Case 4 - Normal Reproductive Anatomy and Physiology females

Question 1

function of hilum of ovary

Answer 1

Blood vessels, nerves and lymphatics enter/exit the ovary via the hilum

Question 2

what does the medulla of the ovary contain

Answer 2

Vascularised loose connective tissue and nerves

Question 3

what is the cortex of the ovary?

Answer 3

The cortex of the ovary is the outer region where the ovarian follicles and stroma (dense irregular connective tissue) are located

Question 4

what is the ovarian capsule made up of

Answer 4

The capsule is made up of a thin layer of simple cuboidal epithelium that’s only
one cell thick, and an underlying dense layer of connective tissue called the
tunica albuginea

Question 5

what is the widest part of the uterine/fallopian tube

Answer 5

ampulla

Question 6

how does the uterine/fallopian tubes allow for peristalsis

Answer 6

Peristalsis is a series of wave-like muscular contractions that move substances through a hollow muscular tube or duct in the body.

The uterine (fallopian) tubes are hollow muscular tubes that transport eggs from the ovaries to the uterus.

The smooth muscle in the walls of the uterine tubes contracts in waves of peristalsis, helping to move the egg (oocyte) from the ovary toward the uterus.

Question 7

in the uterine tube, what is the site for fertilisation?

Answer 7

ampulla

Question 8

the epithelium of the uterine tubes has what?

Answer 8

Highly convoluted, mucosal folds. this increases surface area and controls movement of the oocyte/zygote

Question 9

The isthmus functions as a sperm reservoir. how?

Answer 9

Isthmus is like a gate that decreases the number of sperm for fertilisation (limits polyspermy) by allowing only a
gradual entry of sperm into the ampulla

Question 10

what is the type of epithelium of the uterine tubes?

Answer 10

Simple columnar epithelium

Question 11

what are the two types of epithelium cells in the uterine tubes?

Answer 11

Ciliated - alter in height in during menstrual cycle
Secretory - watery secretion for gamete nourishment

Question 12

what are the secretory columnar epithelial cells for?

Answer 12

Secretory columnar epithelial cells are abundant in the isthmus due to watery secretion for gamete nourishment

Question 13

The growth and function of cilia in the fallopian tubes are influenced by what?

Answer 13

Oestrogen promotes the growth and increased activity of cilia in the fallopian tubes
Progesterone leads to the shrinkage and reduced activity of cilia in the fallopian tubes after ovulation during the luteal phase

Question 14

Different arrangements of myometrium?

Answer 14

Myometrium: triple muscle layer
* Transverse
* Longitudinal
* Oblique

Question 15

where can the sites of Uterine Fibroids (leiomyoma) be?

Answer 15

Sites of fibroids:
* Submucosal – between endometrium
and myometrium
* Intramural – within myometrium (most
common)
* Subserosal – between myometrium and
parametrium
* Pedunculated – ‘foot’

Question 16

what are uterine fibroids?

Answer 16

Benign smooth muscle tumours

Question 17

what about the endocervix have

Answer 17

• Simple columnar; crypts
• Mucus secreting cells
• Influenced by Oestrogen &
  progesterone

Question 18

what about the ectocervix

Answer 18

• Stratified squamous non-keratinised
• Continuous with vagina
• Prevent abrasion

Question 19

what is the Squamo-columnar junction (SCJ):

Answer 19

Squamo-columnar junction (SCJ): the junction
between the squamous epithelium and the
columnar epithelium. Its location on the cervix is variable

Question 20

what is the transformation zone (TZ)?

Answer 20

Transformation zone: Area between the original SCJ and the new SCJ where the columnar epithelium is being replaced by the
new metaplastic squamous epithelium

Question 21

what about primordial follicles?

Answer 21

◼ Oocytes enclosed by a single layer of
flattened pre-granulosa cells and basal
lamina
◼ Resting follicles entering the early
growth phase is dependant primarily on
intra-ovarian paracrine factors that are
produced by granulosa cells & the
oocyte: Gonadotropin-independent

Question 22

what about Primary Follicle

Answer 22

• Oocyte enlarges and granulosa cells
  increase in size = cuboidal
• Oocyte begins to produce the zona
  pellucida (Glycoproteins and
  proteoglycans important in binding of
  spermatozoa)
• Gonadotropin-independent

Question 23

what about Secondary Follicle

Answer 23

◼ Granulosa cells increase in number;
follicle increases in thickness (stratified)
◼ Zona pellucida still assembling
◼ Granulosa cells secrete paracrine
factors that induce nearby stromal cells
to differentiate into theca cells
◼ Forms a concentric layers around
follicle
Gonadotropin- independent

Question 24

what about the Tertiary/Early antral Follicle

Answer 24

• FSH stimulates production of oestrogen
  by granulosa cells
• Oestrogen stimulates further granulosa
  development and therefore its own
  production: autocrine effect
• Spaces develop containing follicular fluid:
  coalesce to form a cavity: follicular
  antrum

Gonadotropin- dependent!

Question 25

what about the Proliferative phase (day 6-14)

Answer 25

* Oestrogen produced by the developing follicles increases the thickness of the endometrium * Proliferation of the stratum basalis to form the stratum functionalis * Straight endometrial glands and spiral arteries elongate * Progesterone receptors uregulated

Question 26

what about Ovulation (~ day 14)

Answer 26

◼ Mature follicle protrudes onto the surface of the ovary = stigma ◼ LH stimulates proteolytic activity in the theca externa and tunica albuginea ◼ Ovum expelled into entrance of the uterine tube

Question 27

what about the formation of the corpus luteum

Answer 27

* LH stimulates the transformation of granulosa cells into the corpus luteum (luteinisation) * LH receptors instead of FSH * Lipid within the cells ‘yellow body’ * Endocrine gland * Granulosa cells, now called granulosa lutein cells, produce progesterone * Theca interna cells, now called theca lutein cells, produce androgens which are converted to oestrogen

Question 28

Secretory/Progestational Phase (day 15-28)

Answer 28

◼Progesterone secretion from corpus luteum induces differentiation of epithelial and stromal cells of the endometrium for implantation: decidua ◼Stroma at most vascular Coiled (spiral) arteries Spiral throughout length of endometrium ◼Glands become tortuous; saw-toothed Glands produce thick glycogen-rich product: nourishment of developing blastocyst

Question 29

what about corpus albicans (over day 25)

Answer 29

◼ Loss of LH leads to the involution (leutolysis) of the corpus luteum and decreased progesterone secretion ◼ Cells replaced by collagen ◼ Fibrous ovoid structure Corpus albicans ‘white body’ May persist for years

Question 30

3 phases of the uterine cycle

Answer 30

proliferative phase menstrual phase secretory phase

Question 31

2 phases of the ovarian cycle

Answer 31

follicular phase luteal phase

Question 32

what happens to the spiral arteries in the endometrium to induce menstruation

Answer 32

sharp decline in progesterone causes spiral arteries in the endometrium to constrict. this restricts blood flow to uterine lining which leads to sloughing of endometrium and hence menstrual bleeding

Question 33

which layer of the endometrium is shed during menstruation

Answer 33

stratum functionalis