Female Reproductive System Flashcards
Internal female genitalia
. Ovary . Oviduct . Uterus . Cervix . Vagina
External female genitalia
. Labias majora and minora
. Clit
Functions of female reproductive system
. Production of ovum
. Reception of male gametes
. Provision of suitable environment for fertilization and development
. Mechanism for expulsion of fetus at birth
. Nutrition of newborn w/ accessory sex organs
Ovary gross anatomy
. Endocrine and exocrine
. Almond shaped w/ indistinct medulla and cortex
. Hilus for vessels and Erie to enter and exit
. Endocrine products: estrogen and progesterone
. Exocrine: ovum
Ovary characteristics
. Simple cuboidal (germinal epithelium)
. Deep to epithelium is tunica albuginea (dense CT layer)
. Cortex formed by ovarian follicles in compact cellular stroma
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Ovarian follicles
. Each is immature ovum w/ supporting cells
. 600,000-800,000 at birth
. Primary Oocytes arrested in prophase I
. Initiation of menstruation causes cyclic follicular maturation
. 400-480 follicles mature during lifetime
. Follicles present: primordial, growing, and mature (graafian)
Primordial follicle (unilaminar)
. Resting state, not stimulated by hormones
. Most follicles are this
. In cortex under tunica albuginea
. Primordial follicle formed by primary oocyte surrounded by single layer of flattened follicular cells
. Primary oocyte is 30 mu in diameter w/ round, open-faced nucleus w/ prominent nucleolus, abundant cytoplasm
. Follicular cells flattened epithelial cells on basal lamina
. Small cohorts of follicles begin process of follicular growth
Primary follicle
. Hormonally stimulated primordial follicle
. Primary oocyte enlarges to 50-80 um
. Follicular cells become granulosa cells by being cuboidal and proliferating
Preantral (multilaminar primary follicle)
. Granulosa cells form 2= cell layers around oocyte (stratum granulosum)
. Zona pellucida: refractive layer btw oocyte and stratum granulosum, derived from oocyte, had GAGs and glycoproteins
. Theca folliculi: concentric sheath around folllicle from differentiated stroma cells, separated from stratum granulosum by thick basement membrane
Antral (secondary) follicle
. Later stage of development, moves deeper into cortex of ovary
. Stratum granulosum 6-12 layers thick w/ fluid (liquor folliculi) btw adjacent granulosa cells
. Fluid spaces coalesce to form cavity w/in follicle (follicular antrum/antral cavity)
. Follicle 0.2 mm in this phase, grows into 10 mm or more from granulosa cell proliferation
. Oocyte in eccentric position
. Corona radiata: single layer granulosum cells surrounding oocyte connected via gap junction
. Theca folliculi divided into theca interna (inner vascular layer secreting hormones) and theca externa (outer CT smooth muscle adjacent to stroma)
Cumulus oophorus
. Oocyte plus corona radiata on one side of the antral cavity
Mature (Graafian) follicle
. Extremely large antral follicle (10 mm+)
. Classified as mature based on size
. Final step before ovulation
. cumulus oophorus loosens from rest of cells of stratum granulosum so oocyte floats free in liquor folliculi in antrum
. 1st meiotic division completed prior to ovulation
. Yields secondary oocyte and 1st polar body
. 2nd meiotic division completed at fertilization produces mature ovum and 2nd polar body
Follicular atresia
. Follicle can degenerate at any stage of maturation
. Atretic follicle has clear hyaline membrane be stratum granulosum and theca folliculi (glassy membrane)
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Ovulation
. Process of releasing secondary oocyte from ovarian follicle
. Only 1 follicle reaches maturation each cycle
Follicle changes immediately prior to ovulation
. Follicular fluid inc., pressure in follicle inc.
. Protein lysis causing weakening of follicular wall
. Stratum granulosum, theca folliculi, and tunica albuginea thin out on surface of ovary over follicle
. Epithelium over follicle becomes avascular created macula pellucida/stigma (translucent spot) that is site of follicular rupture
. Secondary oocyte released from oviduct when follicle ruptures and is viable for 24 hours
. Remnants of folliclular wall remain and form corpus luteum
Follicle after oocyte rupture
. Follicular walls collapse forming folded corpus luteum/literal gland w/ stratum granulosum and theca interna
. Remaining stratum granulosum cells inc. in size and fill w/ lipid to become granulosa lutein cells
. Theca interna cels form theca lutein cels found at periphery of corpus luteum
. Corpus luteum is highly vascularized, endo Erin gland secreted estrogen and progesterone
What happens if fertilization doesn’t occur?
. Corpus luteum remains active for 14 days then degenerates (corpus luteum of menstruation)
. Degenerates corpus luteum involutes
. Cells replaced by white scar tissue to form corpus albicans
What happens if fertilization does occur?
. Corpus luteum inc. in size and active during 1st 4-5 months (corpus luteum of pregnancy)
Ovarian medulla
. Contains loose CT, blood vessels, nn.
Follicular phase in menstruation
. Related to growth of follicle
. Up to time of ovulation
. Maturing follicle will secrete estrogen
Luteal phase of menstruation
. Follows ovulation and continues up until start of menstruation
. Corpus luteum secretes estrogen and progesterone
Oviducts gross structure
. Paired tubes 10-12 cm long attached to sup. Aspect of uterus
. 4 segments: infundibulum w/ fimbriae, ampulla, isthmus, and intramural portion
Functions of oviduct
. Transmission of secondary oocyte/fertilized ovum from ovary to uterus
. Provision of good environment for fertilized oocyte
Oviduct outer serosa
. Mesothelium
. Thin layer of CT
Oviduct middle muscularis
. Think inner circular layer of smooth muscle
. Thin outer longitudinal layer smooth muscle
Oviduct inner mucosa
. Simple columnar epithelium
. Lowe columnar cells w/ cilia in infundibuluma Nd ampulla
. High columnar secretory cells w/o cilia (peg cells) that provide nutrients to secondary oocyte as it transverses tube
. CT lamina propria
. Mucosal folds (plicae) that project into lumen, most elaborate in infundibulum and dec. closer to uterus
. Epithelium hypertrophied during follicular phase and trophies during luteal phase
Sequence of events in oviduct during/after ovulation
. Fimbriae of infundibulum make contact w/ surface of ovary
. Ciliated cells sweep secondary oocyte into oviduct
. Secondary oocyte transported through oviduct by peristalsis and ciliary movement
. Fertilization occurs in ampulla near isthmus
. Fertilized ovum passes into uterus on day 4.5 after ovulation and begins implantation
Uterus gross anatomy
. Pear-shaped
. Regions: body fungus w/ uterine cavity proper and the cervix
. Care is contains (endo) cervical canal
. Internal os: sup. Opening into cervical canal from uterine cavity
. External os is inf. Opening from cervical canal into vagina
Uterus functions
. Provision of nutrition and waste removal during fetal development
. Expulsion of fetus at parturition
Perimetrium
. Outer serosa of uterus
. Formed by pelvic peritoneum and underlying CT
Myometrium
. Middle muscularis layer of uterus . Smooth muscle 10-15 mm thick . Inner, middle, and outer layers w/o distinct borders . Inner layer circular and longitudinal . Middle layer (stratum vasculare) circular os spiral, thickest layer, manu blood vessels . Outer layer longitudinal . Non-pregnant: muscle is 50 mu long . Pregnant: muscle over 500 mu long
Endometrium
. Inner mucosa
. Simple columnar epithelium w/ ciliated and non-ciliated cells
. Thick lamina propria (endometrial stroma) formed by stellate cells
. Epithelium invaginates into underlying lamina propria to form simple tubular uterine glands
Endometrium layers
. Basal layer (stratum basale): adjacent to myometrium, has bases of tubular glands, remains after menstruation
. Functional layer (stratum functionale): btw basale layer and lumen, has uterine tube bodies, sloughed off during menstruation
Uterus blood supply
. Uterine aa. Off circumferential arcuate aa. That go in middle layer of myometrium
. Arcuate aa. Give off radial aa. To endometrium that go toward lumen
. Radial aa. Branch into straight aa. That supply stratum basale or spiraled aa. That supply stratum functionale
. Distal part of spiral aa. She’d during menstruation
Proliferative (follicular) phase in menstrual cycle
. End of menstration to day 14
. Rapid repair and regeneration of endometrium from glands and vessels in basal layer
. Tubular uterine glands regenerate (initially have narrow, straight lumens)
. Stroma cells proliferate, endometrium inc. to 3 mm thickness
. Spiral aa. Slightly coiled
. Corresponds w/ growth of ovarian follicle
. Stimulated by estrogen secreted by follicle
. Continues until day 15 (day 1 after ovulation)
Progestational (secretory, luteal)
. Growth of endometrium in prep for implantation
. Uterine glands become tortuous w/ sacculated walls and wide lumen filled w/ secretions (glycogen-rich)
. Spiral aa. Highly coiled and reach lumen
. Thickness inc. to 5-6 mm
. Stroma cells enlarge, capable of being decidual cells upon implantation
. Corresponds to development of corpus luteum
Menstrual stage in menstrual cycle
. Sloughing off of functional layer of endometrium
. Ischemic changes in functional layer from constriction of spiral aa.
. Stroma becomes edematous and infiltrated by leukocytes
. Menstrual flow contains blood, glandular secretions, stroma cells, and epithelial cells
. Corresponds w/ involution of corpus luteum
. Blood loss 35-50 mL
. Basal layer preserved
. Cervix outer adventitia and middle myometrium
. Adventitia of CT
. Myometrium: large amts of dense CT and elastic fibers
. Replace smooth muscle in myometrium of uterus
Endocervix
. Inner mucosa
. Simple columnar and CT lamina propria
. Ciliated and non-ciliated mucus-secreting cells
. Plicae palmatae: large branches glands in mucosa, when blocked form mucus-filled Nabothian cysts
Cervix morphological changes associated w/ menstrual cycle
. Endocervix not sloughed
. Mucus secreted changes consistency: mid cycle it is less viscous, copious alkaline fluid easy for sperm to go through, other times it is more viscous to restrict sperm movement
. Transition from simple columnar to SSNK just inside external os (lies in cervical canal in pre and post menstrual women)
Papanicolaou (pap) smear
. Cervical cells from transitional zone to screen for cancerous lesions of cervix
. Grow at slow rate, frequently diagnosed at precancerous stage
Vagina gross anatomy
. From cervix to vestibule
. Organ of copulation
. Inf. Part of birth canal
. Vagina layers
. Outer adventitia
. Middle muscularis: interlacing bundles of smooth muscle, inner circular, outer longitudinal continuous w/ myometrium of uterus, some skeletal muscle at inf. End vagina
. Inner mucosa: SSNK and lamina propria, large venous sinuses stimulate erectile tissue during arousal
. Abundant lymphocytes and leukocytes and lymph nodules
. No glands (kept wet by cervical mucus seeping through wall)
Mammary gland gross anatomy
. Breast enlarges in puberty from fat deposition
. Modified sweat gland (tubuloalveolar)
. 15-20 lobes divided by CT septa
. Suspensions ligaments of Cooper CT attaching septa to dermis
. End of lobe has lacitferous sinus that drains to lactiferous ducts that open to nipple
Inactive resting) mammary glands
. Lobes divided into lobules
. CT and adipose btw lobules
. Smallest ducts lined w/ simple cuboidal
. Larger interlobular ducts are stratified
. Lactiferous duct lined w/ SSNK
Active (proliferating) gland in pregnancy
. Inc. glandular elements
. Interlobular ducts have stratified cuboidal or columnar epithelium
. Alveoli bud off ducts, formed by simple cuboidal epithelium w/ myoepithelial cells at periphery of alveolus
. Alveoli show secretory activity latter half of pregnancy, produce watery colostrum immediately after parturition
Myoepithelial cell function
. Contraction pushes milk secretion into duct system
Colostrum
. Large number of antibodies for passive immunity of newborn
. Antibodies secreted by lymphocytes and plasma cells found in CT of pregnant mammary gland
Active (lactating) gland
. After birth
. Little CT
. Alveoli ciliated w/ milk product rich in sugar, protein, and fat
. Released apocrine (lipid part) and merocrine (protein part)
. Milk release controlled by suckling reflex
Suckling reflex
. Stimulus causes oxytocin release from pars nervosa
. Myoepithelial cells contract
. Secretory product moves into duct system
Regression of gland after lactation cessation
. Alveoli dec. inn size and number
. CT and fat inc.
. Some alveoli retained so it is more glandular than original breast
Involution of mammary gland
. After menopause
. Secretory elements atrophy and CT becomes dense and homogenous
Hormonal control of mammary gland
. Growth at puberty occurs in presence of estrogen and progesterone from ovary
. Growth from pregnancy from hormones of corpus luteum of pregnancy, placenta, and adrenal glucocorticoids
. Initiation and maintenance of lactation after parturition under control of prolactin
Breast carcinomas
. Arise from lactiferous duct epithelial cells
Fibrocystic disease of breast
. Hyperplasia of CT around ducts . Single or many cyst formation in ducts . Glandular hyperplasia in small ducts and gland buds . Hyperplasia of duct epithelium . Tenderness, pain, lump in breast . Caused by hormonal imbalance
Latational amenorrhea
. High levels of prolactin suppressing LH secretion
. Ovulation occurs after suckling dec. in frequency
. Breastfeeding used as form of birth control but is not reliable
