ORGANA GENITALIA FEMININA

Oleh Dr. Hendra Sutardhio

Figure 27.14a

Ovary
Almond shaped, 3 cm X 1.5 cm Medulla with vessels and loose connective tissue Cortex with ovarian follicles and oocytes Cortical stroma has fibroblast-like cells Surface has simple squamous/cuboidal germinal epithelium covering thick layer of dense irregular connective tissue, the tunica albuginea

Ovarian Follicles
In cortex, surrounded by stromal cells Consist of oocyte surrounded by one or more layers of follicular cells 2 ovaries of young adult female have about 400,000 follicles; most will degenerate (atresia) About 450 follicles will cycle to ovulation in lifetime

Primordial Follicle
Primary oocyte with one layer of flattened follicular cells Most numerous in fetus Oocyte about 25 m diameter Euchromatic nucleus, large nucleolus

Growing Follicles 1
Oocyte diameter increases to 150 m Nucleus enlarges Organelles increase in number and amount (mito., Golgi, ER) Unilaminar primary follicle has one layer of cuboidal follicular cells Multilaminar primary follicle has several layers of follicular (granulosa) cells

Secondary Follicles
Granulosa and theca cells increase in number Fluid-filled spaces in granulosa layer fuse to form the antrum Stem of follicular cells connects oocyte with corona radiata to the surrounding granulosa cells

Theca Interna & Theca Externa

Theca Interna
cells more cuboidal with round nuclei steroid producing cell features
SER, mitochondria with tubular cristae and lipid droplets

produce androstenedione which is converted to estradiol by granulosa cells highly vascularized

Theca externa
connective tissue and stromal cells with vessels forming a plexus cells flattened

Mature (Graafian) Follicles

In later stages may be over 2 cm in diameter, antrum enlarges Bulge from ovary surface Granulosa cells differentiate into corona radiata which adheres to ovum when it is ovulated

Follicular Atresia
Degeneration of follicle that can occur at any stage Phagocytes take up dead cells fragments Common just after birth (loss of maternal hormones), puberty and pregnancy Apoptotic cell death, autolysis Follicle cells replaced by stromal cells

Ovulation
Perifollicular connective tissue broken down by proteases Fluid pressure builds up until follicle ruptures Ovum separates from follicle wall Ovum is drawn into open end of oviduct (fallopian tube) Ovum remains viable about 24 hours after ovulation Fertilization occurs in oviduct

Corpus Luteum 1
Temporary hormone secreting structure formed by granulosa cells and theca interna cells remaining after ovulation Secretes estrogen and progesterone Structure may include coagulated blood and connective tissue from stroma Granulosa cells hypertrophy into granulosa lutein cells with increased SER and mitochondria with tubular cristae

Korpus Luteum
Theca interna cells form theca lutein cells which are smaller and darker staining than granulosa lutein cells Produce estrogen Located in folds of cells in perimeter of corpus luteum Highly vascularized If pregnancy does not occur corpus luteum survives only 10-14 days In pregnancy it enlarges greatly due to HCG and lasts 6 months

Corpus Albicans
Scar of stromal cells that forms when corpus luteum breaks down Large ones form after pregnancy and smaller ones after each ovulation Older ovaries have many

Oviduct
Muscular tube 12 cm long Upper end opens into peritoneal cavity near ovary Lower end passes through the uterus wall 4 segments
intramural part in uterine wall isthmus is adjacent to uterine wall ampulla is dilated part infundibulum is funnel-shaped part near ovary with fimbriae

Oviduct Wall 1
Mucosa
simple columnar epithelium ciliated cell and nonciliated peg cell cilia near ovary beat toward uterus cilia near uterus beat toward ovary lamina propria of loose connective tissue

Oviduct Wall 2
Muscularis
Inner circular layer Outer longitudinal layer Peristaltic movements

Serosa/Adventitia
dense irregular connective tissue vasculature

Uterus
Pear-shaped structure attached to oviducts at upper end and to vagina at lower end Uterina wall has 3 layers
Endometrium Myometrium Adventitia/Serosa

Endometrium
Simple columnar epithelium invaginated into simple tubular glands Ciliated columnar cells and secretory columnar cells Lamina propria of loose connective tissue and vessels 2 zones in endometrium
functional layer basal layer

Endometrial Layers
Functional layer
surface layer sloughed off during menstruation replaced during each menstrual cycle

Basal layer
deeper layer retained after menstruation gland cells give rise to new epithelium

Endometrium Vasculature
Arcuate arteries in the myometrium give rise to the
straight arteries of the basal layer which give rise to the coiled arteries of the functional layer

Myometrium
Thickest layer Four poorly defined layers of smooth muscle separated by connective tissue Inner and outer layers are mostly longitudinal in orientation Middle layers are more circular Middle layer thickens in pregnancy with more smooth muscle cells and increased collagen

Adventitia/Serosa

Dense irregular connective tissue with attached mesothelium (serosa) Dense irregular connective tissue (adventitia) Vasculature

Menstrual Cycle
Estrogen and progesterone from ovary stimulate changes in the endometrium 28 day cycle on average Begins age 12-15 and ends age 45-50 3 main phases of cycle
Menstrual phase: days 1-4 Proliferative (follicular) phase: days 5-14 Ovulation around day 14 Secretory (luteal) phase: days 15-28

Fase Proliferatif (Folikular)

Days 5-14 leading up to ovulation Estrogen produced by theca cells of ovarian follicle Endometrium consists of just gland bases Cells of gland bases proliferate forming simple columnar epithelium Connective tissue cells proliferate in lamina propria 2-3 mm of endometrium form with glands of straight tubes with narrow lumens Coiled arteries grow into regenerated lamina propria

Fase sekretori/Luteal
Begins after ovulation, days 1528 Corpus luteum forms and produces progesterone Glands develop further, become coiled and begin to secrete Endometrium reaches 5 mm

Fase Menstrual
If fertilization does not occur the corpus luteum stops secreting hormones after about 14 days Progesterone and estrogen decrease causing coiled arteries to constrict cutting off blood flow to the functional layer of endometrium Endometrial cells die and the functional layer is sloughed off Vessels distal to constrictions are shed with the functional layer causing some bleeding

Serviks uterus 1

Lower part of uterus Lined by mucous secreting simple columnar epithelium Some smooth muscle and much connective tissue in lamina propria Part of cervix in upper vagina has stratified squamous nonkeratinized epithelium

Figure 26-12d: ANATOMY SUMMARY: Female Reproduction

Uterine Cervix 2
Cervical mucosa has mucous glands Cervical mucosa remains intact during menstrual cycle Cervical gland secretions vary during menstrual cycle

at ovulation mucous is watery so sperm can penetrate easily in luteal phase or pregnancy mucous more viscous to block sperm or microbes

Placenta
Organ that forms from uterine wall and fetal tissues during pregnancy to provide site for exchange between maternal and fetal circulation Fetal part: chorion Maternal part: decidua basalis Chorionic villi contain fetal vessels and are bathed by maternal blood Syncytial trophoblasts make up walls of villi; syncytial knots are groups of nuclei

Vagina
Epithelium is stratified squamous partly keratinized No glands in epithelium Underlying lamina propria of loose connective tissue, highly vascularized with many elastic fibers Muscular layer of circular and longitudinal smooth muscle Adventitia of dense irregular connective tissue with elastic fibers, many vessels and nerves

Vagina

External Genitalia 1
Labia majora, labia minora, clitoris, and Bartholins glands Labia majora have an adipose core and some smooth muscle
skin with hair, sweat and sebaceous glands, many nerve fibers

Labia minora are folds of skin with core of spongy connective tissue with elastic fibers skin with sebaceous and sweat glands, and many nerve fibers

External Genitalia 2
Clitoris is embryonic homologue of penis
contains 2 erectile tissue bodies covered by stratified squamous epithelium heavily innervated

Bartholins glands are mucous glands with ducts opening into the vestibulum of vagina