Cervix (Human Anatomy): Diagram, Location, Conditions, Treatment

The cervix, a soft as well as sensitive part of a female body is both beautiful as well as helps in the process of reproduction, thus helps in continuity of species from generation to generation. It resembles a cylinder-shaped neck of tissue that connects vagina and the uterus. Cervix is located at the lowermost portion of the uterus and consists primarily of fibromuscular tissue.

Cervix is made up of two portions or parts.

1. Ectocervix: In Ectocervix the ecto means outer and ectocervix means outer parts of the cervix that can be seen from inside the vagina during a gynecologic examination. An external os is the opening in the centre of the ectocervix that opens to allow transport between the uterus and the vagina. Some of the main functions are:-
   • Help regulate menstrual cycle
   • Facilitation of childbirth
   • Connection to the vagina
   • Barrier to infection
2. Endocervix or endocervical canal: It is a tunnel into the uterus through the cervix, from the external os. Some of the functions of endocervix are:-
   • Drainage of menstrual blood
   • Sampling for cervical cancer screening
   • Production of cervical mucus
   • Passage of semen during intercourse
   • Protection against infections.
3. The portion between the ectocervix and endocervix is known as the transformation zone. It forms and releases cervical mucus that changes its consistency during the menstrual cycle to prevent or promote pregnancy

• Cervical cancer: Most occurrences of cervical cancer may be traced back to infection with the human papillomavirus (HPV). Cervical cancer may be avoided in most women if they get regular Pap exams.
• Cervical incompetence: The cervix opens or dilates too soon, putting the mother at risk for preterm birth. A healthy foetus may not develop properly under certain circumstances..
• Cervicitis: Inflammation of the cervix caused by infection is termed cervicitis, and it can occur as a result of viral or bacterial infection. Cervicitis is caused by a number of STDs, including Chlamydia, gonorrhoea, and herpes, all of which have a variety of potential vectors.
• Cervical dysplasia: Cervical cancer forms when otherwise healthy cells in the cervix multiply abnormally. The Pap smear test is a common method for detecting cervical dysplasia. Cervical dysplasia is also known as cervical intraepithelial neoplasia (CIN).
• Cervix polyps: Tiny tumours that form on the cervix's vaginal opening. Polyps can induce vaginal bleeding but are otherwise painless and harmless.
• Pelvic inflammatory disease (PID): Cervicitis is an infection of the cervix that causes inflammation of the cervix and can extend to the uterus and fallopian tubes. The reproductive organs of a woman can be harmed by pelvic inflammatory disease or pelvic inflammatory infection, and this can make pregnancy difficult or impossible.
• Human papillomavirus (HPV) infection: Human papillomaviruses are a group of viruses, including certain types that cause cervical cancer. viruses causing genital and cervical warts are thought to be less dangerous for causing cervical cancer.
• Sexually transmitted diseases: Gonorrhea, syphilis, genital herpes, trichomoniasis, etc., all fall within this category.
• Cervical ectropion: This is due to hormonal disbalance of oestrogen and is not harmful. It is mainly found in young females, pregnant women and those who consume oral contraceptive pills regularly. In some cases it can cause vaginal discharge or bleeding in amounts more than usual.
• Nabothian cysts: These are tiny cysts that are on the surface of the neck of the cervix. They are common and most of the time don't cause any symptoms.They can be cured on their own but a proper direction should be maintained.Cervical Cysts: Nabothian cysts most common, caused when glandular columnar cells become covered by squamous epithelial, but still produce mucus.
• Cervical Polyps: Polyps often originate from the endocervical canal, appear as broad based or pedunculated lesions . they are Often asymptomatic, but can cause intermenstrual or postcital bleed
• Cervical Stenosis: Cancer risk associated with a narrowed endocervical canal that might lead to stagnant menstrual flow. Exhibits severe dysmenorrhea, which is alleviated by increasing flow.

• Pap test: from the cervix of a suspected female a sample of cells is taken and examined for any visible signs of changes. It can easily detect cervical dysplasia or cervical cancer if present.
• Cervical biopsy: A sample of tissue that we call a biopsy is taken from the cervix to check for any sign of cervical cancer or other conditions. It is also done during colposcopy.
• Colposcopy: In this a gynaecologist looks into the cervix with the help of a colposcope( a type of magnifying glass) and if they find any anomaly/unnatural happenings there then they can take a biopsy of that area for further tests.
• Cone biopsy: Here a come shaped wedge of the tissue is extracted out and then further examined under the microscope. Usually it is done in case the Pap test is found abnormal.
• Computed tomography (CT scan): Multiple X-rays are taken and with the help of a computer detailed images of the cervix, abdomen and pelvis are formed. It is used to look for the presence of cervical cancer if present and if found positive than how much areas is been affected till far is also known through this.
• Magnetic resonance imaging (MRI ): A high-powered magnet and a computer is used to make images of the cervix, abdomen and the pelvis region with high resolution. In positive cases of cervical cancer it is also used to detect the percentage of areas being affected till now.
• Positron emission tomography (PET scan): It is used to look for the spread or recurrence of cervical cancer. A tracer solution, containing a mildly radioactive chemical is injected into the veins. As the solution moves throughout the body it takes several pictures. If there is presence of cancer then the areas of cancer take up the tracer and can be seen on the scanned images as they 'light up'.
• HPV DNA test: If there is presence of DNA from any type of human papillomavirus (HPV) then it can be detected with the help of this.

• Cervical ectropion for balancing oestrogen: They can be easily treated with a burning technique (cautery) or using an electrical current (diathermy). A local anaesthesia is given during such a process.
• Cervical cerclage for cervical incompetence: In case of cervical incompetence in females the cervix can be sewn closed. During pregnancy this can prevent early opening of the cervix during pregnancy, which can cause premature delivery.
• Cryotherapy for preventing cervical cancer: At abnormal areas of the cervix an extremely cold probe is placed by which the abnormal cells are destroyed or killed through Freezing and the cervical cancer chances are neglected.
• Laser therapy for preventing cervical cancer: A laser of very high energy is used to burn the areas of abnormal cells in the cervix. The abnormal cells are killed thus preventing them from cervical cancer.
• Cervical cancer vaccine for preventing cervical cancer: A vaccine is used to kill certain strains of the human papillomavirus (HPV) in most of the cases of adolescent girls and young females.
• Chemotherapy to kill cervical cancer cells: Certain medications are injected into the vein. In case the cancer has spread already this therapy is given.
• Total Hysterectomy to completely cure cervical cancer: this is a Surgical removal method of the uterus and cervix. It is done in case cervical cancer has not spread and it is also a permanent cure too.
• Cone biopsy for removing the affected part in cervical cancer: It removes the cone-shaped wedge of tissue from the cervix. As a large portion of the cervix is removed, it can help prevent or treat cervical cancer.
• Loop electrosurgical excision procedure (LEEP) for cervical cancer: electrified wire loop is touched against the abnormal cells of the cervix. This current will destroy the cells, and thus prevent or treat cervical cancer.
• Radiation therapy to treat cervical cancer: radioactive rays are used to kill cervical cancer cells. The rays are provided from outside the body or in small pellets implanted in the cervix, known as brachytherapy.
• Radical trachelectomy: A surgical procedure in which the cervix is removed, but the uterus is left intact.
• Exenteration: The removal of the uterus, vagina, lower colon, rectum, or bladder if cervical cancer has spread to these organs after radiation therapy.
• Bilateral salpingo-oophorectomy: If needed, this surgery is the removal of both fallopian tubes and both ovaries. It is done at the same time as a hysterectomy.
• Genomic sequencing: This shows which cells are causing cancer. This can help you to choose which medicine should be prescribed for you.

• Broad Spectrum Antibiotics for cervicitsi: Antibiotics with a wide range of activity, such as ofloxacin, norfloxacin, metronidazole, ceftriaxone, and cefoperazone, are often used. Despite the fact that additional antibiotics like clindamycin, gentamicin, and doxycycline are frequently used in the treatment of complex cervical illnesses,
• Antifungal Medications for cervical fungal infestation: These come in the form of topical solutions that may be applied directly to the affected area, as well as in the form of dusting powders that can be applied directly to the affected area.
• Topical Solution for secreatory fluid secreation of cervix: They are put to use for the local application of pharmaceuticals that include powerful salts like clotrimazole, and the combination of these drugs with terbinafine is also recognised to be a beneficial therapeutic approach.
• Antivirals for viral infection of cervix: To this day, antivirals like as ganciclovir, acyclovir, and others are used to treat illnesses such as herpes, human papillomavirus, and HIV, all of which are forms of sexually transmitted diseases, despite the fact that specific criteria for these diseases are not known. They are known to be used for cervical polyps and chalmydia.
• Hormone Replacement for cervical cancer: Artificial hormone treatments such as ethyl estradiol, medroxyprogesterone, human chorionic gonadotropin Iv, and others are used in the treatment of cervical infections.
• Iv Medications for cervicitis: For medications like amphotericin, isotretinoin, itraconazole, luliconazole, It is also possible to take them in their oral form and give them to a patient through the intravenous or parenteral routes on a daily basis, but this will depend on the severity of the infection or the kind of treatment that is necessary.
• Avastin for cervical cancer: In combination with iv fluorouracil-based chemotherapy and is indicated for the 1st or 2nd line treatment of patients with metastatic colorectal cancer.
• Carboplatin to treat cancer: It is a cytotoxic chemotherapy drug used to treat cancer. It binds to DNA and causes damage that stops the cells from reproducing.
• Zirabev for metastatic colorectal cancer: It is taken with intravenous fluorouracil-based chemotherapy, and is indicated for the first- or second-line treatment of patients with metastatic colorectal cancer.
• Tivdak for cervical cancer: It is a prescribed drug used to treat adults with cervical cancer, that has returned or has spread to other parts of the body, and who have received chemotherapy that did not work or is no longer working.
• Bevacizumab-maly for cervical cancer: It is injected along with other medicines to treat patients with metastatic cancer (carcinoma) of the colon or rectum. some othe more examples includes Topotecan and Hycamtin
• Antiseptic Solutions for cervicitis: Various chemicals such as chloroxylenol solution, hydrogen peroxide, polyhexamethylene biguanide, bithionol, etc. are used in this process.
• Vaginal Gel for cervicitis: Hydrogen peroxide, polyhexamethylene biguanide gel, or chlorhexidine in a vaginal gel or pessary are examples of disinfectants and antiseptics.
• Vaginal Disinfectants for cervical polyps: Disinfectants for the vaginal area, such as ethylenediamine chloride, hydrogen peroxide, octanedione, polyhexamethylene biguanide, and povidone iodine.