The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the
uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...
(womb) in the
human female reproductive system
The female reproductive system is made up of the internal and external sex organs that function in the reproduction of new offspring. In humans, the female reproductive system is immature at birth and develops to maturity at puberty to be abl ...
. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during
pregnancy
Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.
Pregnancy usually occurs by sexual intercourse, but ca ...
. The narrow, central
cervical canal
The cervical canal is the spindle-shaped, flattened canal of the cervix, the neck of the uterus.
Anatomy
The cervical canal communicates with the uterine cavity via the internal orifice of the uterus (or internal os) and with the vagina via the ...
runs along its entire length, connecting the
uterine cavity
The uterine cavity is the inside of the uterus. It is triangular in shape, the base (broadest part) being formed by the internal surface of the body of the uterus between the openings of the fallopian tubes, the apex by the internal orifice of the ...
and the
lumen of the
vagina
In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...
. The opening into the uterus is called the
internal os, and the opening into the vagina is called the
external os
The cervical canal is the spindle-shaped, flattened canal of the cervix, the neck of the uterus.
Anatomy
The cervical canal communicates with the uterine cavity via the internal orifice of the uterus (or internal os) and with the vagina via the ...
. The lower part of the cervix, known as the vaginal portion of the cervix (or ectocervix), bulges into the top of the vagina. The cervix has been documented anatomically since at least the time of
Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
, over 2,000 years ago.
The cervical canal is a passage through which
sperm
Sperm is the male reproductive cell, or gamete, in anisogamous forms of sexual reproduction (forms in which there is a larger, female reproductive cell and a smaller, male one). Animals produce motile sperm with a tail known as a flagellum, whi ...
must travel to fertilize an
egg cell
The egg cell, or ovum (plural ova), is the female reproductive cell, or gamete, in most anisogamous organisms (organisms that reproduce sexually with a larger, female gamete and a smaller, male one). The term is used when the female gamete is ...
after sexual intercourse. Several methods of contraception, including
cervical cap
The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the ''os''.
Terminology
The term ''cervical cap'' has been ...
s and
cervical diaphragms, aim to block or prevent the passage of sperm through the cervical canal. Cervical mucus is used in several methods of fertility awareness, such as the
Creighton model
The Creighton Model FertilityCare System (Creighton Model'', ''FertilityCare, CrMS) is a form of natural family planning which involves identifying the fertile period during a woman's menstrual cycle. The Creighton Model was developed by Thomas Hi ...
and
Billings method, due to its changes in consistency throughout the
menstrual period
The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs ...
. During vaginal
childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
, the cervix must flatten and
dilate
Dilation (or dilatation) may refer to:
Physiology or medicine
* Cervical dilation, the widening of the cervix in childbirth, miscarriage etc.
* Coronary dilation, or coronary reflex
* Dilation and curettage, the opening of the cervix and surgic ...
to allow the
fetus
A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal deve ...
to progress along the birth canal. Midwives and doctors use the extent of the
dilation of the cervix to assist decision-making during childbirth.
The cervical canal is lined with a single
layer of column-shaped cells, while the ectocervix is covered with
multiple layers of cells topped with flat cells. The two types of
epithelia
Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellula ...
meet at the squamocolumnar junction. Infection with the
human papillomavirus
Human papillomavirus infection (HPV infection) is caused by a DNA virus from the ''Papillomaviridae'' family. Many HPV infections cause no symptoms and 90% resolve spontaneously within two years. In some cases, an HPV infection persists and res ...
(HPV) can cause changes in the epithelium, which can lead to
cancer of the cervix.
Cervical cytology tests can often detect cervical cancer and its precursors, and enable early successful treatment. Ways to avoid HPV include avoiding sex, using condoms, and
HPV vaccination. HPV vaccines, developed in the early 21st century, reduce the risk of cervical cancer by preventing infections from the main cancer-causing strains of HPV.
Structure
![Gray1167](https://upload.wikimedia.org/wikipedia/commons/f/f7/Gray1167.svg)
The cervix is part of the
female reproductive system
The female reproductive system is made up of the internal and external sex organs that function in the reproduction of new offspring. In humans, the female reproductive system is immature at birth and develops to maturity at puberty to be able ...
. Around in length,
[ it is the lower narrower part of the uterus continuous above with the broader upper part—or body—of the uterus.][ The lower end of the cervix bulges through the anterior wall of the vagina, and is referred to as the ]vaginal portion of cervix
The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during ...
(or ectocervix) while the rest of the cervix above the vagina is called the supravaginal portion of cervix.[ A central canal, known as the ]cervical canal
The cervical canal is the spindle-shaped, flattened canal of the cervix, the neck of the uterus.
Anatomy
The cervical canal communicates with the uterine cavity via the internal orifice of the uterus (or internal os) and with the vagina via the ...
, runs along its length and connects the cavity of the body of the uterus with the lumen of the vagina.[ The openings are known as the internal os and ]external orifice of the uterus
The cervical canal is the spindle-shaped, flattened canal of the cervix, the neck of the uterus.
Anatomy
The cervical canal communicates with the uterine cavity via the internal orifice of the uterus (or internal os) and with the vagina via the ...
(or external os), respectively.[ The mucosa lining the cervical canal is known as the ]endocervix
The cervical canal is the spindle-shaped, flattened canal of the cervix, the neck of the uterus.
Anatomy
The cervical canal communicates with the uterine cavity via the internal orifice of the uterus (or internal os) and with the vagina via the ...
, and the mucosa covering the ectocervix is known as the exocervix. The cervix has an inner mucosal layer, a thick layer of smooth muscle
Smooth muscle is an involuntary non-striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit mus ...
, and posteriorly the supravaginal portion has a serosal
The serous membrane (or serosa) is a smooth membrane, tissue membrane of mesothelium lining the contents and inner walls of body cavity, body cavities, which secrete serous fluid to allow lubricated sliding (motion), sliding movements between op ...
covering consisting of connective tissue and overlying peritoneum
The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesoth ...
.[
]
In front of the upper part of the cervix lies the bladder
The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...
, separated from it by cellular connective tissue known as parametrium
The parametrium is the fibrous and fatty connective tissue that surrounds the uterus. This tissue separates the supravaginal portion of the cervix from the bladder. The parametrium lies in front of the cervix and extends laterally between the la ...
, which also extends over the sides of the cervix. To the rear, the supravaginal cervix is covered by peritoneum, which runs onto the back of the vaginal wall and then turns upwards and onto the rectum
The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...
, forming the recto-uterine pouch
The rectouterine pouch (recto-uterine pouch), pouch of Douglas, or rectovaginal pouch is the extension of the peritoneum between the rectum and the posterior wall of the uterus in the human female. Its anterior boundary is formed by the posterior f ...
.[ The cervix is more tightly connected to surrounding structures than the rest of the uterus.]
The cervical canal varies greatly in length and width between women or over the course of a woman's life, and it can measure 8 mm (0.3 inch) at its widest diameter in premenopausal
Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often d ...
adults.[ It is wider in the middle and narrower at each end. The anterior and posterior walls of the canal each have a vertical fold, from which ridges run diagonally upwards and laterally. These are known as ''palmate folds'', due to their resemblance to a palm leaf. The anterior and posterior ridges are arranged in such a way that they interlock with each other and close the canal. They are often effaced after pregnancy.]
The ectocervix (also known as the vaginal portion of the cervix) has a convex, elliptical shape and projects into the cervix between the anterior and posterior vaginal fornices
The fornices of the vagina (sing. fornix of the vagina or fornix vaginae) are the superior portions of the vagina, extending into the recesses created by the vaginal portion of cervix. The word "fornix" is Latin for "arch".
Structure
There are t ...
. On the rounded part of the ectocervix is a small, depressed external opening, connecting the cervix with the vagina. The size and shape of the ectocervix and the external opening (external os) can vary according to age, hormonal state, and whether natural or normal childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
has taken place. In women who have not had a vaginal delivery, the external opening is small and circular, and in women who have had a vaginal delivery, it is slit-like. On average, the ectocervix is long and wide.
Blood is supplied to the cervix by the descending branch of the uterine artery
The uterine artery is an artery that supplies blood to the uterus in females.
Structure
The uterine artery usually arises from the anterior division of the internal iliac artery. It travels to the uterus, crossing the ureter anteriorly, to the ute ...
and drains into the uterine vein
The uterine vein is a vein of the uterus. It is found in the cardinal ligament. It drains into the internal iliac vein. It follows a similar course to the uterine artery. It helps to drain blood from the uterus, and removes waste from blood in th ...
. The pelvic splanchnic nerves
Pelvic splanchnic nerves or nervi erigentes are splanchnic nerves that arise from sacral spinal nerves S2, S3, S4 to provide parasympathetic innervation to the organs of the pelvic cavity.
Structure
The pelvic splanchnic nerves arise from t ...
, emerging as S2– S3, transmit the sensation of pain from the cervix to the brain. These nerves travel along the uterosacral ligament
The uterosacral ligaments (or rectouterine ligaments) belong to the major ligaments of uterus.
Structure
The rectouterine folds contain a considerable amount of fibrous tissue and non-striped muscular fibers which are attached to the front of the ...
s, which pass from the uterus to the anterior sacrum
The sacrum (plural: ''sacra'' or ''sacrums''), in human anatomy, is a large, triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30.
The sacrum situates at the upper, back part ...
.
Three channels facilitate lymphatic drainage
The lymphatic system, or lymphoid system, is an organ system in vertebrates that is part of the immune system, and complementary to the circulatory system. It consists of a large network of lymphatic vessels, lymph nodes, lymphatic or lymphoid o ...
from the cervix. The anterior and lateral cervix drains to nodes
In general, a node is a localized swelling (a "knot") or a point of intersection (a Vertex (graph theory), vertex).
Node may refer to:
In mathematics
*Vertex (graph theory), a vertex in a mathematical graph
*Vertex (geometry), a point where two ...
along the uterine arteries, travelling along the cardinal ligament
The cardinal ligament (or Mackenrodt's ligament, lateral cervical ligament, or transverse cervical ligament) is a major ligament of the uterus. It is located at the base of the broad ligament of the uterus. There are a pair of cardinal ligaments i ...
s at the base of the broad ligament
The broad ligament of the uterus is the wide fold of peritoneum that connects the sides of the uterus to the walls and floor of the pelvis.
Structure
Subdivisions
Contents
The contents of the broad ligament include the following:
* Reproduc ...
to the external iliac lymph nodes
The external iliac lymph nodes are lymph nodes, from eight to ten in number, that lie along the external iliac vessels.
They are arranged in three groups, one on the lateral, another on the medial, and a third on the anterior aspect of the vessel ...
and ultimately the paraaortic lymph node
The periaortic lymph nodes (also known as lumbar) are a group of lymph nodes that lie in front of the lumbar vertebrae near the aorta. These lymph nodes receive drainage from the gastrointestinal tract and the abdominal organs.
The periaortic ly ...
s. The posterior and lateral cervix drains along the uterine arteries to the internal iliac lymph nodes
The internal iliac lymph nodes (or hypogastric) surround the internal iliac artery and its branches (the ''hypogastric vessels''), and receive the lymphatics corresponding to the distribution of the branches of it, i. e., they receive lymphatics fr ...
and ultimately the paraaortic lymph nodes
The periaortic lymph nodes (also known as lumbar) are a group of lymph nodes that lie in front of the lumbar vertebrae near the aorta. These lymph nodes receive drainage from the gastrointestinal tract and the abdominal organs.
The periaortic lymp ...
, and the posterior section of the cervix drains to the obturator and presacral lymph node
A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that inclu ...
s. However, there are variations as lymphatic drainage from the cervix travels to different sets of pelvic nodes in some people. This has implications in scanning nodes for involvement in cervical cancer.[
After ]menstruation
Menstruation (also known as a period, among other colloquial terms) is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hor ...
and directly under the influence of estrogen
Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal acti ...
, the cervix undergoes a series of changes in position and texture. During most of the menstrual cycle, the cervix remains firm, and is positioned low and closed. However, as ovulation
Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized ...
approaches, the cervix becomes softer and rises to open in response to the higher levels of estrogen present. These changes are also accompanied by changes in cervical mucus,[ described below.
]
Development
As a component of the female reproductive system
The reproductive system of an organism, also known as the genital system, is the biological system made up of all the anatomical organs involved in sexual reproduction. Many non-living substances such as fluids, hormones, and pheromones are als ...
, the cervix is derived from the two paramesonephric duct
Paramesonephric ducts (or Müllerian ducts) are paired ducts of the embryo that run down the lateral sides of the genital ridge and terminate at the sinus tubercle in the primitive urogenital sinus. In the female, they will develop to form the fal ...
s (also called Müllerian ducts), which develop around the sixth week of embryogenesis
An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male sperm ...
. During development, the outer parts of the two ducts fuse, forming a single urogenital
The genitourinary system, or urogenital system, are the organs of the reproductive system and the urinary system. These are grouped together because of their proximity to each other, their common embryological origin and the use of common pathwa ...
canal that will become the vagina
In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...
, cervix and uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...
. The cervix grows in size at a smaller rate than the body of the uterus, so the relative size of the cervix over time decreases, decreasing from being much larger than the body of the uterus in fetal life, twice as large during childhood, and decreasing to its adult size, smaller than the uterus, after puberty. Previously it was thought that during fetal development, the original squamous epithelium of the cervix is derived from the urogenital sinus
The urogenital sinus is a part of the human body only present in the development of the urinary and reproductive organs. It is the ventral part of the cloaca, formed after the cloaca separates from the anal canal during the fourth to seventh we ...
and the original columnar epithelium is derived from the paramesonephric duct. The point at which these two original epithelia meet is called the original squamocolumnar junction. New studies show, however, that all the cervical as well as large part of the vaginal epithelium
The vaginal epithelium is the inner lining of the vagina consisting of multiple layers of (squamous) cells. The basal membrane provides the support for the first layer of the epithelium-the basal layer. The intermediate layers lie upon the basal ...
are derived from Müllerian duct tissue and that phenotypic differences might be due to other causes.
Histology
The endocervical mucosa is about thick and lined with a single layer of columnar mucous cells. It contains numerous tubular mucous glands, which empty viscous alkaline mucus into the lumen.[ In contrast, the ectocervix is covered with nonkeratinized stratified squamous epithelium,][ which resembles the squamous epithelium lining the vagina.][ The junction between these two types of epithelia is called the squamocolumnar junction.] Underlying both types of epithelium is a tough layer of collagen
Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
. The mucosa of the endocervix is not shed during menstruation. The cervix has more fibrous tissue, including collagen and elastin
Elastin is a protein that in humans is encoded by the ''ELN'' gene. Elastin is a key component of the extracellular matrix in gnathostomes (jawed vertebrates). It is highly elastic and present in connective tissue allowing many tissues in the bod ...
, than the rest of the uterus.[
File:Cervix Normal Squamocolumnar Junction (565238127).jpg, The squamocolumnar junction of the cervix, with abrupt transition: The ectocervix, with its stratified squamous epithelium, is visible on the left. Simple columnar epithelium, typical of the endocervix, is visible on the right. A layer of ]connective tissue
Connective tissue is one of the four primary types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tiss ...
is visible under both types of epithelium.
File:Transformation zone types.png, Transformation zone types:
Type 1: Completely ectocervical (common under hormonal influence).
Type 2: Endocervical component but fully visible (common before puberty).
Type 3: Endocervical component, not fully visible (common after menopause).
In prepubertal
Preadolescence is a stage of human development following middle childhood and preceding adolescence.New Oxford American Dictionary. 2nd Edition. 2005. Oxford University Press. It commonly ends with the beginning of puberty. Preadolescence is c ...
girls, the functional squamocolumnar junction is present just within the cervical canal.[ Upon entering puberty, due to hormonal influence, and during pregnancy, the columnar epithelium extends outward over the ectocervix as the cervix everts.][ Hence, this also causes the squamocolumnar junction to move outwards onto the vaginal portion of the cervix, where it is exposed to the acidic vaginal environment.][ The exposed columnar epithelium can undergo physiological ]metaplasia
Metaplasia ( gr, "change in form") is the transformation of one differentiated cell type to another differentiated cell type. The change from one type of cell to another may be part of a normal maturation process, or caused by some sort of abno ...
and change to tougher metaplastic squamous epithelium in days or weeks,[ which is very similar to the original squamous epithelium when mature.][ The new squamocolumnar junction is therefore internal to the original squamocolumnar junction, and the zone of unstable epithelium between the two junctions is called the ''transformation zone'' of the cervix.][ Histologically, the transformation zone is generally defined as surface squamous epithelium with surface columnar epithelium or stromal glands/crypts, or both.][ ]
After menopause, the uterine structures involute and the functional squamocolumnar junction moves into the cervical canal.[
]Nabothian cyst
A nabothian cyst (or nabothian follicle) is a mucus-filled cyst on the surface of the cervix. They are most often caused when stratified squamous epithelium of the ectocervix (portion nearest to the vagina) grows over the simple columnar epithe ...
s (or Nabothian follicles) form in the transformation zone where the lining of metaplastic epithelium has replaced mucous epithelium and caused a strangulation of the outlet of some of the mucous glands.[ A buildup of mucus in the glands forms Nabothian cysts, usually less than about in diameter,][ which are considered physiological rather than pathological.][ Both gland openings and Nabothian cysts are helpful to identify the transformation zone.][
]
Function
Fertility
The cervical canal is a pathway through which sperm enter the uterus after being induced by estradiol
Estradiol (E2), also spelled oestradiol, is an estrogen steroid hormone and the major female sex hormone. It is involved in the regulation of the estrous and menstrual female reproductive cycles. Estradiol is responsible for the development of f ...
after sexual intercourse, and some forms of artificial insemination
Artificial insemination is the deliberate introduction of sperm into a female's cervix or uterine cavity for the purpose of achieving a pregnancy through in vivo fertilization by means other than sexual intercourse. It is a fertility treatme ...
. Some sperm remains in cervical crypts, infoldings of the endocervix, which act as a reservoir, releasing sperm over several hours and maximising the chances of fertilisation. A theory states the cervical and uterine contractions during orgasm
Orgasm (from Greek , ; "excitement, swelling") or sexual climax is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic, involuntary muscular contractions in the pelvic region charac ...
draw semen into the uterus. Although the "upsuck theory" has been generally accepted for some years, it has been disputed due to lack of evidence, small sample size, and methodological errors.
Some methods of fertility awareness
Fertility awareness (FA) refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gynec ...
, such as the Creighton model
The Creighton Model FertilityCare System (Creighton Model'', ''FertilityCare, CrMS) is a form of natural family planning which involves identifying the fertile period during a woman's menstrual cycle. The Creighton Model was developed by Thomas Hi ...
and the Billings method involve estimating a woman's periods of fertility and infertility by observing physiological changes in her body. Among these changes are several involving the quality of her cervical mucus: the sensation it causes at the vulva, its elasticity ('' Spinnbarkeit''), its transparency, and the presence of ferning.
Cervical mucus
Several hundred glands in the endocervix produce 20–60 mg of cervical mucus
Mucus ( ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It is ...
a day, increasing to 600 mg around the time of ovulation. It is viscous because it contains large proteins known as mucin
Mucins () are a family of high molecular weight, heavily glycosylated proteins (glycoconjugates) produced by epithelial tissues in most animals. Mucins' key characteristic is their ability to form gels; therefore they are a key component in most ...
s. The viscosity and water content varies during the menstrual cycle
The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs a ...
; mucus is composed of around 93% water, reaching 98% at midcycle. These changes allow it to function either as a barrier or a transport medium to spermatozoa. It contains electrolytes such as calcium, sodium, and potassium; organic components such as glucose, amino acids, and soluble proteins; trace elements including zinc, copper, iron, manganese, and selenium; free fatty acids; enzymes such as amylase
An amylase () is an enzyme that catalyses the hydrolysis of starch (Latin ') into sugars. Amylase is present in the saliva of humans and some other mammals, where it begins the chemical process of digestion. Foods that contain large amounts of ...
; and prostaglandins
The prostaglandins (PG) are a group of physiologically active lipid compounds called eicosanoids having diverse hormone-like effects in animals. Prostaglandins have been found in almost every tissue in humans and other animals. They are derive ...
. Its consistency is determined by the influence of the hormones estrogen and progesterone. At midcycle around the time of ovulation
Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized ...
—a period of high estrogen levels— the mucus is thin and serous to allow sperm to enter the uterus and is more alkaline and hence more hospitable to sperm. It is also higher in electrolytes, which results in the "ferning" pattern that can be observed in drying mucus under low magnification; as the mucus dries, the salts crystallize, resembling the leaves of a fern.[ The mucus has a stretchy character described as ''Spinnbarkeit'' most prominent around the time of ovulation.]
At other times in the cycle, the mucus is thick and more acidic due to the effects of progesterone. This "infertile" mucus acts as a barrier to keep sperm from entering the uterus. Women taking an oral contraceptive pill Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control.
Female
Two types of female oral contraceptive pill, taken once per day, are widely available:
* The combin ...
also have thick mucus from the effects of progesterone. Thick mucus also prevents pathogen
In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...
s from interfering with a nascent pregnancy.
A cervical mucus plug A cervical mucus plug (operculum) is a plug that fills and seals the cervical canal during pregnancy. It is formed by a small amount of cervical mucus.
The mucus plug acts as a protective barrier by deterring the passage of bacteria into the uterus ...
, called the operculum, forms inside the cervical canal during pregnancy. This provides a protective seal for the uterus against the entry of pathogens and against leakage of uterine fluids. The mucus plug is also known to have antibacterial properties. This plug is released as the cervix dilates, either during the first stage of childbirth or shortly before. It is visible as a blood-tinged mucous discharge.
Childbirth
The cervix plays a major role in childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
. As the fetus
A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal deve ...
descends within the uterus in preparation for birth, the presenting part, usually the head, rests on and is supported by the cervix.[ As labour progresses, the cervix becomes softer and shorter, begins to dilate, and withdraws to face the anterior of the body.] The support the cervix provides to the fetal head starts to give way when the uterus begins its contractions. During childbirth, the cervix must dilate to a diameter of more than to accommodate the head of the fetus as it descends from the uterus to the vagina. In becoming wider, the cervix also becomes shorter, a phenomenon known as effacement.
Along with other factors, midwives and doctors use the extent of cervical dilation Cervical dilation (or cervical dilatation) is the opening of the cervix, the entrance to the uterus, during childbirth, miscarriage, induced abortion, or gynecological surgery. Cervical dilation may occur naturally, or may be induced surgically o ...
to assist decision making during childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
.[NICE (2007). Section 1.7, ''Normal labour: second stage''] Generally, the active first stage of labour, when the uterine contractions become strong and regular,[ begins when the cervical dilation is more than . The second phase of labor begins when the cervix has dilated to , which is regarded as its fullest dilation,] and is when active pushing and contractions push the baby along the birth canal
In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen. ...
leading to the birth of the baby. The number of past vaginal deliveries is a strong factor in influencing how rapidly the cervix is able to dilate in labour. The time taken for the cervix to dilate and efface is one factor used in reporting systems such as the Bishop score, used to recommend whether interventions such as a forceps delivery
Obstetrical forceps are a medical instrument used in childbirth. Their use can serve as an alternative to the ventouse (vacuum extraction) method.
Medical uses
Forceps births, like all assisted births, should only be undertaken to help prom ...
, induction
Induction, Inducible or Inductive may refer to:
Biology and medicine
* Labor induction (birth/pregnancy)
* Induction chemotherapy, in medicine
* Induced stem cells, stem cells derived from somatic, reproductive, pluripotent or other cell t ...
, or Caesarean section
Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or mo ...
should be used in childbirth.
Cervical incompetence
Cervical weakness, also called cervical incompetence or cervical insufficiency, is a medical condition of pregnancy in which the cervix begins to dilate (widen) and efface (thin) before the pregnancy has reached term. Definitions of cervical wea ...
is a condition in which shortening of the cervix due to dilation and thinning occurs, before term pregnancy. Short cervical length is the strongest predictor of preterm birth
Preterm birth, also known as premature birth, is the Childbirth, birth of a baby at fewer than 37 weeks Gestational age (obstetrics), gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 we ...
.
Contraception
Several methods of contraception
Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...
involve the cervix. Cervical diaphragms are reusable, firm-rimmed plastic devices inserted by a woman prior to intercourse that cover the cervix. Pressure against the walls of the vagina maintain the position of the diaphragm, and it acts as a physical barrier to prevent the entry of sperm into the uterus, preventing fertilisation
Fertilisation or fertilization (see spelling differences), also known as generative fertilisation, syngamy and impregnation, is the fusion of gametes to give rise to a new individual organism or offspring and initiate its development. Proce ...
. Cervical cap
The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the ''os''.
Terminology
The term ''cervical cap'' has been ...
s are a similar method, although they are smaller and adhere to the cervix by suction. Diaphragms and caps are often used in conjunction with spermicide
Spermicide is a contraceptive substance that destroys sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicid ...
s. In one year, 12% of women using the diaphragm will undergo an unintended pregnancy, and with optimal use this falls to 6%. Efficacy rates are lower for the cap, with 18% of women undergoing an unintended pregnancy, and 10–13% with optimal use. Most types of progestogen-only pill
Progestogen-only pills or progestin-only pills (POP) are contraceptive pills that contain only synthetic progestogens (progestins) and do not contain estrogen (medication), estrogen. They are colloquially known as mini pills.
Although such pills ...
s are effective as a contraceptive because they thicken cervical mucus, making it difficult for sperm to pass along the cervical canal. In addition, they may also sometimes prevent ovulation.[ In contrast, contraceptive pills that contain both oestrogen and progesterone, the ]combined oral contraceptive pill
The combined oral contraceptive pill (COCP), often referred to as the birth control pill or colloquially as "the pill", is a type of birth control that is designed to be taken orally by women. The pill contains two important hormones: progest ...
s, work mainly by preventing ovulation
Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized ...
.[ They also thicken cervical mucus and thin the lining of the uterus, enhancing their effectiveness.]
Clinical significance
Cancer
In 2008, cervical cancer was the third-most common cancer in women worldwide, with rates varying geographically from less than one to more than 50 cases per 100,000 women. It is a leading cause of cancer-related death in poor countries, where delayed diagnosis leading to poor outcomes is common. The introduction of routine screening has resulted in fewer cases of (and deaths from) cervical cancer, however this has mainly taken place in developed countries. Most developing countries have limited or no screening, and 85% of the global burden occurring there.
Cervical cancer nearly always involves human papillomavirus (HPV) infection.[ HPV is a virus with numerous strains, several of which predispose to precancerous changes in the cervical epithelium, particularly in the transformation zone, which is the most common area for cervical cancer to start.] HPV vaccines
Human papillomavirus (HPV) vaccines are vaccines that prevent infection by certain types of human papillomavirus (HPV). Available HPV vaccines protect against either two, four, or nine types of HPV. All HPV vaccines protect against at least HP ...
, such as Gardasil
Gardasil is an HPV vaccine for use in the prevention of certain strains of human papillomavirus (HPV). Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledge ...
and Cervarix
Cervarix is a vaccine against certain types of cancer-causing human papillomavirus (HPV).
Cervarix is designed to prevent infection from HPV types 16 and 18, that cause about 70% of cervical cancer cases. These types also cause most HPV-induced ...
, reduce the incidence of cervical cancer, by inoculating against the viral strains involved in cancer development.
Potentially precancerous changes in the cervix can be detected by cervical screening
Cervical screening is the process of detecting and removing abnormal tissue or cells in the cervix before cervical cancer develops. By aiming to detect and treat cervical neoplasia early on, cervical screening aims at Preventive healthcare#Seconda ...
, using methods including a Pap smear
The Papanicolaou test (abbreviated as Pap test, also known as Pap smear (AE), cervical smear (BE), cervical screening (BE), or smear test (BE)) is a method of cervical screening used to detect potentially precancerous and cancerous processes in t ...
(also called a cervical smear), in which epithelial
Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellula ...
cells are scraped from the surface of the cervix and examined under a microscope.[ The ]colposcope
Colposcopy ( grc, κόλπος, kolpos, hollow, womb, vagina + ''skopos'' "look at") is a medical diagnostic procedure to visually examine the cervix as well as the vagina and vulva using a colposcope.
The main goal of colposcopy is to prevent ...
, an instrument used to see a magnified view of the cervix, was invented in 1925. The Pap smear was developed by Georgios Papanikolaou
Georgios Nikolaou Papanikolaou (or George Papanicolaou ; el, Γεώργιος Ν. Παπανικολάου ; 13 May 1883 – 19 February 1962) was a Greek physician who was a pioneer in cytopathology and early cancer detection, and inventor of ...
in 1928. A LEEP procedure using a heated loop of platinum
Platinum is a chemical element with the symbol Pt and atomic number 78. It is a dense, malleable, ductile, highly unreactive, precious, silverish-white transition metal. Its name originates from Spanish , a diminutive of "silver".
Platinu ...
to excise a patch of cervical tissue was developed by Aurel Babes in 1927. In some parts of the developed world including the UK, the Pap test has been superseded with liquid-based cytology
Liquid-based cytology is a method of preparing samples for examination in cytopathology. The sample is collected, normally by a small brush, in the same way as for a conventional smear test, but rather than the smear being transferred directly to ...
.
A cheap, cost-effective and practical alternative in poorer countries is visual inspection with acetic acid (VIA). Instituting and sustaining cytology-based programs in these regions can be difficult, due to the need for trained personnel, equipment and facilities and difficulties in follow-up. With VIA, results and treatment can be available on the same day. As a screening test, VIA is comparable to cervical cytology in accurately identifying precancerous lesions.
A result of dysplasia
Dysplasia is any of various types of abnormal growth or development of cells (microscopic scale) or organs (macroscopic scale), and the abnormal histology or anatomical structure(s) resulting from such growth. Dysplasias on a mainly microscopic ...
is usually further investigated, such as by taking a cone biopsy
Cervical conization ( CPT codes 57520 (Cold Knife) and 57522 (Loop Excision)) refers to an excision of a cone-shaped sample of tissue from the mucous membrane of the cervix. Conization may be used for either diagnostic purposes as part of a biopsy ...
, which may also remove the cancerous lesion.[ ]Cervical intraepithelial neoplasia
Cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer. More specifically, CIN refers to the potentially precancerous t ...
is a possible result of the biopsy and represents dysplastic changes that may eventually progress to invasive cancer. Most cases of cervical cancer are detected in this way, without having caused any symptoms. When symptoms occur, they may include vaginal bleeding, discharge, or discomfort.
Inflammation
Inflammation of the cervix is referred to as cervicitis
Cervicitis is inflammation of the uterine cervix. Cervicitis in women has many features in common with urethritis in men and many cases are caused by sexually transmitted infections. Non-infectious causes of cervicitis can include intrauterine d ...
. This inflammation may be of the endocervix or ectocervix. When associated with the endocervix, it is associated with a mucous vaginal discharge and sexually transmitted infection
Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are Transmission (medicine), spread by Human sexual activity, sexual activity, especi ...
s such as chlamydia
Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium ''Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several wee ...
and gonorrhoea
Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium ''Neisseria gonorrhoeae''. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with ur ...
. As many as half of pregnant women having a gonorrheal infection of the cervix are asymptomatic.[ Access provided by the University of Pittsburgh.] Other causes include overgrowth of the commensal flora
Commensalism is a long-term biological interaction ( symbiosis) in which members of one species gain benefits while those of the other species neither benefit nor are harmed. This is in contrast with mutualism, in which both organisms benefit fr ...
of the vagina. When associated with the ectocervix, inflammation may be caused by the herpes simplex
Herpes simplex is a viral infection caused by the herpes simplex virus. Infections are categorized based on the part of the body infected.
Oral herpes involves the face or mouth. It may result in small blisters in groups often called cold ...
virus. Inflammation is often investigated through directly visualising the cervix using a speculum, which may appear whiteish due to exudate, and by taking a Pap smear and examining for causal bacteria. Special tests may be used to identify particular bacteria. If the inflammation is due to a bacterium, then antibiotics may be given as treatment.
Anatomical abnormalities
Cervical stenosis is an abnormally narrow cervical canal, typically associated with trauma caused by removal of tissue for investigation or treatment of cancer, or cervical cancer
Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal ...
itself. Diethylstilbestrol
Diethylstilbestrol (DES), also known as stilbestrol or stilboestrol, is a nonsteroidal estrogen medication, which is presently rarely used. In the past, it was widely used for a variety of indications, including pregnancy support for those with a ...
, used from 1938 to 1971 to prevent preterm labour and miscarriage, is also strongly associated with the development of cervical stenosis and other abnormalities in the daughters of the exposed women. Other abnormalities include: vaginal adenosis
Vaginal adenosis is a benign abnormality in the vagina, commonly thought to be caused by intrauterine and neonatal exposure of diethylstilbestrol and other progestogens and nonsteroidal estrogens, however it has also been observed in otherwise ...
, in which the squamous epithelium of the ectocervix becomes columnar; cancers such as clear cell adenocarcinoma
Clear-cell adenocarcinoma is a type of adenocarcinoma that shows clear cells.
Types include:
* Clear-cell adenocarcinoma of the vagina
* Clear-cell ovarian carcinoma
* Uterine clear-cell carcinoma
Uterine clear-cell carcinoma (CC) is a rare ...
s; cervical ridges and hoods; and development of a cockscomb cervix appearance, which is the condition wherein, as the name suggests, the cervix of the uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...
is shaped like a cockscomb
A comb is a fleshy growth or crest on the top of the head of some gallinaceous birds, such as domestic chickens. The alternative name cockscomb (with several spelling variations) reflects the fact that combs are generally larger on cock birds t ...
. About one third of women born to diethylstilbestrol
Diethylstilbestrol (DES), also known as stilbestrol or stilboestrol, is a nonsteroidal estrogen medication, which is presently rarely used. In the past, it was widely used for a variety of indications, including pregnancy support for those with a ...
-treated mothers (i.e. in-utero exposure) develop a cockscomb cervix.
Enlarged folds or ridges of cervical stroma (fibrous tissues) and epithelium
Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellul ...
constitute a cockscomb cervix. Similarly, cockscomb polyps lining the cervix are usually considered or grouped into the same overarching description. It is in and of itself considered a benign
Malignancy () is the tendency of a medical condition to become progressively worse.
Malignancy is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malign ...
abnormality; its presence, however is usually indicative of DES exposure, and as such women who experience these abnormalities should be aware of their increased risk of associated pathologies.
Cervical agenesis
Cervical agenesis is a congenital disorder of the female genital system that manifests itself in the absence of a cervix, the connecting structure between the uterus and vagina. Milder forms of the condition, in which the cervix is present but def ...
is a rare congenital condition in which the cervix completely fails to develop, often associated with the concurrent failure of the vagina to develop. Other congenital cervical abnormalities exist, often associated with abnormalities of the vagina and uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...
. The cervix may be duplicated in situations such as bicornuate uterus
A bicornuate uterus or bicornate uterus (from the Latin ''cornū'', meaning "horn"), is a type of mullerian anomaly in the human uterus, where there is a deep indentation at the fundus (top) of the uterus.
Pathophysiology
A bicornuate uterus ...
and uterine didelphys.
Cervical polyps, which are benign overgrowths of endocervical tissue, if present, may cause bleeding, or a benign overgrowth may be present in the cervical canal. Cervical ectropion
Cervical ectropion is a condition in which the cells from the 'inside' of the cervical canal, known as glandular cells (or columnar epithelium), are present on the 'outside' of the vaginal portion of the cervix. The cells on the 'outside' of th ...
refers to the horizontal overgrowth of the endocervical columnar lining in a one-cell-thick layer over the ectocervix.
Other mammals
Female marsupials have paired uteri and cervices. Most eutheria
Eutheria (; from Greek , 'good, right' and , 'beast'; ) is the clade consisting of all therian mammals that are more closely related to placentals than to marsupials.
Eutherians are distinguished from noneutherians by various phenotypic tra ...
n (placental) mammal species have a single cervix and single, bipartite or bicornuate uterus. Lagomorph
The lagomorphs are the members of the taxonomic order Lagomorpha, of which there are two living families: the Leporidae (hares and rabbits) and the Ochotonidae (pikas). The name of the order is derived from the Ancient Greek ''lagos'' (λαγ ...
s, rodents, aardvarks and hyraxes have a duplex uterus and two cervices. Lagomorphs and rodents share many morphological characteristics and are grouped together in the clade Glires
Glires (, Latin ''glīrēs'' 'dormice') is a clade (sometimes ranked as a grandorder) consisting of rodents and lagomorphs ( rabbits, hares, and pikas). The hypothesis that these form a monophyletic group has been long debated based on morp ...
. Anteaters of the family myrmecophagidae
The Myrmecophagidae are a family of anteaters, the name being derived from the Ancient Greek words for 'ant' and 'eat' (''myrmeco-'' and '). Two genera and three species are in the family, consisting of the giant anteater, and the tamanduas. T ...
are unusual in that they lack a defined cervix; they are thought to have lost the characteristic rather than other mammals developing a cervix on more than one lineage. In domestic pig
The pig (''Sus domesticus''), often called swine, hog, or domestic pig when distinguishing from other members of the genus '' Sus'', is an omnivorous, domesticated, even-toed, hoofed mammal. It is variously considered a subspecies of ''Sus s ...
s, the cervix contains a series of five interdigitating pads that hold the boar's corkscrew-shaped penis during copulation.
Etymology and pronunciation
The word ''cervix'' () came to English from Latin, where it means "neck", and like its Germanic counterpart, it can refer not only to the neck
The neck is the part of the body on many vertebrates that connects the head with the torso. The neck supports the weight of the head and protects the nerves that carry sensory and motor information from the brain down to the rest of the body. In ...
f the body
F, or f, is the sixth letter in the Latin alphabet, used in the modern English alphabet, the alphabets of other western European languages and others worldwide. Its name in English is ''ef'' (pronounced ), and the plural is ''efs''.
Hist ...
but also to an analogous narrowed part of an object. The cervix uteri (neck of the uterus) is thus the uterine cervix, but in English the word ''cervix'' used alone usually refers to it. Thus the adjective ''cervical'' may refer either to the neck (as in ''cervical vertebrae
In tetrapods, cervical vertebrae (singular: vertebra) are the vertebrae of the neck, immediately below the skull. Truncal vertebrae (divided into thoracic and lumbar vertebrae in mammals) lie caudal (toward the tail) of cervical vertebrae. In ...
'' or ''cervical lymph nodes
Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to a number of different pathological conditions including tumours, infection and inflammati ...
'') or to the uterine cervix (as in ''cervical cap
The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the ''os''.
Terminology
The term ''cervical cap'' has been ...
'' or ''cervical cancer
Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal ...
'').
Latin ''cervix'' came from the Proto-Indo-European
Proto-Indo-European (PIE) is the reconstructed common ancestor of the Indo-European language family. Its proposed features have been derived by linguistic reconstruction from documented Indo-European languages. No direct record of Proto-Indo-E ...
root ''ker-'', referring to a "structure that projects". Thus, the word cervix is linguistically related to the English
English usually refers to:
* English language
* English people
English may also refer to:
Peoples, culture, and language
* ''English'', an adjective for something of, from, or related to England
** English national ide ...
word "horn
Horn most often refers to:
*Horn (acoustic), a conical or bell shaped aperture used to guide sound
** Horn (instrument), collective name for tube-shaped wind musical instruments
*Horn (anatomy), a pointed, bony projection on the head of various ...
", the Persian
Persian may refer to:
* People and things from Iran, historically called ''Persia'' in the English language
** Persians, the majority ethnic group in Iran, not to be conflated with the Iranic peoples
** Persian language, an Iranian language of the ...
word for "head" ( fa, سر ''sar''), the Greek word for "head" ( grc-gre, κορυφή ''koruphe''), and the Welsh and Romanian words for "deer" ( cy, carw, Romanian: ''cerb'').
The cervix was documented in anatomical literature in at least the time of Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
; cervical cancer was first described more than 2,000 years ago, with descriptions provided by both Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
and Aretaeus
Aretaeus ( grc-gre, Ἀρεταῖος) is one of the most celebrated of the ancient Greek physicians. Little is known of his life. He presumably was a native or at least a citizen of Cappadocia, a Roman province in Asia Minor (modern day Turkey ...
. However, there was some variation in word sense
In linguistics, a word sense is one of the meanings of a word. For example, a dictionary may have over 50 different senses of the word "play", each of these having a different meaning based on the context of the word's usage in a sentence, as fo ...
among early writers, who used the term to refer to both the cervix and the internal uterine orifice. The first attested use of the word to refer to the cervix of the uterus was in 1702.
References
Citations
Cited texts
*
External links
*
{{Authority control
Human female reproductive system
Women's health