Biology of Human

Uterus
BY

S R I V I D YA H

MIRM MAHE
Gross anatomy
The uterus or womb
 Major female hormone responsive organ of the
female reproductive system.​
 Pelvis between the bladder & rectum.​
 Measures around 7cm length,5cm breadth & 2-
5cm thickness.
 Receives developing embryo from the uterine
tube.​
 Embryonic & fetal development occurs within
https://my.clevelandclinic.org/health/diseases/16408-uterine-sarcoma
the uterus.

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 Development of uterus
The reproductive system in an embryo develops after
6 weeks of fertilization.
It primarily gives rise to mesonephric duct (Mullerian ducts),
which later fuses to give out fallopian tube & uterus.
the development of these ducts is due to the absence of anti-
Mullerian hormone.
 At eight weeks gestation, the paramesonephric ducts fuse
vertically.
The fused cranial and horizontal ends will give rise to what will
ultimately become the fallopian tubes, while the caudal component
will fuse to form the uterus, cervix, and upper third of the vagina.
The uterine corpus remains underdeveloped at birth and reaches
https://www.invitra.com/en/uterine-malformations/uterus/
functional and anatomical maturity at the time of menarche
The adult human matured non pregnant
uterus is a hollow and thick-walled organ.
Anatomically organ is divided into three
regions:
 Fundus-dome shaped structure
 Body-the expanded portion
 Cervix-cylindrical in shape, that connects to
vagina

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Uterus Support Structure

Broad Ligament: The broad ligament is a flat sheet of

peritoneum, associated with the uterus, fallopian
tubes and ovaries. It extends from the lateral pelvic
walls on both sides, and folds over the internal
female genitalia, covering their surface anteriorly and
posteriorly.
Round Ligament: Originates at uterine horns to the
labia majora via the inguinal canal. It functions to
maintain the anteverted position of the uterus.
Ovarian Ligament: Joins the ovaries to the uterus.
Uterine Vasculature

The uterine artery is the main blood supply to the uterus, with some
collateral supply from the ovarian artery.
 Histological features of Uterus

https://instruction.cvhs.okstate.edu/Histology/HistologyReference/HRFemaleRS.htm

 Made up of three histologically distinct layers- https://www.austincc.edu/apreview/PhysText/Reproductive.html

Endometrium, myometrium & the perimetrium.

 Each of these layers are made up of different kinds of cells that line them up.
 The outermost layer –Perimetrium
 The middle layer – Myometrium- Smooth muscle cells.
 Innermost-Endometrium – columnar epithelium cells present on stroma

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Perimetrium
The perimetrium is the outer serous layer of the uterus.
Made up of Squamous epithelium and connective tissue beneath it.
The serous layer secretes a lubricating fluid that helps to reduce friction.
The perimetrium is also part of the peritoneum that covers some of the organs
of the pelvis
Endometrium
The endometrium (uterine mucous membrane)
is lined with simple columnar epithelium
 (lamina epithelialis)
It contains numerous tubular glands.
thickness of the layer changes according to the
phase of menstrual cycle.
 It is followed by a cell-rich connective tissue
layer (lamina propria).
Physiologically the endometrium is divided
into the functional layer (stratum functionale)
and basal layer (stratum basale).
 Bulk of the uterine wall​
Myometrium Forms a thick coat about 15-20mm
in depth.​
Consists of bundle of smooth
muscle cells separated
by thin strands of connective tissue
that
contains fibroblasts, collagenous and
reticular fibers, mast
cells and macrophages​
Has three layers of smooth muscle
fibers that extended in all directions,
longitudinally, transversely and
obliquely and give the uterus
strength. ​( Kevin T. Patton, 2015)

•https://embryology.med.unsw.edu.au/embryology/index.php/Smooth_Muscle_Histolo
gy https://www.dartmouth.edu/~anatomy/Histo/lab_
2/muscle/DMS080/popup.html 10
 Physiological unit of contraction in the uterine muscles are smooth muscles
Uterine individually.
 These muscles are of irregular shape, the size ranges between 5 – 10 um in
smooth diameter and 300- 600 um in length

muscle During the gestation the consecutive process of hypertrophy occur, which is
followed by hyperplasia in smooth muscles of uterus.
Till the end of the gestation period 3-5 folds of hypertrophy is seen.
The size of smooth muscles cells changes according to the changing species
 In comparison to murine species the size of human uterus is found to be large
 Ultrastructure of Smooth Muscle:
• actin and myosin filaments
• intermediate filaments of desmin (also vimentin in vascular smooth muscle)
• membrane associated and cytoplasmic dense bodies containing  actinin (similar to Z lines)
• relatively active nucleus (smooth muscle cells make collagen, elastin, and proteoglycans)
 Smooth
Muscle
Viewed in
Cross Section
(TEM)

SMC secrete ECM:

collagen (I,III, IV),
elastin, and
proteoglycans
*
*
 Smooth Muscle Contraction:
also Ca+ dependent, but mechanism is different than striated muscle
1. Ca2+ ions released from caveloae/SER and complex with calmodulin

2. Ca2+-calmodulin activates myosin light chain kinase

3. MLCK phosphorylates myosin light chain
4. Myosin unfolds & binds actin; ATP-dependent contraction
cycle ensues.
5. Contraction continues as long as myosin is phosphorylated.
6. “Latch” state: myosin head attached to actin dephosphorylated
Causing decrease in ATPase activity –myosin head unable
to detach from actin.
7. Smooth muscle cells often electrically coupled via gap
8. junctions

Triggered by:
• Voltage-gated Ca+ channels activated by depolarization
• Mechanical stimuli
• Neural stimulation
• Ligand-gated Ca+ channels
Function
The uterus carries out many functions:
Implantation site of the blastocyst
Provides protection and support for the fetus to grow
Site of menstruation
Pathological
States
 
of Uterus Fibroids

Congenital
Adenomyosis Anomalies of
female genital
tract

Endometritis Asherman’s
Syndrome

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Congenital
anomalies
of Uterus
 Uterine Fibroids
A fibroid is a benign tumour of uterine smooth muscle,
termed a leiomyoma
Current theory : Neoplastic transformation from normal
myometrium to leiomyoma is the result of a somatic mutation
in the single progenitor cell affecting cytokines that affect
cell growth. The growth may be influenced by estrogen and
progesterone levels
Most common symptoms are pain including dysmenorrhea,
menorraghea, sub fertility, malpresentation and postpartum
haemorrhage
 Asherman’s
Syndrome
When the endometrium has been damaged in particular
when it has been removed down to or beyond the basal
layer, normal regeneration does not occur, instead there
is fibrosis and adhesion formation
Consequence of excessive curettage, especially for
retained placental tissue or miscarriage or secondary
postpartum hemorrahage
Some of the clinical presentations are Amnorrahea,
dysmenorrhea, infertility
 Endometritis
Endometritis is an inflammation or irritation of the lining of the uterus
(the endometrium).
It can affect all layers of the uterus.
 The uterus is typically aseptic. However, the travel of microbes from the
cervix and vagina can lead to inflammation and infection.
Causes
Endometritis is caused by an infection in the uterus. It can be due to
chlamydia, gonorrhea, tuberculosis, or a mix of normal vaginal bacteria. It
is more likely to occur after miscarriage or childbirth. It is also more
common after a long labor or C-section.
Adenomyosis
Defined as presence of nests of benign
endometrial glands and stroma within the
myometrium, deep in the wall of uterus.
 It leads to uterine enlargement and irregular
thickening of uterine wall
Possible cause- metaplasia or estrogenic
stimulation due to endocrine dysfunction of ovary
Clinical presentations are Menorrhagia,
dysmenorrhea and menstrual pain in the sacral
regions
Treatment Strategies
The defective uterus is the cause of obstetric complications. Recurrent pregnancy loss, preterm labour, abnormal menstruation, abnormal foetal presentation all these leads to
Absolute Uterine Factor Infertility.

CONVENTIONAL STRATEGIES NEW GENERATION STRATEGIES

Organ Transplantation
Mechanical barriers
Medical Balloon Uterine Stent
Medication to control​
 symptoms and to shrink
fibroids
Myomectomy
Hysterectomy Tissue Engineering

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Thank you