female embryology, anatomy and histology a gari md

Female Embryology, Female Embryology, Anatomy and HistologyAnatomy and Histology

A Gari MD.A Gari MD.

1-Embryology1-Embryology

Gonads.Gonads. Internal Genitalia.Internal Genitalia. External Genitalia.External Genitalia.

A-Embryology (Gonads)A-Embryology (Gonads) Starts @ 4 weeks.Starts @ 4 weeks. Thickened peritoneal (coelomic) membrane Thickened peritoneal (coelomic) membrane

(genital ridge)(genital ridge) Y chromosome can be identified by 7 w.Y chromosome can be identified by 7 w. First follicles is seen @ about 20 weeks.First follicles is seen @ about 20 weeks.

B-Embryology (Internal B-Embryology (Internal Genitalia)Genitalia)

Paramesonephric duct (mullerian) Paramesonephric duct (mullerian) vs.vs.

Mesonephric duct (wollfian).Mesonephric duct (wollfian).

Upper vagina, cervix, uterus and Upper vagina, cervix, uterus and tubes are formed from the tubes are formed from the paramesonephric ducts.paramesonephric ducts.

Absence of Y chromosome is the key Absence of Y chromosome is the key factor.factor.

If present… MIFIf present… MIF If not…regression of wollfian ducts If not…regression of wollfian ducts

(10-16w)(10-16w)

C-Embryology (External C-Embryology (External Genitalia)Genitalia)

By 7By 7thth week M&F appearance are the week M&F appearance are the same.same.

Genital tubercle and urogenital Genital tubercle and urogenital membranemembrane

(endo/ecto dermal cells)(endo/ecto dermal cells)

*Genital folds (laterally)… Labia Majora*Genital folds (laterally)… Labia Majora

*Urogenital folds (medially)… Labia *Urogenital folds (medially)… Labia Minora, Prepuce and Clitoris.Minora, Prepuce and Clitoris.

C-Embryology (External Genitalia) C-Embryology (External Genitalia) cont’dcont’d

2 - Female Anatomy2 - Female Anatomy Abdominal cavity: Abdominal cavity:

Female Anatomy Female Anatomy Abdominal wall (gross anatomy)Abdominal wall (gross anatomy)

Surgical IncisionsSurgical Incisions

The Bony Pelvis:The Bony Pelvis:

The Internal OrgansThe Internal Organs The The UterusUterus thick walled thick walled

pear shaped muscular pear shaped muscular organ. Usually organ. Usually anteverted anteflexed, anteverted anteflexed, approximately 7.5 cm. approximately 7.5 cm. Long, 5cm broad. Long, 5cm broad.

The uterus is located The uterus is located inside the inside the pelvispelvis immediately immediately dorsaldorsal to to the the urinary bladderurinary bladder and and ventralventral to the to the rectumrectum..

The myometrium is 3 The myometrium is 3 lyers lyers

L-O-LL-O-L

Vagina:Vagina: H shape with rugea.H shape with rugea. No glandsNo glands 8-12 cm in length.8-12 cm in length. Supplied with (vaginal art.).Supplied with (vaginal art.). Lymphatics varies according to the Lymphatics varies according to the

segment.segment.

Cervix:Cervix: 3-4cm in length X 8 mm3-4cm in length X 8 mm Uterine / Cx ratio varies with age.Uterine / Cx ratio varies with age. Columnar epith.Columnar epith. Blood supply (3-9 o'clock)Blood supply (3-9 o'clock) Lymphatics:Lymphatics:

Tubes:Tubes: 10-14-cm10-14-cm 4 segments4 segments Interstitial 2 cm.Interstitial 2 cm. Isthmus 4 cmIsthmus 4 cm Ampullary 4-6-cmAmpullary 4-6-cm Infundibulum 20-25 finger projections.Infundibulum 20-25 finger projections. Inner circular and outer longitudinal Inner circular and outer longitudinal

muscles.muscles. Blood supply: uterine & ovarian art.Blood supply: uterine & ovarian art.

Ovaries:Ovaries: 1.5x2.5x4 cm1.5x2.5x4 cm Rests on the ovarian fossa.Rests on the ovarian fossa. IP & Ovarian ligaments:IP & Ovarian ligaments: Blood supply: Art Vs Venous.Blood supply: Art Vs Venous.

PerineumPerineum

Perineum Perineum

Pelvic DiaphragmPelvic Diaphragm

Urogenital diaphragmUrogenital diaphragm

Bartholin’s glands.Bartholin’s glands. Skene’s glands.Skene’s glands.

Blood supplyBlood supply

Blood supplyBlood supply

Lymphatic drainageLymphatic drainage

3- Histology of the Female 3- Histology of the Female Genital tractGenital tract

Vulva:Vulva:--L Majora: L Majora:

Cornified squamous epithelium. Cornified squamous epithelium.

-L Minora:-L Minora:

Less Cornified w/ no hair follicle, erectile CTLess Cornified w/ no hair follicle, erectile CT

vaginavaginaA - MucosaA - Mucosa

- The stratified squamous epithelium - The stratified squamous epithelium - deep stratum basalisdeep stratum basalis- intermediate stratum spinosumintermediate stratum spinosum- superficial layers of flat eosinophilic cells, superficial layers of flat eosinophilic cells,

contain keratin but (do not horny layer).contain keratin but (do not horny layer).- typical erectile tissue.typical erectile tissue.

B - MuscularisB - Muscularis - Inner - Inner circularcircular and outer and outer longitudinallongitudinal layers of layers of

smooth muscle are present.smooth muscle are present.- Inferiorly, the striated, voluntary - Inferiorly, the striated, voluntary

bulbospongiosus muscle forms a sphincter bulbospongiosus muscle forms a sphincter around the vagina.around the vagina.

C - AdventitiaC - Adventitia - Bordering the muscularis, contains many - Bordering the muscularis, contains many

elastic fibres. elastic fibres.

Cervix Cervix Is made up of Is made up of epitheliumepithelium and underlying and underlying stromastroma. . The The stromastroma contains an admixture of smooth muscle contains an admixture of smooth muscle

and fibrous and elastic tissues. and fibrous and elastic tissues. The The ectocervixectocervix is lined by is lined by nonkeratinizing stratified nonkeratinizing stratified

squamous epithelium. squamous epithelium. The The endocervixendocervix is covered by mucin-secreting, is covered by mucin-secreting, simple simple

columnar epitheliumcolumnar epithelium, , The cells seen in a Pap smear: cells of the ectocervical The cells seen in a Pap smear: cells of the ectocervical

and endo-cervix.and endo-cervix. The border between the stratified squamous epithelium The border between the stratified squamous epithelium

of the ectocervix and the columnar epithelium of the of the ectocervix and the columnar epithelium of the endocervix is called the endocervix is called the squamocolumnar junctionsquamocolumnar junction ((SCJSCJ).).

Original SCJOriginal SCJ: is the site at which the neonatal : is the site at which the neonatal squamous epithelium of the ectocervix meets the squamous epithelium of the ectocervix meets the endocervical columnar epithelium at birth.endocervical columnar epithelium at birth.

New, functional or physiologic SCJNew, functional or physiologic SCJ: newly formed : newly formed SCJ as a result of the dynamic remodeling that takes SCJ as a result of the dynamic remodeling that takes place during the life of the female. place during the life of the female.

Uterus Uterus A - The MyometriumA - The Myometrium

The muscle fibres of the uterus form layers with preferred The muscle fibres of the uterus form layers with preferred orientations of fibres (actually 3-4), but this is very difficult to see orientations of fibres (actually 3-4), but this is very difficult to see in most preparations.in most preparations.

L.O.LL.O.L

B - The EndometriumB - The Endometrium consists of consists of a simple columnar epitheliuma simple columnar epithelium (ciliated cells and (ciliated cells and

secretory cells) and secretory cells) and stroma stroma The mucosa forms many simple The mucosa forms many simple uterine glandsuterine glands. . The endometrium is subject to cyclic changes that result in The endometrium is subject to cyclic changes that result in

menstruation. menstruation.

divided into two divided into two 1- 1- basalisbasalis and and 2- 2- functionalisfunctionalis.. The The basalisbasalis is not sloughed off during menstruation but is not sloughed off during menstruation but

functions as a regenerative zone for the functionalis after its functions as a regenerative zone for the functionalis after its rejection. rejection.

The The functionalisfunctionalis is sloughed off during every menstruation. is sloughed off during every menstruation. These cyclic changes are divided into These cyclic changes are divided into proliferativeproliferative (or (or

follicular), follicular), secretorysecretory (or luteal), and (or luteal), and menstrualmenstrual..

C - Serosa C - Serosa

Tubes (Oviducts)Tubes (Oviducts) A - The mucosaA - The mucosa

Is formed by Is formed by a a ciliated and secretory ciliated and secretory epithelium.epithelium.

The number of ciliated cells and secretory The number of ciliated cells and secretory cells varies along the oviduct.cells varies along the oviduct.

B - The muscularisB - The muscularis - inner circularinner circular muscle layer. muscle layer.- outer longitudinalouter longitudinal layer. layer. - inner longitudinal layerinner longitudinal layer is present in the is present in the

isthmus and the intramural part of the isthmus and the intramural part of the oviduct. oviduct.

- C – The SerosaC – The Serosa

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