Test 1 Flashcards
The timeframe for gonads to acquire their sex
determination
gonads do not acquire male or female characteristics until the seventh week of development.
The key to sexual dimorphism is found on the…
short arm of the Y chromosome, called the Sex-
Determining Region on Y (SRY), which is the testis-determining factor.
In its absence, female development is established
Primordial germ cells Start…
Mesenchymal or stem cells (future sperm or eggs)
that develop in the wall of the yolk sac near the
allantois that migrate along the mesentery of the
hindgut. This occurs at about the 3rd week of
embryologic development.
Homolog for the Scrotum?
labia majora
Homolog for Spongy urethra?
labia minora
Other names for paramesonephric ducts in a female.
also called Mullerian ducts
Other names for Mesonephric ducts in a male
also called Wolffian ducts
What does the Cranially part of paramesonephric become?
Opens up, funnel like structure. Will become fallopian tube fimbria/open ended fallopian tubes
What does the Caudally part of paramesonephric become?
Fuses together to form:
Uterine canal, Uterus, cervix, distal 1/3 of the vagina
The Mesonephric duct in male becomes?
o Epididymis o Vas deferens o Seminal vesicles o Ejaculatory duct o Connects to the primitive kidney
Primordial germ cells develop in the…
wall of the yolk sac near allantois
Primordial germ cells Migrate along the…
mesentery of the GI tract, called the hindgut
Primordial germ cells continue migration until they..
Reach the gonadal ridges and penetrate into the
primitive gonad
Before After, and during migration, Primordial germ cells penetrate into the primitive gonad, What happens?
The genital ridge proliferates and penetrates underlying mesenchyme forming a number of primitive sex cords, inserted itself down past the epithelium.
After the After Primordial germ penetrate the genital ridge they become immature eggs or sperm when they are surrounded by…
the sex cord cells
The sex cord cells surrounding the primordial germ cells will become…
the follicle cells
The lower part of the vagina is formed from
the…
posterior wall of the urogenital sinus
The anterior portion of the urogenital sinus forms…
urinary bladder and urethra.
Contact of the urogenital sinus by the paramesonephric ducts induces formation of the…
sinovaginal bulbs, a collection of endoderm from the wall of the urogenital sinus
Hymen formation occurs during
canalization
Congenital absence of the uterus is called…
agenesis
results from the failure of the
embryonic mullerian ducts to fuse properly and
the resulting median wall does not resorb.
Septate Vagina
The most common and most distal form of
vaginal outflow obstruction, occurring in 0.1%
of infant girls
Imperforate Hymen
o The presence of increased mucus secretions in the vagina secondary to maternal estrogen effects may result in Mucocolpos, appearing as a bulging hymenal membrane between the
labia
o The membrane may be white because of the trapped mucoid material and may lead to»>
Urinary tract infections, Bladder obstructions Due to urethral compression
Identifying Imperforate Hymen in the Neonate…
o Primary amenorrhea (no period/menstrual cycle) o Presence or absence of secondary sexual characteristics should be noted
o Lower abdominal or pelvic pain
o Urinary retention/constipation
o Diagnosis is made when a distended bluish hymenal membrane is observed in the vaginal
orifice/opening due to collected menstrual blood (hematocolpos)
Imperforate Hymen in an Adolescent
Refers to failure of the normal glandular
epithelium that lines the embryonic vagina to be
replaced by squamous epithelium during fetal
development
Vaginal Adenosis Due to DES
a synthetic estrogen, was used in the 1940’s and 1950’s for high-risk pregnancies (used to prevent abortion)
DES (morning after pill)
DES exposure anywhere from the 10th to about
the 18th week of gestation, arrests this
transformation process
At the 10th week of gestation, the upgrowth of
squamous epithelium derived from the urogenital
sinus replaces the glandular (mullerian)
epithelium lining the vagina and exocervix.
Manifests grossly as red, granular patches on the
vaginal mucosa which usually disappear as the
woman gets older.
Vaginal Adenosis Due to DES
A rare tumor of the vagina encountered
exclusively in women exposed to Diethly-
stilbesterol (DES).
Clear Cell Adenocarcinoma due to DES
Clear Cell Adenocarcinoma due to DES is Most common between ages…
17 and 22
Clear Cell Adenocarcinoma due to DES Develops most frequently on the…
anterior wall of the upper third of the vagina.
In more advanced stages of Clear Cell Adenocarcinoma due to DES they may spread by…
hematogenous or lymphatic routes.
A congenital anomaly of the female genital tract that
presents as a deformed, obstructed and nonfunctional
vagina that occurs in 1 in 4-5000 live female births
Vaginal Atresia
Rokatansky-Mayer-Kuster-Hauser Syndrome is a….
congenital lack of a uterus, vaginal atresia or agenesis, despite normal ovaries and external genitalia.
develops during embryogenesis due to incomplete fusion of the two mullerian ducts, resulting in a double vagina, with a chance of a double cervix and uterus
Longitudinal Septum
develops during embryogenesis when the two mullerian ducts fuse improperly to the urogenital sinus. A complete septum blocks menstrual flow and is a cause of primary amenorrhea.
Transverse Septum
Transverse Septum, and Longitudinal Septum defects Both may cause.
obstruction to flow and dyspareunia
is usually associated with dilation of the lower uterine segment, and may be an obstruction with menstrual flow.
Congenital stenosis
is a uterus with a common 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
refers to a double uterus with a double vagina. Again due to failure of the two mullerian ducts to fuse during embryonic life.
Uterus Didelphys
refers to a single uterus with a partial remaining septum, owing to failure of the wall of the fused mullerian ducts to fully resorb.
Uterus Septae
When trapped menstrual secretions/blood backs up into the uterus
hematometrocolpos
When Reflux of endometrial tissue and blood through the fallopian tubes
hematosalpinx, secondary endometriosis
Form from the Mullerian (paramesonephric) Duct
The upper
vagina, cervix, uterus, fallopian tubes and ovaries
Embryologically, the lower 2/3 of the vagina
develop from the
urogenital sinus
The consequences of Imperforate Hymen in the adolescent/neonates…
o Hematometrocolpos
o Hematosalpinx or secondary endometriosis
o Endometriosis: tissue that normally lines the inside of the uterus, grows outside of the uterus. Displaced endometrial tissue continues to act as it normally would, thickens,
breaks down and bleeds with each menstrual cycle Because this displaced tissue has no way to exit your body, it becomes trapped
o An accumulation of infected material within the vaginal cavity may cause ascending genital
tract infections
Histology of the Vagina
stratified squamous epithelium (no glands)
Histology of the Cervix
lower end of uterus; stratified squamous
epithelium
Histology of the cervical os
squamous epithelium changes to tall columnar mucinous epithelium
squamocolumnar junction =
transformation zone
Histology of the endometrium
columnar cells, glands, stroma
Histology of the fallopian tube
columnar epithelium, glands, secretory function
connecting tissue fibers covering the ovaries
Tunica albuginea:
the region between the labia minora where the vagina, the urethra, and bartholin’s glands open.
The Vestibule
fringe tissue around the ostium of the fallopian tube (opening)
What is Fimbria?
temporary endocrine structure in female mammals involved in the production of relatively high levels of progesterone
Corpus luteum
Develops from primary follicle, secondary fo llicle, after rupture of the mature oocyte, the follicle is turned into a
Corpus luteum
Two pea sized compound alveolar/acinar gland located slightly posterior and to the left and right of the opening of the vagina. They secrete the mucus to lubricate the vagina to provide vaginal lubrication during female sexual arousal
Bartholin’s gland
inside the vagina there are lots of folds/bumpy tissue called rugae, allows for expansion
Vaginal Rugae
Primitive sex cords differentiate into…
Follicles
What type of cancers will be vulvar, vaginal and cervical?
squamous cell carcinoma
3% of all GYN cancers
o Cancer of older women
o Wart like or slightly raised mucosal lesion/ulcers o In Situ or Invasive Cancer
o Almost always squamous cell carcinoma
o Preneoplastic lesions Leukoplakia (white plaque) o 70% chance survivability, 5 years
Vulvar Carcinoma
VIN stands for…
Vulvar Intraepithelial Neoplasia (VIN)
2% of all GYN cancers o Cancer of older women o >90% are squamous cell carcinomas o 80% chance survivability, 5 years stage I o 20% survivability, stage IV
Vaginal Carcinoma
20% of all malignant tumors in the female reproductive tract
o Accounts for more deaths > uterus, vagina, vulva cancers combined
o N:C ratio INCREASE
Carcinoma of the cervix
CIN stands for…
Cervical intraepithelial neoplasia
These transformed cells do not respond to normal regulatory stimuli in the tissue, they do not mature as the normal cervical cells do but remain undifferentiated and proliferate uncontrollably. This is a feature of…
cervical cancer
Risk factors for cervical cancer (etiology)
- Sexual intercourse at an early age
- Multiple sex partners
- Evidence of HPV infection
- Other venereal diseases (STD’s) such as Herpes or Syphilis
- Smoking/HIV
is a precancerous condition in which abnormal cell growth occurs on the surface lining of the cervix, the opening between the uterus and the vagina.
Cervical Dysplasia
- In Situ, N:C Ratio
gradually increasing - Confined to the basal
1/3 of the epithelium
CIN1
- In Situ, N:C Ratio UP even more
- Epithelial layer is
thickening - Confined to the basal
CIN2
- In Situ, N:C Ratio is drastically increased
- Epithelial layer is very thick
- Spans more than the 2/3 of the epithelium, may involve full thickness
CIN3
What is the most common cause of death in advanced cervical cancer?
Carcinoma cells crossing the basement membrane, no longer in SITU, becomes Invasive. Spreads to lymphatics/blood streams and metastasizes to distant sites.
In breast tissue Lobules are separated by these suspensory ligaments
Suspensory ligaments of cooper
no gross lesions. The carcinoma is limited to the mucosa (Carcinoma In Situ or CIS)
Stage 0
Invasive, but confined to the cervix
Stage 1
Cancer extends beyond the cervix, not reaching the pelvic wall or upper vagina
Stage 2
Cancer reaches the pelvic wall and invades the lower third of the vagina
Stage 3
cancer has spread beyond the pelvis and has infiltrated adjacent organs
Stage 4
two layers of the Endometrium
Stratum Functionalis and Stratum Basalis
the layer of the Endometrium closest to
the uterine cavity and the layer shed during
menstruation.
Stratum Functionalis
The deep narrow layer of the Endometrium whose glands and C.T. elements proliferate and thereby regenerate the functionalis during each menstruation cycle.
Stratum Basalis
Benign tumors originating from the smooth muscle cells of the MYOMETRIUM
locations of leimyomas
is the middle layer of the uterine wall, consisting mainly of uterine smooth muscle cells and vascular tissue
Myometrium
Abnormal growth of the vulvar skin,
characterized by WHITE plaques, atrophy of the skin, parchment like consistency (VERY THIN SKIN IN OLDER WOMEN)
Lichen Sclerosis
This happens when
- These paired glands produce a clear mucoid
secretion, which continuously lubricates the vestibular surface
- The ducts are prone to obstruction and
consequent CYST formation
Bartholin Gland Cyst
