Unit 7 - Female Reproductive System II Flashcards
what are the 4 anatomical subdivisions of the oviducts?
- infundibulum - funnel shaped end where the oviduct lumen opens to the peritoneal cavity
- fimbriae surround opening - ampulla - longest portion, and widest except for infundibulum
- isthmus - straight part connecting ampulla and uterus
- intramural part - passes through uterine wall
what are the 3 layers of the oviduct wall?
- inner mucosa
- middle muscularis
- outer serosa
what comprises the inner mucosa of the oviduct?
- mucosal folds - fill much of oviduct lumen to increase SA
- most elaborate in ampulla, simplest in intramural part - mucosal epithelium - simple columnar epithelium
- lines oviduct lumen and surfaces of fimbraie
- ciliated and secretory cells - lamina propria - highly cellular, well-vascularized CT
- has smooth muscle in finbriae for movement
what are the cell types in mucosal epithelium of oviduct?
- ciliated cells - pale eosinophilic cytoplasm, large euchromatic basal nucleus, prominent apical cilia, and darkly staining basal bodies at cilia bases
- have motile cilia to sweep oocyte complex or fertilized embryo toward uterus - secretory (peg) cells - dark staining secretory products; apical surfaces protrude above epithelial surface
- secretions nourish and protect gametes/embryos, and help sperm activation
how do hormones affect mucosal epithelium of oviduct?
estrogen stimulates cilia elongation, increase secretions, and hypertrophy of both ciliated and secretory cells
oviduct muscularis
smooth muscle and some CT
- thick, inner, circularly-oriented layer and thin, outer, longitudinally-oriented layer
- thickens and becomes better defined from infundibulum to isthmus
- contractions bend infundibulum closer to ovary
- sweeps fimbriae over ovary surface
- peristaltic contractions propel fertilized embryos toward uterus
oviduct serosa
well-vascularized loose CT
- covered by simple squamous to cuboidal mesothelium
- provides blood and nerve supply to oviduct
what happens if an ectopic pregnancy is not aborted?
developing placenta erodes thick lining of blood vessels in oviduct serosa
-growing fetus eventually ruptures oviduct, causing lethal hemorrhage
anatomical overview of uterus
- upper uterine body (“uterus”)
- lower uterine body (“cervix)
- inner endometrium, middle myometrium, outer perimetrium/epimetrium
what are the layers of the endometrium?
- stroma - CT of amorphous ground substance (some type III collagen, many fibroblasts)
- simple columnar surface epithelium (mostly present)
- uterine glands - simple, tubular glands lined by simple columnar secretory cells continuous w/ surface epithelium
- spiral arteries (functionalis) and straight arteries (basalis)
what are the 2 arteries of the endometrium?
- spiral arteries - supply upper endometrium (functional layer = functionalis)
- straight arteries - supply lower endometrium (basal layer = basalis)
menstrual phase endometrium
progesterone loss after luteolysis causes constriction of spiral arteries and hypoxia of functionalis
- straight arteries and basalis are unaffected
- very short glands
- lacks surface epithelium
proliferative phase endometrium
estrogen from growing ovarian follicles promotes proliferation of stromal and gland cells (mitotic profiles)
- surface epithelium regenerates from growing uterine gland secretory cells
- stroma thickens via replication of basalis fibroblasts and ECM production
- straight uterine glands lengthen
- spiral arteries grow into reformed functionalis and sprout arterioles
secretory phase endometrium
progesterone from CL stimulates secretory cell hypertrophy and secretory activity, and promotes vascular changes
- coiling and dilation of uterine glands and secretion of glycogen-rich (apocrine) and glycoPRO-rich (merocrine) product
- thin-walled vascular lacunae develop and fill with blood
- -abundant blood flow to placenta
endometriosis
presence of endometrial stromal and parenchymal cells outside uterus
- endometrium sloughed off during menses passes retrograde through oviducts, into peritoneal cavity (ovaries, outer surfaces of oviduct/uterus, broad ligament, colon, rectouterine pouch, rectal sheath)
- tissue is still hormone sensitive, undergoing cycles of growth and bleeding through menses
- pain (no longer cycle-dependent), inflammation, and adhesions between organ and peritoneal wall
what is a chocolate cyst?
specific case of endometrial tissue invading ovary tunica albuginea
-brown due to accumulated blood
myometrium
thickest layer of uterine wall
- bundles of smooth muscle are separated by CT
- organized into 3 partially interwoven, indistinct layers
what happens to the myometrium in pregnancy?
smooth muscle cell hyperplasia and hypertrophy
- increased collagen prouction
- thicken/strengthen myometrium during pregnancy
- changes revert after pregnancy through smooth muscle cell apoptosis, atrophy, and removal of excess collagen
what are uterine leiomyomas?
fibroids; 1:4 women
-benign smooth muscle tumors in myometrium
perimetrium/epimetrium
- serosal where exposed to peritoneal cavity
- -loose CT, prominent blood vessels, covering of mesothelium
- -continuous with broad ligament (uterine mesentery)
- adventitial where not exposed
- loose CT that blends into surrounding tissues
cervical mucosa
simple, columnar epithelium of mucous secretory cells
- long, non-coiled, branching tubular glands with wide lumens
- produce hormone-dependent consistency mucus that is not shed during menses
what are Nabothian cysts?
result from occlusion of cervical gland ducts
- secretory product accumulates in plugged ducts
- not neoplastic, and usually resolve without intervention
- also found in endometrium, so not reliable to identify cervix
cervical wall and during pregnancy?
dense CT with smaller amounts of smooth muscle
-during pregnancy, collagen and elastin fibers rearrange for birth
external os
protrusion of cervix into superior part of vagina
-transformation zone is junction between cervix (simple, columnar) and vagina (stratified squamous
what is the most frequent origin of cervical carcinomas?
external os
what are Pap smears?
cytological examinations of transformation zone scrapings to detect cervical carcinomas
- normal: squamous cells are uniform size with pyknotic nuclei
- abnormal: heterogenous and euchromatic nuclei
vaginal mucosa
statified, squamous, non-keratinized epithelium that accumulate glycogen in response to estrogen (fermented by bacteria to make acidic)
- frequently infiltrated by lymphocytes and neutrophils
- lamina propria is well vascularized and rich in elastic fibers (to muscularis), lymphocytes, and neutrophils
- NO GLANDS
vaginal muscular layer
smooth muscle fibers in 2 indistinct layers (inner circular and outer longitudinal)
vaginal adventitia
elastic CT forms resiliant sheath around muscular layer
nipple and areola
- highly pigmented skin that increases at puberty
- long dermal papillae
- radial and circumferential smooth muscle fibers in underlying dense, irregular CT allows erection
- sebaceous, sweat, and modified mammary (Montgomery) glands underlie areola
what empties at the nipple surface?
termini of lactiferous ducts (ductuli papillares)
breast general histology
- parenchyma - mammary glands (ducts and secretory elements)
- Montgomery and compound tubuloalveolar glands - stroma - CT surrounding parenchyma
what is a breast lobe?
largest unit of duct system (15-25 lobes in each breast)
- drain into lactiferous duct and sinus at nipple
- fibrous CT and white adipose separate lobes
- lactiferous ducts subdivide within lobes to form interlobular (extralobular) ducts that end at breast lobules
what is a breast lobule?
basic structural unit of duct system
- intralobular ducts, secretory element in loose CT stroma
- separated by dense irregular CT stroma (interlobular stroma) and adipocytes
what is a terminal duct lobular unit? why is it clinically relevant?
a breast lobule plus its associated interlobular duct
-most common place where breast cancer arises
breast development before puberty
for both genders
- lactiferous sinuses near nipple
- small, branching ducts
breast development during puberty in girls
estrogen stimulates adipose and CT accumulation (determine size)
-duct system elongates
inactive adult breast
- parenchyma
- stroma
- menstrual cycle changes
- parenchyma - simple, cuboidal epithelium for ducts, with little/no secretory component
- myoepithelial cells abundant in duct epithelium and basement membrane - stroma - loose CT within lobules (intralobular stroma)
- dense irregular CT with adipocytes between lobules (interlobular stroma) - menstrual cycle changes
- early in cycle: duct lumens reduced
- ovulation - secretory cells increase in height, make some secretions
breast during pregnancy (general)
- parenchyma
- stroma
- parenchyma grows due to estrogen, progesterone, prolactin, and placental lactogen
- stroma decreases
- -plasma cells, lymphocytes, eosinophils infiltrate intralobular stroma
first half VS second half pregnancy breast
- intralobular duct cells proliferate (strongly estrogen-dependent) with mitotic profiles
- end buds (stratified, cuboidal epithelium) form at duct ends
- duct cell cytoplasm is basophilic (prepare for PRO) - end buds hollow out to form alveoli (simple cuboidal with myoepithelial cells)
- fat and PRO droplets accumulate in alveolar epithelium
- -apocrine snouts appear on alveolar epithelial cell apical surfaces
lactating breast
milk accumulates in alveoli as basophilic lumen secretions
- alveolar epithelial cells are prominent basophilic cytoplasm, frequently large pale apical cytoplasmic lipid droplet that produces colostrum/milk
- -alveoli that actively make milk and those that rest co-exist in same breast
colostrum VS milk contents
C: higher PRO, vit A, Ab; lower lipid, CHO
milk: merocrine PRO and apocrine lipid
where do IgAs in milk come from?
made by plasma cells in intralobular stroma for passive immunity
breasts in menopause
atrophy of breast parenchyma
-alveoli disappear, ducts persist
reduction of stroma
-loss of fibroblasts, collagen, elastic fibers
