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By Catrina Bain MBChB MRCOG, Kevin Burton MD MRCOG, Jay McGavigan MBBS MD MRCOG FRANZCOG

This can be a visible presentation of Gynaecology geared toward undergraduate clinical scholars. The powerful structure is perfect for exam guidance. every one web page covers one subject with concise textual content and linked diagrams. formerly less than the authorship of Hart and Norman, the hot writer has comprehensively revised the 6th variation of this very hot scholar textual content. The titles within the illustrated sequence are valued through scholars due to their visible presentation of knowledge and are relatively powerful for exam arrangements. For the extra conventional classes this ebook will fulfil the function of a direction textual content; for problem-based classes it is going to be a very good source for problem-solving workouts

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Secretory Phase Following ovulation, the corpus luteum produces large quantities of progesterone, which induce secretory changes in the glands and swelling of the stromal cells. There is a rich blood supply, and the capillaries become sinusoidal. Menstruation Towards the end of the 28-day cycle, the stroma becomes even more vascular and oedematous, small haemorrhages and thrombi appear, and the endometrium ultimately breaks down due to withdrawal of the hormonal support. Vessel necrosis is preceded by intense vasospasm, possibly stimulated by prostaglandin F2-a.

The tube has a lining of ciliated cells interspersed with non-ciliated secretory cells (‘peg’ cells). There is little or no submucosa. The epithelium is arranged in a complex pattern of plications, which becomes more marked as the outer end is approached. 32 ANATOMY OF THE REPRODUCTIVE TRACT BROAD LIGAMENT BLOOD VESSELS Fallopian tube There is an anastomosis between the uterine and ovarian arteries, and the fallopian tube is supplied by vessels in an arcade pattern (cf. bowel). Anastomosis Uterine vessels Ovarian vessels VESTIGIAL STRUCTURES The epoo¨phoron and the paroo¨phoron are remnants of the mesonephros, and the duct (Gartner’s duct) is the vestige of the mesonephric duct, which passes into the uterine muscle about the level of the internal os and continues downwards in the vaginal wall.

There is an additional sympathetic supply by the nerves accompanying the ovarian vessels. The function of the autonomic nerves is not understood. The cervix or vagina may be grasped by forceps in some patients with only minimal sensation, and a uterine sound or intrauterine contraceptive device in the uterine cavity may only cause a vague ‘visceral’ discomfort. However, there are cases where cervical stretch at a procedure or during passage of a clot causes vasovagal symptoms, and on occasion collapses.

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