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Reproductive System > Histology > Flashcards

Histology Flashcards

1
Q

After the descent of the ovary, the gubernaculum becomes the ___________________.

A

Ovarian ligament and round ligament

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2
Q

The round ligament attaches to which structures?

A

Labia majora (through inguinal canal) and uterus

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3
Q

True or false: The suspensory ligaments of the ovary are parts of the gubernaculum.

A

False.
They are peritoneal folds that contain the ovarian vessels

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4
Q

What is the surface of the ovary called and what is it composed of?

A

Tunica albuginea
- composed of connective tissue fibres and fusiform cells between

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5
Q

What is the function of the ovarian stroma?

A

1) Structural support
2) Microenvironment for development and function of ovarian follicles

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6
Q

What are the 5 components of an ovary?

A

Superficial to deep:
1) Tunica albuginea
- connective tissue + fusiform cells

2) Hilum
- entry/exit of vessels

3) Cortex
- ovarian follicles

4) Stroma
- in outer cortex and inner medulla
- structural support + ovarian follicle microenvironment

5) Medulla
- loose connective tissue, abundant vasculature, lymphatics and innervation

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7
Q

The primordial germ cells are precursors to the gametes that originate in the _____________ then migrate to the _________________ where they undergo multiple mitotic divisions.

A

Yolk sac wall near allantois → through dorsal mesentery → genital ridge → undergo mitotic divisions

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8
Q

The tunica albuginea of the ovaries are covered by _________________ which is composed of ________ cells.

A

Germinal epithelium
- simple squamous layer
- visceral peritoneum that covers ovaries

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9
Q

True or false: The germinal epithelium of the ovaries give rise to germ cell.

A

False.

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10
Q

What is the histological appearance of a primordial follicle?

A

Primary oocyte surrounded by single layer of flattened cells

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11
Q

What is the histological appearance of a primary follicle?

A

Deep to superficial:
1) Primary oocyte

2) Zona pellucida
- thick homogenous layer of glycoprotein and acid proteoglycans

3) Multiple layers of Follicular cells

4) Theca cells
- outermost stromal cells
- synthesises androgens

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12
Q

What is the most common site for ovarian cancers?

A

Germinal epithelium (90%)

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13
Q

Which layer of the ovary contain species-specific receptors for spermatozoa?

A

Zona pellucida

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14
Q

What is the histological appearance of a secondary follicle?

A

Superficial to deep:
1) Primary oocyte
2) Antrum
- fluid-filled follicular lumen
3) Inner granulosa cells
4) Outer theca cells

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15
Q

What is the histological appearance of a graafian/mature follicle?

A

1) Primary oocyte off-center
2) Zona pellucida
3) Corona radiata
4) Cumulus oophorus (crowded granulosa cells)
5) Follicular antrum
6) Outer granulosa cells

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16
Q

What is the histological appearance of a Corpus albicans?

A

White scar tissue on the surface of the ovary

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17
Q

What is the appearance of the corpus albicans on ultrasound?

A

Small, lobulated, hyperechogenic intra-ovarian lesion

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18
Q

What is the largest and longest part of the fallopian tube?

A

Ampulla

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19
Q

What is the histological appearance of the fallopian tube?

A

Lumen to basal:
1) Mucosa lined by simple columnar epithelium
- mucosa have multiple longitudinal folds

2) Well defined inner circular, outer longitudinal muscular layer

3) Outer serosa layer

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20
Q

The oviduct epithelium consists of 2 important cell types:
i) _______________________
ii) _______________________

A

i) Ciliated cells
- ciliary movement aids in movement of ovum toward uterus

ii) Secretory (peg) cells
- non-ciliated often dark stained cells
- secretes glycoproteins for the ovum’s nutrition

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21
Q

What are the 3 layers of the uterine wall?

A

1) Endometrium
- inner most
- lined by simple columnar epithelium
- numerous tubular glands

2) Myometrium
- middle layer
- highly vascularised, thick, smooth muscular layer in poorly-defined layers w bundles of fibres interwoven in varying directions
- induces uterine contractions

3) Perimetrium
- outer connective tissue
- some parts adventitial, others serosal

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22
Q

What are the layers of the endometrium?

A

1) Stratum functionale
- proliferates, secretes then sheds during menstrual cycle

2) Stratum basale
- closer to myometrium
- does not shed, regenerates endometrium for next menstrual cycle

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23
Q

True or false. The layers of the endometrium are separated by a basal membrane.

A

False.
There is no discrete border between the 2 layers, but can be differentiated as stromal tissue is more cellular than basal layer

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24
Q

Describe the arterial supply of the endometrium.

A

Bilateral uterine arteries penetrate myometrium
→ Circumferential arcuate arteries → branch
→ radial arteries → transverse myometrium
→ spiral arteries + basal arteries in endometrium

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25
Q

What are 2 differences between spiral and basal arteries of the endometrium?

A

1) Spiral respond to hormones, basal don’t

2) Spiral constrict @ end of cycle → ischemic phase → mensus

Basal support basal endometrial layer → proliferative cells for endometrial growth

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26
Q

What are the histological changes in the early vs late proliferative phase?

A

Early:
- tubular glands w columnar cells and surrounding dense stroma proliferate

Late:
- endometrium thickens further
- glands coil and become closely packed

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27
Q

What is the histological appearance of the endometrium in secretory/luteal phase?

A

Glands are complexly coiled as endometrium reaches max thickness (only stratum functionale thickens)

  • saw-tooth glands w glycogen and glycoprotein rich secretions in lumina
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28
Q

True or false: During pregnancy, under the influence of hormones, the myometrium increases in size through both hypertrophy and hyperplasia.

A

True

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29
Q

What is endometriosis?

A

Painful condition where tissue lining uterus grows outside uterine cavity
→ chronic inflammation + complications (eg. adhesions, pelvic pain, subfertility)

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30
Q

What are 3 signs and symptoms of endometriosis?

A

1) Dysmenorrhea
2) Dyspareunia (pain during sex)
3) Pain during urination or bowel movements
4) Bleeding between periods
5) Infertility

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31
Q

What is a “chocolate cyst”?

A

Endometrioma

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32
Q

The endocervix is lined by ___________ epithelium whereas the ectocervix is lined by _______________ epithelium.

A

Endocervix: simple columnar epithelium (w thick LP)

Ectocervix: Non-keratinised stratified squamous epithelium

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33
Q

What is the main histological difference between the cervix and uterus?

A

Cervix contains ««< smooth muscle compared to uterus

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34
Q

Which part of the cervix can nabothian cysts be found?

A

Ectocervix (can only form from glands on stratified squamous epithelium)

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35
Q

What is the other name for the transformation zone between the endocervix and ectocervix and what is its clinical significance?

A

Squamo-columnar junction
- high risk of malignant change

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36
Q

True or false: Vaginal mucus/secretions are produced by glands within the walls of the vagina.

A

False.
No glands within vaginal wall, all mucus produced by cervical glands

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37
Q

What are the layers of the vagina?

A

Lumen to basal:
1) Mucous layer
- non-keratinised stratified squamous epithelium

2) Lamina propria
- contains elastic and collagen

3) Muscular layer
- ill-defined smooth muscle layer

4) Adventitia
- connective tissue layer mostly elastic fibres

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38
Q

The cells of the vaginal wall typically contain a large of cytoplasm as it _________________. This is why the epithelial cells appear slightly vacuolated due to __________ which is removed during histological fixation.

A

Contains glycogen

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39
Q

Why is the vagina physiologically acidic?

A

Estrogen → ↑ epithelial glycogen in vagina
→ commensal Lactobacilli convert glycogen into lactic acid

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40
Q

What are 2 histological differences between the labia minora and labia majora?

A

1) Epithelium
Majora: keratinised
Minora: non-keratinised

2) Hair follicles and adipose tissues
Majora: present
Minora: absent

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41
Q

What type of glands are mammary glands?

A

Modified apocrine sweat glands

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42
Q

The glandular elements of the breast are __________________ and thus modified apocrine sweat glands consisting of __________________________.

A

Branched tubulo-acinar glands
- multiple acini lined by epithelial cells surrounded by myoepithelial cells

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43
Q

What is the stroma of the breast made of?

A

Connective and adipose tissue

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44
Q

What kind of epithelium lines the nipple and areola?

A

Stratified squamous

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45
Q

What is the term for ligaments within the stroma of the breast?

A

Ligaments of Cooper

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46
Q

Which cells in the breast produce milk?

A

Luminal cells in terminal duct lobular units

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47
Q

What cells form the innermost layer lining the ducts and acini of the breast?

A

Luminal cells

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48
Q

What are 3 histological features of luminal cells of the breast?

A

1) Cuboidal to columnar
2) Small, round to oval nuclei w inconspicuous nucleoli
3) Moderate amount of eosinophilic cytoplasm
4) Small have hormonal (estrogen/progestrone) receptors

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49
Q

What are the main precursor cells for malignant breast cancers?

A

Luminal cells

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50
Q

What cells form the outermost layer between the luminal cells and basement membrane of the breast?

A

Myoepithelial cells

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51
Q

What is the function of myoepithelial cells in the breast?

A

1) Help in contraction for milk ejection during lactation

2) Produces basement membrane (under oxytocin influence)

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52
Q

What are 2 histological features of myoepithelial cells in the breast?

A

1) Flattened
2) Small round nuclei
3) May become spindled with aging

53
Q

How do prolactin and oxytocin work together for breastfeeding?

A

Prolactin (from AP) stimulate milk secretion by luminal cells in acini/alveoli

Oxytocin stimulate myoepithelial contraction surrounding alveoli deep in breast → squeeze secreted milk into larger ducts

54
Q

What are the 2 types of connective tissue in the breast and how are they different?

A

1) Intralobular:
- loose
- more vascular
- more cellular (fibroblasts, plasma cells)

2) Interlobular:
- dense
- more collagen
- less cellular

55
Q

What type of tissue replaces fibrous tissue in the breast with age?

A

Adipose tissue

56
Q

What is the clinical significance of the ratio of ductal/fibrous tissue to adipose tissue in a woman’s breast?

A

Determines mammographic density → ↓dense → ↑radiolucency → ↑sensitivity to calcification/small masses with age

57
Q

What are 4 histological differences between a breast in inactive and active breast?

A

Inactive:
1) Only 2 layers of epithelium
2) Dense irregular interlobular connective tissue between quiescent lobules that have few ducts surrounded by less dense intralobular connective tissue

Active:
1) ↑glandular tissue
2) ↓connective tissue
3) ↑epithelial and myoepithelial cells (form secretory alveoli)
4) Epithelial cells have large clear areas of apical cytoplasm full of glycogen and lipid
5) ↑plasma cells in intralobular connective tissue (secreting IgA into milk)

58
Q

Describe the superficial and deep lymphatic drainage of the breast

A

1) Superficial lymphatics drain skin (except nipple an areola)

2) Deep lymphatics drain parenchyma + skin of nipple and areola

59
Q

What are the components of a mammary gland?

A

1) Parenchyma
- non-lactating/lactating

2) Ducts
- lactiferous, interlobar, intralobar, alveolar

3) Stroma
- intralobular/interlobular

60
Q

Describe the drainage of the breast in quadrants.

A

1) Upper medial → Internal mammary

2) Lower medial → (i) Internal mammary (ii) Subperitoneal → ovary

3) Upper lateral → Axillary → Deltopectoral → Apical

4) Lower lateral → (i) Axillary → Deltopectoral → Apical (ii) Posterior intercostal

61
Q

What is the lymphatic route of a metastatic breast cancer spreading to the ovaries?

A

Lower medial quadrant → subperitoneal lymph plexus → ovary

62
Q

What is the lymphatic route of a metastatic breast cancer spreading to the contralateral breast?

A

Medial breast quadrants → internal mammary lymph nodes → internal mammary lymph nodes on other side → other breast

63
Q

What causes the “Peau d’orange” breast appearance?

A

Lymphatic blockage → (i) edema (ii) retraction of ligaments of cooper → pitting

64
Q

What is the lining of the scrotal skin?

A

Keratinised stratified squamous epithelium

65
Q

The skin of the scrotum is often (darker/lighter) than the skin in neighbouring regions.

A

darker

66
Q

The skin of the scrotum contains long and thin hairs and contains ______________ and thus a common site for sebaceous cysts. It also (has/does not have) subcutaneous layer of adipose tissue.

A

Contains sebaceous and apocrine glands

No subcutaneous layer of adipose tissue

67
Q

The dartos muscle is a sheet of _______ muscle innervated by___________________.

A

Smooth muscle
- by sympathetic fibres from genital branch of genitofemoral nerve (L1/2)

68
Q

The cremaster muscle is a ____________ muscle innervated by _______________________.

A

Skeletal
- genital branch of genitofemoral nerve

69
Q

How do the dartos and cremaster muscles maintain scrotal temperature homeostasis?

A

Cold → muscles contract → draw testes closer to body
→ ↓SA of scrotal skin exposed to cold environment

Warm → muscles relax → tests hang further away → ↑SA of scrotal skin exposed to external environment → ↑heat dissipation

70
Q

What is the major lymphatic drainage pathway of the perineal structures?

A

Inguinal lymph nodes:
1) Horizontal/superficial
- directly below inguinal ligament & extends horizontally

2) Vertical/deep
- along great saphenous vein & extends vertically

71
Q

True or false: It is normal for 1 testis to be bigger than the other and thus for the right testicle to usually hang lower than the left.

A

False.
Normal but left lower than right

72
Q

Where is testosterone mainly produced in females?

A

Peripheral tissues

73
Q

Describe the arterial supply of the testes.

A

Testicular arteries from abdominal aorta

74
Q

Describe the venous drainage of the testes.

A

Right → IVC
Left → L renal vein → IVC

75
Q

Describe the lymphatic drainage of the testes.

A

Follows testicular arteries → para-aortic nodes

76
Q

What is the primary function of the pampiniform plexus?

A

Regulate temperature of the testes
- countercurrent heat exchanger
- cools arterial blood before reaching the testes

77
Q

Where does the spermatic cord terminate?

A

Posteromedial border of the testis

78
Q

What is cryptorchidism?

A

Undescended testis

78
Q

What are the contents of the spermatic cord?

A

1) Vas deferens
2) Testicular artery
3) Pampiniform plexus
4) Genital branch of genitofemoral nerve
5) lymphatics
6) ANS fibres

79
Q

What is the surgical correction of cryptorchidism?

A

Orchidopexy/Cryptorchidopexy

80
Q

What is a variocele?

A

Enlarged pampiniform plexus veins in scrotum due to valvular defects

“Bag of worms”

81
Q

What are 3 symptoms of a varicocele?

A

1) Dull to sharp discomfort
2) Worsening pain w standing or physical exertion esp for long hours
3) Worsen over course of the day

82
Q

Describe the superficial reflex arc of the cremasteric reflex.

A

Afferent:
Sensory by ilioinguinal & femoral branch of genitofemoral nerve

Spinal cord:
L1-2

Efferent
- Genital branch of genitofemoral nerve

83
Q

What are the risks of an cryptorchidism?

A

1) Infertility
2) testicular cancer
3) hernias
4) testicular torsion

84
Q

What is used to diagnose testicular torsion?

A

Cremasteric reflex

85
Q

Describe the gross structure of the testis.

A

Superficial to deep:
1) Tunica albuginea
2) Testicular lobules → seminiferous tubules
3) Septae (inbetween testicular lobules)
4) Rete testis
5) Efferent ductules

86
Q

In which part of the testis does spermatogenesis occur?

A

Seminiferous tubules

87
Q

The tunica albuginea which subject the seminiferous tubules to rhythmic contractions and is composed of which cells?

A

1) Fibroblasts
2) Myofibroblasts
3) Very few smooth muscle cells

88
Q

What are the 2 layers of the tunica albuginea?

A

1) Tunica vasculosa (inner)
- connective tissues, lymphatics, blood vessels

2) Tunica vaginalis (outer)

89
Q

What is the histological appearance of the spermatogonium?

A

Large round nucleus with condensed chromatin, peripheral nucleoli and nuclear vacuole

90
Q

What is the histological appearance of a primary spermatocyte?

A

Copious cytoplasm, large nuclei, thin-thread chromatin

91
Q

What is the histological appearance of secondary spermatocytes?

A

Smaller than primary spermatocytes, with dispersed chromatin

92
Q

Sertoli cells are ________ cells with extensive _______________ that surround and support adjacent spermatogenic cells.

A

Columnar, extensive apical and lateral processes

93
Q

Which cells form the blood testis barrier?

A

Sertoli cells

94
Q

What are 4 functions of sertoli cells?

A

1) Structural support

2) Nutritional support

3) Secrete important substances: inhibin B, Androgen-binding protein, anti-mullerian hormone

4) Phagocytic
- clean up cellular debris

95
Q

Where are leydig cells found in the testes?

A

In interstitial supporting tissues be the seminiferous tubules

96
Q

What is the characteristic feature of leydig cells?

A

Abundant SER for steroid hormone synthesis

97
Q

What is the function of leydig cells?

A

1) Testosterone synthesis
2) Hormonal regulation
- produce testosterone in presence of LH

98
Q

What are the parts of the epididymis and their respective functions?

A

1) Head
- receives spermatozoa from testis via efferent ductules

2) Body
- facilitates functional maturation of spermatozoa (where they develop motility)

3) Tail
- where sperm are stored until ejaculation

99
Q

The epididymis is a long coiled tube that transports sperm from ___________ to ______________.

A

From testes to vas deferens

100
Q

Where in the scrotum is the epididymis located?

A

In scrotum along superior and posterolateral side of each testis

101
Q

What is the lining epithelium of the epididymis?

A

Pseudostratified columnar epithelium

102
Q

What are the 3 cell types of the epididymis?

A

1) Principal cells
- tall columnar cells
- stereocilia
- faciliates absorption and secretion functions

2) Basal cells
- small, round cells near basement membrane
- produces new cells

3) Smooth muscle layer
- increases from single later @ proximal end to triple layer @ distal end

103
Q

Principal cells form most of the epithelium and have long stereocilia. What is their function?

A

Help absorb excess fluid and dead/defective sperm

104
Q

How long does a sperm usually take to pass through the epididymis?

A

2-4wks

105
Q

The vas deferens is a long, thick-walled muscular tube with a relatively small lumen that transports sperm from __________ to ______________.

A

Epididymis to prostatic urethra

106
Q

What is a vasectomy?

A

Permanent sterilisation method via cutting and tying the vas deferens on either side.

107
Q

The lumen of the vas deferens is lined by what kind of epithelium?

A

Pseudostratified columnar epithelium

108
Q

What are the layers of the vas deferens?

A

Lumen to basal:
1) Pseudostratified columnar epithelium (w few stereocilia vs epididymis)

2) Lamina propria
- both fold to allow expansion

3) Thick muscular layer:
a) inner and outer longitudinal
b) middle circular

109
Q

What is the major energy source for spermatozoa?

A

Frutose

110
Q

What is the main function of the secretions of the bulbourethral glands?

A

1) Contribute to final volume of semen
2) Lubricates urethra and tip of penis

111
Q

Seminal vesicles contribute up to 70-80% of seminal fluid containing ___________________.

A

1) Protein
2) Mucus
3) Fructose
4) Prostaglandins

112
Q

Where are the seminal vesicles located?

A

Below posterior wall of urinary bladder

113
Q

What is the function of prostaglandins in semen?

A

1) Aid in sperm movement
2) Soften mucus of cervix

114
Q

Why do the lumen of seminal vesicles have a “honeycomb appearance” at low magnification?

A

Lumen are highly irregular

115
Q

What is the lining epithelium of the seminal vesicles?

A

Pseudostratified columnar epithelium

116
Q

What are the histological features of seminal vesicles?

A

1) Pseudostratified columnar epithelium

2) Lamina propria
- w blood vessels, lymphatics, elastic fibres

3) Primary, secondary and tertiary folding of mucous membrane

4) Inner circular and outer longitudinal layers

117
Q

What are the components of prostatic fluid?

A

1) Zinc
2) Citric acid
3) Calcium
4) Phosphates
5) Other enzymes essential for sperm health and motility

118
Q

What is PSA and why is it used in cancer screening?

A

Androgen-regulated serine protease produced by both prostate epithelial cells and prostate cancer
- usually liquifies semen to facilitate sperm swimming
- normally, small amounts leak into vasculature → elevated levels → abnormal glandular mucosa (usually due to prostatic cancer or inflammation)

119
Q

The prostate gland is composed of ____________ glands with a surrounding ______________.

A

Tubuloacini/alveolar glands

Surrounded by prostatic stroma
- fibromuscular w abundant smooth muscle cells admixed with fibroblasts, blood vessels and nerves
- NO adipose tissue

120
Q

What is the lining epithelium of the prostate gland?

A

Pseudostratified columnar epithelium

121
Q

What cells rest on the basement membrane of the prostate gland?

A

Basal cells
- small, round stem cells

122
Q

What is the unique histological feature of the prostate gland?

A

Corpora amylacea
- concentrations of prostatic fluid in lumen of some glands in older men
- contain glycoprotein and keratin sulfate
- concentric lamellar appearance
- increase in number and size w age

123
Q

What are 2 histological differences between corpora cavernosa and corpus spongiosum?

A

Corpora cavernosa:
- numerous sinusoids lined by endothelial cells
- cavernous spaces separated by trabeculae containing smooth muscle fibres and connective tissue

Corpus spongiosum:
- Fewer and smaller sinusoids
- more elastic tissue
- surrounds urethra

124
Q

What are the changes to the lining epithelium along the male urethra?

A

1) Pre-prostatic: transitional

2) Prostatic: transitional

3) Membranous: transitional → pseudostratified columnar epithelium

4) Spongy: Pseudostratified columnar except terminal portion → stratified squamous epithelium

125
Q

What type of cells make up the urothelium?

A

Large, polyhedral umbrella cells
- uniquely can stretch and flatten when bladder is full

126
Q

What are the general layers of the male urethra?

A

Luminal to basal:
1) Inner epithelial lining
2) Lamina propria
3) Inner longitudinal
4) Outer smooth muscle
5) Outer fibroelastic connective tissue layer

127
Q

What are Littre’s glands?

A

Tubulo-acinar glands located within mucosa of male urethra
- pale eosinophilic w clear cytoplasm and flat nucleus
- lubricate urethra

128
Q
A

Reproductive System (7 decks)

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