Test 1 Flashcards by Spencer Rickers

The timeframe for gonads to acquire their sex

determination

gonads do not acquire male or female characteristics until the seventh week of development.

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The key to sexual dimorphism is found on the…

short arm of the Y chromosome, called the Sex-
Determining Region on Y (SRY), which is the testis-determining factor.

In its absence, female development is established

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Primordial germ cells Start…

Mesenchymal or stem cells (future sperm or eggs)
that develop in the wall of the yolk sac near the
allantois that migrate along the mesentery of the
hindgut. This occurs at about the 3rd week of
embryologic development.

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Homolog for the Scrotum?

labia majora

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Homolog for Spongy urethra?

labia minora

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Other names for paramesonephric ducts in a female.

also called Mullerian ducts

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Other names for Mesonephric ducts in a male

also called Wolffian ducts

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What does the Cranially part of paramesonephric become?

Opens up, funnel like structure. Will become fallopian tube fimbria/open ended fallopian tubes

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What does the Caudally part of paramesonephric become?

Fuses together to form:

Uterine canal, Uterus, cervix, distal 1/3 of the vagina

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The Mesonephric duct in male becomes?

o  Epididymis
o  Vas deferens 
o  Seminal vesicles 
o  Ejaculatory duct 
o Connects to the primitive kidney

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Primordial germ cells develop in the…

wall of the yolk sac near allantois

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Primordial germ cells Migrate along the…

mesentery of the GI tract, called the hindgut

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Primordial germ cells continue migration until they..

Reach the gonadal ridges and penetrate into the

primitive gonad

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Before After, and during migration, Primordial germ cells penetrate into the primitive gonad, What happens?

The genital ridge proliferates and penetrates underlying mesenchyme forming a number of primitive sex cords, inserted itself down past the epithelium.

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After the After Primordial germ penetrate the genital ridge they become immature eggs or sperm when they are surrounded by…

the sex cord cells

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The sex cord cells surrounding the primordial germ cells will become…

the follicle cells

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The lower part of the vagina is formed from

the…

posterior wall of the urogenital sinus

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The anterior portion of the urogenital sinus forms…

urinary bladder and urethra.

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Contact of the urogenital sinus by the paramesonephric ducts induces formation of the…

sinovaginal bulbs, a collection of endoderm from the wall of the urogenital sinus

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Hymen formation occurs during

canalization

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Congenital absence of the uterus is called…

agenesis

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results from the failure of the
embryonic mullerian ducts to fuse properly and
the resulting median wall does not resorb.

Septate Vagina

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The most common and most distal form of
vaginal outflow obstruction, occurring in 0.1%
of infant girls

Imperforate Hymen

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o The presence of increased mucus secretions in the vagina secondary to maternal estrogen effects may result in Mucocolpos, appearing as a bulging hymenal membrane between the
labia
o The membrane may be white because of the trapped mucoid material and may lead to»>
Urinary tract infections, Bladder obstructions Due to urethral compression

Identifying Imperforate Hymen in the Neonate…

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o Primary amenorrhea (no period/menstrual cycle) o Presence or absence of secondary sexual characteristics should be noted o Lower abdominal or pelvic pain o Urinary retention/constipation o Diagnosis is made when a distended bluish hymenal membrane is observed in the vaginal orifice/opening due to collected menstrual blood (hematocolpos)

Imperforate Hymen in an Adolescent

Refers to failure of the normal glandular epithelium that lines the embryonic vagina to be replaced by squamous epithelium during fetal development

Vaginal Adenosis Due to DES

a synthetic estrogen, was used in the 1940’s and 1950’s for high-risk pregnancies (used to prevent abortion)

DES (morning after pill)

DES exposure anywhere from the 10th to about the 18th week of gestation, arrests this transformation process

At the 10th week of gestation, the upgrowth of squamous epithelium derived from the urogenital sinus replaces the glandular (mullerian) epithelium lining the vagina and exocervix.

Manifests grossly as red, granular patches on the vaginal mucosa which usually disappear as the woman gets older.

Vaginal Adenosis Due to DES

A rare tumor of the vagina encountered exclusively in women exposed to Diethly- stilbesterol (DES).

Clear Cell Adenocarcinoma due to DES

Clear Cell Adenocarcinoma due to DES is Most common between ages...

17 and 22

Clear Cell Adenocarcinoma due to DES Develops most frequently on the...

anterior wall of the upper third of the vagina.

In more advanced stages of Clear Cell Adenocarcinoma due to DES they may spread by...

hematogenous or lymphatic routes.

A congenital anomaly of the female genital tract that presents as a deformed, obstructed and nonfunctional vagina that occurs in 1 in 4-5000 live female births

Vaginal Atresia

Rokatansky-Mayer-Kuster-Hauser Syndrome is a....

congenital lack of a uterus, vaginal atresia or agenesis, despite normal ovaries and external genitalia.

develops during embryogenesis due to incomplete fusion of the two mullerian ducts, resulting in a double vagina, with a chance of a double cervix and uterus

Longitudinal Septum

develops during embryogenesis when the two mullerian ducts fuse improperly to the urogenital sinus. A complete septum blocks menstrual flow and is a cause of primary amenorrhea.

Transverse Septum

Transverse Septum, and Longitudinal Septum defects Both may cause.

obstruction to flow and dyspareunia

is usually associated with dilation of the lower uterine segment, and may be an obstruction with menstrual flow.

Congenital stenosis

is a uterus with a common fused wall between two distinct uterine cavities. Due to a failure of the common wall between the apposed mullerian ducts to degenerate, forming a single uterine cavity

Bicornis (septate) Uterus

refers to a double uterus with a double vagina. Again due to failure of the two mullerian ducts to fuse during embryonic life.

Uterus Didelphys

refers to a single uterus with a partial remaining septum, owing to failure of the wall of the fused mullerian ducts to fully resorb.

Uterus Septae

When trapped menstrual secretions/blood backs up into the uterus

hematometrocolpos

When Reflux of endometrial tissue and blood through the fallopian tubes

hematosalpinx, secondary endometriosis

Form from the Mullerian (paramesonephric) Duct

The upper | vagina, cervix, uterus, fallopian tubes and ovaries

Embryologically, the lower 2/3 of the vagina | develop from the

urogenital sinus

The consequences of Imperforate Hymen in the adolescent/neonates...

o Hematometrocolpos o Hematosalpinx or secondary endometriosis o Endometriosis: tissue that normally lines the inside of the uterus, grows outside of the uterus. Displaced endometrial tissue continues to act as it normally would, thickens, breaks down and bleeds with each menstrual cycle Because this displaced tissue has no way to exit your body, it becomes trapped o An accumulation of infected material within the vaginal cavity may cause ascending genital tract infections

Histology of the Vagina

stratified squamous epithelium (no glands)

Histology of the Cervix

lower end of uterus; stratified squamous | epithelium

Histology of the cervical os

squamous epithelium changes to tall columnar mucinous epithelium

squamocolumnar junction =

transformation zone

Histology of the endometrium

columnar cells, glands, stroma

Histology of the fallopian tube

columnar epithelium, glands, secretory function

connecting tissue fibers covering the ovaries

Tunica albuginea:

the region between the labia minora where the vagina, the urethra, and bartholin’s glands open.

The Vestibule

fringe tissue around the ostium of the fallopian tube (opening)

What is Fimbria?

temporary endocrine structure in female mammals involved in the production of relatively high levels of progesterone

Corpus luteum

Develops from primary follicle, secondary fo llicle, after rupture of the mature oocyte, the follicle is turned into a

Corpus luteum

Two pea sized compound alveolar/acinar gland located slightly posterior and to the left and right of the opening of the vagina. They secrete the mucus to lubricate the vagina to provide vaginal lubrication during female sexual arousal

Bartholin’s gland

inside the vagina there are lots of folds/bumpy tissue called rugae, allows for expansion

Vaginal Rugae

Primitive sex cords differentiate into...

Follicles

What type of cancers will be vulvar, vaginal and cervical?

squamous cell carcinoma

3% of all GYN cancers o Cancer of older women o Wart like or slightly raised mucosal lesion/ulcers o In Situ or Invasive Cancer o Almost always squamous cell carcinoma o Preneoplastic lesions Leukoplakia (white plaque) o 70% chance survivability, 5 years

Vulvar Carcinoma

VIN stands for...

Vulvar Intraepithelial Neoplasia (VIN)

``` 2% of all GYN cancers o Cancer of older women o >90% are squamous cell carcinomas o 80% chance survivability, 5 years stage I o 20% survivability, stage IV ```

Vaginal Carcinoma

20% of all malignant tumors in the female reproductive tract o Accounts for more deaths > uterus, vagina, vulva cancers combined o N:C ratio INCREASE

Carcinoma of the cervix

CIN stands for...

Cervical intraepithelial neoplasia

These transformed cells do not respond to normal regulatory stimuli in the tissue, they do not mature as the normal cervical cells do but remain undifferentiated and proliferate uncontrollably. This is a feature of...

cervical cancer

Risk factors for cervical cancer (etiology)

1. Sexual intercourse at an early age 2. Multiple sex partners 3. Evidence of HPV infection 4. Other venereal diseases (STD’s) such as Herpes or Syphilis 5. Smoking/HIV

is a precancerous condition in which abnormal cell growth occurs on the surface lining of the cervix, the opening between the uterus and the vagina.

Cervical Dysplasia

- In Situ, N:C Ratio gradually increasing - Confined to the basal 1/3 of the epithelium

CIN1

- In Situ, N:C Ratio UP even more - Epithelial layer is thickening - Confined to the basal

CIN2

- In Situ, N:C Ratio is drastically increased - Epithelial layer is very thick - Spans more than the 2/3 of the epithelium, may involve full thickness

CIN3

What is the most common cause of death in advanced cervical cancer?

Carcinoma cells crossing the basement membrane, no longer in SITU, becomes Invasive. Spreads to lymphatics/blood streams and metastasizes to distant sites.

In breast tissue Lobules are separated by these suspensory ligaments

Suspensory ligaments of cooper

no gross lesions. The carcinoma is limited to the mucosa (Carcinoma In Situ or CIS)

Stage 0

Invasive, but confined to the cervix

Stage 1

Cancer extends beyond the cervix, not reaching the pelvic wall or upper vagina

Stage 2

Cancer reaches the pelvic wall and invades the lower third of the vagina

Stage 3

cancer has spread beyond the pelvis and has infiltrated adjacent organs

Stage 4

two layers of the Endometrium

Stratum Functionalis and Stratum Basalis

the layer of the Endometrium closest to the uterine cavity and the layer shed during menstruation.

Stratum Functionalis

The deep narrow layer of the Endometrium whose glands and C.T. elements proliferate and thereby regenerate the functionalis during each menstruation cycle.

Stratum Basalis

Benign tumors originating from the smooth muscle cells of the MYOMETRIUM

locations of leimyomas

is the middle layer of the uterine wall, consisting mainly of uterine smooth muscle cells and vascular tissue

Myometrium

Abnormal growth of the vulvar skin, | characterized by WHITE plaques, atrophy of the skin, parchment like consistency (VERY THIN SKIN IN OLDER WOMEN)

Lichen Sclerosis

This happens when - These paired glands produce a clear mucoid secretion, which continuously lubricates the vestibular surface - The ducts are prone to obstruction and consequent CYST formation

Bartholin Gland Cyst

Test 1 Flashcards

(87 cards)