Female Genital System
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Module A Female Genital System Martin Špaček Histology and Embryology • Pictures from: • Junqueira et al.: Basic histology • Rarey, Romrell: Clinical human embryology • Sadler: Langman’s medical embryology • Young, Heath: Wheather’s functional histology • http://www.med.unc.edu/embryo_images Female Genital System Development • Development of the indifferent stages – see presentation “Male genital system” http://www.lf3.cuni.cz/histologie Development of the Ovary • Absence of TDF (testis-determining factor) • Primitive sex cords degenerate Development of the Ovary • Surface epithelium gives rise to a second generation of cords – cortical cords • Epithelial cells surrounding the germ cells form the follicular cells Development of the Genital Ducts • Absence of MIS (Müllerian inhibiting substance) in the female • Regression of the mesonephric (Wolffian) ducts Development of the Genital Ducts • Paramesonephric (Müllerian) ducts: – cranial ends → uterine tubes – caudal segments → uterus, upper part of the vagina Development of the Genital Ducts • Vagina develops from: – caudal segments of the paramesonephric ducts – vaginal plate Development of the Genital Ducts • Abnormalities of the uterus and vagina – lack of fusion of the paramesonephric ducts – or the atresia Development of the Genital Ducts • Remnants of the mesonephric tubules and ducts – epoophron, paroophron, Gartner’s canal External Genitalia in the Female • indiferent stage • female genital – absence of testosterone • genital tubercle • clitoris • urogenital folds • labia minora • genital swellings • labia majora Female Pseudohermaphroditism Adrenogenital syndrome masculinization of the external genitalia caused by excessive production of androgens by the adrenals 46, XX: Histology of the Female Genital System •Ovary • Uterine tube • Uterus (Womb) •Vagina • External genitalia Ovary Cortical region simple squamous or cuboidal epithelium (germinal epithelium) tunica albuginea loose connective tissue, fibroblasts ovarian follicles Medullary region loose connective tissue, vessels Ovarian Follicles Primordial Follicles Oocyte spherical cell with large nucleus Single layer of flattened follicular cells Primary Follicles Follicular cells cuboidal, single → stratified epithelium = granulosa layer Zona pellucida surrounds oocyte (glycoproteins) Theca folliculi differentiating stroma around the follicle Secondary (vesicular) Follicle Cavities between the cells → antrum Theca differentiates into two layers: theca interna – produce androstendion theca externa Mature Follicle (Graafian) Measures about 2 cm in diameter Cumulus oophorus cluster of follicular cells between the oocyte and the wall of the follicle Corona radiata single layer of follicular cells around the oocyte Ovulation Rupture of the mature follicle Oocyte with the zona pellucida and the corona radiata is released Oocyte enters the uterine tube Slide G1 – Ovary HE Slide G1 – Ovary HE Slide G1 – Ovary HE SlideSlide G3G3 –– OvaryOvary (rabbit)(rabbit) HEHE Corpus Luteum After ovulation the granulosa cells and the theca interna transform into a corpus luteum Corpus luteum of menstruation (lasts 14 days) Corpus luteum of pregnancy (stimulated by hCG) Corpus albicans Corpus Luteum Invasion of blood vessels, connective tissue Granulosa lutein cells and theca lutein cells produce progesteron and estrogens SlideSlide G2G2 –– CorpusCorpus LuteumLuteum HEHE SlideSlide G2G2 –– CorpusCorpus LuteumLuteum HEHE Oviducts (Fallopian or Uterine Tube) Mucosa mucosal folds simple columnar epithelium – ciliated and secretory cells lamina propria Muscular layer inner circular outer longitudinal Serosa layer = visceral peritoneum SlideSlide G4G4 –– uterineuterine tubetube ((isthmusisthmus)) SlideSlide G5G5 –– uterineuterine tubetube ((ampullaampulla)) SlideSlide G5G5 –– uterineuterine tubetube ((ampullaampulla)) SlideSlide G5G5 –– uterineuterine tubetube ((ampullaampulla)) Uterus Endometrium (mucosa) simple columnar epithelium with ciliated and secretory cells lamina propria – simple tubular glands functionally basal layer and functional layer Myometrium thick smooth muscle layer Adventitia or serosa Menstrual Cycle The menstrual phase (the 1st to the 4th day) The proliferative phase (the 5th to the 14th day) Secretory (luteal) phase (the 15th to the 28th day) Menstrual Phase Corpus luteum ceases function → drop of the levels of progesterone and estrogens Ischemia Necrosis of the functionalis layer Bleeding Proliferative Phase Estrogenic or follicular phase Proliferation of the cells Glands straight and narrow Secretory Phase Depends on the progesterone secreted by the corpus luteum Endometrial glands initiate their secretory activity Glands become highly coiled SlideSlide G6G6 –– fundusfundus uteriuteri HEHE SlideSlide G6G6 –– fundusfundus uteriuteri HEHE Uterine Cervix Endocervix simple columnar epithelium cervical glands (may become obstructed → nabothian cysts) Ectocervix external segment that bulges into the vagina stratified squamous epithelium Uterine Cervix Transformation zone abrupt epithelial transition between the endocervix and the ectocervix dysplasia, carcinoma in situ, invasive carcinoma Papanicolaou Smear • Cytologic analysis of smears of the cervical epithelium • Can detect dysplasia and carcinoma in situ SlideSlide G7G7 –– cervixcervix uteriuteri HEHE Vagina • Mucosa layer – stratified squamous epithelium • accumulate glycogen (→ lactic acide) – lamina propria (devoid of glands) • Muscular layer – mainly longitudinal smooth muscle • Adventitial layer – dense connective tissue, rich in elastic fibers SlideSlide G9G9 –– VVaginaagina ((PASPAS++HH)) SlideSlide G9G9 –– VVaginaagina ((PASPAS++HH)) SlideSlide G10G10 –– VVaginaagina HEHE SlideSlide G10G10 –– VVaginaagina HEHE External Genitalia • Modified skin structures – (keratinized) stratified squamous epithelium •Monspubis • Labia majora – adipose tissue, hair – apocrine sweat glands and sebaceous glands • Labia minora – skin folds without adipose tissue • Clitoris – two erectile bodies.