The cervix is the lower portion of the uterus, an organ of the female reproductive tract. It connects the vagina with the main body of the uterus, acting as a gateway between them. Anatomically and histologically, the cervix is distinct from the uterus, and hence we consider it as a separate anatomical structure. In this article, we shall look at the structure of the cervix, its vasculature, innervation, functions, and any clinical relevance.
The cervix is composed of two regions; the ectocervix and the endocervical canal. The ectocervix is the portion of the cervix that projects into the vagina. It is lined by stratified squamous non-keratinized epithelium; its opening, the external os, marks the transition from the ectocervix to the endocervical canal. The endocervical canal (or endocervix) is the more proximal, and 'inner' part of the cervix. It is lined by a mucus-secreting simple columnar epithelium. The endocervical canal ends, and the uterine cavity begins, at a narrowing called the internal os.
The cervix performs two main functions-
The blood supply to the uterus is via the uterine artery. Venous drainage is via a plexus in the broad ligament that drains into the uterine veins. Lymphatic drainage of the uterus is via the iliac, sacral, aortic and inguinal lymph nodes.
Cervicitis is a chronic inflammation and infection of the cervix, most commonly caused by Chlamydia trachomatis or Neisseria gonorrhoeae. It is usually asymptomatic, although pelvic pain, vaginal discharge, postcoital bleeding and dyspareunia may be present. Complications of cervicitis include pelvic inflammatory disease, whilst the potential blockage of mucus ducts and cyst formation increases the risk of infertility by increasing the hostility of the environment for sperm.
Cervical cancer is broadly classified into two types: squamous cell carcinoma, cancer of the epithelial lining of the ectocervix, and adenocarcinoma, cancer of the glands found within the lining of the cervix. Infection of the female genitalia with human papillomavirus (HPV) is widely known as the cause of the majority of cervical cancers. The latest vaccinations against cervical cancer are, in essence, vaccinations against HPV.
Cervicitis is a common infection of the female genitalia, often times being asymptomatic. However, in some cases pelvic pain, vaginal discharge, postcoital bleeding, and dyspareunia may arise as symptoms. The complications of cervicitis include pelvic inflammatory disease, and the potential to block mucus ducts and create cysts can make the environment hostile to sperm, thus increasing the risk of infertility.
Cervical cancer is classified into two main classifications: squamous cell carcinoma, which is cancer found in the epithelial lining of the ectocervix, and adenocarcinoma, which is cancer found in the glands found within the lining of the cervix. Human papilloma virus (HPV) infection is the primary cause behind the majority of cervical cancers, and modern vaccinations are offered as a preventative measure against HPV, which can prevent cervical cancer.
Infection of the female genitalia with HPV is a well known cause of cervical cancer, and can result in a wide array of potential symptoms. The most common symptoms of HPV infection and cervical cancer are vaginal discharge, pelvic pain, postcoital bleeding, and dyspareunia. In some cases, however, the infection may be asymptomatic.
The potential complications of cervicitis, which is an infection of the cervix, can be severe. Pelvic inflammatory disease is a serious complication, and the potential blockage of mucus ducts and cyst formation increases the hostile environment for sperm, thus increasing the risk of infertility.
Vaccinations against the virus can help prevent cervical cancer, and may be available depending on the individual's age and other factors. Vaccines against HPV exist, and are a form of preventative measure to help reduce the rate of HPV infection, and thus, reduce the rate of cervical cancer.
Overall, understanding the risks of cervical cancer and the importance of preventive measures such as vaccination are key for women to stay healthy. It is important for healthcare providers to be knowledgeable and aware of the risks posed by HPV, and the potential for cervical cancer.
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