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Female Reproductive Tracts Flashcards

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1
Q

What does the female external genitalia consist of

A

Mons pubis
Labia major and minor
Clitoris

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2
Q

What covers the mons pubis from puberty

A

Hairy skin with substantial fatty connective tissue beneath

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3
Q

How is the skin of the mons pubis and labia different

A

Mons pubis = hairy skin with enlarged sebaceous glands and apocrine sweat glands
Labia = no hairs, sebaceous glands and heavily pigmented epidermis

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4
Q

Lining of vagina

A

Stratified squamous epithelium
Vulval end - thinly keratinised
Elsewhere - moist non-keratinised

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5
Q

Thickness of vaginal epithelium

A

Thin before puberty and after menopause
At onset of menarche and throughout reproductive life becomes thickened

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6
Q

What lies beneath epithelium of vagina

A

Lamina propria containing many small blood vessels
Fluid diffusing from these keeps the epithelium moist

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7
Q

What surrounds the vaginal epithelium

A

A fibro-muscular tube consisting of a mixture of collagen , elastic and smooth muscle fibres
At its lower end a vaginal sphincter of skeletal muscle is also present

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8
Q

Which glands discharge postero-laterally into the lower end of the vagina at its junction with the vulva

A

Mucous secreting glands of Bartholin

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9
Q

Cyclic changes in epithelium of vagina and cervix during menstrual cycle

A

The surface cells accumulate glycogen and many flake off (desquamate) following ovulation.
The desquamated cells rupture and bacteria feed on the glycogen, generating lactic acid.
This creates a low pH within the vagina that deters the entry of pathogenic organisms.

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10
Q

What generates a low pH within the vagina

A

Production of lactic acid by bacteria feeding on glycogen from desquamated cells

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11
Q

How can you take a sample of exfoliated Squames

A

With a spatula or brush and smearing it on to a glass slide

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12
Q

What colour are cells from the outermost layer of vagina

A

Pale green

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13
Q

What colour are cells from the inner layer of vagina

A

Pink

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14
Q

Location of cervix

A

Protrudes into the anterior superior wall of the vagina
Surrounded by the anterior, lateral and posterior fornices

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15
Q

What epithelium covers the cervix

A

Stratified squamous non-keratinising epithelium

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16
Q

What lines the cervical canal between the internal and external Ostia

A

Tall columnar epithelium that is thrown into deep gland-like folds

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17
Q

Stroma of cervix

A

Consists of fibrous connective tissue intermingled with smooth muscle fibres

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18
Q

How is the Stroma of the cervix hormonally sensitive

A

Softens during childbirth and canal widens to become part of birth canal

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19
Q

Mucus secreted by cervix during first half of menstrual cycle

A

Thin and watery

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20
Q

Mucus secreted by cervix after ovulation and during pregnancy

A

Viscous
Serves as a plug to prevent the entry of microorganisms into the uterine cavity

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21
Q

Where is the transition zone

A

Between the sensitive cervical lining and outer stratified squamous epithelium

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22
Q

What is the transition zone vulnerable to

A

Prone to infection and erosion
Common site for development of cancerous lesions

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23
Q

What lines the inside of the body and Fundus of the uterus

A

Epithelial endometrium

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24
Q

What composed the myometrium of the body and Fundus of the uterus

A

3 poorly defined layers of smooth muscle

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25
How does pregnancy affect the myometrium of the uterus
Hormonally sensitive Increase in number- hyperplasia Become enlarged - hypertrophy
26
Where do large arteries and veins run in the uterus myometrium
Inner and middle layers
27
Large arteries and veins in the myometrium of the uterus
Supply the endometrium of uterus and give rise to spiral arteries that play a role in the process of menstruation
28
Endometrium of uterus
Simple columnar epithelium with tubular glands surrounded by a sub-epithelial stroma
29
What happens to the endometrium in the proliferative phase of the menstrual cycle
Thickness of stroma and length of glands increases during first half of menstrual cycke
30
What happens to the endometrium in the secretory phase of the menstrual cycle
Glands secrete Stroma differentiates to create an environment conducive to implantation of a fertilised ovum
31
What is shed at menstruation
Most of the endometrium- decidua (functional layer) Only the bases of the glands and surrounding stroma are left to establish a new endometrium in the next cycle
32
How long is the proliferation phase of endometrial development
10 days
33
What occurs during the proliferation phase of menstruation
Regrowth of new glands, stroma and blood vessels Tubular glands appear straight and do not yet secrete endometrial mucus Stroma is compact and contains straight extensions of endometrial arteries and veins
34
What is successful regrowth of the endometrium dependent on
Presence of oestrogen
35
Secretory endometrium structure
At time of ovulation - cells of endometrial glands display large vacuole-like accumulations of glycogen below their nuclei used to synthesise mucins that are secreted and line uterine cavity Glands take on an irregular sacculated appearance and secretions appear in lumina Stroma become oedematous (swollen with fluid) in places and arteries within it lengthen and take on spiral form
36
Function of mucins that line surface of uterine cavity
Attract and nourish the conceptus should fertilisation occur
37
Length of secretory phase
12 days
38
What happens towards the end of the secretory phase
Spiral arteries briefly close down, open again and leak blood into the stroma
39
What causes the decidua to detach and menses to begin
Temporary anoxia coupled with hydraulic pressure of the blood disrupts the stroma following spiral arteries closing then reopening
40
What is required for the successful transition from proliferative endometrium to secretory endometrium
Progesterone and oestrogen
41
Length of fallopian tube
10cm
42
Where is the fallopian tube located
Within broad ligament
43
Regions of uterine tube
Intramural part - embedded in wall of uterus Short narrow isthmus Long ampulla Wide infundibulum closest to ovary
44
Epithelium of uterine tubes- how does it vary
Thrown into complex folds at wide infundibulum but reduces to a simple star shaped folding at isthmus
45
Fimbriae
Finger-like processes of the infundibulum that become erect at ovulation and clasp the ovary ensuring safe transfer of ovum to tube
46
Structure of uterine tubes
2 helical layers of smooth muscle- inner circular and outer longitudinal
47
Lining of uterine tubes
Simple columnar epithelium- some ciliated and some mucous secreting cells
48
How are the epithelial cells of the uterine tubes hormonally sensitive
Cells are taller and cilia beat more strongly at time of ovulation Secretions are thinner and more copious
49
Germinal epithelium
A layer of cuboidal cells sitting on a thickened basement membrane Where the mesovarium is continuous with the surface layer of the ovary
50
3 parts of the ovary
Hilum Medulla Cortex
51
Medulla of ovary
Contains stromal cells including some testosterone-secreting cells
52
Cortex of ovary
Contains primordial germ cells May also contain follicles known as one or more stages of development from primary to atretic follicles
53
When do germ cells migrate into the ovary
10th week of uterine development
54
When is prophase 1 of meiosis (primary oocytes) reached
Around time of birth
55
How many primordial germ cells begin to differentiate each menstrual cycle
Up to 20
56
Dormant primordial follicles
A germ cell enclosed in a theca derived from stromal cells
57
Follicular development
Initially the theca consists of a single layer of squamous cells (primordial follicles) that later become cuboidal or columnar in shape. The theca then differentiates into inner granulosa cells (theca interna) that begin to secrete oestrogen and outer flattened cells (theca externa) and the follicle becomes a secondary follicle. At this stage too the germ cell develops a prominent zona pellucida that separates it from the theca. Further growth and development of the theca, particularly the granulosa cells results eventually in the development of a mature Graafian follicle by which time the follicle has developed a fluid filled antrum and the oocyte is attached to the periphery by a stalk of granulosa cells know as the cumulus oophorus. It should be noted that many follicles that start to differentiate fail to develop fully and perish as atritic follicles. Once the oocyte is released from the Graafian follicle at ovulation the theca persists and continues to secrete oestrogen and progesterone as a corpus luteum even beyond the end of the menstrual cycle should fertilization and implanation occur (corpus luteum of pregnancy).
58
Theca interna
Inner granulosa cells that secrete oestrogen
59
Theca externa
Outer flattened cels
60
Zona pellucida
Separates the germ cell from the theca
61
Graafian follicle
Follicle has developed a fluid filled antrum
62
Cumulus oophorus
A stalk of granulosa cells that attaches the oocyte to the periphery of the Graafian follicle
63
What does the corpus luteum secrete
Oestrogen and progesterone
64
Which hormone causes thecal cells to secrete oestrogen and progesterone
Luteinising hormone
65
For how long does the corpus luteum secrete oestrogen and progesterone
10 days
66
For how long does the corpus luteum of pregnancy secrete oestrogen and progesterone
Up to 4 weeks until the developing placenta is fully established
67
Thecal lutein cells
Synthesise oestrogen Small proportion of cells found in the centre of the corpus luteum
68
Final involution of the corpus luteum- corpus albicans
Results in formation of a pale staining fibrous mass
69
What hormone do most surviving thecal cells produce
Progesterone
70
What colour do cells stain from the deeper layers of the vaginal wall later in the menstrual cycle
Darker-staining orange
71
What colour do cells stain from the deeper layers of the vaginal wall in the first half of the menstrual cycle
Paler grey-staining
72
How does the uterus increase during pregnancy
As placenta begins to develop, burst in mitotic division within the myometrium that increases number of smooth muscle cells- short duration Most of enlargement due to hypertrophy of muscle cells
73
How does the uterus regress after birth
Muscle cells lose mass and uterus returns to more or less original size
74
Where does fertilisation of an ovum normally occur
Ampulla of uterine tube but can occur anywhere in tube or uterus
75
Where do ectopic pregnancies often implant
Uterine tube Can also occur in peritoneal cavity
76
What is the cycle of a follicle
Primordial Primary Secondary Graafian OR reabsorbed as atretic follicles
77
Shape of cells in theca externa
Outer spindle shaped cells Small stellate in shape Pale staining
78
Shape of cells in theca interna
More rounded Larger Strongly pink staining
79
Name of 2 major regions of endometrium
Stratum basale - remains after menses Decidua -shed at menses
80
What vestigial structure is often present in the mesovarium and what is its origin
Oophoron Homologue of part of male genital tract
81
Through which part of the ovary does eruption of the Graafian follicle normally occur
Erupts through the germinal epithelium on the anti mesenteric border of the ovary - simple cuboidal epithelium that is continuous with squamous epithelium of peritoneum
82
Attachments of the ovary
To broad ligament by mesovary To uterus by utero-ovarian ligament To pelvic wall by suspensory ligament
83
What covers the ovary
A single layer of modified mesothelium
84
Ovarian cortex
Spindle stromal cells arranged in whorls/storiform pattern Ovarian follicles Some luteinised cells
85
Ovarian medulla
Loose fibroelastic tissue with blood vessels, lymphatics and nerves Rete ovarii-analogue of rete testis - present at the hilum
86
Where are primordial follicles located
Periphery of cortex
87
What surrounds the primordial follicles
Single layer of squamous epithelial cells - granulosa cells
88
What stimulates follicular development
Cyclic FSH secretion from anterior pituitary
89
Transition from primordial to primary follicle
Follicular epithelial cells proliferate- squamous to cuboidal or columnar appearance Oocyte enlarges Stromal cells become organised into connective tissue sheath Zona pellucida forms directly around oocyte
90
Primary to secondary follicle
Formation of antrum (space filled with follicular fluid) CT differentiates into theca interna and theca externa Oocyte supported by cumulus oophorus
91
Structure of Graafian follicle
Ovum surrounded by thick Zona pellucida and corona radiata
92
Corpus luteum shape of cells
Granulosa and theca cells become polygonal, larger in size and have abundant cytoplasm contains lipid
93
Regression of corpus luteum
Granulosa cells decrease in size Develop pyknotic nuclei and accumulate abnormal lipid Cells undergo dissolution and are Phagocytosed Progressive fibrosis by ingrowth of connective tissue
94
Composition of corpus albcians
Densely packed collagen with occasional follicles
95
Cell types in fallopian tube
Secretory Ciliated Peg cells Basal
96
Peg cells
Effette secretory
97
Basal cells in fallopian tube
Lymphocytes
98
3 layers of uterus
Endometrium Myometrium Serosa
99
Layers of uterine endometrium
Deep basal layer- stratum basalis Superficial functional layer- stratum compactum and stratum spongiosum
100
Characteristics of proliferative endometrium
Straight proliferating glands with mitotic activity No luminal secretions Spindled stromal cells and compact with mitotic activity
101
Characteristics of early secretory endometrium
Sub-nuclear glycogen vacuoles
102
Characteristics of mid secretory endometrium
Vacuoles above and below the nucleus Later intraluminal secretions Glands more rounded Stroma - oedema
103
Characteristics of late secretory endometrium
Elongated and saw-toothed glands with more intraluminal secretions Stroma- spiral arterioles, decidual change
104
Characteristics of menstrual endometrium
Stromal haemorrhage and granulocytes Stromal and glandular fragmentation
105
Endocervix
Loose fibromuscular stroma lined by simple columnar ciliated epithelium Thrown into crypts
106
Ectocervix
Dense smooth muscle stroma lined by non-keratinising stratified squamous epithelium Site of squamocolumnar junction varies Atrophic in postmenopausal women
107
Labia majora
Lined by keratinising stratified squamous epithelium Has skin adnexae
108
Labia minora lining
Non keratinising stratified squamous epithelium
109
Bartholin’s glands
Tubuloalveolar glands Acini lined by mucus-secreting epithelium
110
Minor vestibular glands
Simple tubular glands lined by mucus-secreting epithelium
111
Skein’s glands (periurethral glands)
Analogous to prostate Lined by pseudostratified columnar epithelium
112
Hymen
Lined by non-keratinising squamous epithelium
113
Clitoris
Erectile tissue rich in blood vessels and nerves

Histology (17 decks)

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