Chapter 16: Identification of Vaginal Secretions and Menstrual Blood

squamous mucosa

A normal human vagina is covered by the ______, which is composed of stratified squamous epithelial tissue.

submucosa

Lying under the squamous mucosa is the _______, which contains an abundance of connective tissue and capillaries.

muscularis

Below the submucosa is the _______, which is made up of smooth muscle.

Basal Layer

In this layer, basal cells are anchored to the basement membrane that separates the squamous mucosa from the submucosa.

Parabasal Layer

This is where cells undergo differentiation.

Intermediate Layer

The cells are flattened and their nuclei are compressed.

Superficial Layer

This is where the cells are fully differentiated with small and dense nuclei.

Lugol’s iodine solution

Named after the French physician *Jean Lugol*, is originally used as an antiseptic that is applied to skin or tissue to prevent infection.

Glycogen

is the principal storage form of glucose in animal and human cells and is found in the granules in the cytoplasm of the cells of many tissues.

hepatocytes

In addition to squamous epithelial cells, glycogen is also found in ______, which have the highest glycogen content, as well as muscle cells.

Lugol’s stock solution

is an aqueous solution of 5% iodine (I2) and 10% potassium iodide (KI).

Potassium iodide

allows the iodine to be soluble in water through the formation of the triiodide ion.

keratinizing squamous epithelial cells

Differentiated skin epithelial cells are keratinized and are classified as ________

nonkeratinizing squamous epithelial cells

buccal and vaginal epithelial cells are ______

Lactobacillus

It can be found in the respiratory, the gastrointestinal, and the urogenital tract of healthy humans and animals.

Lactobacillus taxa

Are the predominant bacteria in the vagina of women of reproductive age, and they play an important role in protecting the host against invasive pathogenic organisms.

lactic acid

Lactobacillus bacteria produce _____.

MUC4

Encodes a mucin protein that is a major component of vaginal mucus.

HBD1

Encodes a vaginal antimicrobial peptide.

Menstruation

The periodic discharge of blood and the elimination of the degenerated lining of the endometrium from the uterus of nonpregnant women.

400 times

From menarche to menopause, women may menstruate up to ______ during their reproductive age.

Myometrium

Consists of the muscle fibers of the uterus.

Endometrium

Consists of the simple columnar epithelium and the stroma.

Simple columnar epithelium

Formed by single-layered elongated cells located at the apical surface of the endometrium.

Stroma

It consists of connective tissues as well as spiral arteries.

Spiral arteries

Are small arteries that ascend through the endometrium and form a coil-like structure, which supplies blood to the endometrium.

Functionalis

The luminal part of the endometrium. It is the zone of cyclic changes in the endometrium and is shed during menstruation.

Basalis

The basal part of the endometrium and is not shed during menstruation. This zone produces cells to regenerate the functionalis during the next cycle.

repetitive physiological changes

During the uterine cycle, _______occur in the functionalis.

menstrual phase

During the ________, the functionalis degenerates and is sloughed off from the uterine wall and bleeding occurs, known as menses.

proliferative phase

During the _______, the functionalis begins regeneration in which the spiral arteries are proliferated.

secretory phase,

During the ______, the spiral arteries are further developed and coiled.

progesterone level

In the absence of pregnancy, a decrease in the ________ leads to the constriction of the spiral arteries. As a result, the functionalis becomes ischemic, leading to hypoxia.

endometrial hemostasis

The cessation of menstrual bleeding is achieved by ______ that is initiated when injury occurs due to the shedding of the endometrium.

Hemostasis

______ begins with platelet activation and aggregation to form platelet plugs at the site of injury.

Thrombin

A serine protease, converts soluble fibrinogen into fibrin.

Fibrin

A protein involved in blood clotting, aggregates with the platelet plugs and leads to the cessation of bleeding by forming blood clots, known as thrombi.

D-dimer

A degradation product produced during fibrinolysis when cross-linked fibrin is cleaved by plasmin.

ELISA

In ______, antibodies bind to the D-dimer antigens on the solid phase.

Latex agglutination assays

are based on the interaction of antibodies and D-dimers that are located on carriers to form aggregates during the agglutination process.

Immunochromatographic assays

utilize monoclonal antibodies specific to D-dimers, which have been developed recently. It is very specific, sensitive, and rapid, and can be completed within minutes.

Lactate dehydrogenase (LDH)

An enzyme that plays an important role in glycolysis. It catalyzes the reversible reduction of pyruvate into lactate when the amount of oxygen is limited.

A subunit

It is encoded by the LDHA gene and is primarily expressed in skeletal muscle.

B subunit

It is encoded by the LDHB gene and is primarily expressed in cardiac muscle.

C subunit

It is encoded by the LDHC gene, is expressed restrictively in the testes.

peripheral blood

LDH1, 2, and 3 are the predominant forms of the isoenzymes in ______.

menstrual blood

LDH4 and 5 are consistently the predominant isoenzymes in _______.

Matrix metalloproteinase (MMP)

_________ genes are considered tissue-specific markers for human endometrium tissues.

Extracellular matrix (ECM)

The extracellular space of tissue that is filled by macromolecules such as collagens, laminins, fibronectins, and proteoglycans.

*MMP7*

is predominantly expressed in epithelial cells

*MMP11*

is expressed in the stromal cells of the endometrium.

MMP11 mRNA

can be detected in menstrual blood from the first to the eighth day of menstruation but it is absent in peripheral blood and vaginal secretions.

Cytochrome P450, family 2, subfamily B, polypeptide 7, pseudogene 1.

CYP2B7P1

Dickkopf homolog 4

DKK4

Fucosyltransferase 6

FUT6

β Defensin 1

HBD1

Interleukin 19

IL19

Mucin 4

MUC4

Myozenin 1

MYOZ1

Surfactant associated 2

SFTA2

Matrix metalloproteinase 7

MMP7

Matrix metalloproteinase 11

MMP11