FEMALE REPRODUCTIVE SYSTEM TRI HARTINI Y ANATOMY AND HISTOLOGY DEPARTMENT SCHOOL OF MEDICINE AIRLANGGA UNIVERSITY

FEMALE REPRODUCTIVE SYSTEM CONSISTS OF : 1 OVARY 2 THE GENITAL TUBES : - UTERINE TUBES (TUBA FALLOPII) - UTERUS AND PLACENTA - VAGINA 3 EXTERNAL GENITALIA 4 MAMMARY GLANDS

OVARY TUBA FALLOPII UTERUS

OVARY Lies in cavum abdomen Oval-shaped / almond-shaped Composed of cortex and medulla The surface of ovaries is covered by a layer of cuboidal epithelium called GERMINAL EPITHELIUM

CORTEX Consists of three layers, are germinal epithelium, tunica albuginea and the ovarian stroma The tunica albuginea is a dense connective tissue layer The ovarian stroma consists of ovarian follicles, corpus luteum, and corpus albicans MEDULLA Located in central region of ovaries Contains fibroelastic connective tissue There are many blood vessels, lymphatic vessels and smooth muscles in the medulla

OVARY CORTEX MEDULA

OVARIAN CORTEX GERMINAL EPITELIUM T. ALBUGINEA STROMA

OVARIAN FOLLICLES PRIMORDIAL FOLLICLE PRIMARY FOLLICLE GROWING FOLLICLE MATURE GRAAFIAN FOLLICLE CORPUS LUTEUM CORPUS ALBICANS ATRETIC FOLLICLE

PRIMARY FOLLICLE PRIMORDIAL FOLLICLE Primordial follicle is the earliest stage of follicular development Appears in the prenatal Consists of oocyte surrounded by single layer of squamous follicle cells PRIMARY FOLLICLE Appears in baby after he was born Histological appearance is like primordial follicle

PRIMARY FOLLICLE

GROWING FOLLICLE Formed in puberty, stimulated by Follicle Stimulating Hormone (FSH) The oocyte become larger, together with squamous follicle cells form acidophilic refractil membrane called ZONA PELLUCIDA Squamous follicle cells become cuboidal, proliferate, form multilayers of cuboidal cells called granulosa cells Formed cavities that was filled liquor folliculi, called CALL-EXNER BODIES In this stage, there are THECA FOOLICULI LAYER consists of THECA INTERNA LAYER and THECA EXTERNA LAYER Theca interna contains cells produced esterogen Theca interna is surrounded by an outer stromal layer called theca externa The GLASSY MEMBRAN lies between granulosa cells and theca folliculi layer

GROWING FOLLICLE CALL-EXNER BODIES

ZONA PELLUCIDA

MATURE GRAAFIAN FOLLICLE Secondary oocyte of mature Graafian follicle will be expelled from ovary in ovulation Call-exner bodies begin to coalesce, forming a single cavity called ANTHRUM FOLLICULI The follicle cells form : CORONA RADIATA : a single layer of follicle cells surrounding oocyte CUMULUS OOPHORUS : follicle cells located outer of corona radiata, that project into the anthrum fooliculi MEMBRANA GRANULOSA : multilayer of follicle cells form wall of anthrum folliculi There is primary oocyte ( oocyte I ) in the primary follicle until in Graafian follicle

The mature Graafian follicle was developed from primary follicle in 10 – 14 days In this stage, Graafian follicle has the largest anthrum and has a projecting part into the surface of ovary that was called STIGMA In this region, tunica albuginea and theca folliculi became more slight than in the other sides Before ovulation occurred, the Graafian follicle had enlarged and had been filled by liquor folliculi. This condition is called PREOVULATORY SWELLING The anthrum that was filled liquor pressured and ruptured the stigma. Then the oocyte (secondary oocyte), along with zona pellucida and corona radiata moved out from the ovary. The meiotic I (reduction division) reduced number of chromosom to haploid. So the oocyte I becomes secondary oocyte ( oocyte II ) This process occurred just before ovulation

GRAAFIAN FOLLICLE 2 1 3 ANTHRUM FOLLICULI CUMULUS OOPHORUS MEMBRANA GRANULOSA 2 1 3

GRAAFIAN FOLLICLE CORONA RADIATA ZONA PELLUCIDA

CORPUS LUTEUM Formed from wall of anthrum after ovulation Consists of 2 types of cells : 1. GRANULOSA LUTEIN CELLS Derived from granulosa cells The big and pale cells located in the central of corpus luteum Produce progesteron 2. THECA LUTEIN CELLS Derived from the cells of theca interna layer The small cells and deeply staining nucleus Located in periphery of corpus luteum

If fertilization occurs, corpus luteum will increase in size to form corpus luteum of pregnancy (CORPUS LUTEUM GRAVIDITAS) Corpus luteum of pregnancy still exist until five month of pregnancy when placenta was formed completely In this time, progesteron was produced by placenta Then corpus luteum will become CORPUS ALBICANS

CORPUS LUTEUM

CORPUS LUTEUM 1.GRANULOSA LUTEIN CELLS 2. THECA LUTEIN CELLS 1 2

CORPUS LUTEUM 2 1 1 2 GRANULOSA LUTEIN CELLS THECA LUTEIN CELLS

CORPUS ALBICANS Derived from degeneration of corpus luteum when fertilization doesn’t occurred Lutein cells undergo apoptosis, remain a pale fibrous scar called CORPUS ALBICANS It can be formed from follicular atretics and from corpus luteum graviditas when placenta completely formed Formed just before menstruation

CORPUS ALBICANS

CORPUS ALBICANS

ATRETIC FOLLICLE Formed after ovulation Derived from primary follicles, growing follicle, and immature Graafian follicle Oocyte disappears, because it undergoes degeneration and autolysis Scattered granulosa cells The zona pellucida becomes folded and collapses called remnant of zona pellucida

ATRETIC FOLLICLE REMNANT OF ZONA PELLUCIDA

ATRETIC FOLLICLE

UTERINE TUBES ( FALLOPIAN TUBES ) The uterine tubes transport oocyte from the ovary to the uterus Divided into 4 segments : Infundibulum Ampulla Isthmus Intramural part

INFUNDIBULUM A funnel-shaped segment of the tubes adjacent to the ovary The segment opens to the peritoneal cavity Folded mucosa is like fingers called FIMBRIAE at free side of the segment The fimbriae catch the ovum from the ovary AMPULLA The longest segment of the tube, is approximately two thirds of the total length The segment has thin wall and large diameter Has branched mucosal folds Site of fertilization

ISTHMUS INTRAMURAL PART The narrow segment The segment has the thickest wall of the other segments INTRAMURAL PART Lies within the uterine wall and opens into the cavity of the uterus

MICROSCOPIC APPERANCE OF UTERINE TUBES The wall of uterine tubes is consists of three layers : The mucosa  inner layer of the wall, forms longitudinal folds that project into lumen throughout its lumen. The folds are most numerous and complex in the ampulla Consists of two types of cells, are CILIATED CELLS and NON-CILIATED (PEG CELLS) The muscularis is arranged by two layers of smooth muscles The serosa is composed of loose connective tissue with mesothelium in outer surface

UTERINE TUBES AMPULA OF UTERINE TUBES ISTHMUS

UTERUS Consists of 5 parts : Fundus Corpus Isthmus Cervix Portio vaginalis

CORPUS Histological appearance of corpus is similar to fundus They consist of three layers: Serosa ( Perimetrium ) The outer layer, arranged by thin layer of connective tissue that covered by mesothelium Myometrium ( muscularis layer ) Arranged by smooth muscles that enlarge in pregnancy C. Endometrium Histological appearance of endometrium depend on menstrual cycle

ENDOMETRIUM Consists of two layers ; epithel and lamina propria A layer of silindrical epithelium ciliated in some definite sites This epithel continues to lamina propria and forms uterine glands that have branches in the basal site LAMINA PROPRIA : Just beneath the epithelium, consists of reticular fibers There are two types of arteries in lamina propria. Straight arteries in the basal site, and spiral arteries ( coiled arteries) in the upper site

CYCLE CHANGES OF ENDOMETRIUM Depend on menstrual cycle, endometrium divided into 4 phases : PROLIFERATIVE PHASE : The other name of this phase is estrogenic or reparative phase In this phase, the epithelium and the lamina propria are reconstituted The uterine glands proliferate rapidly Coiled arteries are reformed

PROLIFERATIVE PHASE 1 ENDOMETRIUM MYOMETRIUM 2

2. SECRETORY PHASE The other name is LUTEAL OR PROGESTATIONAL PHASE The uterine glands become hypertrophi Endometrium becomes edematous and may eventually reach a thickness of 5 to 6 mm The glands make saw-shaped appearance The coiled arteries are numerous and extend to the surface of the endometrium The stromal cells enlarge and transform into decidual cells In this phase endometrium becomes the thickest stage so it can divided into two layers

Theese layers are : Functional layer  the thick part, will be sloughed off in menstruation and in partus. Divided into : Compact layer : nearly to the surface, a thin layer with straight glands Spongious layer : beneath the compact layer, a thick layer with spiral glands Basal layer : the deeper layer attached to myometrium. This layer is retainedduring menstruation

SECRETORY PHASE

PROLIFERATION PHASE SECRETORY PHASE

ISCHEMIC PHASE ( premenstrual phase ) Contraction of coiled arteri wall cause the stratum functionale become ischemic. Infiltration of leucocytes in stroma . MENSTRUAL PHASE : Endometrium is sloughed off and constitute the vaginal discharge. Vaginal discharge contains : a. blood b. epithelial cells and sloughing stroma c. secret of the glands

MENSTRUAL PHASE

CERVIX UTERI Consists of three layers : MUCOSA : A layer of silindrical epithelium extend to the lamina propria and have branches called CERVIX GLANDS Blockage of the openings of the mucosal glands results in the retention of their secretions This structure becomes a dilated cyst called OVULA NABOTH The lamina propria consists of connective tissue and it lacks coiled arteries so that it can’t be changed by menstrual cycle

MUSCULARIS : ADVENTITIA : Consists of smooth muscle with irreguler arrangement The outer is arranged longitudinaly extending to vagina ADVENTITIA : Consists of fibroelastic connective tissue

CERVIX UTERI 1. OVULA NABOTH CERVIX GLANDS

PORTIO VAGINALIS The portion of the cervix that projects to the vagina Covered by stratified squamous epithelium This part is not changed during menstrual cycle

VAGINA

A fibromuscular tube covered by mucosa Consists of theree layers : Has numerous mocosal folds called RUGAE Consists of : Non-keratinized stratified squamous epithelium The lamina propria that has numerous elastic fibers, bood vessels and nerves

2. MUSCULARIS LAYER 3. ADVENTITIAL LAYER Consists of two layers of smooth muscles 3. ADVENTITIAL LAYER Consists of thin connective tissue with numerous blood vessels and autonomic ganglion

VAGINA

GENITALIA EXTERNA

GENITALIA EXTERNA ( VULVA ) Consists of theese structures : Clitoris Labia minora Labia majora Vestibular glands

CLITORIS The erectile structure that is homolougous to the penis Covered by non-keratinized stratified squamous epithelium The lamina propria forms propria papil that has numerous blood vessels and sensory nerve endings (MEISSNER’S CORPUSCLES and PACINIAN CORPUSCLES)

EPITHELIUM LAMINA PROPRIA ERECTILE TISSUE

LABIA MINORA Folds of skin that border the vestibule Covered by non-keratinized stratified squamous epithelium with melanin pigment in the deep cells of the epithelium Large sebaceous glands in the stroma (lamina propria) The glands doesn’t connect to hair follicles

SEBACEOUS GLANDS

LABIA MINORA

LABIA MAJORA Folds of skin, covers the labia minora The inner surface is covered by non-keratinized stratified squamous epithelium The outer surface is covered by keratinized stratified squamous epithelium with pubic hair

VESTIBULAR GLANDS Consists of : Minor vestibular glands The small mocous glands are present primarily near the clitoris and around external urethral orifice Major vestibular glands (Bartholin’s glands) The large mucous glands in the lateral wall of the vestibule Secrete lubricating mucous

MAMMARY GLANDS

Modification of sweat glands in subcutan They are rudimentary in male Composed of 15 – 20 lobes separated by interlobular tissue (connective tissue) Each lobes has excretory ducts that assemble in the apex of the nipple

Histological Appearance INACTIVE MAMMARY GLANDS Composed of numerous intralobular ducts Consists of dense connective tissue and thick adipose tissue ACTIVE MAMMARY GLANDS The alveoli begin to develop Amount of the adipose and the connective tissue is decrease The alveoli enlarge forming SACCULI that secret milk in the late pregnancy

INNACTIVE MAMMARY GLAND

THE KEYS OF SUCCESS ARE PERSEVERANCE AND DO THE WORK HARDLY