Female Reproductive System Histology Department
Introduction Enam besar fungsi: Produksi gamet betina, ova yang Penerimaan dari gamet laki-laki, spermatozoa yang Penyediaan lingkungan yang sesuai untuk fertilisasi ovum oleh spermatozoa Penyediaan lingkungan untuk perkembangan janin Sebuah alat untuk pengusiran janin dikembangkan untuk lingkungan eksternal Gizi bayi yang baru lahir
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Tiga unit struktural berdasarkan fungsi: Indung telur Saluran kelamin Payudara
Introduction •
INTERNAL PARTS : – – – –
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OVARIES OVIDUCT UTERUS VAGINA
Pembuahan DAN PENGEMBANGAN
EXTERNAL PARTS : OPENING OF THE VAGINA – LABIA (MAJORA & MINORA) MEMBERIKAN DAN EXIT – VESTIBULE – CLITORIS – CATATAN: WALAUPUN TIDAK organ kelamin, kelenjar susu aksesori ADALAH ORGAN PENTING DARI saluran reproduksi wanita. Anatomi INTEGRASI UNTUK REPRODUKSI –
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ANATOMICAL INTEGRATION FOR REPRODUCTION
Picture taken from Basic Histology Text & Atlas , 10th edition, L. Carlos Junquira MD, Jose Carneiro MD, Robert O. Kelley PhD, Lange Medical Books, Mc Graw-Hill , 2003.
Ovary
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KOTOR ANATOMI APROXIMATION CLOSE ATAS saluran telur BADAN dipasangkan Oval YANG LIE ON SETIAP SISI ATAS DARI RAHIM Diadakan di POTITION ATAS RAHIM oleh ligamen 2 .anatomi yang berbeda DAERAH DIJAMIN OLEH mesotelium YANG BERKELANJUTAN DENGAN YANG DARI MESOVARIUM ATAS, ATAS sel skuamosa MENJADI CUBOIDAL DAN BENTUK epitel permukaan ovarium epitel germinal = (JANGKA LAMA) Meduler-sangat vaskular, CT, limfatik dan saraf Korteks-folikel, CT, DAN BEBERAPA OTOT HALUS Tunica albuginea UNTUK MEMISAHKAN DARI
Bagian dari indung telur dengan korteks & meduler daerah. H & E noda. Pembesaran rendah Picture taken from Basic Histology Text & Atlas , 10th edition, L. Carlos Junquira MD, Jose Carneiro MD, Robert O. Kelley PhD, Lange Medical Books, Mc Graw-Hill , 2003.
Daerah kortikal dari indung telur 1.Ovary dikelilingi oleh epitel germinal & oleh tunika albuginea 2.Groups folikel primordial, masingmasing dibentuk oleh oosit dikelilingi oleh lapisan sel 3.follicular datar, yang hadir dalam jaringan ikat indung telur (stroma). Giemsa stain. Pembesaran rendah. Picture taken from Basic Histology Text & Atlas , 10th edition, L. Carlos Junquira MD, Jose Carneiro MD, Robert O. Kelley PhD,
Perkembanga n folikel
Ovarian follicle
Primordial f ol li c le s •
1.Located di korteks hanya di bawah tunika albuginea. 2.One lapisan sel folikel rata mengelilingi oosit (sekitar 30 μm diameter). 3.the inti oosit diposisikan eksentrik dalam sel. Tampaknya sangat ringan dan berisi Nukleolus terkemuka. Sebagian besar dari agregat organel oosit di tengah sel, di mana mereka membentuk tubuh vitelline (mungkin tidak terlihat dalam salah satu persiapan yang tersedia).
Dibentuk oleh: sebuah oosit & satu lapisan dari cuboidal sel granulosa
Pararosaniline – toluidine blue (PT) stain. Low magnification.
Formed by: An Oocyte & flat follicular cells
Picture taken from Basic Histology Text & Atlas, 10th edition, L. Carlos Junquira MD, Jose Carneiro MD, Robert O. Kelley PhD, Lange Medical Books, Mc Graw-
Th e p r i m ar y f o l l ic l e •
Morfologi Tahap pertama yang menandai awal pematangan folikel Sel oosit sebelumnya rata sekitar sekarang membentuk epitel cuboidal atau kolumnar sekitar oosit. Sitoplasma mungkin memiliki penampilan granular (sel granulosa). Perkembangan lanjutan dari sel-sel akan menghasilkan pembentukan epitel berlapis (dengan membran basal berbeda) yang mengelilingi oosit. The zona pellucida (glikoprotein antara proses interdigitating dari oosit dan sel granulosa) menjadi terlihat. sel parenkim dari ovarium sekitar folikel tumbuh menjadi terorganisir di bungkus konsentris, yang folliculi teka.
S ec o n d ar y f o l l ic l e •
ruang kecil berisi cairan menjadi terlihat antara sel granulosa sebagai folikel mencapai diameter sekitar 400 μm. Memperbesar ruang tersebut dan sekering untuk membentuk antrum folikuler (fitur mendefinisikan dari folikel sekunder). oosit ini sekarang terletak eksentrik di folikel di oophorus kumulus, mana dikelilingi oleh sel granulosa. The teka folliculi membedakan dengan pertumbuhan lanjutan dari folikel menjadi teka internasional dan teka eksterna. _Vascularization Dari teka internasional meningkatkan _The sel berbentuk gelendong atau polyhedral dalam lapisan ini mulai memproduksi estrogen. _The Teka eksterna mempertahankan karakteristik dari jaringan ikat yang sangat seluler dengan sel otot polos. Oosit sekunder dari folikel mencapai diameter sekitar 125 μm. Folikel sendiri mencapai diameter sekitar 10-15 mm.
A small part of wall of antral follicle: • Antrum •Granulosa cells •Thecas interna & externa • A basement membrane separates the granulosa layer from the theca interna.
An antral follicle: • Oocyte surrounded by granulosa cells of corona radiata & supported by cumulus oophorus. • The remaining granulosa cells form wall of follicle & surround large antrum. • A theca surrounds the whole follicle.
PT stain. High magnification.
M at u r e o r t e r t ia r y o r p r e o v u l a t o r y o r G r a af i a n f o l l i c l e • •
Increases further in size (in particular in the last 12h before ovulation). The Graafian follicle forms a small "bump" on the surface of the ovary, the stigma (or macula pellucida). –
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Prior to ovulation the cumulus oophorus separates from the follicular wall. The oocyte : floating freely in the follicular antrum. –
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The stigma is characterised by a thinning of the capsule and a progressive restriction of the blood flow to it.
It is still surrounded by granulosa cells which form the corona radiata.
The follicle finally ruptures at the stigma and the oocyte is released from the ovary
Atresia •
Atresia adalah nama untuk proses degeneratif dimana oosit (dan folikel) binasa tanpa telah diusir oleh ovulasi. Hanya sekitar 400 oosit ovulasi - sekitar 99,9% dari oosit yang mana hadir pada saat pubertas mengalami atresia. Atresia mungkin efek oosit pada semua tahap dari "hidup mereka" - baik sebelum lahir dan postnatally. Pada bulan keenam kehamilan sekitar 7 juta oosit dan oogonium yang hadir dalam ovarium. Pada saat lahir jumlah ini berkurang menjadi sekitar 2 juta. Dari jumlah tersebut hanya sekitar 400,000 bertahan hingga pubertas. Atresia juga modus penghancuran pematangan folikel yang dimulai selama Siklus (10-15) tetapi yang tidak berovulasi. Atresia adalah operasi sebelum pubertas untuk menghilangkan folikel yang mulai jatuh tempo selama periode ini (tidak ada yang berovulasi). Mengingat bahwa atresia folikel mempengaruhi pada berbagai tahap perkembangan mereka jelas bahwa proses tersebut dapat mengambil cukup beragam penampilan histologik
1. Loss of cells of corona radiata 2. Oocyte floating free within antrum
3. Death of granulosa cells, many of which are seen loose in antrum
PT stain. Medium magnification Picture taken from Basic Histology Text & Atlas , 10th edition, L. Carlos Junquira MD, Jose Carneiro MD, Robert O. Kelley PhD,
The Corpus luteum The wall of the follicle collapses into a folded structure (characteristic for the corpus luteum). Vascularization increases Connective tissue network is formed. Theca interna cells and granulosa cells triple in size and start accumulating lutein within a few hours after ovulation (granulosa lutein cells and theca lutein cells and produce progesterone and oestrogens) Hormone secretion in the corpus luteum ceases within 14 days after ovulation if the oocyte is not fertilised (the corpus luteum degenerates into a c o r p u s a lb i c a n s whitish scar tissue within the ovaries). Hormone secretion continues for 2-3 month after ovulation if fertilisation occurs.
Corpus luteum
Corpus Luteum
Corpus Luteum
Corpus albicans
Corpus albicans
Oviduct •
-Fungsi: sebagai sarana bagi oosit, dari ovarium ke rahim. -Histologis: _the saluran telur terdiri dari: 1 a mukosa dan muskularis. 2 peritoneal Permukaan saluran telur dibatasi oleh serosa dan jaringan ikat yg terletak di bawah.
Oviduct mukosa yang Dibentuk oleh epitel silia dan sekresi beristirahat pada lamina propria yang sangat selular. Jumlah sel silia dan sel sekretori bervariasi di sepanjang saluran telur (lihat di bawah). Aktivitas Sekretori bervariasi selama siklus menstruasi, dan beristirahat sel sekretori juga disebut sebagai pasak-sel. Beberapa substansi yang dikeluarkan diperkirakan memelihara oosit dan embrio sangat awal. The muskularis Terdiri dari lapisan otot dalam lingkaran dan lapisan longitudinal luar. Lapisan longitudinal dalam hadir di tanah genting dan bagian intramural (lihat di bawah) saluran telur. tindakan otot peristaltik tampaknya lebih penting untuk pengangkutan sperma dan oosit
Oviduct •
1 infundibulum: berbentuk corong (hingga 10 mm diameter) akhir saluran telur. - Finger ekstensi seperti margin nya, fimbriae, adalah erat diterapkan pada ovarium. - Sel berbulu mata yang sering. silia mengalahkan mereka ke arah 2 ampula saluran telur. - Lipatan mukosa, atau plicae, dan lipatan sekunder yang timbul dari plicae yang membagi lumen ampula ke dalam bentuk yang sangat kompleks. - Pemupukan biasanya terjadi di ampula tersebut. 3 tanah genting ini adalah bagian sempit (2-3 mm) dari bagian-bagian saluran telur yang terletak dalam rongga peritoneal. - Mukosa lipatan kurang kompleks dan muskularis yang tebal. Lapisan, dalam otot longitudinal hadir di tanah genting dan 4 intramural bagian dari saluran telur, yang menembus dinding rahim. mukosa adalah halus, dan diameter bagian dalam saluran sangat kecil.
Uterine Tube
Three layers: •
Mucosa
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Muskularis
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Serosa
Picture taken from Basic Histology Text & Atlas , 10th edition, L. Carlos Junquira MD, Jose Carneiro MD, Robert O. Kelley PhD, Lange Medical Books, Mc Graw-Hill , 2003.
Wall of an oviduct •
Sangat melipat mukosa menunjukkan bahwa daerah ini dekat dengan ovarium. PT stain Pembesaran rendah.
Oviduct Epithelial • sel berbulu mata berkontribusi terhadap pergerakan oosit atau konsepsi ke uterus PT noda. Pembesaran tinggi.
Oviduct
The Uterus •
The uterus is divided into 1. Body (upper two-thirds) and 2. Cervix
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The walls of the uterus are composed of a – – –
Mucosal layer (the endometrium) A fibromuscular layer (the myometrium). The peritoneal surface of the uterus is covered by a serosa
Phases on Menstrual Cycle UTERUS
The Uterus
Myometrium The muscle fibres of the uterus form layers with preferred orientations of fibres (actually 4), but this is very difficult to see in most preparations. The muscular tissue hypertrophies during pregnancy, and GAP-junctions between cells become more frequent.
The Uterus Endometrium Consists of a simple columnar epithelium (ciliated cells and secretory cells) and an underlying thick connective tissue stroma. The mucosa is invaginated to form many simple tubular uterine glands. The glands extend through the entire thickness of the stroma. The stromal cells of the endometrium are embedded in a network of reticular fibres. The endometrium is subject to cyclic changes that result in menstruation. Only the mucosa of the body of the uterus takes part in the menstrual cycle
The Uterus • Endometrium –
The endometrium can be divided into two zones based on their involvement in the changes during the menstrual cycle: the basalis and the functionalis . • The basalis is not sloughed off during menstruation but functions as a regenerative zone for the functionalis after its rejection. • The functionalis is the luminal part of the endometrium. It is sloughed off during every menstruation and it is the site of cyclic changes in the endometrium. These cyclic changes are divided into a number of phases: proliferative (or follicular), secretory (or luteal), and menstrual .
Straight uterine glands in deep endometrium during proliferative phase. Smooth muscle of myometrium is also seen. H&E stain. Medium magnification
The surface epithelium & uterine glands are embedded in a lamina propria made of very loose connective tissue. PT stain. Medium magnification.
Uterine glands during luteal phase uterine glands become tortuous and their lumen is filled with secretions. Some edema is present in the connective tissue. H&E stain. Medium magnification.
Cervix •
TRANTITIONAL EPITHELIUM (T zone) GOES FROM SQUAMOUS (ectocervix) TO SECRETING (UTERINE GLANDS) COLUMNAR EPITHELIUM (endocervix).
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VISCOUS OF MUCUS GLANDS CHANGES WITH MENSTRUAL CYCLE
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CERVIX TO VESTIBULE
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MULTILAYERED –
MUCOSAL •
FOLDS OF STRATIFIED EPITH
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NOT KERATINIZED BUT KERATOHYALIN GRANULES MAY BE VISIBLE
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NO GLANDS BUT CELLS ARE HIGH IN GLYCOGEN
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MUCUS COMES FROM CERVICAL GLANDS
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MUSCULARIS-SMOOTH MUSCLE
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ADVENTITIAL
Cervix
Structure of the ectocervix: CT=connective tissue, BM=basement membrane, L1=basal cells (1 layer), L2=parabasal cells (2 layers), L3=intermediate cells (around 8 layers), L4=superficial cells (5 or 6 layers) and
Normal endocervix: epithelium composed of one layer of mucin secreting cells with few reserve cells (arrow).
Ectocervix
- details of S t r u c t u r e o f t h e ec t o c e r v i x
: Structu re of the ectocervix
basal, parabasal & intermediate layers: connective tissue, basal cells (one layer), parabasal cells (two layers), intermediate cells (some layers) with inter-cellular bridges. The N/C ratio of basal & parabasal
details of the superficial layers : superficial cells (5 or 6 layers). The N/C ratio is very low and the axis of cells is parallel to the basement membrane
Transformation Zone
: normal Tr a n s f o r m a t i o n z o n e
squamous epithelium (red star), squamous metaplasia (green star) with some remaining endocervical cells (blue arrow)
Tr a n s f o r m a t io n z o n e : squamous
epithelium islet in the endocervix area. All cervix pictures downloaded from : http://screening.iarc.fr/atlasglossdef.p
Different types of squamous cells - A: superficial cells (arrows); B: intermediate cells; C: parabasal cells; D:
Vagina •
The vagina is a fibromuscular tube with a wall consisting of three layers: –
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Mucosa • The stratified squamous epithelium (deep stratum basalis, intermediate stratum spinosum, superficial layers of flat eosinophilic cells which do contain keratin but which do not normally form a true horny layer) rests on a very cellular lamina propria (many leukocytes). Towards the muscularis some vascular cavernous spaces may be seen (typical erectile tissue). Muscularis • Inner circular and outer longitudinal layers of smooth muscle are present. Inferiorly, the striated, voluntary bulbospongiosus muscle forms a sphincter around the vagina. Adventitia • The part of the adventitia bordering the muscularis is fairly dense and contains many elastic fibres. Loose connective tissue with a prominent venous plexus forms the outer part of the adventitia.
Stratified squamous epithelium of vagina supported by a dense connective tissue. The cytoplasm of these epithelial cells is clear because of accumulated glycogen. PSH stain. Medium magnification.
Female Accessory Reproductive Glands Mammary Glands • • • • • • • •
The mammary glands are modified glands of the skin (resembles that of sweat glands). Compound branched alveolar glands, which consist of 15-25 lobes separated by dense interlobar connective tissue and fat (Each lobe contains an individual gland) The excretory duct of each lobe, also called lactiferous duct , has its own opening on the nipple. The lactiferous duct has a two layered epithelium - basal cells are cuboidal whereas the superficial cells are columnar. Beneath the nipple, the dilated lactiferous duct forms a lactiferous sinus , which functions as a reservoir for the milk. Branches of the lactiferous duct are lined with a sim ple cuboidal epithelium. The secretory units are alveoli, which are lined by a cuboidal or columnar epithelium. A layer of myoepithelial cells is always present between the epithelium and the basement membrane of the branches of the lactiferous duct and the alv eoli .
Breast
Mammary Gland
Pregnancy
Placenta
Placenta
Placenta
Placenta •
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The placenta may be usefully understood as a "parasite" feeding on blood from the endometrium (Imagine scooping out a portion of the endometrium). The resulting bowl will fill with blood from broken vessels in the endometrial stroma. Now lay a cover over the bowl, and imagine many "roots" extending down from the cover into the blood-filled hollow (the roots can absorb oxygen and nutrients from the blood in which they are bathed).
Placenta • •
The cover is the chorionic plate of the placenta. The "roots" are the chorionic villi. – Both the placenta and the chorionic villi are entirely fetal tissue (orange in the diagram above). – "Anchoring villi" attach the placenta to the endometrium. – Smaller branching villi extend out into the intervillous space. – Fetal circulation passes down the umbilical cord, though vessels in the villi, and back up the umbilical cord. – Maternal blood "spills" from open endometrial arteries (the spiral arteries) into the intervillous space (pink in the diagram above), and returns into endometrial veins. – The chorionic villi are surrounded and bathed by "lakes" of maternal blood. Within the intervillous space, maternal blood is not contained by blood vessels – The surface of the chorionic villi is an epithelial layer, the fetal syncytiotrophoblast , which has the ability to grow invasively into the maternal endometrium. The syncytiotrophoblast also has microvilli on the surface for absorbing nutrients from maternal blood. – Beneath the syncytiotrophoblast (i.e., toward the core of the villus), is the cytotrophoblast, a layer of cuboidal cells which eventually disappear. (The cytotrophoblast also forms trophoblast columns, masses of cells filling the ends of anchoring villi.) – Maternal endometrial stromal tissue adjacent to the placenta differentiates into large decidual cells (so named because the outer layer of the endometrium is shed at birth along with the placenta). Decidual cells may intermix with fetal cells in the cytotrophoblast. The boundary between maternal and fetal tissue is
Umbilical Cord •
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The umbilical cord is simply a conduit carrying fetal blood between the fetus and the placenta. It normally contains two arteries and one vein, surrounded by extensive mesenchymal tissue ("Wharton's jelly"). Consists of so-called "mucous" or mesenchymal connective tissue, also called Wharton's jelly (widely scattered mesenchymal fibroblasts within soft, jelly-like ground substance of hyaluronic acid and chondroitin sulfate) Surrounded by a thin stratified squamous epithelium and including typically two arteries and one vein. [The second vein in this image presumably represents one portion of a double U-shaped bend in this single vein.] The arteries lack internal and external elastic layers.
Umbilical Cord
