Function The uterus provides structural integrity and support to the bladder, bowel, pelvic bones and organs.

The uterus helps separate and keep the bladder in its natural position above the pubic bone and the bowel in its natural configuration behind the uterus. The uterus is continuous with the cervix, which is continuous with the vagina, much in the way that the head is continuous with the neck, which is continuous with the shoulders. It is attached to bundles of nerves, and networks of arteries and veins, and broad bands of ligaments such as round ligaments, cardinal ligaments, broad ligaments, and uterosacral ligaments. The uterus is essential in sexual response by directing blood flow to the pelvis and to the external genitalia, including the ovaries, vagina, labia, and clitoris. The uterus is needed for uterine orgasm to occur. The reproductive function of the uterus is to accept a fertilized ovum which passes through the utero-tubal junction from the fallopian tube. It then becomes implanted into theendometrium, and derives nourishment from blood vessels which develop exclusively for this purpose. The fertilized ovum becomes an embryo, attaches to a wall of the uterus, creates a placenta, and develops into a fetus (gestates) until childbirth. Due to anatomical barriers such as the pelvis, the uterus is pushed partially into the abdomen due to its expansion during pregnancy. Even during pregnancy the mass of a human uterus amounts to only about a kilogram (2.2 pounds). Anatomy The uterus is located inside the pelvis immediately dorsal (and usually somewhat rostral) to the urinary bladder and ventral to the rectum. The human uterus is pear-shaped and about 3 in. (7.6 cm) long. A female's uterus can be divided anatomically into four segments: The fundus, corpus, cervix and the internal os. Regions From outside to inside, the path to the uterus is as follows:

Cervix uteri - "neck of uterus"

External orifice of the uterus Canal of the cervix Internal orifice of the uterus

corpus uteri - "Body of uterus"

Cavity of the body of the uterus Fundus (uterus)

The cervix is the lower most part of the uterus and is made up of strong muscles. It also provides support to the uterus due to attachment of muscles from the pelvic bone. The cervix protrudes and opens through a canal into the vagina. The function of the cervix is to allow flow of menstrual blood from the uterus into the vagina, and direct the sperms into the uterus during intercourse. The opening of the cervical canal is normally very narrow. However under the influence of the body hormones and the pressure from the fetal head, this opening widens to about 4 inches (10 cm.) during labor, to allow the birth of a baby. If the opening is loose, as observed in some women, it can lead to miscarriages during pregnancy. I. Columnar Epithelium Landmarks (Uterus) Endocervical canal Columnar epithelium villi Ectropion Eversion of columnar epithelium onto ectocervix

Appears like an Erosion

II. Transitional Landmarks (Squamous Metaplasia) Transformation Zone True Squamocolumnar junction Upper or proximal limit of squamous metaplasia Usually not visualized I. Original Squamocolumnar Junction Squamous epithelium Ectocervix Within endocervical canal Approximately 3 cm from observed SCJ Immature Squamous metaplasia From True (proximal) to Original (distal) SCJ Where premalignant changes and neoplasia occur Encompasses Immature and mature squamous metaplasia

Observed Squamocolumnar Junction

Squamous Epithelium Landmarks (Vagina) Mature squamous metaplasia

Nabothian cysts/follicles are in this area