Female Reproductive

Question 1

Gross anatomy

Answer 1

Cervix= neck of uterus

Question 2

Ovary covering and regions

Answer 2

Surface is covered by a single layer of epithelium (term germinal epithelium is a misnomer in the ovary).

3 Regions-
- Hilum - entry/exit point for vasculature and lymphatics
- Medulla- inner region
- Cortex- contains the gametes and support cells (stroma)

Produce steroid hormones and release eggs

Question 3

Hypothalamic-Pituitary-Ovarian Axis

Answer 3

Question 4

Stages of ovarian follicular development

Answer 4

Finite number that are present at birth

Question 5

What does each mature follicle contain and what are the maturation stages?

Answer 5

Each mature follicle contains:
- an oocyte and its outer zona pellucdia
- support cells of the follicle (granulosa and theca cells)
- the fluid-filled antral cavity

Question 6

Primordial follicle

Answer 6

Follicles develop during embryogenesis and the female has their full complement of oogonia by the second trimester of pregnancy.

Question 7

Primary follicle

Answer 7

• Zona Pellucida develops at this stage. It is a glycoprotein coating that sperm must penetrate to get into oocyte during fertilisation
• Granulosa cell layers thicken

Question 8

Secondary follicle

Answer 8

Can now see all 5 things in a mature follicle

Question 9

Tertiary/Pre-ovulatory/Mature/Dominant/Graafian Follicle

Answer 9

• Bigger than secondary
• Fluid filled cavity enlarges to form the antrum
• Granulosa cells that separate the antrum and the oocyte form the cumulus-oocyte-complex (cumulus oophorus)
• Cumulus cells degenerate leaving the corona radiata

Question 10

What is ovulation?

Answer 10

• Primary oocyte becomes secondary oocyte and you can see a polar body
• Follicle ruptures and fluid, oocyte and cumulus are released and coaxed into the Fallopian tube
• Follicle becomes the corpus luteum

Question 11

Primary oocytes

Answer 11

All oocytes are present at birth within primordial follicles. All of the oocytes are paused in the meiosis I and called primary oocytes.

Question 12

Secondary oocytes

Answer 12

Meiosis I is completed in the hours before ovulation and becomes secondary oocyte (1 polar body). Meiosis II starts but is paused. Meiosis II is only complete if fertilisation occurs (2 polar bodies)

Question 13

Corpus luteum

Answer 13

Life cycle of the corpus luteum:
- Corpus haemorraghicum (red)
- Corpus luteum (yellow)
- Corpus albicans (white) small fibrous mass stops producing hormones and persists for a long time

Programmed to be steroidogenic for 14 days ± 2 and then undergoes leutolysis. If pregnant the CL remains until the placenta takes over steroidogenesis at week 13 of gestation

Question 14

Corpus albicans

Answer 14

• White Body
• Oval mass of fibrous tissue
• Theca externa and fibroblasts produce collagen - replace lutein cells. Thus non-steroidogenic.
• Scar tissue which remains in the ovary in life.

Question 15

Regions of fallopian tube

Answer 15

Question 16

Layers of fallopian tube

Answer 16

Question 17

Ampulla

Answer 17

• Site of fertilisation
• Highly folded epithelium allows for an increased surface areas
• Less smooth muscle (contraction is less important for transport)
  1. Mucosa
  2. Muscularis

Question 18

Structures in and function of fallopian tube

Answer 18

Structures: secretory cells, ciliated cells and smooth muscle cells, tubal fluid

Functions: gamete survival, fertilisation, early embryo development

Question 19

Uterine cycle

Answer 19

Menses (Day 0-5)
- Shedding of endometrial lining

Proliferative Phase (Day 5-14)
- Growth of endometrial lining

Secretory Phase (Day 14-28)
Preparation for implantation

Question 20

Menses

Answer 20

• Menses is the shedding of the functional layer of the endometrium.
• Onset of menses is often associated with muscle spasm and pain.
• Frequency 24-35 days
• Duration of flow 4-8 days
• Volume of blood loss 5-80 ml

Question 21

Uterine body

Answer 21

Functional zone is shed during menses
Basalis layer not shed during menses

C = stratum compactum
S = Stratum spongiosum
B = Stratum basalis
My = Myometrium- Myometrial smooth muscle has three ill-defined layers. It is sensitive to hormones and undergoes hyper trophy (size) and hyperplasia (numbers) during pregnancy.

Question 22

Uterine glands and arteries

Answer 22

Question 23

Proliferative Phase Day 4-14

Answer 23

• Oestrogen promotes cell proliferation of basal layer to regenerate the endometrial lining.
• Stroma is compact
• Glands (G): short, straight, narrow, with little secretion
• M: mitotic divisions

Question 24

Secretory Phase Day 14-28

Answer 24

1. Progesterone inhibits further endometrial growth
2. Induces differentiation of epithelium and stroma in preparation for decidualisation
3. Early in the secretory phase subnuclear vacuoles appear (V) and then glands become corkscrewed and becomes full of secretion (SE)

Question 25

Menstrual Phase Days 0-5

Answer 25

Progesterone withdrawal induces shedding of the functional layer of endometrium B apoptotic bodies F stratum functionalis L leakage of blood

Question 26

Cervix location and epithelium of ecto and endocervix

Answer 26

- Junction between cervix and uterine body is the internal os - The lumen opens into the vaginal cavity at the external os where there is an important change in epithelium. - Ectocervix- like vaginal squamous epithelium, it is stratified, squamous epithelium (non-keratinizing) & rich glycogen - Endocervix- luminal portion, the canal is lined by a single layer of tall columnar mucus-secreting epithelium

Question 27

Function of secretions in cervix

Answer 27

- Lubrication and mucus plug (composition changes with changes in hormones) - ↑ Oestrogen: Thin, watery and full of electrolytes. High spinbarkeit (stretchable) - ↑ Progesterone: Thick, viscid. Low spinbarkeit

Question 28

Cervical stroma

Answer 28

The cervical stroma is composed of smooth muscle fibres and collagen The ratio of collagen to smooth muscle may increase with age. Associated with increased risk during childbirth.

Question 29

Transformation zone

Answer 29

- Puberty – ectropion, eversion of the endocervix exposed to acidic environment, becomes squamous - The transformation zone is composed of new squamous epithelium in an area previously occupied by columnar epithelium. - This process causes the openings of some of the crypts to become occluded thus forming the Nabothian follicles. These are really common and no reason to cause alarm. - However, the constant change of epithelium include the development of abnormal epithelium which may lead to cancer

Question 30

Vagina structure and function

Answer 30

7-9 cm in length but capable of distention and elongation 4 Layers- - Stratified squamous epithelium - Elastin rich submucosa - Fibromuscular layer (ill-defined) - Adventitia Stratified squamous epithelium- - Protects against acidic environment - High glycogen content. Bacteria breaks down the glycogen + results in acidic pH. The pH restricts it to acid-loving commensals - Deters invasion from pathogens eg. fungi Candida albicans - vaginal ‘thrush’ Elastin rich submucosa- - Ridges shows that it can expand - Important for intercourse and childbirth