The Female Reproductive Tract Flashcards
How is the ovary suspended near the uterus?
It is connected to the uterus via the ovarian ligament.
How are the fallopian tubes kept perpendicular to the uterus?
The suspensory ligament
What does the broad ligament do?
Allows blood supply and nerve supply to reach the ovary.
What are the parts of the broad ligament?
Mesosalpinx surrounds uterine tubes
Mesovarium surrounds ovaries
Mesometrium around the uterus
Where do the ovaries get their blood supply from?
From the ovarian branch of the uterine artery which arises from internal iliac artery.
From the ovarian artery (analagous to testicular artery and comes directly off aorta)
These 2 branches anastomose at the ovaries.
What artery supplies the uterus?
The uterine artery which arises from the internal iliac artery and forms arcuate and spiral arteries in the uterus.
What artery supplies the vagina?
The vaginal artery which arises at the same place as the uterine artery and also originally comes from the internal iliac artery.
What epithelium covers the ovaries?
A layer of cuboidal epithelium
What are the parts of the ovaries?
It can be divided into cortex and medulla.
Cortex contains developing follicles and medulla contains lymphatics and blood vessels.
What do ovarian follicles do?
They house and nurture oocytes.
They secrete oestradiol and inhibin in first half of cycle under stimulation by gonadotrophins
What are follicles homologous to in males?
Seminiferous tubules
When are follicles first produced?
During foetal life (maximum nmber at around 5 months of gestation)
What epithelium do primordial follicles have?
Single layer of flattened squamous cells
What do primordial follicles develop into?
Preantral (primary) follicles which develops into antral (secondary) follicle which then develops into mature (dominant/preovulatory/graafian) follicle.
This then undergoes ovulation.
How are preantral follicles different to primordial follicles?
They are made up of cuboidal granulosa cells and stromal cells (thecal cells). Stromal cells produce oestrogens.
What defines antral follicles?
Granulosa cells produce fluid into a “room” within the follicle called an antrum
What is formed from mature follicle?
Mature follicle undergoes ovulation to form the corpus luteum (after follicle ruptures)
What hormones does the corpus luteum produce?
Also secretes oestradiol and inhibin A
What happens in the corpus luteum?
It gets a rich blood supply and sequesters cholesterol for progesterone synthesis.
At 3 months of pregnancy it is active and if there is no pregnancy it regresses after 10 - 12 days and forms scar tissue (corpus albicans)
What are the parts of the uterine tubes?
Fimbriae
Infundibulum
Ampulla
Isthmus
Intramural uterine tubes
What are the layers of the uterine tubes?
Serosa made up of simple squamous epithelium
Muscularis: contains inner circular and outer longitudinal layer
Mucosa made up of simple columnar epithelium with peg (secretory) and ciliated cells.
What is the function of the uterine tubes?
Site of fertilization
Transport oocyte for fertilization/embryo to uterus
Early nourishment of embryo.
What happens to mucosal folds as we move along the uterine tubes? Why is this the case?
Mucosal folds increase in complexity from isthmus to ampulla, This is thought to slow advancement of sperm to prolong activity of sperm in uterine tube and to avoid polyspermy.
What is an ectopic pregnancy?
Pregnancy that occurs in the wrong location such as in the uterine tube.
What is the dome above the uterus called?
The fundus
What does the uterosacral ligament do?
Anchors the uterus to the pelvic wall.
What does the cardinal ligament do?
It attaches the cervix to the lateral pelvic wall by its attachment to the Obturator fascia of the Obturator internus muscle, and is continuous externally with the fibrous tissue that surrounds the pelvic blood vessels. It thus provides support to the uterus
How does the uterus sit in the body?
It is anteflexed and anteverted on the vagina.
What are the 3 separate layers of the uterus? (from most superficial to deepest)
Perimetrium
Myometrium
Endometrium
What are the 3 separate layers of the uterus? (from most superficial to deepest)
Perimetrium (visceral lining of peritoneum)
Myometrium (Smooth muscle that can expand dramatically)
Endometrium
How long into pregnancy is the uterus as high as the umbilicus?
10 weeks
How long into pregnancy is the uterus as high as the xiphisternum?
36 weeks into pregnancy
What are the endometrial layers?
The stratum functionale (The functional layer): Undergoes cyclic changes and sheds during menstrual bleeding.
The stratum basale (The basal layer): Retained during menstruation which regenerates the functional layer. It is driven by changes in ovarian steroid.
What are the phases of endometrial changes during the menstrual cycle?
Early menstrual phase where lining is thick and ready for pregnancy.
Proliferative phase where the uterus is getting ready for pregnancy (mitosis of functional layer in response to oestrogen)
Secretory phase: After ovulation the corpus luteum is formed and the cells become differentiated.
What hormones are produced during menstrual cycle?
Developing follicles produce lots of oestrogen during the proliferative phase.
After ovulation oestrogen levels drop and progesterone levels rise as the mature corpus luteum is forming and producing progesterone. (Secretory phase produce endometrial milk)
When no fertilisation occurs corpus albicans forms resulting in drop in progesterone, oestrogen, and oestradiol.
How is the cervix different to the rest of the uterus?
It contains less smooth muscle and more connective tissue.
What are the fornices of the vagina?
The cervix protrudes into the vaginal canal and so a trench forms around it. The holes formed are called fornices. There is a lateral fornix and anterior and posterior fornices.
What epithelium lines the cervix?
Simple columnar epithelium more superiorly and then stratified squamous epithelium more posteriorly (distally) [important for childbirth]
What is the clinical significance of the change in epithelium type of the cervix proximally to distally?
It is a site for cervical cancers
What do cervical glands produce?
Mucous and they change between fertile and infertile states based on hormones that are present.
Fertile mucous is the result of oestrogen whereas infertile mucous is the result of progesterone.
What are the important structures in the vagina?
Muscularis of smooth muscle
Skeletal muscle fibers of bulbospongiosus at vaginal opening.
Rugae: Folds in mucosa allow distension during intercourse and childbirth.
What type of epithelium is present in the vagina?
Stratified squamous epithelium (non-keratinised)
What happens to the epithelial cells of the vagina in response to oestrogen?
They accumulate glycogen (converted to lactic acid by lactobacillus bacteria)
Sperm can’t survive well in acidic environments, how does sperm then get past the acidic vagina?
Seminal fluid is alkaline which neutralizes the acid of the vagina.
