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Unit 7 > Histology of the Female Reproductive System > Flashcards

Histology of the Female Reproductive System Flashcards

1
Q

What is the most common cause of female factor infertility?

A

Ovulatory disorders (25%)
Relating to the HPG axis, in which FSH does not stimulate ovulation.

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2
Q

What are the different causes of female factor infertility?

A

Ovulation disorders relating to the HPG axis (25%)
Tubal damage - patency from ectopic pregnancy or sterilisation (20%)
Uterine or peritoneal disorder - endometriosis, fibroids, pelvic inflammatory disease (10%)
Other: Lifestyle, age, infection

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3
Q

How are the ovary and fallopian tube connected?

A

Are not directly connected, are held together by the broad ligament and open into the peritoneal cavity.

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4
Q

Label the following picture of the female reproductive system

A
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5
Q

How does the female erectile tissue compare to the male erectile tissue?

A

Female clitoris also consists of the two corpus cavernosum and one corpus spongiosum.
Same mechanism of erection.
The corpus spongiosum form the gland of the clitoris and the bulb of vestibular.

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6
Q

Give an overview of the components within an ovary.

A

Surface is covered by a single layer of epithelium - called the germinal epithelium
Then the cortex
Then the medulla, which makes up the majority of the middle region
THe hilum acts as the entry/exit points for structures in or out of the ovary such as vasculature and lymphactis
The white spaces shown within a histological image are the follicels.

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7
Q

Identify the features of the ovary shown in this histological image.

A
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8
Q

What is the basic role of the follicle in the ovary?

A

Site of oocyte maturation and secretion of steroid hormones such as progesterone and oestrogen.

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9
Q

What does the cortex in the ovary contain?

A

Gametes (within the follicle )and support cells.

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10
Q

Give an overview of the Hypothalamic pituitary ovarian axis?

A

The hypothalamus released GnRH, the frequency of the pulses of this release regulates the levels of LH and FSH secreted by the anterior pituitary gland.
Note the pulse peaks around ovulation where FSH and LH peak at day 14.
This regulates the ovaries production of oestrogen and progesterone (and inhibin).
This acts as negative feedback to reduce the number of pulses.

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11
Q

Where are gonadotropins produced?

A

The anterior pituitary gland

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12
Q

What are some examples of gonadotropins?

A

Follicle Stimulating Hormone FSH
Lutinising Hormone LH

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13
Q

What is the role of FSH, LH, oestrogen and progesteron functionally in the female reproductive system?

A

FSH - causes follicles to mature and oocyte to mature to ovum
LH - causes ovulation and formation of curpus luteum
Oestrogen - build up on endometrial lining
Progesterone - maintains the uterus lining

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14
Q

What is the role of FSH and LH in male reproductive hormone?

A

FSH - stimulates sertoli cells to produce ABP
LH - stimulate leydig cell to produce testosterone

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15
Q

What two cycles are involved in the menstraul cycle?

A

The ovarian cycle
The uterine cycle
Note both occur simultaneously.

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16
Q

What are the different stages of ovarian follicular development?

A

Primordial follicle
Maturing Primary and Secondary Follicles
Mature (teriaty or graafian) Follicle
(ovulation occurs)
Corpus Luteum
Corpus Albicans

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17
Q

What does each teriary follcile contain?

A

A oocyte
An outer zona pelluicda
Support cells (granulosa and thecal cells)
Fluid filled antral cavity.

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18
Q

What are the alternative terms for….?
Primary follicle
Secondary Follicle
Mature Follicle
Pre-ovulatory follice

A

pre-antral
Late pre-antral
Antral
Pre-ovulatory

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19
Q

Give an overview of primordial follicles.
when do they develop?
what do they contain?

A

Develop during embryogenesis by end of trimester 2, finite number is present at birth.
Made of an outer epithelium, primordial germ cell (contains the oocyte), mesenchymal stroma (Connective tissue that provides cellular framework)

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20
Q

Identify the features of the primordial follicle shown in the image.

A
  1. Primordial Germ cell
  2. mesenchymal stroma
  3. Epithelium
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21
Q

Identify the features of the primordial follicle shown in the image?

A
  1. Granulosa cells
  2. Oocyte
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22
Q

What is a tip for identifying primaordial germ cells?

A

Pink circular nucleus
Surrounded by a white cytoplasmic rim
Sits within denser pink structures, more cellular build up.

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23
Q

What are the key features of a primary follicle?

A

The oocyte
The zona pellucida
Granulosa cells

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24
Q

What development happens between the primordial follicle and the primary follicle?

A

Development occurs after puberty when the follicle is recruited during the menstraul cycle.
The zona pellucida develops around the oocyte
Around the zona pellucida the number and layers of franulosa cells increases.

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25
Q

Identify the key features of a primary follicle shown in the image?

A

1 oocyte
2 zona pelucida
3 granulso cell layer

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26
Q

What are the key features of a secondary follicle?

A

oocyte
Zona pellucida
Granulosa cells
Theca interna (spindle)
Theca externa (plump)
Antral cavity

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27
Q

What is the function of the antral cavity?

A

Filled with necessary supportive fluid.
Grows to seperate the granulosa layers into those that will be released on fertilisation as the corona radiata and those that remain.

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28
Q

What is the function of granulosa cells in the follicle?

A

Secretory cells
Produce oestrogen, progesterone and other hormones

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29
Q

What is the function of theca interna and theca externa?

A

Theca externa - provides structural support to the growing follicle and oocyte, maintains cAMP dependent smooth muscle function to help with ovulation
Theca interna - produce ovarian androgens which are converted to oestrogen

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30
Q

How do you differentiate between theca interna and theca externa on a histological image?

A

Theca interna are located just after the compact granulos layer
Theca externa are located more peripherally
Note nucleus is more elongated than granulosa cells.

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31
Q

What is the difference in the function of granulosa cells and theca interna cells?

A

Granulosa cells respond to FSH and produce oestrogen
Theca interna cells respond to LH and produce androgens and progesterone.

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32
Q

Label the key features shown in the image of the secondary follicle.

A

Antral cavity
Granulosa cells
oocyte
Theca interna
Theca externa.

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33
Q

What are the key features of the tertiary/mature follicle?

A

The antral cavity enlarges to form the antrum, makes up majority of space
Granulosa cells tha seperate the antrum and the oocyte form the cumulus-oocyte comples
Cumulus cell layer is made of granulosa cells.

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34
Q

What is the function of the cumulus layer around the oocyte in the mature follicle?

A

Leaves the ovary alongside the oocyte during ovulation.
forms the corona radiata

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35
Q

What is ovulated? changes structurally in what is ovulated?

A

The primary oocyte becomes a secondary oocyte.
A single polar body develops as the first phase of meiosis occurs and is paused
The follicle ruptures and fluid, oocyte and cumulus are released.

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36
Q

How do the stages of meiosis related to oocyte development?

A

All oocytes at birth are paused in meiosis one and are called primary oocytes
Meisosis 1 is completed hours before ovulation and a secondary oocyte is formed
Meisosis two starts but is paused during ovulation
Meisosis two is only complete if fertilisation occurs.

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37
Q

What are polar bodies in relation to an oocyte?

A

A small haploid cell that arises due to the completion of a meiosis phase in a oocyte.
Contains the DNA that the oocyte chucks away.

38
Q

What is lutenisation?

A

The process by which the remaining follicle after ovulation is stimulated to develop into a corpus leuteum and evetually a corpus albicans.
Stimulated by LH.

39
Q

What happens to the remaining follicle after ovulation?

A

LH stimulates it to undergoe lutenisation
Becomes a corpus letuem then a corpus albicans.

40
Q

What is the life cycle of the corpus luteum?

A

Corpus haemorraghicum (red) straight after ovulation, formation process
Corpus luteum (yellow), bloom process
Corpus albicans (white) regression process

41
Q

What is the function of the corpus luteum?

A

Is steroidogenic for 14 days +/-2 days, meaning it secretes progesterone (mainly).
If not fertilised it undergoes leutolysis (programmed cell death).
If fertilised remains until the placenta takes over steroidgenesis at week 13

42
Q

Give an overview of the structure of the corpus leuteum?

A

‘yellow body’
in histoligcal image is quite large in proportion to the rest of the ovary reaching 2cm by 1.5cm
Blood clot fills the lumen (shows as a bright red)
Surroudning theca interna and granulosa are lutenised cells.

43
Q

Idenitfy the features of the corpus luteum in the image below.

A

Shows in context of the ovary
1 is blood clot
2 luteinised granulosa cells.

44
Q

Give an overview of the corpus albicans.
Shape, appearance, content.
How does it form from a corpus luteum?

A

Is an oval mass of fibrous sacr tissue
Theca externa cells and fibroblasts produce collogen which replaced lutein cells, so it becomes non-steroidogenic
Remains in the ovary for life

45
Q

What does a corpus albicans look like on a histological image?

A

A white or pale pink mass.
In ovary
About 1.5 cm in diameter

46
Q

What is the function of the fallopian tube?

A

Secretion and transport to support fertilisation (1 day) and early embryo survival (5 days)
Supports sperm survial for several days

47
Q

What are the differnt parts of the fallopian tube?

A

(uterus)
The uterotubal junction
The isthmus
The ampulla
The infundibulum
(ovary)
Roughly 10 to 12 cm long

48
Q

Where is the fallopian tube does fertilisation occur?

A

The ampulla.

49
Q

What are the four different histological layers in the fallopain tube?
Why might the proportion of these layers vary?

A

Mucosa
Submucosa
Muscularis (inner circular - outer longitudinal smooth muscle)
Serosa
Proportion of layers vary with function

50
Q

When do the different variations in the histological layers of the fallopian tubes arise? Why?

A

Interstitial part (near uterus) has a thick muscular layer to contract to aid movement.
The isthmus has even proportion of epithelium and muscle
The infundibulum has greater proportion of epithelial layer and very little muscle, this increases the surface area to help secure oocye attachment during ovulation.

51
Q

Lable the histological cross sections shown in the image of the ampulla?
Why is each layer important?

A
  1. Mucosa - large surface area as highlf folded epithelium
  2. less smooth muscle in muscularis layer - contraction less important for transport.
52
Q

What is the epithelium of the fallopian tube like?

A

Highly folded
Contains secretory and ciliated cells (transport).
Secretory cells may be stained blue to mucin
Or are identified by SEM, where transport cillia cells hair longer hair like projections whilst secreoty cells have smaller microvilli.

53
Q

What aids transport in the fallopian tube?

A

Ciliated cells
Smooth muscle contraction
Composition of tubal fluid (glucose).

54
Q

How do hormones affect the function of the fallopian tube?

A

Oestrogen - incteases transport speed and secretions for oocyte
Progesteron - decreases transport speed and secretions for embryo

55
Q

What are the layers of the uterus?
Which layers are lost during menstration?

A

Epithelium
Stratum Compactum
Stratum spongiosum
Stratum basalis
Myomterium
The SC and SS are lost during menstration
The SB contributes to the thickening and regneratrion
TIP: Come, sex, baby, mania

56
Q

What are the three different stages of the uterine cycle?
What harppens in each cycle.
How long does it last

A

Menses day 0 to 5 -shedding of the endometrial lining
Proliferation phase day 5to14, growth of endometrial lining
Secretory phase day 14 to 28, preparation for implantation

57
Q

How do oestrogen and progesterone levels change during the proliferative and secretory phase of the menstrual cycle?

A

Oestrogen peaks in the late proliferative phase then decreases.
Both oestrogen and progesterone increase to peak in the middle of the secretory phase

58
Q

What are the common symptoms of menses of the uterine cycle?

A

Muscle spasm and pain

59
Q

Give an overview of the time span of menses.

A

Occurs every 24 to 35 days
Lasts for 4 to 8 days
Loss of 5 to 80ml of blood

60
Q

What different features are found in the endometrial lining?

A

The uterine glands - within the stratum compactum and stratum spongiosum
The uterine artery within the myometrium layer, this branches into the radial branch and the straight and spiral arteries in the stratum spongiosum, the spiral artery extends branches into the stratum compactum
There are also venous lakes in the strarum compactum
These are essential for nutrients for foetal and placenta growth.

61
Q

What three layers make up the myometrium?
How is it affected by pregnancy?

A

It is made of smooth muscle that has three ill-defined layers. Outer and inner longitudinal smooth muscle and an intermediate circular smooth muscle layer.
it is sensitive to hormones and undergoes hyperplasia and hypertrophy during pregnancy.

62
Q

What does the endometrial lining look like during the proliferative phase?
What causes these changes to occur?

A

The stroma is compact.
Glands are short, straight, white and narrow with little secretion
Mitotic divisions may be occuring
Oestrogen promotes cell proliferation of the stratum basal layer to regenerate the endometrial lining.

63
Q

What makes up the stroma of the endotermial lining?

A

The stratum compactum, the straum spongiosum, stratum basalis.

64
Q

Based on the image identify the stage of the uterine cycle?

A

The proliferative phase Day 4 to 14
Compact layers
Glands and long, thin and clear of secretions

65
Q

What are the key features of the endometrial lining in the secretory phase?
What causes these changes?

A

Progesterone inhibits endometrial growth
Induces differentiation of epithelium and stroma in preparation for decidualisation
Early in the phase subnuclear vacuoles appear as white patches below the nucleus of secretory cells.
The glands becoem corckscrewed (more squished and irregular in appearance) and filled with secretions (appear a faded greyish colour)

66
Q

Based on the images identify the stage of the uterine cycle

A

The secretory phase
Subnuclear vacuoles appear
Glands are more squished and irregular, filled with greyish secretions.

67
Q

What is decidualisation?

A

Cellular and structural changes to the endometrial lining in preparation of or during pregnancy, including vascular changes.

68
Q

What is the stratum functionalis?

A

The layers of the endometrium that are lost during menses (the stratum compactum and the stratum spongiosum)

69
Q

What are the key featuers of the endometrial lining during menses?

A

Apoptotic bodies
Stratum functionals layer starts to shed
Leakage of blood
Layers are more defined and loops as if it could be scraped off

70
Q

Based on the images shown what stage of the uterine cycle is this?

A

The menstraul phase
Apoptopic bodies (white mass with coloured clumps)
leakage of blood (pink circular massess, looks like blood clots)
Defined stratum functionalis layer

71
Q

What causes the menstrual phase to begin?

A

Progesterone withdrawl induces shedding of the functional layer of the endometrium

72
Q

When do females recieve cervical screening from the NHS?

A

Invited for the first scan up to six months before your 25yrs}
Then recieve one every three years until you turn 50
Then recieve one every 5 years
Only recieve tests after 65yrs if one of your last three was abnormal.

73
Q

How us cervical screening don e?

A

A speculum opens the vaginal canal
A brush is inserted and gently removes cells from the internal os of the cervix.

74
Q

What are the different sections of the cervix?

A

The internal os - next to the uterus
The external os - next to the vagina
Think vagina opens into the external world.

75
Q

What is the epithelium like of ectocervix?

A

Adapts to the acidic nature of the vaginal environment
Is straitifed sqaumous epithelium (non -keratinised)
is rich in glycogen (source of glucose in early pregnancy)
Cyclical alteration under the influence of oestrogen and progesterone.

76
Q

What is the difference between the external os, ectocervix and the internal os and the endocervix.

A

The ectocervix and endocervix are bulges within the uterus or vagina
The internal os and external os are the opening from the cervix into these structures.

77
Q

What is the endothelium like of the endocervix?

A

The lumina portion (opens into a lumen)
Simple columnar epithelium
Secretory
Contious with the uterus lining
Has invaginations of the epithelium (look similar to glands on a histological image)

78
Q

Why is it important that the endocervix has a large surface area?

A

Large SA is provided by invaginations
Secrete cervical mucus to fill the endocervical canal.

79
Q

What is the function of the cervix?

A

Lubrication and mucous plug
Mucus barrier fluctuates and changes consistency with hormones

80
Q

How does the mucus barrier of the cervix change when influenced by hormones?

A

When oestrogen is high, the barrier is watery and full of electrolytes. This is describes as high spinbarkeit (strechable) so encourages fertilisation as sperm moves through easily

When progesterone is high the mucus is thick and viscid, with a low spinbarkeit. This protects the early embryo form external environment.

81
Q

What is the cervical stroma like?

A

Is composed of smooth muscle fibres and collagen
The ratio of collagen to smooth muscle increases with age
This is associated with an increased risk of premature birth with age.

82
Q

What is the transformation zone in the cervix?
How is it formed

A

Pre-puberty the ectocervix is lined by stratified sqaoumous epithelium
During puberty the increase exposure to oestrogen causes the endocervix simple columnar to grow and cover the ectocervix replacing the epithelium time (this is normal)
Over time the epithelium changes back to stratified sqaoumous this is the transitional zone
This change can occlude the crypts of the epithelium resulting in mucus filled nabothian follicles within the cervix wall.

83
Q

What area of the cervix is of greatest risk of cervical cancer?

A

The transformational zone
Part of the ectocervix - undergoes more epithelial changes naturally.

84
Q

What is the ectropian? what does it look like on a cervical exam?

A

Pre-dates the transformational zone, first appears during puberty as an eversion of the endocervix eventually becomes statified sqamous as exposed to acidic vaginal environment
Appars red as epithelial layer is thinner than surrounding tissue.

85
Q

Give an overview of the structure of the vagina.
Dimensions
Layers

A

The vagina is 7-9cm in length but can distend and elongate during sexual intercourse or labour
Consists of:
Stratified squamous epithelium
Elastin rich submucosa
Fibromuscualr layer (ill defined)
Adventitia

86
Q

What is the importance of the epithelium type in the vagina?

A

Startified sqaumous epithelium
protects against acidic environment
High glycogen content, broken down by bacteria to create acidic pH.
Deter invasion from pathogens

87
Q

What is the function of the elastin rich submucosa in the vagina?

A

Can expand during intercourse and chilbirth.

88
Q

Identify the tissue shown

A

Endocervix - is simple columnar epithelium

89
Q

Identify the type of tissue shown

A

Ectocervix - is stratified squamous epithelium

90
Q

Identify the type of tissue shown in the image?

A

Teritiary of mature follicle

91
Q

What does the cervix stroma look like in a histological image?

A

TZ is the transitional zone
NF is Nabothian Follicles

Unit 7 (20 decks)

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