FEMALE REPRODUCTIVE SYSTEM Flashcards
1
Q
External
A
VULVA Mons pubis Labia min and maj Clit Vaginal orifice Urethral orifice
2
Q
Internal
A
Vag
Uterus
Fallopian t
Ovaries
3
Q
Triangular eminence in front of pubic bones
Consists adipose
Covered by hair-bearing skin up to its jxn w abdominal wall
A
Mons pubis
4
Q
Pair of fibroadipose folds
Extends from mons downward to meet in midline in front of anus at the posterior fourchette
A
Labia majora
5
Q
Bet lab maj wc they merge posteriorly and separated into 2 folds to clitoris anteriorly
Unite to form
Anterior: prepuce of clit
Posterior: frenulum
Hairless
Very vascular
Posterior forms vestibule of vag
A
Labia minora
6
Q
Erectile organ
2-3 cm length
2 cruca 2 corpora cavernosa covered by sensitive rounded tubercle (glans)
A
Clit
7
Q
Surrounded by hymen
Variable crescentic mucous mem that is replaced by rounded caruncles after rupture
On each side of vestibule lies the opening of greater vestibular glands (BARTHOLIN)
A
Vaginal orifice
8
Q
Immediately anterior to vaginal orifice
2-3 cm beneath clit
Posterior surface are found the openings of SKENE or paraurethral gland
A
Urethral orifice
9
Q
Blood supply of vagina
A
Vaginal artery
Branches from uterine, middle rectal and internal pudendal arteries
10
Q
Hollow fibromuscular tube extending from vulvar vestibule to the uterus
A
Vag
11
Q
Fibromuscular organ divided into upper corpus or uterine body and lower cervix
A
Uterus
12
Q
Accommodation of conceptus, support for implantation & dev
A
Fxn of uterus
13
Q
Endometrium layers
A
Deep basal
Superficial
14
Q
This changes little thru the mens cycle
Not shed at mens
A
Deep basal
15
Q
A hormone sensitive layer
Proliferates in resp to estrogen
Becomes secretory im resp to progesterone
Shed at end of mens and regenerates from cells in the basal layer
A
Superficial fxnal layer
16
Q
As progesterone fall at end of mens, they respond by
A
Constriction
17
Q
The superficial layer becomes ischemic and undergoes necrosis which causes
A
Shedding and hemorrhage = menstruation
18
Q
Anteriorly, bladder lies over the isthmic and cervical regions of uterus
A
Laterally, the broad ligament inserts into cervix and corpus
19
Q
A double layer of peritoneum covering the neurovascular supply of uterus
A
Broad ligament
20
Q
Uterus blood supply
A
Uterine artery wc anastomoses freely w ovarian and vaginal arteries
21
Q
Hollow 7-12cm length
Representing the proximal unfused ends of Mullerian duct
Covered by peritoneum
Connected to upper margin of broad ligament thru its mesentery (mesosalpinx)
A
Fallopian tubes
22
Q
Fxns of fallopian t
A
Ovum pick up
Site of fertilization
Provides physical environment for conception and transport
And nourishment for fertilized ovum
23
Q
Parts of fallopian tube
A
Interstitial - narrowest; lies within uterine cavity; forms tubal ostia at the endometrial cavity
Isthmus - narrow segment closest to uterine wall
Ampulla - larger diameter segment lateral to isthmus
Fimbria - funnel shaped abdominal ostia of the tubes; opening into peritoneal cav (fingerlike)
24
Q
Lined by ciliated columnar epithelium
Inner circ outer longi muscularis
A
Fallopian t
25
Fallopian tube blood supply
Uterine and ovarian arteries
26
Paired gonadal structure that lies suspended bet pelvic wall and uterus by:
infundibulopelvic ligament laterally and uteri-ovarian ligament medially
Ovaries
27
Ovaries average size
5x3x3 cm
Covered by flatted cuboidal to low columnar epithelium
28
Composed of specialized stroma and ovarian follicles in various stages of dev
CORTEX of ovaries
29
Composed of fibroblasts loosely embedded in collagen rich meshwork and cont BV lymph and nerve fibers
MEDULLA of ovaries
30
BV of ovaries
Ovarian artery which anastomoses w uterine artery
31
Ovaries fxn
Follicle storage and maturation (oogenesis cycle)
| Sex steroid prodxn: estradiol, prog and androgens
32
Physiologic actions of estradiol and progestins
Developmental effects
Neuroendocrine actions involved in ctrl of ovulation
Cyclical prep of reproductive tract for fertilization & implantation
Major actions on mineral (Ca) CHO CHON lipid
33
Most potent naturally occurring estrogen followed by estrone and estriol
17b-Estradiol
34
Formed from either androstenedione or testosterone as immediate precursors
Secreted in the ovary mainly by developing follicles
Acts on endocervical glands to produce abundant watery secr (easily pen by sperm)
Estrogen
35
Secreted by ovary mainly from corpus luteum
Resp for dev of secretory endometrium
Important for maintenance of preg
Suppresses mens and uterine contractility
Influences endocervical glands to prod scanty secretions wc decrease penetration of cervix by sperms
Brings abt proliferation of breast acini
Progestins
36
Biosynthetic pathway for estrogen
Dehydroepiadrosterone --> 16a hyep --> 16a hyan --> ESTRIOL
Aromatose
Dehydroepiadrosterone --> androstenedione --> estrone --> ESTRIOL
Dehydroepiadrosterone --> testosterone --> estradiol --> ESTRIOL
37
Cordlike below uterolubal jxn
| Extends thru internal inguinal ring into labia majora
Round ligament
38
Double reflection of peritoneum stretching from lateral pelvic sidewalls to uterus
Broad ligament
39
Extends from lateral aspect of upper part of cervix and vagina to pelvic wall
Major support of uterus
Cardinal liga
40
Extends from upper of cervix posteriorly to third sacral vertebra
Uterosacral liga
41
From adnexa to lateral pelvic sidewalls
contains ovarian vessels
Infundibulopelvic liga
42
Runs in broad liga from uterine pole of ovary to inferior angle of uterotubal jxn
Ovarian liga
43
Average length of human follicular phase
10-14 days
44
Released by basophils of anterior pituitary
| Stimulates sev primary follicles to mature into secondary follicles
FSH
45
As more fluid is produced, individual droplets of liquor folliculi coalesce to form a single fluid filled chamber
ANTRUM
46
Granulosa cells become rearranged so the primary oocyte surround a small grp of granulosa that projects out from the wall in the antrum
Cumulus oophorus
47
Single granulosa cells that immediately surrounds primary oocyte
Corona radiata
48
The female gamete arrested in the prophase stage of meiosis I
Oocyte
49
A glycoprotein surrounds like eggshell
Zona pellucida
50
Cuboidal surr oocyte
| Secret estrogen
Granulosa cells
51
Stromal cell layer that secrete androgens
Theca interna
52
Non sec stromal layer
Theca externa
53
Causes graafian fol to rupture
LH
54
Tine from ovulation to onset of mes
| Ave length 14 days
Luteal phase
55
Cells divide and become yellow
Lutein
56
Ruptured follicle
Corpus luteum
57
Progesterone and estrogen secreted by the granulosa lutein and that got lutine cells inhibit the secretion of
LH and FSH respectively
58
The absence of FSH prevents the development of new follicles thus preventing a second of ovulation
The falling LSH fail to maintain the corpus luteum so it undergoes involution
59
FSH&LH secretion rice causing ovarian follicles to grow thus starting the next cycle
FSH levels begin to rise and a cohort of growing follicles is recruited
60
Rising estrogen levels provide negative feedback on
pituitary FSH secretion
61
LH initially _______ in response to rising estradiol levels but late in the follicular phase the LH level is increased dramatically
decreases initially
62
At the end of follicular phase FSH induced LH receptors are present on the granulosa cells and with LH stimulation modulate that secretion of progesterone
Estrogen level decreases through the early luteal phase from before ovulation until the mid luteal phase when it begins to rise again as a result of corpus luteum secretion
63
________ levels rise after ovulation and can be used as a presumptive sign that ovulation has occurred
Progesterone
64
menstrual phase the ischemic and necrotic functionali layer of the endometrium is shed off along with blood from the degenerating spiral arteries
Day 1-4
65
menstrual phase the ischemic and necrotic functionali layer of the endometrium is shed off along with blood from the degenerating spiral arteries
Day 1-4
66
Proliferative or follicular phase
| this is caused by the rising estrogen levels
Day 5-14
67
secretory or luteal phase commences after ovulation the progesterone secretion by the corpus luteum activates the endometrium
day 15 - 28
68
ovulation the gland begin to see create a glycogen rich substance in preparation for a potential embryo
Five days after
69
Progesterone and estrogen levels fall then spiral arteries supplying the functional endometrium begin to coil and constrict causing
ischaemia
| necrosis
70
all oogonia Develop into primary oocytes and enter the prophase of the first meiotic division
2nd trimester of pregnancy
71
Protein transcribed by is
TDF or testis determining factor
72
SRY gene not activated until
7th wk of gest
73
Development is identical in both sex
First 6 weeks
74
Gonads begin to form during
5th week
75
Mesothelial cells
Origin: mesodermal lining of peritoneum
Structure at 6wks: cortex
Adult structure: ovarian follicles or seminiferous tubules
76
Mesenchymal cells
Origin: surrounding mesoderm
Structure at 6wks: medulla
Adult structure: leydig and supporting stroma
77
Primordial germ cells
Origin: migrate from endodermal lining of yolk sac
Structure at 6wks: primary sex cords
Adult structure: gamete producing male spermatogonia and female oocytes
78
Mesothelium abd mesenchyme proliferate to form a bulge called
Gonadal or genital ridge
79
Mesenchyme forms ______
While
Mesothelium forms an _____
Mesenchyme inner medulla
Meso outer cortex
80
Fingerliie proj that reach into medulla
Primary sex cords
81
This duct drains the urine from the mesonephros
| Forms male genit e.g epididymis and vas def
Wolffian duct (mesonephric)
82
Funnel-ender duct lies laterally to the mesonephros duct
| It forms female genit ducts example fallopian tube and uterus
Mullerian duct (para mesonephric)
83
External genitalia begin to develop around
4th wk
84
5 swellings (ext geni)
One genital tubercle
Two urogenital folds
Two labioscrotal folds
85
Genital tubercle enlarges to form the
Phallus
86
Cloacal mem divides to form
```
Urogenital orifice (thru the vagina remains covered by the hymen)
Anus
```
87
A ligament forms between the indifferent gonad and the labioscrotal swelling thru the inguinal canal
Gubernaculums
88
It guides the descent of testes into the scrotum and forms the round ligaments od uterus and overies
Gubernaculums
89
Leydig cells begin to secrete androgens (DHT, testosterone) from the
8th week
90
What secrete mullerian inhibiting subs (MIS) A HORMONE THAT CAUSES THE MULLERIAN DUCTS TO REGRESS
Sertoli cells
91
Secreted by leydig
| Responsible for the development of male external genitalia
Testosterone
92
Enlarges to form glans (distal end) of penis
Phallus
93
Fuse ventrally to form body of penis
Urogenital folds
94
Fuse to form Scrotum
Labioscrotal folds
95
Urethra is an endodermal structure that is enclosed by the urogenital fusion. Failurr of this process results in
Epispadias
96
Forms the CT stroma that supports these follicles
Mesenchymal medulla
97
Develop into oogonia which undergo mitosis to increase germ cells
They enter the first prophase of meiosis before birth, after wc further mitosis is not possible
Primordial germ cells
98
This develops dt the absence of testosterone and MIS
Unstimulated wolffian duct regr sses while Mullerian develops
Internal genitalia
99
Derived from endodermal urethra and other two layers dev from surrounding mesenchyme
Vaginal epi
100
Formed from cloacal mem covering the urogenital orifice that the vagina develops from
Hymen
101
External genitalia also dev dt absence of testosterone
Phallus : forms clit
Urogenital folds: dont fuse and form labia minora
Labioscrotal folds dont fuse but form labia majora
102
Breast compo
20% glandular tissue (central)
| 80% fat and CT (predominant in periphery)
103
Lobules consist of blind ending expansion
Alveoli - sites of milk secret ion
104
12-20 lobes arranged in radial fashion from nipple
Each lobe is triangular and has an excretory duct that opens to the exterior or nipple
105
Accessory glands located around periphery of areola, can also secrete milk
Montgomery glands
106
Fibrous septa extending from skin to underlying pectoralis fascia
Also support breast
Invasion by malignant cells produces skin retraction (sign if advanced carcinoma)
Cooper's ligaments
107
Conical to flattened
Projects centrally from anterior portion of breast
4th intercostals
Nipple or mammary papilla
108
Discoidal skin wc encircles the base of nipple
Areola
109
Breast vascular supply
Internal mammary artery
Thoracic branches of axillary artery
Intercostal arteries
110
Mens: follicular phase
Stroma becomes less dense
| Changes take place in ducts (expansion lumen w occasional mitosis but no secretion)
111
Luteal phase
Progressive increase in stromal density
112
Maximal on day 25 after wc epi cell apoptosis occurs
Cell proliferation
113
Progressive atrophy of lobules w fatty replacement of breast tissue
During postmenopausal phase
114
Initially spindle
Preg: myoepi become highly branches stellate cells
115
Redxn of adipose but increase in WBC and eo
In stroma (preg/lactating)
116
Symmetry
Contour
Skin app
Nipple contraction
Inspection
117
Entire breast
| Axilla
Palpation
118
Only reproducible mtd of detecting nonpalpable breast cancer
Mammography
Detects 35-50% early breast cancers
Never subs for biopsy
119
Cystic lesions
Feels a mass (pt)
Can't detect microcalcifications
Not as useful for fatty breasts
Ultrasound
120
Most reliable for diagnosis
Nondiag or equivocal
Open biopsy
121
Most common
Ages 20-50
Uncommon meno
Decrease in taking pills
Symptoms: pain cyclic bilateral or upper outer quad
Signs: engorg, dense, nodular, fluctuate, tender
Pathophysiology cyst, epithelial and fibrous proliferation, fluid retention
FIBROCYTIC CHANGES/DSE OF BREAST
Diag: imaging, FNA, exci biopsy
DD: PAIN on dorsal radiculitis abd Tietze syn
122
Second most common
Fibroadenoma
123
Firm, rubbery, mobile, solid, solitary masses
Frequent in adolescent and early 20s
30% spon disappear
Fibroadenoma
- diag breast exam, imaging, FNA
- long term risk of invasive breast cancer 2x higher than ctrls
124
75% located beneath areola
Diag galactography
Tx exci biopsy
Two fold risk of subsequent dev of carcinoma
Intraductal papilloma
