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I. Overview
work together for the purpose of sexual production. In addition, the female
The organs of the female reproductive system include the ovaries, fallopian tubes,
uterus, vagina and external organs which are collectively called as vulva.
1. Ovaries
- These are paired glands which resemble an almond as to size and shape. It is
responsible in the production of (1) gametes (secondary oocytes that develop into
2. Fallopian Tubes
- These are two uterine tubes which extend laterally from the uterus. The tube
measure about 10 cm. they provide a route for sperm to reach the ovum and
transport secondary oocytes and fertilized ova from the ovaries to the uterus. It
3. Vagina
- It is the receptacle for the penis during sexual intercourse, the outlet of menstrual
flow, and the passageway for childbirth. Situated between the urinary bladder and
the rectum
4. Vulva – composed of the mons pubis, labia majora, labia minora, clitoris, vestibule ,
5. Uterus
pregnancy. During reproductive cycle, when fertilization does not occur, it is the
a. Anatomy
Situated between the urinary bladder and the rectum, the uterus is the size
a.3. Cervix – An inferior narrow portion that opens into the vagina.
a.4. Isthmus – Between the body of the uterus and the cervix
a.6. Cervical canal – the interior of the cervix. It opens into the uterine
b. Histology
fibers that are thickest in the fundus and thinnest in the cervix.
b.3.1. Components
connective tissue)
b.3.2. Layers
and inorganic salts. Cervical mucus supplements the energy needs of the sperm
and both cervix and cervical mucus protects the sperm from phagocytes and
III. Hormones
Lowers blood
cholesterol
Moderate levels
inhibit release of
LH
IV. Menstrual Cycle
constrict
die
(graffian) follicle
OVULATION (day 14)
GnRH
Events in the Ovaries (Luteal phase) Events in the Uterus (secretory phase)
and inhibin
cycle begins
If fertilization occurs…
V. Fertilization
The union of an ovum and a sperm. This usually occurs in the ampulla of the
fallopian tube. As the ovum is extruded from the graffian follicle of an ovary with
a circle of cells (corona radiata). the is extruded from the gaafian follicle of an ovary
pellucida) and a circle of cells. (the corona radiata). The ovum and these surrounding
cells are propelled into a nearby fallopian tube by currents initiated by the fimbriae.
woman’s cervical mucus, which makes it easy for spermatozoa to penetrate it.
Spermatozoa moves through the cervix and the body of the uterus and into the
flagella (tails) and uterine contractions. All of the spermatozoa that reach the ovum
ovum.
Once it penetrates the cell, the cell membrane changes composition to become
Out of this single-cell fertilized ovum (zygote), the future child and also the
accessory structures needed for support during intrauterine life (placenta, fetal
toward the body of the uterus, aided by the currents initiated by the muscular
after ovulation, the blastocyst sheds the last residues of the corona and zona pellucida,
brushes against the rich uterine endometrium and settles down into its soft folds.
I. BRIEF DESCRIPTION
3. Stage IV-A – the carcinoma has extended beyond the pelvis or has clinically
involved the mucosa of the bladder or rectum. “A” means it has already spread to
adjacent organs.
Cancer is caused by certain changes to genes that control the way cells function,
especially how they grow and divide. These changes include mutations in the DNA that
makes up the genes. Genetic changes that increase cancer risk can be inherited from
parents if the changes are present in germ cells (egg cells and sperm cells). Such changes,
called germ line changes are found in every cell of the offspring. Types of defective
genes include:
through direct synthesis of proteins that accelerate proliferation; once mutated and
proliferation
c. Mismatch Repair Gene (mutated) – normally encode proteins that are involved in
rays, mutations from drugs and chemicals); once mutated, defective DNA tend to
Virus-linked cancer account for about 80% of cancer of the cervix. Virtually, all
human cervical cancer is due to infection with specific subtypes of HPV. HPV infects
basal skin cells and many subtypes cause warts. It is spread primarily through sexual
contact. HPV causes cancer when the viral DNA becomes accidentally integrated into the
infected cervical basal cell chromosome and directs the production of viral oncogenes.
Cancer cells express tumor-associated antigens (TAA) that are not normally found
in normal cells. This TAA is recognized by the immune system as foreign, thus, it
destroys these cancer cells and prevents it from developing into a clinically detectable
tumors. However, some cancer cells are capable of bypassing this surveillance through
a. Tumor cell camouflage – some cancer cells can mimic the normal cells because
they are coated with fibrin which gives them protection from the immune system
b. Antigen modulation – some cancer cells have the ability to modulate this TAA in
c. Overwhelming antigen exposure – cancer cells grow at a rate more rapid than the
d. Blocking agents – some cancer cells produce fibrin blocking them against
antibodies
a. After injury, inflammatory cells release factors which stimulate cell proliferation.
proliferation.
species and other reactive molecules that can both promote mutations and block
c. Also, cancer cells and macrophages may secrete inflammatory mediators such as
5. Age
Generally, the incidence of cancer increases dramatically with advancing age and
cigarettes are inhaled and absorbed in the lungs and carried through the bloodstream.
However, the molecular mechanisms by which it increases the risk of cervical cancer
remain unknown. There are two possible explanations but still under active investigation
b. There were instances that tobacco substances are found in the cervix of a
woman who smokes and researchers believe that these carcinogens damage
7. Sexual activity (multiple sex partners, sex with uncircumcised males, sexual contact with
males whose partners have had cervical cancer) – higher risk in acquiring HPV infection
Women who have had 3 or more pregnancies and got pregnant at an early age
have an increased risk in developing cervical cancer. It is still under study however, it is
pointed out to hormonal changes during pregnancy as possibly making women more
susceptible to HPV infection or cancer growth. Another though is that pregnant women
might have weaker immune system allowing HPV infection and cancer growth
vaginal and cervical cell carcinomas. It stimulates proliferation and may increase the risk
of mutation at the same time stimulate the replication of the mutated cell.
some women between 1940 and 1971 to prevent miscarriage. Women whose
mothers took DES when pregnant with them are at risk in developing clear-
b. Prolonged use of birth control pills – birth control pills’ main ingredient is
estrogen. Thus taking oral contraceptives increases the risk of cervical cancer.
Many low-income women do not have easy access to adequate health care
services, including Pap tests. This means they may not get screened or treated for
cervical pre-cancers.
endocrine and metabolic signals from other organs, adipose tissue responds by increasing
or decreasing the release of free fatty acids (fuel for skeletal muscles and other tissues),
peptide hormones leptin, resistin, tumor necrosis factor-y and reduce adiponectin
(important for energy balance and lipid metabolism). Increased release of free fatty acids,
resistin and TNF-y and reduced release of adiponectin give rise to insulin resistance (a
synthesis and blood levels of Insulin-like Growth Factor-Binding Protein (IGFP). IGFP
functions to stabilize large pool of IGF-1 in the circulation. Thus, a decrease of such leads
An increased insulin and IGF-1 in the blood signal insulin receptors and
IGF-1 receptors to stimulate cell proliferation and inhibit apoptosis. These events
The process begins with a single cell that has sustained genetic change.
Carcinogenesis is a multistep process and involves a number of genetic mutations that cause
development is categorized into four stages namely: (1) Initiation, (2) Latency/Promotion,
Initiation Stage. In the first stage, cells are exposed to an initiating agent or
DNA of a cell. Viral, environmental or lifestyle and genetic factors have all been identified
as initiators of carcinogenesis.
Progression Stage. In the third stage, the tumor cells acquire malignant
a. Anaplasia – marked change in the structure and orientation of cells completely not in
resemblance to the original cell. Cancer cells have an evident increase in size with
ongoing proliferation. They are variable in size and shape. In response to anaplasia,
b. Loss of contact inhibition – cancer cells also loss respect for boundaries.
c. Loss of cellular cohesiveness – cancer cells do not stick together therefore, they can
e. Tumor angiogenesis – cancer cells stimulate the formation of a vascular supply which
is essential for continued tumor growth and metastasis. Tumor cells produce
Invasion Stage. Tumor spread can occur by direct extension or local invasion of
1. Growth and progression of the primary tumor – the first requirement for metastasis is
rapid growth of the primary tumor. Most tumours must reach 1 billion cells or 1 cm in
2. Angiogenesis at the primary site – extensive angiogenesis is necessary for the tumor
3. Local invasion – Several factors are involved in tumor cell invasion. First, rapid
cancer cells into the adjacent tissue. Second, increased cell motility can contribute to
tumor cell invasion. The lack of adhesion among tumor cells increases their ability to
escape and invade. Third, tumor cells secrete enzymes (hyaluronidase) that are
capable of destroying the basement membrane. With these events, tumor cells then
break down the tissue stroma and basement membrane of adjacent tissue to reach
4. Detachment and embolization – once in the circulation, tumor cells are vulnerable to
destruction by the host cells. Therefore, as a protection, they cluster with blood cells
primarily platelets and for a fibrin-platelet emboli. This protects the tumor cells and
promotes metastasis by enhancing their ability to adhere to the capillary walls of the
target organ.
5. Arrest in distant organ capillary beds – The most frequent location of metastases is
the first capillary bed or lymphatic tissue in an organ adjacent to the primary site.
Factors that may influence certain tumors to metastasize to specific sites include
6. Extravasation – After the tumor cells have firmly attached themselves to the
endothelial cells of a vessel, the tumor cells must penetrate through the vessel wall to
grow into the extravascular tissue. Once tumor cells escape the vessel wall, it invades
7. Proliferation – Once tumor cells arrive in the extravascular tissue, a blood supply and
- Pelvic pain
- Anorexia and weight loss related to the pain which supresses appetite
B. Growing tumor causes rupture of minute blood vessels along the affected area
- Post-coital bleeding
- Pain
- Fever
stool or pus in the vagina, foul smelling vaginal discharge, irritation or pain,