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UGS Anatomy 3 Final
Gametogenesis in females and histology
| Question | Answer |
|---|---|
| Where are the ovarian follicles located? | In the cortex of the ovary deep to the tunica albuginea |
| What do ovarian follicles consists of? | 1) An immature ovum 2) A surrounding layer of epithelial cells |
| At birth how many ovarian follicles are there? | 1-2 million |
| By puberty, how many ovarian follicles remain? | 300-400 thousand |
| How many ovarian follicles reach maturity during each menstrual cycle? | One The rest degenerate |
| Most ovarian follicles, especially in young women are: | Primordial follicles found in the peripheral cortex |
| What are the specific constituents of the primordial follicle? | 1) A primary oocyte suspended in the prophase of the first meiotic division 2) A single layer of flattened follicular cells which rests on a basement membrane |
| What are the characteristics of the organelles of the primordial follicle? | 1) Primary oocyte is large 2) Prominent nucleus and nucleolus 3) Well-developed golgi apparatus 4) Spherical mitochondria concentrated in the centrosomal region |
| The primordial follicle develops into the: | Primary follicle |
| What are the characteristics of the unilaminar primary follicles? | 1) Increase in oocyte size 2) Multi-structured golgi apparatus 3) Increased ribosomes 4) Dispersed mitochondria 5) More extensive ER 6) Lipid droplets appear 7) Yolk granules accumulate |
| Which structure grows between the oocyte and adjacent follicular cells in the multilaminar primary follicles? | The zona pellucida |
| The microvilli of the oocyte which extend into the zona pellucida are made up of: | Glycoproteins ZP1,2, and 3 |
| In the conversion of the unilaminar primary follicle to the multilaminar primary follicle, what happens to the follicular cells? | They become cuboidal or columnar and proliferate to form the stratum granulosum |
| What are the organelle changes in the conversion of the unilaminar primary follicle to a multilaminar primary follicle? | 1) Increased mitochondria 2) Increased free ribosomes 3) Increased ER 4) Prominent Golgi apparatus 5) Slender cytoplasmic process from the granulosa extend and penetrate the zona pellucida |
| How are the processes of the oocyte and granulosa cells united? | By gap junctions |
| In the conversion of the unilaminar primary follicle to the multilaminar primary follicle, what happens to the adjacent stroma? | It becomes organized into a sheath/capsule called the theca folliculi |
| How is the theca folliculi separated from the granulosum? | By a basement membrane |
| When does the stratum become vascular? | After ovulation |
| What are the layers of the theca folliculi? | Theca externa Theca interna |
| The blood vessels of which substance supplies the theca interna? | The theca externa |
| FSH promotes production of which substances in the granulosa cells? | Estradiol and inhibin |
| How is the dominant follicle chosen? | It is the follicle most sensitive to FSH, when FSH levels decrease after estradiol and inhibin negative feedback |
| Other than negative feedback of FSH, what other effect does estrogen have on the anterior pituitary? | Increased LH production without secretion |
| What changes occur to the follicle in the conversion of the primary follicle to the secondary follicle? | The growing follicle becomes ovoid and sinks deeper into the cortex |
| When the stratum granulosum becomes 8-12 layers, what happens? | Thick fluid-filled spaces appear and liquor folliculi increases until the spaces fuse and form the follicular antrum |
| What substances are contained in the liquor folliculi? | Steroid, gonadotrophs, and growth factors in greater concentration than in the plasma |
| At the formation of the follicular antrum, what stage is the follicle in? | The secondary follicle |
| Why does the secondary follicle continue to increase in size despite it having reached maximum growth? | The liquor follicle continues to accumulate |
| The ovum is surrounded by a mass of granulosa cells that protrudes into the antrum and forms: | The cumulus oophorus |
| In the secondary follicle, granulosa cells which immediately surround the oocyte form: | The corona radiata anchored to the zona pellucida by cytoplasmic processes |
| How long does it take for a follicle to reach maturity? | 10-14 days |
| In addition, to increased estradiol and inhibin, the growing follicle produces: | A small amount of progesterone |
| The proliferative phase of the uterine cycle corresponds to which phase of the ovarian cycle? | The follicular phase |
| During what days of the menstrual cycle does the proliferative/Follicular phase occur? | 5-14 days |
| What general changes occur in the endometrium during the proliferative phase? | Rapid regeneration and repair |
| During the last few days of the follicular phase what happens to the glands? | They increase in number and length They become more tortuous, closely-spaced, and have wider lumens |
| During the last few days of the follicular phase, glycogen accumulates where? | In the basal region of the glandular epithelium |
| What changes occur in the surface epithelium during the last few days of the follicular phase? | It goes from simple cuboidal/low columnar to tall columnar cells Ciliated cells decrease and secretory cells increase |
| Describe the secretory cells in the follicular phase: | 1) Large numbers of mitochondria 2) Poorly developed ER and golgi 3) Microvilli on their free borders 4) Nuclei are round/oval and contain chromatin with 1 or more nucleoli |
| What changes occur to the vascular system of the endometrium? | Spiral arteries lengthen and are tightly coiled Spiral arteries do not lengthen beyond the superficial third of the endometrium |
| What changes occur in the ovary during the proliferative phase? | Maturation of the ovarian follicle up until ovulation |
| Estrogen secreted by the ovarian follicles leads to: | Endometrial growth |
| What hormone changes occur in the follicular phase? | 1) LH receptors are induced in the theca cells --> androgen synthesis 2) FSH receptors induced in the granulosa cells -->estradiol synthesis 3) Estradiol increase --> endometrial proliferation and negative feedback of FSH and LH 4) Low progesterone |
| What day does ovulation occur on? | Day 15, on average |
| When does ovulation occur relative to menses? | 14 days prior to menses regardless of cycle length |
| What effect does increased estradiol at mid-cycle have? | Positive feedback on LH and FSH |
| Ovulation occurs due to which hormone change? | Estrogen-induced LH surge |
| Estrogen levels fall just after ovulation, but rise again in: | The luteal phase |
| What changes occur in the cervical membrane during ovulation? | The mucous becomes less viscous and more easily penetrated by sperm |
| Which days does the secretory/luteal phase occur during? | Days 15-28 |
| What changes occur to the endometrium during the secretory/luteal phase? | It increases in thickness Due to hypertrophy of stromal and glandular cells, stromal edema, and increased vascularity |
| What glandular changes occur in the glands during the secretory/luteal phase? | Glands lengthen, become coiled and convoluted, and have wide lumina |
| What changes occur in the epithelium in the secretory/luteal phase? | The epithelial cells become larger and have long microvilli |
| What organelle changes occur in the cells of the endometrium during the secretory phase? | 1) Large mitochondria 2) Rich ER 3) Prominent golgi apparatus 4) Nuclei enlarged 5) Distant nucleoli 6) Glycogen and mucoid materials increase from base to apex to lumina |
| What structure is formed during the secretory/luteal phase? | The corpus luteum |
| What substance secreted by the corpus luteum is important for the changes in the secretory phase? | Progesterone |
| What changes occur in the ischemic phase of the secretory phase? | Spiral artery constriction and anoxia of the stratum functionale for hours at a time The stratum functionale is infiltrated by leukocytes and undergoes edema |
| What hormone changes occur in the secretory/luteal phase? | 1) CL synthesizes progesterone and estrogen 2) Increased body temperature due to progesterone's effect on the hypothalamus 3) No fertilization leads to regression of the CL and abrupt decrease of estradiol and progesterone |
| During which days of the menstrual cycle does menses occur? | 1-5 days |
| What is the main function of menses? | Shedding of the necrotic functional layer of the endometrium |
| How is the endometrial functional layer shed after necrosis? | Necrotic spiral arteries lead to loss of blood from arteries and veins Small lakes of blood form and unite in the underlying mucosa detaching it from the endometrial wall |
| What does the menstrual discharge consists of? | 1) Blood 2) Degenerated epithelial cells 3) Glandular secretions |
| Onset of the menstrual cycle coincides with the involution of which structure? | Corpus luteum |
| Which hormonal changes bring on menses? | Withdrawal of estrogen and progesterone |
| What is the function of GnRH in female menstrual cycle? | It is produced in every phase and stimulate the anterior pituitary to secrete FSH and LH |
| What is the function of FSH in the female menstrual cycle? | Only granulosa cells have receptors for FSH It stimulates the growth of granulosa cells in the primary follicles leading to increased estrogen production It peaks at the end of the follicular phase |
| Which hormones regulate FSH production from the anterior pituitary? | GnRH increases production Estradiol has negative feedback on it during the follicular phase Estradiol has POSITIVE feedback on it mid-cycle/ovulation Progesterone have negative feedback on it during the luteal phase |
| What effect does FSH have on the follicles? | FSH saves the antral follicles from apoptosis If FSH is decreased, only the dominant follicle which is most sensitive to it at low concentrations will remain and the antral follicles will degenerate |
| What effect does LH have on the female menstrual cycle? | The estrogen induced LH surge at the end of the follicular phase is what initiates ovulation It leads to rupture of the dominant follicle just before ovulation and release of the secondary oocyte |
| During what stage of ovum development can follicular atresia occur? | During any stage |
| What changes occur in the early atretic primary follicle? | 1) The ovum shrinks, degenerates, and undergoes cytolysis 2) Follicular cells also shrink, degenerate, and undergo cytolysis 3) The follicle is reabsorbed and CT space replaces it |
| What changes occur in the larger atretic follicles? | 1) The zona pellucida persists for a longer time 2) The cells of the theca interna outlive the stratum granulosa 3) The basal lamina between the granulosa and theca interna form a hylanized, characteristic glassy membrane |
| What is the fate of larger atretic follicles? | Eventually, the follicle is reabsorbed and a large, white scar resembling the corpus albicans appears in its place This scar eventually also dissapears into the stroma |
| What is the function of the corpus luteum? | It is a temporary endocrine structure which elaborates estrogen, progesterone, and inhibin |
| What changes in the follicle turn it into the corpus hemmorrhagicum? | 1) Walls of the follicle collapse 2) The stratum granulosum is thrown into folds 3) Bleeding theca interna capillaries lead to the formation of a blood clot in the center of what will become the corpus luteum |
| What changes in the granulosa cells cause them to turn into granulosa lutein cells? | 1) Increase in size 2) Become polyhedral 3) Lipids accumulate in the cytoplasm 4) Increased in SER and mitochondria |
| What changes occur after the formation of the corpus hemmorrhagicum and granulosa lutein cells to form the final corpus luteum? | Theca luteal cells now have a vacuolated cytoplasm and form progesterone, androgens, and estrogens Capillaries and CT penetrate the lutein cells and form a network around them |
| How is the corpus albicans formed? | Due to involution of the corpus luteum within 14 days after ovulation(IF the ovum is not fertilized) |
| What changes occur to convert the corpus luteum into the corpus albicans? | 1) CT cells become pyknotic with condensed nuclei 2) Fibroblasts enter and make type 1 collagen 3) Hyaline accumulates between the lutein cells and the CL 4) The hyaline material is replaced by an iregular, white, CT scar |
| If the ovum is fertilized, what happens to the corpus luteum? | It enlarges and persists for 6 months |
| How is the connection between the secondary follicle and stratum granulosa weakned? | Liquid spaces appear between the ranulosa cells and the cumulus oophorus |
| What happens to the theca folliculi when the secondary follicle is being prepared for release into the ovarian tube? | It assumes the cytologic characteristics of a steroid secreting endocrine gland |
| Which substances does the theca interna produce? | Androstenidione and testosterone |
| What is the purpose of the substances released by the theca interna? | They serve as a substrate for estrogen biosynthesis by granulosa cells |
| Which hormone influences the theca? | LH |
| Which enzyme converts estrogen substrates into estradiol? | Aromatase |
| How does estradiol go from the granulosa cells and enter the circulation? | It diffuses across the BM into the stratum granulosum and enters the theca interna It travels through the capillaries in the theca interna into the blood stream |
| A escondary oocyte is in which stage of meiosis? | Suspended in the metaphase of the 2nd meiotic division |
| When the follicle buldges from the wall of the ovary, what changes occur to its wall? | The wall becomes thinner A translucent, avascular, and small area called the macula pellucida/stigma is produced |
| How is the follicle released from the ovary? | The tunica albuginea thins out making the surface epithelium discontinuous Collagenase produced by granulosa cells break down the stigma The stigma protrudes and ruptures leading to extrusion of the ovum, zona pellucida and corona radiata |
| What is the size of the ovum? | 120 microns |
| Where does the breast lie? | Vertically it extends from the 2nd to 6th rib Horizontally it extends from the lateral sternum to the midaxillary line in the 4th coastal cartilage |
| All of the breast lies in the superficial pectoral fascia except: | The axillary tail |
| What do the male and female breast have in common? | It's a modified sex gland in both sexes, but its rudimentary in males |
| What is the axillary tail of Spence? | The superolateral part of the breast gland which is prolonged upward and laterally |
| Where is the axillary tail located? | It pierces the deep fascia at the anterior fold of the axilla and lies at the level of the 3rd rib |
| The opening into the deep fascia where the axillary tail enters is called: | The Foramen of Langer |
| Why is the breast freely movable over the pectoral fascia? | Due to the retromammary space of areolar tissue underlying it |
| Why was the retromammary space of areolar tissue under the breat previously known as the Lake of Mercielle? | Due to the false belief that free flow of lymphatics exist here |
| What are the layers deep to the breast? | Deep fascia --> Pectoralis major --> Serratus anterior --> External oblique |
| The breast is divided into 3 parts: | 1) The skin 2) Parenchyma 3) Stroma |
| The skin forms which 2 parts of the breast: | 1) The nipple 2) The areola |
| What is the nipple? | A conical projection just below the center of the breast at the 4th coastal space |
| What is the nipple pierced by? | 15-20 lactiferous ducts |
| What does the nipple contain? | 1) Circular and longitudinal smooth muscle 2) Sebaceous glands 3) Rich nerve supply with many end organs |
| What is the function of the circular and longitudinal muscles of the nipple? | The circular muscles erect it The longitudinal muscles flatten it |
| What is the areola of the nipple? | A pigmented area of skin surrounding the nipple |
| What does the areola contain? | Modified sebaceous glands at its outer margin Sweat and accessory mammary glands |
| What happens to the areola during pregnancy and lactation? | It enlarges and forms raised tubercles known as the tubercles of Montgomery Oily secretions lubricate it and the nipple to prevent cracking during lactation |
| What is absent from the nipple and areola? | Hair |
| What is the parenchyma of the breast? | Mammary gland Glandular tissue which secretes milk |
| How many lobes are there in the parenchyma of the breast? | 15-20 |
| What are the lobes of the parenchyma of the breast? | A cluster of alveoli drained by a lactiferous duct |
| Where are the lactiferous ducts drained into? | A lactiferous sinus below the areola |
| What clinical importance does the direction of drainage of the lactiferous ducts have? | In surgery, we perform incisions radially |
| What is the stroma of the breast? | The fibrous support |
| What are the types of stroma in the breast? | 1) Fibrous stoma 2) Fatty stroma |
| What does the fibrous stroma of the breast form? | Ssepta known as the suspensory ligaments of cooper |
| What is the function of the suspensory ligaments of cooper? | Anchors the skin and breasts to the pectoral fascia |
| What clinical manifestations does infiltration of the suspensory ligaments of cooper by cancer cells have? | Fixity of the gland and puckering of the skin |
| What part of the breast does the fatty stroma form? | The main bulk |
| Where in the breast is the fatty stroma distributed? | All over excepts beneath the nipple and areola |
| What is the arterial blood supply of the breast? | 1) Internal thoracic artery --> a branch of the subclavian artery 2) Lateral, superior, and acromiothoracic branches of the axillary artery 3) Lateral branches of the posterior intercostal arteries |
| What is the venous drainage of the breast? | 1) Superficial veins --> drain into the internal thoracic and superficial veins of the lower neck 2) Deep veins --> drain into internal thoracic, axillary, and posterior intercostal veins |
| The posterior intercostal veins which drain the deep veins of the breast are connected to: | The vertebral plexus of veins |
| What is the importance of the posterior intercostal veins being connected to the vertebral plexus? | Carcinoma spreads from the breast to the spine quickly |
| Veins converge towards the base of the nipple and form: | An anastomatic venous circle which runs in sets of superficial and deep veins |
| What is the nerve supply of the breast? | Anterior and lateral branches of the 4th and 6th intercostal arteries |
| What types of fibers does the nerve supply of the breast convey? | 1) Sensory fibers to the skin 2) Autonomic fibers to the smooth muscles and blood vessels |
| If nerves do not control secretion of the nipple, what does? | Prolactin |
| What is the importance of knowing the lymphatic drainage of the breast? | It is the most significant site for metastatic spread of carcinoma |
| What are the principal nodes of the breast? | The anterior/pectoral group Posterior, central, lateral, and apical groups |
| Where do the lymphatics from the deep surface of the breast drain? | Pass through the pectoralis major and apipectoral fascia to reach the apical and internal mammary nodes |
| Where do lymphatics from the lower and inner quadrant of the breast drain? | Cross the coastal margin and pierce the lower abdominal wall at the upper part of the linea alba Communicate with subdiaphragmatic and subperitoneal lymph plexuses |
| What is the importance of breast lymphatics communicating with the subdiaphragmatic and subperitoneal lymph plexuses? | Carcinoma can spread to the liver and peritoneal cavity and subsequently the pelvis |
| Peau d'Orange or edema with pitting in the breast is due to: | Infiltration of the cutaneous lymphatics by cancer cells and subsequent fixation of hair follicles to subcutaneous tissue |
| Axillary lymph node involvement in breast carcinoma manifests as: | Stony hard and fixed nodes Felt as lumps in the axillary region |
| Retraction of nipples can be due to: | 1) Metastatic invasion of the suspensory ligaments of Cooper 2) Growths along the lactiferous ducts with accompanying fibrosis |
| If carcinoma of the breast spreads to adjacent structures, this may manifest as: | Breast fixation to deep fascia, pectoral muscle, and the chest wall |
| Carcinoma of the breast is likely to spread to: | Vertebra, lungs, liver, bones, and ovaries |
| What is the resting breast? | The post pubertal, non-lactating breast |
| What are the principal glandular elements of the resting breast? | Ducts which are grouped together to form lobules |
| Describe the intralobular CT between the ducts of the resting breast? | Loose, cellular, and devoid of fat |
| Where is the intralobular CT between the ducts of the resting breast derived from? | From downgrowths of the papillary layer of the dermis |
| Describe the interlobular CT around lobules of the resting breast? | Abundant, dense, and rich in fat |
| Where is the interlobular CT around lobules of the resting breast derived from? | The reticular layer of the dermis |
| Ducts of the resting breast are lined with what type of epithelium? | Cuboidal to low columnar epithelium |
| What is the difference between the epithelial linings of wide and narrow ducts in the resting breast? | Wider ducts have epithelium arranged as a double layer Narrower ducts have epithelium arranged as a single layer |
| When does the resting breast become an active, proliferative breast? | During pregnancy |
| What is the active, proliferative breast basically? | Abundant alveoli lined by simple cuboidal epithelium and surrounding myoepithelial cells |
| How do the alveoli of the active, proliferative breast arise? | By budding off at the ends of the intralobular ducts |
| How is intralobular and interlobular connective tissue different in the active breast than in the resting breast? | It is markedly reduced in the active breast |
| In the third trimester of pregnancy, which substance is produced by the alveoli of the active breast? | Colostrum |
| What is colostrum? | A protein-containing serous fluid with low-fat content that is secreted by the lactating breast before milk production |
| Why do the secretory alveoli and ducts become distended more so in some lobules than in others? | Due to uneven rates of secretion |
| What effects do estrogen and progesterone have on the breast? | They stimulate growth and development of the breast preparing them for lactation Estrogen stimulates prolactin secretion |
| Why doesn't lactation occur during pregnancy if the prolactin levels are so high? | Because of the blocking effects of estrogen and progesterone on the breast |
| How doe we differentiate the active , proliferating breast from the thyroid gland? | Presence of ducts and alveoli in the breast Lack of colloid material in the breast |
| What is the appearance of alveoli in the active, lactating breast? | Saccular and distended with milk with a flat epithelial lining in some lobules Resting with narrow lumen and tall epithelial cells in other lobules |
| What happens to interlobular CT in the lactating breast? | It is reduced to thin septa between lobules |
| What are the hormone changes AFTER childbirth? | Progesterone and estrogen levels are reduced due to removal of the placenta and no longer block prolactin Prolactin begins its role in lactation |
| How is lactation in the female breast maintained? | Due to the suckling reflex which stimulates oxytocin and prolactin |
| Why does lactation suppress ovulation? | Because during lactation. GnRH is inhibited, therefore no LH and FSH is being stimulated for release from the anterior pituitary |
| What is the embryological origin of the breast? | The gland is ecotdermal in origin The stroma is mesodermal in origin It develops from an abnormal thickening,the mammary ridge, milk like, or line of Schultz |
| When does the mammary ridge appear and where does it persist? | It appears in the 4th week of development and persists in the pectoral region in humans |
| Where does the mammary ridge extend originally? | From the axilla to the inguinal region |
| The remaining portion of the mammary ridge is converted into: | Mammary pit |
| What structures grow down from the floor of the mammary pit? | 15-20 secondary buds which divide to form lobes |
| What further changes occur in the development of the breast? | The entire system is canalized and the nipple is everted |
| Which hormone controls growth of the breasts at puberty? | Estrogen |
| Secretory alveoli in the breast develop under the influence of which hormones? | Estrogens, progesterone, and anterior pituitary hormones |
| What is absence of the birth at birth called? | Amastia |
| What is absence of the nipple at birth called? | Athelia |
| What is the congenital name for supranumerary breasts? | Polymastia |
| What is the congenital name for supranumerary nipples? | Polythelia |
| In which disorder does gynecomastia in males occur? | Klein-Felter syndrome |
Created by:
Ulaisl
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