unit 14 Flashcards

1
Q

how are the cyclic changes that the female reproductive system undergoes controlled?

A

neurohumeral mechanisms

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2
Q

what is the function of the ovaries

A

produce sex steroids (estrogen and progesterone)
produce gametes

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3
Q

what is the composition of the ovaries from superficial to deep

A

germinal epithelium
tunica albuginea
cortex
medullary region

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4
Q

ovary germinal epithelium

A

covers surface of ovary
simple squamous, sometimes cuboidal

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5
Q

ovarian tunica albuginea

A

composed of dense CT, deep to germinal epithelium
white appearance

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6
Q

ovarian cortex

A

deep to tunica albuginea
contains follicles

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7
Q

ovarian medullary region

A

vascular bed, loose CT, lymphatics, and nerves

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8
Q

where are follicles found

A

embedded in the stroma of the cortex region

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9
Q

what does a follicle consist of

A

oocyte surrounded by layer(s) of follicular cells

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10
Q

what are the stages of follicular development

A

primordial
primary (preantral)
secondary (astral)
Graafian (mature)

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11
Q

primordial follicles consist of what

A

primary oocyte (large nucleolus & eccentric nucleus)
surrounded by single layer of squamous follicular cells (joined by desmosomes)
basal lamina surrounds that layer (boundary between follicle and stroma)

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12
Q

follicular cells in early primary follicle

A

proliferate to form a single layer of cuboidal cells
secrete steroid hormones & growth factors that promote oocyte development/maturation

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13
Q

what is the follicle called after the follicular cell form a single cuboidal layer?

A

unilaminar primary follicle

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14
Q

oocyte in early primary follicle

A

enlarges, secrete GAGs and glycoproteins that form zona pellucida

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15
Q

what is the zona pellucida

A

glycoprotein coat between the oocyte and follicular cells

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16
Q

what do follicular cells do in the late primary follicles

A

continue to proliferate, form a stratified epithelium called stratum granulosum
follicular cells are now called granulosa cells

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17
Q

other changes to late primary follicles

A

zona pellucida thickens and becomes visible
oocyte grows/matures, cortical granules form in cytoplasm and contain proteases
stromal cells differentiate and form a 2 layered CT sheath (theca folliculi)

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18
Q

layers of theca folliculi

A

theca interna - cuboidal, steroid producing secretory cells; fibroblasts and BV
theca externa - SM and collagen

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19
Q

secondary follicle

A

granulosa cells secrete fluid rich in hyaluronan, proteoglycans, and steroid binding proteins
stratum granulosum, 6-12 layers thick, fluid filled cavities form an antrum
oocyte reaches max size, positioned eccentrically in follicle
theca layers more distinct

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20
Q

mature follicle

A

mound of granulosa cells project into and line antrum, are called cumulus oophorus
oocyte suspended in antrum , surrounded by corona radiata, complete meiosis I, enters II
theca layers actively secrete hormones

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21
Q

where is a Graafian follicle located

A

just beneath the surface of the ovary, causes bulging

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22
Q

what causes expulsion of the secondary oocyte and corona radiata from the follicle

A

disruption of blood flow, creating avascular area that ruptures
protease-mediated weakening of the follicular wall
follicular fluid pressure
contraction of SM in theca externa

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23
Q

what happens if the oocyte is fertilized

A

completes meiosis II, becomes an ovum

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24
Q

what happens after the follicle remnant collapses

A

forms deeply folded structure around a cavity that fills with blood to become corpus hemorrhagicum
once this wound heals, structure remaining is called corpus luteum

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25
Q

corpus luteum

A

highly vascular and large
thick inner folds of granulosa lutein cells with cords of cells from outer layer theca lutein cells

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26
Q

what happens to the corpus luteum

A

if fertilization does not occur, degeneration and formation of corpus albicans
if fertilization occurs, maintained until parturition

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27
Q

what do lutein cells do

A

produce steroids (progesterone & some estrogens)
prepare the uterus for implantation
maintain early pregnancy

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28
Q

where do lutein cells come from

A

granulosa and theca interna cells increasing in size, filling with lipid droplets

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29
Q

what cells undergo atresia

A

primordial follicles that began the maturation phase but do not finish it

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30
Q

atresia in primordial and early primary follicles

A

oocyte and follicle shrink and degenerate at the same time

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31
Q

atresia in more mature follicles

A

death of granulosa cells, loss of oocyte
macrophages & neutrophils infiltrate granulosa layer
sloughing of granulosa cells into antrum
hypertrophy of theca interna
follicular collapse

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32
Q

what does FSH do during the cycle

A

stimulates follicular growth and secretion of estradiol

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33
Q

what happens to the dominant follicle?

A

becomes increasingly sensitive to FSH, LH, and estradiol

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34
Q

what does estradiol do

A

stimulates the hypothalamus to secrete gonadotropin-releasing hormone
stimulates anterior pituitary to secrete FSH

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35
Q

what does GnRH do

A

stimulates a surge of luteinizing hormone to be released from anterior pituitary

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36
Q

what does estradiol do

A

stimulates a lesser spike of FSH to be released

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37
Q

what does luteinizing hormone induce

A

primary oocyte completion of meiosis I
rapid build up of follicular fluid and swelling of follicle
secretion of enzymes that weaken follicular wall by macrophages and leukocytes

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38
Q

uterine tubes

A

narrow bilateral tubes that extend from uterus toward ovaries
infundibulum, ampulla*, isthmus, uterine

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39
Q

mucosa of uterine tubes

A

simple columnar epithelium containing ciliated (pale staining, motile!) and nonciliated (PEG cells, slender elongated nucleus) cells with underlying lamina propria
complex longitudinal folds, most complex in ampulla

40
Q

muscularis of uterine tubes

A

thick, inner circular layer
thin, outer longitudinal layer
composed of visceral smooth muscle (peristalsis moves ovum into uterus)
thickness is greatest in isthmus

41
Q

serosa of uterine tubes

A

outer serous membrane of mesothelium and thin CT

42
Q

uterine tubes during menses

A

epithelial cells undergo cyclic hypertrophy during follicular phase, atrophy during luteal phase in response to hormonal changes

43
Q

what affect does estrogen have on uterine tubes during menses

A

increases height of secretory cells, greatest around ovulation
stimulates cilia production, peak around ovulation
increases secretory activity

44
Q

what affect does progesterone have on uterine tubes during menses

A

stimulates PEG cell proliferation
PEG cell number increases after ovulation
increases number of PEG cells

45
Q

uterine blood supply

A

uterine artery branches > arcuate arteries (circle myometrium)
arcuate arteries divide > radial arteries (penetrate into myometrium)
endometrium - straight and spiral
stratum functionalis, capillary beds, lacunae - spiral
stratum basalis - straight

46
Q

layers of the uterine wall, superficial to deep

A

perimetrium (outer serous layer, continuous with pelvic and abdominal peritoneum)
myometrium (thick, muscular, continuous with uterine tube and vaginal muscle)
endometrium (mucosa)

47
Q

endometrium

A

simple columnar epithelium (ciliated and secretory cells) line lumen
endometrial glands penetrate down into underlying stroma

48
Q

what are the layer of the endometrium

A

stratum functionalis
stratum basalis

49
Q

stratum functionalis

A

thick, superficial endometrial layer
includes surface epithelium, upper part of glands, associated stroma
shed during menstration

50
Q

stratum basalis

A

thin, deep endometrial layer
lower portion of glands, associated stroma
retained during menstruation, regenerates stratum functionalis

51
Q

myometrium

A

composed of 3 indistinctly defined layers of SM
inner and outer are mostly longitudinal, middle is circular and spirally arranged

52
Q

what are the 3 phases of the menstrual cycle

A

proliferative
secretory
menstrual

53
Q

endometrium at the end of the menstrual phase consists of

A

thin band of Ct
basal portion of uterine glands and spiral arteries
straight arteries

54
Q

what happens in response to estrogen in the proliferative phase

A

epithelial cells in glands proliferate, migrate to cover surface and elongate glands
stromal cells proliferate
spiral arteries lengthen
glands have narrom lumens and are mostly straight
stratum functionalis is regenerated

55
Q

when does the proliferative phase end

A

one day after ovulation

56
Q

what regulates the secretory phase

A

progesterone

57
Q

what happens during secretory phase

A

stratum functionalis layer thickens, becomes edematous
cells hypertrophy
glands enlarge, become corkscrew shape, lumen has saw tooth appearance
spiral arteries lengthen and reach surface

58
Q

what does the menstrual phase result from

A

decline in secretion of progesterone and estrogen

59
Q

corpus luteum in menstrual phase

A

produces hormones for about 10 days if fertilization does not occur
hormone levels rapidly decline just prior to menstruation

60
Q

corpus luteum changes cause what

A

periodic contractions of spiral arteries, this results in transient ischemia that leads to reduced glandular secretion, endometrial height shrinkage, leukocyte infiltration, RBC extravasation into stroma

61
Q

extended contraction of spiral arteries causes

A

disruption of epithelium
sloughing of tissue and bleeding
this continues until only the stratum basalis remains

62
Q

what is the chorionic plate

A

CT plate with vessels to/from the umbilical cord
stem villi > intermediate villi > free villi > anchoring villi

63
Q

what is the decidual plate

A

composed of decidual cells (large, round, pale staining) covered by a layer of trophoblast cells
anchoring villi invade decidua

64
Q

syncytiotrophoblast layer

A

epithelial-like outer layer that covers chorionic villi
early: nuclei evenly distributed, epithelium cuboidal

65
Q

cytotrophoblast layer

A

proliferative middle layer
early: underlie syncytiotrophoblast
term: few cytotrophoblasts remain deep to syncytiotrophoblast

66
Q

connective tissue stroma

A

found in the core of the villi
cellular stroma with mesenchymal cells, fibroblasts, SM cells, macrophage-like, antigen-presenting cells, fetal blood vessels whose lumens dilate over time

67
Q

what is the placental barrier composed of

A

semi-permeable barrier between maternal and fetal circulation
syncytiotrophoblast layer
cytotrophoblast cells
trophoblast basal lamina
villous stroma/CT
endothelial basal lamina
endothelial cell

68
Q

what can cross the placental barrier

A

gases, small molecules and drugs (low molecular weight, non polar, lipid soluble)
antigens and antibodies
some viruses

69
Q

what is the cervical mucosa composed of

A

epithelial ranges from simple columnar epithelium with branched glands to stratified squamous epithelium
not sloughed during menstruation
mucus secretions impacted by cycle

70
Q

cervix

A

robust CT stroma
modest muscularis

71
Q

ectocervix

A

projects into vagina, comprised of stratified squamous epithelium

72
Q

endocervix

A

lines cervical canal and is comprised of simple columnar epithelium with large, branched glands with mucus secreting cells

73
Q

transformation zone

A

abrupt transition between ecto- and endo- cervix
most common site for cervical cancer

74
Q

mucosa of vagina

A

numerous transverse folds
stratified, squamous, nonkeratinized epithelium
prominent lamina propria containing abundant elastic fibers
CT papillae from lamina propria project into overlying epithelium

75
Q

muscularis layer of vagina

A

two intermingling SM layers, outer longitudinal and inner circular
the outer layer is continuous with the corresponding layer of the uterus and much thicker

76
Q

adventitia of vagina

A

inner layer of dense CT with numerous elastic fibers
outer loose CT layer, numerous blood and lymphatic vessels, nerves

77
Q

histology of vaginal mucosa

A

stratified squamous, non-keratinized epithelium, some thickening during luteal phase, NO glands, produces glycogen

cellular, loose CT lamina propria with many WBCs, elastic fibers, and rich vascularization

78
Q

what is the breast composed of

A

glandular tissue embedded in subcutaneous adipose and CT
suspensory ligaments suspend breast from deep fascia

79
Q

breast glandular tissue

A

branched modified sweat glands that produce milk
organized as 15-20 lobes per breast, radiate out from nipple

80
Q

breast glandular lobes

A

branched ductal system with branches ending in many lobules

81
Q

breast glandular lobules

A

functional unit of mammary glands
composed of central interlobular duct with branches ending at terminal ductules surrounded by loose interlobular CT

82
Q

when do true alveoli form

A

during pregnancy

83
Q

intralobular duct epithelium

A

simple columnar/cuboidal secretory

84
Q

terminal ductal lobular unit

A

lobule + associated extra lobular terminal duct (connects intra to inter duct)
most breast cancers arise in TDLU

85
Q

what is the glandular tissue of the lobule surrounded by

A

loose intralobular CT

86
Q

duct order

A

intra > extra > inter > main

87
Q

breast interlobular stroma

A

dense irreglar CT and adipose
surrounds lobules and interlobular ducts

88
Q

luminal epithelial cells

A

near nipple - stratified squamous
lactiferous sinus - transitions to simple cuboidal

89
Q

what happens beginning at the sinus

A

myoepithelial cells surround the epithelium

90
Q

where are luminal and myoepithelial cells derived from

A

basally positioned stem/progenitor cells

91
Q

histology of inactive mammary gland

A

abundant interlobular stroma (DCT)
sparse glandular tissue
small ductal lumens
consists of sparse ductal structures surrounded by abundant loose CT
slight changes during menstrual cycle

92
Q

pregnancy induced changes in mammary glands

A

glandular epithelium and myoepithelial cells proliferate, increase ductal branching, alveoli develop
luminal cells begin to differentiate and produce milk
decrease in intralobular and interlobular stromal CT, adipose tissue

93
Q

lactating mammary glands

A

alveoli more uniform in size
abundant lipid secretions in lumens
tight junctions between secretory cells ensure luminal storage of secretions

94
Q

ultrastructural changes to lactation mammary gland

A

spherical nucleus more basally positioned
increase in apical secretory vesicles and lipid droplets
hypertrophy of ERs, Golgi
numerous apical microvilli

95
Q

mammary secretions

A

milk proteins (exocytosis)
lipids (apocrine secretion)
IgA from plasma cells transcytosed