Histology and Anatomy of the Reproductive Tract Flashcards
What is the Histology of the Uterus?
Simple columnar epithelium
Has 2 layers- stratum functionalis (deep spongy and compact) and stratum basalis
Lamina Propria
Myometrium- 4 Layers of smooth muscle
What is the Histology of the Fallopian Tube?
Variations?
Simple Columnar, cilliated, has folds, and peg cells (non-ciliated and mucus secreting)
Lamina Propria
Muscular Layer
Serosa
Tha ampulla has a lot of folds and is very ciliated, only 2 layers of muscle
The isthmus is the thickest layer, with 3 layers of muscle has more peg cells
What are the parts of the female reproductive tract?
Include its divisions
Ovary
Fallopian Tubes: Fimbrae, Infundibulum, Ampulla, Isthmus
Uterus
Cervix- internal and external O’s and endocervical canal
Vagina
Bulbourethral Glands
What are the parts of the Male reproductive tract?
Scrotum - encloses testes epididymis and first part of vas deferens
Testes- has seminiferous tubules, rete testes and ductus deferens.
Seminal Vesicle and Ejaculatory duct
Prostate Gland
Spermatic Cord - transmits stuff
Penis- base, shaft, glans
Bulbourethral Glands- Cowpers and Littles
What is the blood supply to the uterus?
Uterine arteries and veins which branch into arcuate arteries
Coiled in functional layer and straight in basal layer
Arteries come from the Internal Iliac
Which artery of the FRT comes from the abdominal aorta?
Ovarian Artery
What are the ligaments of the FRM?
The round ligament of the uterus and ovary
The Broad Ligament
The suspensory ligament
Minor: Transverse Cervical
Uterosacral Ligament
Describe the Broad Ligament
It is a transverse fold of peritoneum Mesentery of the uterus Has 3 parts: Mesosalphinx Mesovariam Mesometrium
It allows mobility and attaches it to the posterior abdominal wall
Describe the Round Ligament,
Clinical Relevence,
Origins
Comes from the gubernaculum
Attaches Ovary to the fundus of the uterus and the uterus to the labium majorus
Travels through the inguinal canal
**Spread infection to labia via inguinal nodes
Describe the suspensory ligament
It transmits the ovarian lymphatics, arteries and veins and nerve plexus
From ovary to the lateral wall
Describe the histology of the primordial follicle
Flat epithelial layer
Before month 7, surrounds multiple oogonia, after surrounds each individual primary oocyte.
Simple squamous cells
Describe the primary follicle
Stimulated by FSH
squamous cells -> cuboidal
Becomes multilaminar:
Theca cells produced
Zona pellucida produced by granulosa cells
Stratified GC
Describe the secondary follicle
Fluid produced between granulosa cells coalesce to form an antrum
Oocyte is attached via the cumulus oophorus and surrounded by the corona radiata
Describe the Graafian Follicle
The Mature follicle
Oocyte is free floating in the antrum as the CO has broken down before ovulation
What happens to the Follicle at/post ovulation
It becomes ischaemic and ruptures, allowing the oocyte to move into the lumen of the FT
After, it becomes vascular and the GC and TC become the Corpus Luteum which secretes Oestrogen and Progesterone
What is the Histology of the Ovary
Has 2 parts:
Medulla- for passage of blood vessels, nerves, CT and stroma.
Cortex- where germ cells are
Hilum
Surrounded by simple squamous epithelial cells (peritoneum)
What is the Histology of the Breast?
It is a system of ducts and tubules
Nipple -> Lactiferous Ducts ->Interlobular Ducts -> Lobules -> Acini/Alveola
Surrounded by Fibrous tissue and adipose
Each Acini has a layer of myoepithelium
Has suspensory ligaments of Cooper to hold breast in position
Describe the ducts of inactive breast
Limited branches
Non functioning
Lots of stroma, dense, fibrous
Squamous or Columnar epithelium
Describe the ducts of active breast tissue
Very little stroma (interlobular tissue) Adipose tissue increases Milk secretions can be seen Ducts have more branches Ducts are more columnar
What is the Histology of the Vagina
Stratified Squamous Epithelia- produced gycogen
Submucosa- rich in elastin, highly vascular
Muscle - smooth and skeletal
What is the Histology of the Testes?
Tunica Vaginalis
Thick Fibrous Capsule -Tunica Albicans
Seminiferous tubules - Sertoli cells, germ line cells and Leydig
Rete testes - simple cuboidal
Ductus efferentes - scalloped epithelia, myloid and ciliated cells
What is the Histology of the Epididymis?
Smooth muscle
1) Basal Cells
2) Myloid (peritubular) layer
3) Principle Cells (Pseudostratified) with Stereocilia
What is the Histology of the Vas Deferens?
Pseudostratified Columnar
3 Layers of SM:
Long: Circular: Long
What is the Histology of the Seminal Vesicle?
Secretory Epithelium
Smooth Muscle
What is the Histology of the Prostate
Cuboidal/Columnar or Pseudostratified
Fibromuscular Stroma
Organised into Zones
Describe the Scrotum
Comes from the Labioscrotal folds
It is a cutaneous sac enclosing: Testes, Epididymis and the first part of the Vas deferens/Spermatic cord
What is the Arterial, Venous and Lymphatic supply of the Scrotum?
A:
V:
L: Superficial Inguinal
Describe the Testes
Surrounded by tunica vaglinalis (remnent of the processus vaginalis)
Then has a thick fibrous capsule - Tunica albicans
(invades into the testes to form interlobular septa)
Made up of Seminiferous tubules which produce spermatazoa
Rete Testes and Ductus Deferens connect them to the epididymis
What is the Arterial, Venous and Lymphatic supply of the Testes
A: Testicular Artery (from AA)
V: Testicular Vein (to IVC and LRV)
L: Para aortic nodes
Describe the Epididymis
Has a head, body and tail
Enclosed in the scrotum
Attaches testes to the vas deferens
Describe the Spermatic Cord
Transmits?
Where Travels?
Transmits the cremasteric artery, artery to VD and the testicular artey
Transmits lymphatic drainage
Pampniform Plexus of Veins
The genital branch of the genitofemoral nerve
Vas Deferens
Travels through the inguinal canal
What are the fascial coverings of the spermatic cord?
What are their origins?
External Spermatic Fascia - aponeurosis of the external oblique
Cremasteric Muscle and Fascia- from transversalis and internal oblique
Internal- from transversalis fascia
What are the borders of the inguinal canal?
Roof: Internal Oblique and Transverse Abdominus
Floor: Inguinal Ligament
Medial:Transversalis fascia and the Conjoint Tendon
Lateral: Aponeurosis of External Oblique
What are the borders of Hesselbachs Triangle?
Inferior Epigastric Vessels
Inguinal ligament
Rectus Abdominus
Describe the Vas Deferens
Ascends in the spermatic cord.
Passes through inguinal canal, ascends the pelvic side wall, between the bladder and ureter and forms an ampulla
Describe the Seminal Vesicle
70-80% semen
Joins the VD to form the ejaculatory duct
It is a diverticulum of the VD
Between the bladder and rectum
Describe the Prostate Gland
Fibromuscular Gland
Divided into Zones: Peripheral, Transitional, Central
Describe the Penis
Root, Body, Glans
2 dorsal corpora cavernosa
1 ventral corpus spongiosum
What is the Arterial, Venous and Lymphatic supply of the Penis?
Internal Pudendal Arteries (internal iliac) and Veins
Describe the Perineum of the male
Made up of bulbospongiosus and ischocavernosus
Supplied by internal pudendal artery
What is the vascular supply of the ovaries?
Ovarian Artery from the AA
Ovarian Veins to the IVC and LRV
What are the parts of the uterus?
The Fundus
The Body
The Cervix
The Fallopian (Uterine) Tubes
How does the uterus communicate with the GI and Urinary Tract?
The Uterovesicular pouch
The pouch of Douglas (GI)
Can get to via the posterior fornix
How is the uterus positioned?
Anteverted to the vagina
Anteflexed compared to the cervix
How can the position of the uterus change?
It is elevated during sexual excitation
The angle of anteflexion can change depending on how full the bladder is
It can be retroverted - easier to prolapse
What are the parts of the Fallopian Tube?
Describe
The Fimbrae - finger-like projections sweep the ooctye into the FT
The Infundibulum - bell-shaped
The Ampulla- the widest part of the FT, fertilisation normally takes place here
The Isthmus- narrowest part, connects the ampulla to the cavity
Adbominal Ostium - where it is open to the abdominal cavity **spread of infection
Describe the Cervix
Internal O’s - narrowing of the uterus, seperates Cervix from the Uterus
Endocervical Canal- the most proximal part of the cervix
Mucus secreting columnar cells
External O’s - marks barrier between endo/ectocervix
Ectocervix- stratified squamous epithelia
What is the Vascular Supply of the FRT?
Ovarian A -> AA
Uterine, Cervical and Vaginal Arteries from the Internal Iliac Artery
How can surgery e.g. hysterectomy damage the Urinary system?
Ureter passes underneath the uterine artery/vein and can be damaged when they’re removed
Where does the uterus drain to?
Fundus - Paraaortic and Inguinal Nodes
Body -External/Internal Iliac
Cervix - Sacral and E&I Iliac Nodes
Describe the external genitalia
Labia Majora- encloses pudendal cleft
Labia Minora- encloses the vestibule
The Vestibule- Vestibular/Bartholins glands, vaginal oriface, urethral oriface,
Describe the vagina
Has anterior and posterior fornices **can be a place where infection collects, can get into pouches through them
What is the innervation of the FRT?
Inferior 5th - Pudendal Nerve SOMATIC
Superior- Uterovaginal Plexus
AFFERENT PAIN - S2-4
Perineum - Pudendal and Ilioinguinal nerves
What is the path of the pudendal nerve?
it goes through the greater sciatic foramen to leave the pelvis and enters the perineum via the lesser sciatic foramen
Travels through the pudendal canal
What are the borders of the pelvic inlet?
Anterior: The pubic symphysis
Posterior: Sacral prominity
Lateral: The Iliopectineal line
What are the borders of the pelvic outlet (hint, they’re the same as the borders of the Perineum)
Anterior: Pubic Symphysis
Posterior: The Coccyx
Lateral: Ischial tuberosities and the Sacrotuberous ligaments
What muscles make up the Pelvic Floor
Levator Ani Muscles
Coccygeus
Superficial Transverse Perineal Muscles
What is the function of the pelvic floor?
What is it?
To support pelvic viscera
To resist increasing intra-abdominal pressure, prevent prolapse
Attachment for muscles
Act as a sphincter for urinary and faecal continence
It is an layer that separates the perineum from the pelvic cavity
What are the levator ani muscles?
What are they attached to?
Innervation?
Pudendal Nerve (S2-4)
They form a broad, muscular sheath
Puborectalis (tonic contractions create the anorectal angle, help continence)
Pubococcygeus - main part, forms around the urogenital hiatus/triangle
Iliococcygeus - thin fibres
All insert into the tendinous arch (formed by obturator internus)
Describe Coccygeus
Smallest, most posterior pelvic floor muscle
Ischial spines -> Coccyx and Sacrum
Innervated by anterior rami of S4 and 5
What is the Perineum?
An anatomical area between the thighs, inferior to the pelvic floor
What are the boundaries of the Perineum?
Divisions?
Anterior: The pubic symphysis
Posterior: The Coccyx
Lateral: the ischial tuberosities and the sacrotuberous ligaments.
Anterior Triangle : Urogenital Hiatus/Triangle
Posterior Triangle: Anal Triangle
Inbetween there is the Perineal body
What are the layers of the anterior triangle?
From the Pelvic Floor Muscles downwards
What is in each layer?
The deep perineal pouch - urethra and external urethral sphincters located here. In the male the bulbourethral glands and deep transverse P. muscle
The perineal membrane- thick fascia, urethra and vagina perforate. Muscles attach
The superficial Pouch - Bulbospongiosus and superficial transverse perineal muscle in males
Bartholins glands in female
Erectile tissue of clitoris and penis
Deep perineal fascia
The superficial Fascia - forms mons pubis and labia majora, fatty tissue
What is the contents of the posterior triangle (the anal triangle)
Anal aperture
External anal sphincter - maintains faecal continence
Ischiorectal fossae - 2x located either side of the anal aperture, aid expansion during defaecation, can become infected
What is the perineal body?
Located?
Function?
Clinical Relevence?
An irregular, fibromuscular mass, located in between the 2 triangles, just deep to the skin
Acts as an attachment for muscles (continence, support viscera, prevent prolapse) and is tear-resistant
Be careful giving birth
What is the innervation of the Perineum?
The pudendal nerve
What is the arterial supply of the perineum?
The internal pudendal artery
What muscles attach to the perineal body?
Levator Ani muscles
Bulbospongiosus muscle
external anal/urethral sphincters
