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Cervix

1950

Measures 2.5-3 cm in diameter and 3-5 cm in length.

The cervix is angulated downward and backward.

Projects into the vagina with the opening of the cervical canal into the vagina, the external os.

External os is small, round in nulliparous women but can be slit like in patients who have had cervical dilation during labor.

The cervical canal measures approximately 8 mm wide and contains longitudinal ridges.

The opening of the cervix into the uterus is called the internal cervical os.

The lower uterine segment is the area between the endocervical and endometrial cavity.

Lmphatic drainage is to the parametrical nodes, and then to the obturator, internal iliac and external iliac nodes.

Secondary lymphatic drainage is to the presacral, common iliac and para-aortic lymph nodes.

Is continuous with the body of the uterus but its mucosa does not undergo cyclic desquamation.

Has regular changes in cervical mucus.

Estrogen makes cervical mucus thinner and more alkaline to promote the survival and transport of sperm.

Progesterone makes cervical mucus thicker, tenacious and more cellular.

Mucus is thinnest at the time of ovulation, and its elasticity increases at midcycle.

Mucus elasticity is ref2242ed to as spinnbarkeit, and elasticity during midcycle is such that a drop of mucus can be stretched into a long thread up to 8-12 cm in length.

When cervical mucus dries a thin layer appears as an arborizing, fern-like pattern.

Following ovulation and during pregnancy cervical mucus becomes thick and does not form the fern pattern.

Visualization of the cervix is straightforward in most patients, but in nulliparous or postmenopausal women, those with retroverted uterus with anterior displacement, those with prior vaginal surgery, a full bladder, constipation, uterine enlargement, a pelvic mass, pelvic scarring, or high body mass index may have impaired examination.

Cervical myomas are solid smooth muscle masses that arise from the lower uterine segment and can protrude through the cervical os and become ulcerated, infected and expand to cause pressure symptoms, urinary obstructive symptoms and cervical obstruction.

Cervical myomas may be associated with menorrhagia or dysmenorrhea.

Cervical myomas can be observed for rate of growth if asymptomatic, or the patient could undergo hysterectomy for enlarging or symptomatic lesions.

Cervical ectropion, or erosion, can occur when the endocervix exposes columnar epithelium to vaginal secretions. Is

Cervical erosion gives a reddish appearance and is common in adolescents, pregnancy and women taking estrogen containing contraceptives.

Cervical ectropion is most commonly associated with vaginal discharge, and postcoital bleeding may occur.

Cervical ectropion rarely requires treatment, but with excessive mucus and spotting cryotherapy or electro-cautery may be employed.

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