancer of the cervix (cervical cancer) - a malignant neoplasm of the cervix. The location and type of cancer varied. The main component of the disease - abnormal cells that can divide uncontrollably and replace normal cells. In 90% of cases, the cause of cervical cancer is the human papilloma virus. The main path of transmission - sexual intercourse.

Factors in which the risk of developing the disease increases:

• early onset of sexual activity (17 years);
• failure to comply with the rules of hand hygiene and body;
• precancerous states (proliferative leukoplakia, polyps);
• frequent change of sexual partners;
• bad habits;
• papilloma virus infection in another way (for medical intervention, the transmission from the mother to the fetus).

Clinically suspected cancer in the early stages it is difficult to manage. Patients do not complain, secretions can not be.

With progression when malignant disease moves to the next stage and is growing, you may experience vaginal bleeding and pain, pulling character, in the abdomen. Suspected cervical cancer is only in the biopsy of the affected tissue for abnormal cells.

Diagnosis of Cervical Disease

Some abnormal cervical condition your doctor may suspect during gynecological examination (inspection body in the mirror). This diagnostic is informative only in diseases affecting the vaginal portion of the cervix. Cervical canal at this stage - is not available.

Swabbing the cervix special brush bacterial seeding - a painful but informative procedure.

To clarify the diagnosis, a gynecologist resorts to sample Schiller - use iodine to detect abnormal areas. Healthy cervical cells will rapidly absorb iodine, turning to brown, and the hearth area, where there are no such cells become pale.

Ultrasound diagnosis of pelvic informative in severe conditions - cancer, endometriosis. It conducted a survey in order to avoid destruction of the body and the bottom of the uterus, as well as the spread of the disease to neighboring organs.

Colposcopy allows to evaluate the morphology of the cells due to the magnifying power of a colposcope. Biopsy - diagnostic extreme measure which uses a gynecologist in case of no informative value of the previous methods.

The purpose of a biopsy - taking on the border of the healthy zone and hearth, tissue for cytological study to determine the presence of cancer cells in the biomaterial. Sometimes doctors use CT data to identify metastases (remote cancer cells) in other organs and systems.

Methods of treatment of cervical

Therapeutic measures in cervical diseases are aimed at removing the affected area and prevent the escalation of this zone on the healthy parts of the body.

Mark several approaches treatment of cervical:

• conservative;
• surgical;
• physiotherapy.

It is the most effective surgical method, taking into account a number of features. Surgeries performed in the first two weeks of the menstrual cycle when estrogen levels upgraded, and regenerative ability of the body contribute to rapid healing postoperative wounds.

Coagulation

Coagulation - minimally invasive intervention, whose purpose is to stop bleeding by coagulated blood and "moxibustion" pathological zones on the vaginal surface of the cervix. This technique is effective for diseases such as polyps, endometriosis, cervical canal, leukoplakia.

Benefits of Coagulation:

• rapid regeneration of tissue;
• additional antiseptic;
• a small area of ​​impact, without affecting the healthy tissues;
• absence of complications (bleeding).

diathermocoagulation

The cervix (photo diathermocoagulation given below) with a pseudo-indication for diathermocoagulation. Treatment consists of an electric high-frequency current to the affected area, creating a high temperature and causing coagulation of tissue proteins. The aim of therapeutic measures - to prevent possible complications.

Contraindications carrying out such manipulations are:

• pregnancy;
• malignant neoplasm of the cervix;
• second half of the menstrual cycle.

laser treatment

Laser coagulation (vaporization) - Electrosurgical treatment of cervical erosion of various sizes, at least - polyps and endometriosis. The essence of the procedure is exposed to the laser beam to the affected tissue, where mechanical energy is converted into heat. Tissue coagulation occurs where the beam is affected.

Advantages of techniques:

• painless;
• ease of use;
• minimal risk of complications;
• the possibility of applying the method for nulliparous patients.

The drawback - the high cost.

cryolysis

Cryodestruction (cryotherapy, cryoablation) - impact on the hearth at very low temperatures (up to 200 °), via kriodestruktory. Cooling tissue occurs under the action of a liquefied gas (nitrous oxide, liquid nitrogen, carbon dioxide) coming from the container and the temperature sharply varies at the transition to the gaseous state. At the point of contact, it stops the blood supply and the tissue dies.

Indications for use:

• ectropion (not more than 3 cm);
• pseudo;
• leukoplakia;
• erythroplakia.

You can not use cryotherapy in the presence of the cervix:

• larger lesions (more than 3 cm);
• malignancies;
• postoperative scars or seams;
• inflammatory diseases.

radiowave therapy

radio wave therapy - one of the major methods of cauterization of erosion or pseudo cervix. The method consists of exposing high-frequency waves emanating from the nozzle unit to the focal zone and subsequent evaporation of these tissues.

Radiowave knife used during the action of high-frequency waves, excised tissue is coagulated and disinfects the damaged vessels. Rehabilitation period passes quickly enough. Indications are the same as for other types of coagulation.

conization

Cone biopsy - surgical intervention, whose purpose is to remove part of the cervix and the cervical canal, where it is located the cancerous tumor, or precancerous condition and preventing progression detected pathology.

The decision to perform such a procedure is based on the data:

• cervical biopsies (presence of atypical cells);
• Cervical examination and speculum dysplasia (deformation) of 4.3 degrees;
• history of the disease and living (previously identified precancerous conditions - erosion, or leukoplakia proliferative cervical polyps);
• patient complaints.

When a state of neglect - adverse outcome. The operation does not guarantee the complete resolution of the disease, but to stop the progression is possible.

Nulliparous patients should be remembered that after the conization, possible complications during pregnancy. This is due to the inability of the cervix to hold the fruit to full ripening, and there are increased risks of premature labor.

Amputation

cervical amputation - surgical intervention to delete the lower uterine segment, in order to prevent further progression of cancers.

In addition to cancer, the indications for surgery are:

• precancerous lesions (leukoplakia, multiple or single polyps obirnye cervical erosion);
• ectropion (3 cm);
• post-operative or post-traumatic cervical defects;
• endometriosis;
• congenital cervical pathology - lengthening, narrowing or obstruction.

A frequent complication of postoperative stenosis is a (impaired permeability) of the cervical canal, as well as bleeding due to failure of seams. Cervical Pathology - the actual problem in the modern world.

This is due to several causes: wear of clinical, medical personnel errors during the diagnosis and treatment of, non-compliance by patients of simple rules of personal hygiene, increasing the number of cases of genetic predisposition, frequent change of sexual partners.

Information and pictures given above describe only part of the whole meets pathology. Due to the large number of cervical disease and the presence of precipitating factors, women should seek the advice of a gynecologist several times a year.

Video of the cervix

Cervical erosion: