Women and Men's Health

flowers

Help

  • esc key shows all the slides
  • arrows left right advance the slide
  • mobile device swipe left right
  • slides can go left-right and up-down
  • ? gives instant help
  • menu bottom left
How to get the most from the revision slides
  • Have a pen & paper ready
  • Answer every question
  • Attempt to label all slides
  • Mark your answer after answering
  • Elaborate on each answer
  • Add relevant clinical content
  • If you have trouble, ask - you know where

Calibration

Community of Truth

What is my answer?
What is the correct answer?
I am am wrong, what was my error?
THUS: Find the truth

Philosophy 1

What is the least amount of work I can do so I can get out of here.

Philosophy 2

Today and Now I will do something for my future self.

Calibration

Assess yourself on each question.

You want incremental improvements over time.
Going up

Assess yourself
Nailed it!
Yes
Not sure...
No
Nailed it!
Not sure...
Please note:
The workbook is available at http://histoweb.co.za/blok11/
Please consult that for the slides that needs to be studied.

Contact me for assistance sooner rather than later using email or other instant messaging system.

The following slide can be printed and used as a template for studying.

Ovaries

Slide 24

Section of the ovary

1. Outer covering.  1'. Attached border.  
2. Central stroma.  3. Peripheral stroma.  
4. Bloodvessels.  5. Vesicular follicles in their earliest stage.  
6, 7, 8. More advanced follicles.  
9. An almost mature follicle.  
9'. Follicle from which the ovum has escaped.  
10. Corpus luteum. 

Ovary

  • Capsule covered by modification of peritoneum
    • Called germinal epithelium
    • Simple squamous/cuboidal
  • Subdivided
    • Not clearly defined
    • Cortex - contains ovarian follicles
    • Medulla - vascular

Germinal epithelium

  • Misnomer
  • NOT source of primary follicles
  • Cover capsule
  • Simple squamous/cuboidal epithelium

Cortex

  • Tunica albuginea
    • Irregular dense CT capsule
  • Follicles in various phases
  • Stroma containing follicles

Stroma

  • Highly cellular loose CT
  • Fibroblasts
  • Elastic & collagen fibres
  • Form layers around follicles

Medulla

  • Blood vessels
  • Hilus cells
  • Stroma

Blood vessels

  • Enter medulla at hilus
  • Supply the cortex
  • Epithelioid cells clump around blood vessels

Epithelioid cells

  • Located in hilus
  • Also called hilus cells
  • Clump around blood vessels
  • ≈ Leydig cells
  • Probably produces androgens

Follicular maturation

  • Primordial follicle
  • Growing follicle
    • Primary follicle
    • Secondary follicle
  • Mature follicle (Graafian)

Components of a follicle

  • Theca
    • externa
    • interna
  • basal lamina
  • Granulosa cells
  • Antrum
  • Cumulus oophorus >> Corona radiata
  • Oocyte
Growing follicle

Corpus luteum

Slide 91

Corpus luteum

  • Two major cell types
    • Granulosa lutein cells
      • modified granulosa cells
    • Theca lutein cells
      • modified theca interna cells
  • Many capillaries

Granulosa lutein cells

  • Modified granulosa cells
  • Large - 30µm
  • Pale cells

Theca lutein cells

  • Modified theca interna cells
  • Smaller - 15µm
  • Dark stained
Many capillaries

Tuba uterina

Slide 97

Also:

Oviduct
Fallopian tube
Uterine tube

Tuba uterina

  • Muscular tube
  • Most frequent site of fertilization
  • Conveys zygote to uterus
  • Four regions
  • Three layers

Four regions

  • Infundibulum
  • Ampulla
    • Usual site of fertilization
  • Isthmus
  • Pars interstitialis
    • Passes through wall of uterus

Three layers

  • Mucosa
  • Muscular layer
  • Serosa

Mucosa

  • Epithelium
  • Lamina propria

Epithelium

  • Simple columnar
  • 2 types of cells
  • Peg cells
    • Secretory cell
  • Ciliated cells
    • Beats towards uterus
    • Facilitate movement of zygote to uterus

Lamina propria

  • Loose connective tissue
  • Reticular fibres
  • Fibroblasts
  • Mast cells
  • Lymphoid cells

Muscular layer

  • Ill-defined
  • Inner circular
  • Outer longitudinal
  • Play role in moving zygote towards uterus

Serosa

  • Simple squamous epithelium
  • Contains
    • Blood vessels
    • Lymphatics
    • Nerves

Uterus

Slide 88

Uterus

3 regions
3 layers

Three regions

Fundus
Body
Cervix

Three layers

  • Endometrium
  • Formation placenta
  • Myometrium
    • Enlarge during pregnancy
    • Expulsion fetus & placenta
    • Adventitia

Endometrium

  • Formation of placenta
  • Hormonally modulated cyclic alterations
    • menstrual cycle
  • Two layers
    • Thick superficial functional
    • Deeper basal layer
    • Separation indistinct

Endometrium

  • Epithelium
    • Simple columnar
      • Two cell types
      • Secretory
    • Ciliated
  • Glands
  • Similar but fewer ciliated

Endometrium Stroma

  • Mesenchymal-like CT
  • Reticular fibres
  • Stellate-shaped cells
  • Macrophages
  • Lymphoid elements
  • Functional layer
  • Basal layer

Functional layer

  • Thick superficial layer
  • Cyclic monthly hormonal changes

Basal layer

  • Thin deeper layer
  • Preserved during menstruation

Endometrial glands

  • Extend through basal layer
  • Source of cells to reestablish endometrium

Blood supply

  • Originate from myometrium
  • Helical arteries
    • Extend into functional layer
  • Straight arteries
    • Terminate basal layer

Menstrual cycle

  • Follicular phase
  • Luteal phase
  • Menstrual phase

Follicular phase

  • Epithelium reform
  • Proliferation of
    • Glands
    • Connective tissue
    • Blood vessels
  • Glands become coiled
  • Helical arteries 2/3 into endometrium

Luteal phase

  • Thickening endometrium
    • Edema
    • Endometrial gland secretion
  • Glands
    • Glandular cells at apex
    • Basal accumulation glycogen
  • Helical arteries reach superficial regions

Menstrual phase

  • Vasoconstriction
    • Ischaemia
    • Necrosis functional layer
  • Basal layer
    • No necrosis
    • Short straight vessels

Myometrium

  • Enlarge during pregnancy
  • Expulsion fetus & placenta
  • 3 layers indistinct smooth
    • Inner longitudinal/oblique
    • Central circular
      • Large blood vessels
      • Stratum vasculare
    • Outer longitudinal/oblique

Adventitia

  • Or serosa
  • Covers myometrium

Cervix

  • Uterus projecting into vagina
    • Dense collagenous CT
      • Elastic fibres
      • Some smooth muscle fibres
    • Simple columnar epithelium
    • Transition to stratified squamous
  • Cervical glands

Vagina

Slide 90

Vagina

  • Fibromuscular tube with 3 layers
    • Inner mucosa
    • Middle muscle layer
    • External adventitia

Fibro = fibrous tissue

Muscular = muscle tissue

Tube = epithelium

Mucosa

  • Epithelium
    • Thick stratified squamous nonkeratinized
  • Lamina propria
    • Fibroelastic connective tissue
    • Rich in elastic fibres
    • Contains lymphoid elements
    • Deep portion highly vascular
  • No glands

Muscle layer

  • Thin inner circular
  • Thick outer longitudinal
  • External orifice ring of skeletal muscle

Adventitia

  • Fibroelastic connective tissue
  • Fixes onto surrounding structure
  • Blood vessels and nerves

Testis

Slide 84

Testis

  • Tunica albuginea
  • Lobuli
  • Seminiferous tubuli
  • Epididymus
  • Ductus deferens

Tunica albuginea

  • Thick fibrous CT capsule
  • Forms septae
  • Divide testis into lobuli

Lobuli

  • Pyramidal shaped compartments
  • Contain 1 - 4 seminiferous tubules each within
  • Meshwork of loose CT
    • AVN
    • Leydig cells

Leydig cells

  • Interstitial cells
  • Surrounded by rich AVL
  • Large round - polygonal shape with clear cytoplasm
  • Large central nucleus
  • Endocrine - testosterone

Seminiferous tubuli

  • Site of spermatozoa production
  • 150 - 250 µm diameter
  • Complex stratified epithelium
  • Blood-testis barrier
Blood-testis barrier

Seminiferous epithelium

  • Two types of cells
    • Spermatogenic cells
    • Sertoli cells
  • 4 - 8 cell layers thick
  • Forms the blood-testis barrier

Sertoli cells

  • Complex columnar shape
  • Basal lamina to lumen
  • Irregular outline
    • Envelope developing germ cells
  • Large pale nucleus with indentations & large nucleolus
  • Occludens junctions with adjacent cells
  • Establish blood-testis barrier

Barrier systems

Blood-air barrier - Membrane separating alveolar air from blood in lung capillaries
Blood-brain barrier - Semipermeable capillary border that allows selective passage of blood constituents into the brain
Blood-ocular barrier - A physical barrier between the local blood vessels and most parts of the eye itself
Blood-retinal barrier - Part of the blood-ocular barrier that prevents certain substances from entering the retina
Blood-thymus barrier - A barrier formed by the continuous blood capillaries in the thymic cortex
Blood-testis barrier - A physical barrier between the blood vessels and the seminiferous tubules of the animal testes

Spermatogenic cells

  • Several stages of spermatogenesis
    • Spermatogonia
    • Primary spermatocytes
    • Secondary spermatocytes
    • Spermatids
    • Spermatozoa

Spermatogonia

  • Diploid
  • Sits on basal lamina
  • 3 types
    • Pale type A
      • Small, pale nucleus
      • Produce pale type A or type B
    • Dark type A
      • Dark nucleus
      • Reserve cell to produce pale type A
    • Type B
      • Undergo mitosis
      • Form primary spermatocytes

Primary spermatocytes

  • Largest germ cells
  • Diploid
  • Undergoes first meiotic division
  • Produce secondary spermatocytes

Secondary spermatocytes

  • Haploid
  • Short stage
  • Secondary meiosis
  • Produce spermatids

Spermatids

  • Haploid
  • Small
  • Near lumen
  • Condensed chromatin in nuclei
  • Undergo spermiogenesis

Spermatozoa

  • Head
    • Contains nucleus
    • Dense chromatin
    • Acrosomal cap anterior over nucleus
  • Midpiece
    • Mitochondrial sheath
    • Small amount cytoplasm
    • ATP for flagellar motility
  • Tail
    • Principle piece
    • End piece
    • Microtubuli for movement
Epididymus

Epididymus

  • Long convoluted duct
  • With fibrous covering
  • Inside visceral layer of tunica vaginalis testis

Epididymus

  • Simple ciliated columnar epithelium
  • Tall ciliated cells
    • Elongated nuclei away from BM
  • Low absorptive cells
    • Spherical nuclei close to BM
  • Surrounded circular smooth muscle

Ductus deferens

Also vas deferens

Ductus deferens

  • Muscular duct with small lumen
  • Lumen
    • Pseudostratified columnar epithelium
    • Stereocilia
  • Fibroelastic lamina propria
  • Muscle
    • Inner longitudinal
    • Middle circular
    • Outer longitudinal

Ductus deferens

  • Longitudinal folds in
    • Epithelium
    • Lamina propria

Ductus deferens

  1. Adventitia
  2. Loose CT with AVNL

Vesicula seminalis

Slide 81

Vesicula seminalis

  • Mucosa
  • Epithelium
  • Lamina propria
  • Muscle layer

Mucosa

  • Lumen
    • Irregular
    • Store secretions
  • Pseudostratified columnar epithelium
  • Lamina propria
    • Contains AVL
  • Folded mucosa ^^ surface area

Muscle layer

  • Inner circular
  • Outer longitudinal

Prostate

Slide 80

Prostate

  • Surrounds urethra
  • Largest accessory gland
  • 30 - 50 branched tubuloalveolar glands
  • Via excretory ducts
  • Into urethra

Glands

  • 3 concentric layers
  • Around urethra
    • Mucosal
    • Submucosal
    • Main

Capsule

  • Fibroelastic capsule containing smooth muscle
  • Divides into lobes

Concretions

  • Sometimes in lumen
  • Calcified
  • Increase with age

Epithelium

  • Simple columnar or
  • Pseudostratified columnar
  • Surrounded fibroelastic CT
  • CT with rich vascular supply

Penis

Slide 83

Penis

  • 3 cylindrical masses erectile tissue
    • 2x corpora cavernosa
    • 1x corpus spongiosum
  • Surrounded by tunica albuginea
  • Covered by skin
  • Traversed by urethra

Tunica albuginea

  • Fibrous connective tissue sheath
  • Surround erectile bodies
  • Dense collagen bundles

Corpora cavernosa

  • Paired erectile bodies
  • Irregular vascular spaces
  • Lined with endothelium
  • Trabeculae CT
  • Smooth muscle cells

Corpus spongiosum

  • Erectile body surrounding urethra
  • More elastic fibres
  • Few smooth muscle cells
  • Vascular spaces uniform
  • Glands

Glands of Littré

Present whole length of urethra

The End