Test 1 Flashcards
Although the sex is determined genetically at the point of fertilization, the gonads do not acquire male or femal characteristics until the _______ week of development
7th
What is the testis-determining factor?
The key to sexual dimorphism -> Sex Determining Region (SRY) - found on the short arm of the Y chromosome. Without this, female development is established.
Where do mesenchymal or stem cells or primordial germ cells develop?
In the wall of the yolk sac near the allantois
Where do mesenchymal or stem cells or primordial germ cells migrate to?
They migrate along the mesentery of the hindgut until they reach the gonadal ridges and penetrate into the primitive gonad
by the 6th week
What happens before and during the arrival (MIGRATION) of the primordial germ cells?
the overlying epithelium of the genital ridge proliferates and penetrates the underlying mesenchyme forming a number of primitive sex cords - no sex differentiation yet
What are primitive sex cords?
structures that contain hormones and develop from the gonadal ridge. After sexual differentiation -> cell clusters of primitive germ cells then follicular cells around oogonia or testis cords
Both names for male genital ducts
- Mesonephric duct
2. Wolffian duct
Both names for females genital ducts
- Paramesonephric duct
2. Mullerian duct
primordial germ cell migration order
yolk sac -> hind gut -> mesenchyme of the genital ridge -> gonadal ridge -> ovary
In males what does the distal mesonephric duct become?
seminal vesicles, ejaculatory duct, and the vas deferenes
in males what does the proximal portion of the mesonephric duct become
rete testies, efferents, and epididymis - drains the testes
in females what does the cranial end of the paramesonephric duct form?
fallopian tube
in females what does the caudal end of the paramesonephric duct form?
comes into close contact with opposing paramesonephric duct just separated by a septum -> eventually fuses together to form the uterine canal -> uterus, cervix, and vagina
In females the urogenital sinus forms what?
The posterior wall forms the lower 2/3 of the vagina
and the anterior portion forms the urinary bladder and urethra
Contact of the urogenital sinus by the paramesonephric ducts induces the formation of what?
the sinovaginal bulb - a collection of endoderm
What becomes of the sinovaginal bulb?
first -> proliferation forms a solid column of endodermal tissue
second -> the tissue canalizes to form lower 2/3 of vagina
third -> canalization continues forms hymen with central opening
What is DES? why is it used and when?
Diethylstsilbesterol -> “morning after pill” but to save pregnancys - used in the 40s and 50s
Names the male and female homologue of the Gonads
Males - testes
Female - Ovaries
Names the male and female homologue of the Genital tubercle
Male -Penis
Female - Clitoris
Names the male and female homologue of the Urethral Swellings
Male -Scrotum
Female - Labia Majora
Names the male and female homologue of the Urethral Folds
Male -Spongy urethra
Female - Labia Minora
Names the male and female homologue of the Urogenital Sinus
Male - Bladder, Cowpers gland, Urethra, Prostate
Female - Skeens Gland, Lower Vagina, Urethra, Bladder, Bartholins Gland
Names the male and female homologue of the Wolffian Duct
Male -Rete testis, Epididymis, Vas Deferens, Seminal Vesicles
Female - rete ovarii
Names the male and female homologue of the Mullerian Duct
Male -Appendix Testis
Female - Fallopian Tubes, Uterus, Cervix, Upper Vagina
Each breast contains 15-20 __________ separated by adipose tissue
lobes
Each lobe contains ______ composed of CT and embedded alveoli
lobules
Milk secreting cells, embedded in lobules, arranded in grapelike clusters & convey milk into a series of secondary tubules and then into mammary ducts
Alveoli
Secondary tubules give way to mammary _______ which drain into the ampullae. The ampullae continues as the lactiferous ______ that terminate in the nip
ducts
AKA Lactiferous sinuses - site of milk storage until it passes through the nipple
Ampullae
Strands of CT between lobules - run between the skin and deep fascia - support the breast
Suspensory ligaments of Cooper
Circular pigmented area of skin surrounding the nipple - appears rough bc it contains sebaceous glands
Areola
Three layers of the uterus
- Serosa - Perimetrium -> broad ligament
- Myometrium
- Endometrium -> Stratum Functionalis (shed during menstruation and Stratum Basalis (proliferates to regnerate the functionalis) contains lamina propria -> tubular glands
Three layers of the Fallopian Tube
- Internal Muscosa -> ciliated columnar/secretory cells
- Muscularis Layer -> thick circular and logitudinal layers of smooth muscle
- Serosa Layer
Three layers of the ovaries
- Germinal Epithelium -> simple cuboidal
- Tunica Albuginea -> capsule of collagenous CT
- Stroma -> deep dense cortex
Ova and their surrounding tissues in various stages of development
ovarian follicles
made up of mature ovum and its surrounding tissues that secretes estrogen
Graffian Follicles
Glandular body that develops from a graffian follicle after extrusion of the ovum. What does it produce?
Corpus Lutem
-> progesterone and estrogens
Vaginal mucosa contains rugae, smooth muscle, and is made up of what type of cell?
Stratified squamous
4 parts of the vulva
- Mons Pubis
- Labia Majora - adipose tissue, sweat, sebaceous glands
- Labia Minora - many sebaceous glands
- Clitoris
Where are the skenes glands located?
behind and on either side of the urethra aka lesser vestibular glands -> secrete mucus
What glands are on either side of the vaginal orifice and produce lube?
Greater Vestibular or Bartholins Glands
Imperferate hymen, what and its affects
Vaginal outflow obstruction- solid hymen
Newborns -> mucocolpos may lead to UTI or bladder obstruction
Adolescent -> amenorrhea with pain -> distended bluish hymenal membrance -> hematocolpos
What is Vaginal Adenosis?
when vaginal epithelium doesnt undergo proper metaplasia
Normal -> glandular columnar epi (like mullerian) to squamous cell
Adenosis -> glandular tissue remains - manifests as red patches, benign and disappears with age
What is the name of a rare tumor of the vagina called that develops frequently on the anterior wall of the upper third of the vagina most common between the ages of 17 and 22. Mothers tooks DES while pregnant
Clear Cell Adenocarcinoma - Malignant
Abundant glycogen accounts for clear nature of the cytoplasm - curable when small and asymptomatic
What are two congenital defects of the vagina that may cause obstruction to flow and dyspareunia
- Longitudinal septum - double vagina
2. Transverse Septum
What is a uterus with a commmon fused wall between two distinct uterine cavities due to a failure of the common wall between the apposed mullerian ducts to degenerate forming a single uterine cavity
Bicornis (septate) uterus
What refers to a double uterus with a double vagina due to failure of the 2 mullerian ducts to fuse during embryonic life
Uterus Didelphys
Refers to a single uterus with a partial remaing septum owing to a failure of the wall of the fused mullerian ducts to fully resorb. Heart shaped
Uterus Septae
What type of cancer is associated with
- older women - 60ish
- wart like or slighly raised mucosal lesion/ulcer
- symptoms include itching, discomfort, pain, bleeding or asymptomatic
- preneoplastic lesions may lead to invasive cancer such as leukoplakia
- slow growing squamous cell carcinoma
- 70% of 5 year survival before it metastasizes
- treatment -> surgical resection or tumor or entire area plus radiation and chemo
Vulvar Carcinoma - invasive cancer is preceded by carcinome insitu -> Vulvar intraepithelial neoplasia
Carcinoma of the Vagina
- What type of cancer is associated with ______% of all GYN cancers
- Disease of _________ women
- _________ Cell Carcinoma, accounts for ___% of all primary malignant tumors of the vagina
- ______ only upon GYN examination
- Stage 1, 5 year survival rate _________
- Stage 4, 5 year survival rate______
2% Older Squamous 90% Detected 80% 20%
Carcinoma of the _________
- accounts for ____% of all malignant tumors of the female repro tract but accounts for more death then the rest combined
- Mortality reduced greatly over last 50 years due to _____
- Cells do not _____ as normal but remain ________ and proliferate uncontrollably (Dysplasia)
Cervix
20%
Pap smears
mature, undifferentiated
4 risk factors of cervical cancer
- sex at early age
- multiple partners
- HPV
- other STD
What is a dysplasia?
lack of normal maturation of squamous epithelium- dont respond normally to stimuli - dont differentiate and proliferate uncontrollably (seen in early cancer)
What scale are dysplasias on? (Pathologist grades)
- CIN-1 mild
- CIN-2 moderate
- CIN-3 severe
Carcinoma limited to basement membrane is called?
Carcinoma In-Situ (CIS)
It becomes severe when the carcinoma cells cross the BM and spread to blood/lymph
If caught early, can be removed surgically
What is the most common cause of death in advanced cervical cancer?
Renal Failue - UT obstruction
What type of cyst is caused by an abscess obstruction due to an infection of staph, chlamydia, and or anaerobes?
Bartholins Gland Cyst
Abnormal growth of vulvar skin characterized by white plaques, atrophy and parchment like consistency. no malignant potential. usually older women.
Lichen sclerosis
Name the stage of cervical cancer - No gross lesions, carcinoma is limited to mucosa
CIS
Stage 0
Name the stage of cervical cancer - Cancer reaches pelvic wall and invades the lower third of the vagina
Stage 3
Name the stage of cervical cancer - cancer extends beyond cervix not reaching pelvic wall or upper vagina
Stage 2
Name the stage of cervical cancer - cancer has spread beyond the pelvis and has infiltrated the adjacent organs
Stage 4
Name the stage of cervical cancer -Invasive but confined to the cervix
Stage 1
