Female Reproductive System P2
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Questions and Answers

What are the three layers that make up the wall of the uterus?

  • Myometrium, Endometrium, Perimetrium (correct)
  • Endometrium, Perimetrium, Epithelium
  • Serosa, Mucosa, Muscularis
  • Mucosa, Muscularis, Serosa (correct)

    • Which part of the uterus connects to the vagina through the external os?

  • Fundus
  • Isthmus
  • Cervix (correct)
  • Body

    • What triggers the onset of the menstrual phase in the uterus?

  • Hormonal changes leading to endometrial shedding (correct)
  • Implantation of an embryo
  • Increased blood flow to the endometrium
  • Ovulation of the dominant follicle

    • Which layers of the uterine wall undergo cyclic changes each month?

    <p>Endometrium and Myometrium</p> Signup and view all the answers

    Which feature is NOT associated with the endometrium?

    <p>Muscular layer of the uterus</p> Signup and view all the answers

    What is the primary function of the endometrium during the menstrual cycle?

    <p>Create a suitable environment for embryo implantation</p> Signup and view all the answers

    What anatomical feature of the cervix connects it to the uterine cavity?

    <p>Internal os</p> Signup and view all the answers

    Which phase of the menstrual cycle is characterized by changes in the functional and basal layers of the endometrium?

    <p>Menstrual phase</p> Signup and view all the answers

    What is the function of the mucus secreted by Bartholin's glands?

    <p>To lubricate the vaginal opening</p> Signup and view all the answers

    Which structure is primarily responsible for maintaining the acid pH in the vaginal lumen?

    <p>Lactate produced by bacteria</p> Signup and view all the answers

    What is the primary epithelium type that constitutes the vaginal mucosa?

    <p>Non-keratinized stratified squamous epithelium</p> Signup and view all the answers

    What type of glands are the lesser vestibular glands commonly referred to as?

    <p>Skene's glands</p> Signup and view all the answers

    Which layer of the vaginal wall consists of inner circular and outer longitudinal smooth muscle?

    <p>Muscularis</p> Signup and view all the answers

    What type of arteries supply the stratum basale of the endometrium?

    <p>Straight arteries</p> Signup and view all the answers

    During menstruation, which layer of the endometrium is shed?

    <p>Stratum functionale</p> Signup and view all the answers

    What is a characteristic of the myometrium during pregnancy?

    <p>Smooth muscle cells undergo hypertrophy.</p> Signup and view all the answers

    What percentage of the endometrial thickness does the functional layer constitute?

    <p>80%</p> Signup and view all the answers

    Which arteries are responsible for supplying the stratum functionale?

    <p>Spiral arteries</p> Signup and view all the answers

    What role do gap junctions play in the myometrium during pregnancy?

    <p>They enhance synchronization of muscle contractions.</p> Signup and view all the answers

    Which hormone induces powerful contractions of the uterine muscles during parturition?

    <p>Oxytocin</p> Signup and view all the answers

    What is the primary function of the basal layer of the endometrium?

    <p>To act as a regenerative zone after menstruation.</p> Signup and view all the answers

    What is the orientation of the muscle bundles in the middle layer of the myometrium?

    <p>Circular or spiral pattern.</p> Signup and view all the answers

    What happens to the spiral arteries during menstruation?

    <p>They are shed along with the stratum functionale.</p> Signup and view all the answers

    What occurs during the secretory phase of the menstrual cycle?

    <p>The blastocyst can be implanted into the uterine endometrium.</p> Signup and view all the answers

    What is the primary characteristic of uterine glands during the secretory phase?

    <p>They become corkscrew-shaped and enlarge.</p> Signup and view all the answers

    What happens to the uterine glands at the time of menstruation?

    <p>The greater parts are lost along with the entire lining epithelium.</p> Signup and view all the answers

    Which statement about endometriosis is true?

    <p>It is characterized by the presence of endometrial tissue in unusual locations.</p> Signup and view all the answers

    What symptom is commonly associated with endometriosis?

    <p>Pelvic pain.</p> Signup and view all the answers

    How does the endometrium of the cervix differ from that of the rest of the uterus?

    <p>It has a different structure and function.</p> Signup and view all the answers

    What is the position of the cervix in relation to the uterus?

    <p>It protrudes through the vagina and sits below the isthmus.</p> Signup and view all the answers

    During which phase do uterine glands elongate and increase in diameter?

    <p>Proliferative phase</p> Signup and view all the answers

    Which age group is most commonly affected by endometriosis?

    <p>20-30 years</p> Signup and view all the answers

    What effect does menopause have on endometriosis?

    <p>It leads to a reduction in symptoms.</p> Signup and view all the answers

    What type of epithelium lines the cervical canal?

    <p>Simple columnar epithelium</p> Signup and view all the answers

    What is the transformation zone in the cervix?

    <p>The transition area from columnar to squamous epithelium</p> Signup and view all the answers

    What is the primary function of cervical glands during the menstrual cycle?

    <p>Modification of mucus consistency</p> Signup and view all the answers

    What characterizes an adequate Pap smear?

    <p>Includes surface, endocervical cells, and mucin</p> Signup and view all the answers

    What is the consequence of blockage in the openings of cervical mucosal glands?

    <p>Formation of Nabothian cysts</p> Signup and view all the answers

    During which phase of the menstrual cycle do the cervical secretions become watery?

    <p>Proliferative phase</p> Signup and view all the answers

    What changes characterize the cervical epithelial cells observed in a Pap smear?

    <p>Surface cells have small, contracted nuclei and are pink-stained</p> Signup and view all the answers

    What is the most common site of origin for carcinoma of the cervix?

    <p>Transformation zone</p> Signup and view all the answers

    The surface cells of the stratified squamous epithelium in the cervix are primarily stained what color in a Pap smear?

    <p>Pink</p> Signup and view all the answers

    What type of glands are present in the cervix?

    <p>Mucus-secreting branched tubular glands</p> Signup and view all the answers

    Which layer of the uterine wall is primarily responsible for the muscle contractions during childbirth?

    <p>Myometrium</p> Signup and view all the answers

    What is the effect on the endometrium if an embryo successfully implants?

    <p>It continues to grow and differentiate.</p> Signup and view all the answers

    Which of the following best describes the function of the perimetrium?

    <p>Serves as a protective outer layer.</p> Signup and view all the answers

    During which phase of the menstrual cycle is the endometrium most prepared for implantation?

    <p>Secretory phase</p> Signup and view all the answers

    What role do blood vessels play in the endometrium during the menstrual cycle?

    <p>They supply nutrients and oxygen to the tissue.</p> Signup and view all the answers

    Which part of the cervix connects to the uterine cavity?

    <p>Internal os</p> Signup and view all the answers

    What is the primary role of the endometrium during the menstrual cycle?

    <p>Provides a site for embryo implantation.</p> Signup and view all the answers

    What triggers the cyclic changes in the endometrium?

    <p>Development of follicles in the ovaries</p> Signup and view all the answers

    What role does glycogen in the vaginal epithelium play in maintaining vaginal health?

    <p>It inhibits the growth of bacteria and helps maintain an acid pH.</p> Signup and view all the answers

    Which structure secretes mucus to provide vaginal lubrication?

    <p>Bartholin's glands</p> Signup and view all the answers

    What is the epithelial type found in the vaginal mucosa?

    <p>Non-keratinized stratified squamous epithelium</p> Signup and view all the answers

    What is the primary component of the vaginal wall that contributes to its elasticity?

    <p>Elastic fibers in the adventitia</p> Signup and view all the answers

    Which of the following correctly describes the role of the vestibular glands?

    <p>They produce mucus to lubricate the vagina.</p> Signup and view all the answers

    What is a key characteristic of uterine glands during the secretory phase?

    <p>They enlarge and become corkscrew-shaped.</p> Signup and view all the answers

    Which statement about endometriosis is accurate?

    <p>It can lead to infertility in affected individuals.</p> Signup and view all the answers

    What occurs to the uterine glands during menstruation?

    <p>They are largely lost along with the uterine lining.</p> Signup and view all the answers

    Which of the following describes the cervix?

    <p>It connects the vagina to the external os.</p> Signup and view all the answers

    What is the age range during which endometriosis is most commonly diagnosed?

    <p>20 to 30 years old.</p> Signup and view all the answers

    What is a prominent feature of the endometrium during the secretory phase?

    <p>Rich mucous fluid is secreted to support implantation.</p> Signup and view all the answers

    How does the endometrium of the cervix differ from that of the rest of the uterus?

    <p>It has a different type of epithelium.</p> Signup and view all the answers

    Which of these structures is part of the uterine cervix anatomy?

    <p>Fornix.</p> Signup and view all the answers

    What happens to the uterine glands as the endometrium thickens during the proliferative phase?

    <p>They become twisted and elongated.</p> Signup and view all the answers

    What is the primary symptom associated with endometriosis?

    <p>Persistent pelvic pain.</p> Signup and view all the answers

    What primarily triggers the transition from the menstrual phase to the proliferative phase of the menstrual cycle?

    <p>Elevation of estrogen levels</p> Signup and view all the answers

    What structural change occurs in the endometrial glands during the secretory phase?

    <p>Glands increase in length and secrete glycoproteins</p> Signup and view all the answers

    What is the approximate thickness of the endometrium at the end of the proliferative phase?

    <p>2-3 mm</p> Signup and view all the answers

    Which hormone is primarily responsible for the changes observed in the secretory phase of the menstrual cycle?

    <p>Progesterone</p> Signup and view all the answers

    During which specific phase does ischemia and necrosis of the functional layer of the endometrium predominantly occur?

    <p>Menstrual phase</p> Signup and view all the answers

    What remains in the uterus after the menstrual phase concludes?

    <p>The basal layer of the endometrium</p> Signup and view all the answers

    How does the thickness of the endometrium at its maximum compare between the secretory phase and the menstrual phase?

    <p>It is thicker during the secretory phase</p> Signup and view all the answers

    What causes the blood vessels to rupture during the menstrual phase?

    <p>Lack of oxygen supply due to constriction</p> Signup and view all the answers

    Which cell transformation occurs in the stromal cells during the secretory phase?

    <p>Transformation into decidual cells</p> Signup and view all the answers

    What initial stimulus starts the proliferative phase of the menstrual cycle?

    <p>Increase in estrogen levels from ovarian follicles</p> Signup and view all the answers

    What is a key characteristic of the transformation zone in the cervix?

    <p>It is the site of origin for most cervical cancers.</p> Signup and view all the answers

    Which type of epithelium is found lining the cervical canal?

    <p>Simple columnar epithelium</p> Signup and view all the answers

    What happens to cervical gland secretions during the proliferative phase of the menstrual cycle?

    <p>The secretions are watery to facilitate sperm passage.</p> Signup and view all the answers

    What is the primary purpose of a Pap smear?

    <p>To collect cervical cells for cancer screening.</p> Signup and view all the answers

    What indicates an adequate Pap smear sample?

    <p>Inclusion of endocervical cells.</p> Signup and view all the answers

    What leads to the formation of Nabothian cysts?

    <p>Blockage of cervical mucosal gland openings.</p> Signup and view all the answers

    Which is NOT a feature of the surface cells observed in a Pap smear?

    <p>Stained blue/green cytoplasm</p> Signup and view all the answers

    What occurs to cervical secretions during the secretory phase of the menstrual cycle?

    <p>They turn highly viscous.</p> Signup and view all the answers

    Where is the squamocolumnar junction located?

    <p>At the external os of the cervix</p> Signup and view all the answers

    What is a primary function of cervical glands?

    <p>To secrete mucus that varies in consistency.</p> Signup and view all the answers

    Study Notes

    Uterus

    • Non-paired hollow muscular organ shaped like a pear.
    • Contains a mucous membrane that undergoes cyclic changes.
    • These changes are to create the most suitable environment for embryo implantation and fetal development.
    • Divided into 4 parts: body, fundus, isthmus, and cervix.

    Wall of the Uterus

    • Composed of 3 layers: mucosa (endometrium), muscularis (myometrium), and serosa (perimetrium).
    • Both the myometrium and endometrium undergo cyclical changes each month to prepare the uterus for embryo implantation.
    • These changes are known as the menstrual cycle.
    • If an embryo implants, the cycle stops and both layers undergo significant growth and differentiation during pregnancy.

    Endometrium

    • The mucosal lining of the uterus.
    • Each uterine artery forms arcuate branches, which then form radial arteries that supply the myometrium.
    • In the myometrium, radial arteries divide into two types:
      • Straight arteries located in the stratum basale.
      • Spiral arteries which are long and coiled in the stratum functionale.
      • During menstruation, spiral arteries are shed along with the stratum functionale.

    Zones of the Endometrium

    • Two zones based on cyclical changes:
      • Basal Layer: deeper layer, not sloughed off during menstruation, serves as a regenerative zone, supplied by straight arteries.
      • Functional Layer: superficial layer, makes up 80% of endometrial thickness, sloughed off during menstruation, site of cyclical changes, supplied by spiral arteries.

    Myometrium

    • Composed of 3 layers of smooth muscle tissue.
    • Middle layer is the thickest, contains large blood vessels, and is called the stratum vascularis.
    • Contains smooth muscle bundles oriented in a circular or spiral pattern.
    • Inner and outer layers contain smooth muscle bundles oriented parallel to the long axis of the uterus.
    • Smooth muscle cells are located in a network of collagen and elastic fibers.
    • In a non-pregnant woman, they are 50 µm long; during pregnancy, their size increases (hypertrophy) up to 500 µm and simultaneously, their number increases (hyperplasia).
    • Interconnected by gap junctions, which multiply during pregnancy and facilitate synchronicity of the cells during contractions.
    • Blood vessels are present between the smooth muscle bundles.
    • Rhythmic contraction of these muscles may intensify during menstruation and cause cramps.
    • At parturition, the hormone oxytocin induces powerful contractions of the uterine muscles to expel the fetus.

    Uterine Glands

    • Simple tubular glands lined by columnar epithelium.
    • Mucous fluid produced by the glands is rich in glycogen, required to support placental development if implantation occurs.
    • At the time of menstruation, the greater parts of the uterine glands are lost (along with the entire lining epithelium) leaving behind only basal parts.
    • In the proliferative phase, uterine glands are straight.
    • As the endometrium increases in thickness, the glands elongate, increase in diameter, and become twisted.
    • In the secretory phase, the glands enlarge and become corkscrew-shaped.
    • Lumina become sacculated as they fill with secretory products.

    Endometriosis

    • Common gynecologic disease where endometrial tissue appears in unusual locations in the lower abdomen and pelvis.
    • Affects females between puberty and menopause, most common between 20 and 30 years.
    • Symptoms include pelvic pain and premenstrual bleeding.
    • Etiology is unknown, but may result when endometrial cells detach from the uterine lining during menstruation and migrate through fallopian tubes to the peritoneal cavity.
    • Condition often subsides after menopause when estrogen stimulation declines.

    Uterine Cervix

    • Part of the uterus below the isthmus.
    • Endometrium of the cervix differs from the rest of the uterus.
    • Protrudes through the vagina and is called the vaginal part of the cervix.
    • Vaginal part of the cervix is surrounded by a circular furrow, the vaginal fornix.
    • Cervix encloses a narrow cervical canal that communicates with the uterine cavity through the internal os and the vagina through external os.

    Features of the Uterine Cervix

    • Mucosa: epithelium + lamina propria.
    • Underneath the mucosa, there is CT + some smooth muscles forming the bulk of the cervix.
    • Cervical canal is lined by simple columnar epithelium.
    • Lamina propria consists of CT with numerous cervical glands.
    • At the external os, the epithelium changes to non-keratinised stratified squamous epithelium.
    • This continues over the vaginal part of the cervix and further with the epithelium of the vagina.
    • Cervical mucosa is not shed during menstruation.

    Transformation Zone

    • Site where the epithelium changes from simple columnar to non-keratinised stratified squamous.
    • Most common site of origin for carcinoma cervix.

    Pap Smear (Papanicolaou Smear)

    • Cervical epithelial cells are constantly shed (exfoliated) into the vagina.
    • These cells can be collected, stained, and observed for routine screening and diagnosis of cancerous conditions of the cervix.
    • Smear of cells on the glass slide is called a Pap smear.
    • Surface scraping is done by a cervical spatula/brush/broom around the external os.
    • Cells in the scraping are studied under the microscope.

    Cervical Glands

    • Mucus-secreting branched tubular glands.
    • Secretory activity of glands undergoes cyclical changes during the menstrual cycle.
    • During the proliferative phase, secretions are watery (to allow easier sperm passage).
    • During the secretory phase, secretions become highly viscous (to prevent microorganisms from passing from the vagina into the cervix).

    Nabothian Cysts

    • Blockage of the openings of the mucosal glands resulting in retention of secretions leads to the formation of Nabothian cysts.
    • Nabothian cysts develop frequently but are clinically important only if numerous cysts produce marked enlargement of the cervix.

    Vagina

    • Fibromuscular tube extending from the vaginal part of the cervix to the external genitalia.
    • Wall composed of 3 layers: mucosa, muscularis, and adventitia.
    • Mucosa: epithelium is non-keratinised stratified squamous epithelium.
    • Lamina propria: dense CT.
    • Vaginal mucosa is devoid of glands and lubricated by mucus secreted by cervical glands.
    • Muscularis: inner circular and outer longitudinal layers of smooth muscle.
    • Adventitia: contains many elastic fibers, contributing to the elasticity of the vaginal wall.
    • Cells of the vaginal epithelium contain abundant glycogen and often have a pale-staining appearance.
    • When these cells are shed into the vaginal lumen, the glycogen is converted to lactate by bacteria, resulting in an acid pH that helps depress the growth of foreign microorganisms.

    Vestibular Glands

    • Two types:
      • Greater (Major) vestibular glands: Also known as Bartholin's glands.
      • Lesser (Minor) vestibular glands: Also known as Skene's glands.

    Bartholin's Glands

    • Two pea-sized compound racemose glands located slightly posterior and to the left and right of the vaginal opening.
    • Secrete mucus to provide vaginal lubrication.

    External Genitalia (Vulva)

    • Includes several structures covered by stratified squamous epithelium:
      • Vestibule: a space whose wall includes the tubulo-acinar vestibular glands.
      • Paired labia minora: folds of skin lacking hair follicles but with numerous sebaceous glands.
      • Paired labia majora: homologous and histologically similar to the skin of the scrotum.
      • Clitoris: an erectile structure homologous to the penis with paired corpora cavernosa.

    Uterus

    • A pear-shaped organ responsible for implantation and development of embryo and fetus.
    • Consists of:
      • Body
      • Fundus
      • Isthmus
      • Cervix
    • Myometrium and endometrium undergo cyclical changes during the menstrual cycle.
    • Both layers undergo significant growth and differentiation during pregnancy.

    Wall of the Uterus

    • Formed by three layers, from inside to outside:
      • Endometrium (Mucosa)
      • Myometrium (Muscularis)
      • Perimetrium (Serosa)

    Perimetrium

    • Outer serous layer, continuous with the pelvic and abdominal peritoneum.
    • Contains two layers:
      • Outer layer - Mesothelium (Simple squamous epithelium)
      • Inner layer - Vascular connective tissue

    Parametrium

    • Fibrous layer covering the subperitoneally located part of the uterus.

    Endometrium

    • Mucosal lining of the uterus.

    Menstrual (Uterine) Cycle

    • Series of developmental stages in the functional layer of the endometrium, repeating every 28 days.
    • Three phases:
      • Menstrual
      • Proliferative
      • Secretory

    Menstrual Phase (1-4-5 Days)

    • Rapidly decreasing ovarian hormone levels result in contraction of spiral arteries.
    • The spiral artery closure causes ischemia and necrosis of the functional layer of the endometrium.
    • Blood vessels rupture, leading to bleeding.
    • Average blood loss during menstruation is 35-50 mL.
    • Remaining basal layer initiates the proliferative phase.

    Proliferative Phase (5-14 Days)

    • Influenced by estrogens from growing ovarian follicles.
    • Regeneration of lost epithelium from basal portions of uterine glands.
    • Endometrium reaches 2-3 mm thickness.
    • Glands appear as straight tubules with narrow lumens.

    Secretory Phase (15-28 Days)

    • Regulated by progesterone from the corpus luteum.
    • Glands become highly coiled and secrete glycoproteins for embryonic nutrition.
    • Endometrium reaches maximum thickness (5 mm) due to secretions and stroma edema.
    • Last few days are called the ischemic phase.
    • Estrogen and progesterone influence stromal cell transformation into decidual cells, stimulated by blastocyst implantation.

    Secretory Phase (15-28 Days)

    • The window for blastocyst implantation into the uterine endometrium.

    Uterine Glands

    • Simple tubular glands, lined by columnar epithelium.
    • Secrete mucous fluid rich in glycogen for placental development.
    • At menstruation, most glands are lost, leaving only their basal parts.
    • Glands elongate, increase in diameter, and become twisted during the proliferative phase.
    • Glands enlarge, become corkscrew-shaped, and their lumina become sacculated in the secretory phase.

    Endometriosis

    • A common gynecologic disease where endometrial tissue appears in unusual locations.
    • Occurs between puberty and menopause, most common between 20-30 years old.
    • Symptoms include pelvic pain and premenstrual bleeding.
    • Etiology is unknown but may be caused by endometrial cell migration via fallopian tubes during menstruation.
    • Often subsides after menopause due to declining estrogen levels.

    Uterine Cervix

    • The part of the uterus below the isthmus.
    • Endometrium of the cervix differs from the rest of the uterus.
    • The vaginal part of the cervix protrudes through the vagina, surrounded by the vaginal fornix.
    • Contains the cervical canal connecting the uterine cavity and vagina.

    Features of the Uterine Cervix

    • Mucosa: epithelium + lamina propria.
    • CT and smooth muscle form the bulk of the cervix below the mucosa.
    • Cervical canal is lined by simple columnar epithelium.
    • Lamina propria consists of CT with numerous cervical glands.
    • Non-keratinised stratified squamous epithelium covers the external os and vaginal part of the cervix.
    • Cervical mucosa is not shed during menstruation.

    Transformation Zone

    • The site where simple columnar epithelium transitions to non-keratinised stratified squamous epithelium.
    • The most common site of origin for cervical carcinoma.

    Pap (Papanicolaou) Smear

    • Collected cervical epithelial cells for screening and diagnosing cancerous conditions of the cervix.
    • Surface scraping is done around the external os using a spatula, brush, or broom.
    • Cells are then studied under a microscope.

    Cervical Cytology Papanicolaou (HP)

    • Stratified squamous epithelium surface cells have small, contracted nuclei and are stained pink.
    • Deeper cells have plump nuclei and blue/green cytoplasm.
    • Adequate Pap smears also contain endocervical cells, cervical mucin, and inflammatory cells.

    Cervical Glands

    • Mucus-secreting branched tubular glands.
    • Glands undergo cyclical changes during the menstrual cycle.
    • Secrete watery mucus during the proliferative phase for easier sperm passage.
    • Secrete highly viscous mucus during the secretory phase to prevent microorganisms from entering the cervix.

    Nabothian Cysts

    • Formed by blockage of cervical gland openings, leading to secretion retention.
    • Clinically significant only if numerous cysts cause significant cervical enlargement.

    Vagina

    • Fibromuscular tube extending from the vaginal part of the cervix to the external genitalia.
    • Contains three layers:
      • Mucosa: non-keratinised stratified squamous epithelium + dense CT.
      • Muscularis: inner circular and outer longitudinal layers of smooth muscle.
      • Adventitia: contains many elastic fibers, providing elasticity to the vaginal wall.
    • Vaginal mucosa is devoid of glands and is lubricated by cervical gland secretions.
    • Vaginal epithelium contains abundant glycogen, resulting in a pale appearance with hematoxylin and eosin stains.
    • Glycogen is converted to lactate by bacteria in the vaginal lumen, creating an acidic pH that inhibits the growth of foreign microorganisms.

    Vestibular Glands

    • Two types of glands found near the vaginal opening:
      • Greater vestibular glands (Bartholin's glands): pea-sized, compound racemose, secrete mucus for vaginal lubrication.
      • Lesser vestibular glands (Skene's glands): smaller structures.

    External Genitalia (Vulva)

    • Covered by stratified squamous epithelium.
    • Includes:
      • Vestibule: space containing tubulo-acinar vestibular glands.
      • Labia minora: skin folds without hair follicles, containing numerous sebaceous glands.
      • Labia majora: homologous to the scrotum and similar in histology.
      • Clitoris: erectile structure homologous to the penis, with paired corpora cavernosa.

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    Description

    Explore the anatomy and functions of the uterus in this quiz. Learn about its structure, including the wall layers and the menstrual cycle, as well as the role of the endometrium in embryo implantation and development. Test your knowledge on this essential reproductive organ!

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