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Autonomic innervation of the abdominal and pelvic organs. The cartilage tissue. Fetal
membranes. Umbilical cord. Amniotic fluid. Fetal circulation.
1. Vagus nerve
2. Pelvic splanchnic nerve (S2-4)
o only splanchnic n that carry PNS fibers
o all others have SNS fibers
o contribute to formation of pelvic (inf hypogastric) plexus, supply => desc colon,
sigmoid colon, other viscera in pelvis and perineum
• These project to the paravertebral plexuses, which are situated anterior to the aorta
and vertebral column.
Paravertebral Plexuses
Coeliac Plexus
• This contains the paired coeliac ganglia and is located at the level of the last
thoracic and 1st lumbar vertebra.
• It surrounds the root of the coeliac trunk and the superior mesenteric artery.
• The coeliac ganglia are paired structures, which lie between the suprarenal glands
and the coeliac trunk origin.
• The lower part is partially detached and is sometimes referred to as the aorticorenal
ganglion as it forms most of the renal plexus.
• Secondary plexuses derived from or connected to the coeliac are the phrenic, splenic, left
gastric, intermesenteric (aortic), suprarenal, renal, gonadal, superior mesenteric and
inferior mesenteric.
Phrenic Plexus
• This accompanies the inferior phrenic artery to the diaphragm and suprarenal gland.
Hepatic Plexus
• This is the largest coeliac derivative and receives filaments from both the right and left
vagus as well as from the phrenic nerves.
• It accompanies the hepatic artery and the portal vein and their branches and also supplies
the cystic plexus to the gallbladder.
• Branches may also supply the pylorus, greater curvature of stomach as well as the lower
bile duct, pancreatic head and 1st and 2nd part of duodenum.
Splenic Plexus
• This is formed by branches of the coeliac plexus, left coeliac ganglion and the
right vagus.
• It supplies the blood vessels and smooth muscles of the splenic capsule and
trabeculae.
Suprarenal Plexus
Renal Plexus
• This is formed by fibres from the coeliac ganglion and plexus, aorticorenal
ganglion, lowest thoracic splanchnic nerves, 1st lumbar splanchnic nerve
and the aortic plexus.
• It gives off the ureter and gonadal plexuses (ovarian or testicular).
• The ureteric plexus accompanies the ureter and the gonadal plexuses accompany the
appropriate artery to the respective organs.
• This supplies the IVC, and testicular plexuses as well as connecting the superior and
inferior mesenteric plexuses.
• This receives supply from the aortic plexus and 2nd and 3rd lumbar splanchnic
nerves.
• It supplies the colon from the left trisection of the transverse colon to the rectum.
• This is situated anterior to the aortic bifurcation, L5 and the sacral promontory.
• This plexus is formed from branches of the aortic plexus, 3rd and 4th lumbar
splanchnic nerves.
• It divides into the left and right hypogastric nerves, which descend to the 2 inferior
hypogastric plexuses, which lie anterior to the sacrum.
o lies in extraperitoneal CT lat to rectum
o sends br to sigmoid, desc colon
• located retroperitoneally
• has preggl/post ggl SNS fibers, visc aff fibers + PNS fibers (few), which may run a
recurrent course thru inf hypogastric plexus
• This is formed from the pelvic splanchnic nerves (from the sacral plexus, S2-4) and
also receives the sacral splanchnic nerves., and hypogastric n
• lies against post/lat pelvic wall
• lat to rectum, vagina, base of bladder
• contains pelvic ggl = where SNS, PNS preggl fibers synapse
• Several plexuses arise from the inferior hypogastric plexuses, including:
Fetal Membranes
Around the beg of 2nd month, villi system in trophoblast layer consists mostly of sendary &
tertiary villi
Villi system covers the entire span of chorion @ early stages of development
However, w/ time changes will occur on diff poles of the embryo
1. villi on embryonic pole will continue to grow creating = chorion frondosum –> fetal portion
of placenta
2. villi on abembryonic pole will degenerate leaving a smooth side = chorion laeve
From maternal side, b/w 3 deciduas which are functional layers of endometrium
1. Decidua basalis – in contact w/ chorion frondosum, decidual cells w/ lipids, glycogen
2. Decidua capsularis – covering abembryonic pole, will later degenerate when embryo grows
3. Decidua parietalis – covering opp side of uterine wall, will fuse w/ amnion & chorion laeve
Once amnion/chorion laeve unite – they form amniochroionic membrane which destroys
chorionic cavity
Umbilical Cord
@ 5th week, opening can be found connecting amnion & ectoderm = primitive umbilical ring
Contains:
a) Yolk sac stalk (= vitelline duct) along w/ vitelline vessels
b) Canal connecting intra/extra embryonic cavities
c) Connecting stalk: allantois, umbilical vessels (2 arteries, v)
During growth of abdominal organs, abdominal cavity isn’t big enough for organs, so intestinal
loops push into umbilical cords = umbilical herniation
Come out again @ end of 3rd month
vitelline vessels are obliterated
Only umbilical vessels, and Wharton’s jelly left inside – jelly has many PGs, and protects the
a/v
Amniotic fluid
formed by amnioblasts (cells from epiblast that line amniotic cavity) & maternal blood
replaced every 3 hours – sterile because waste products are filtered out
Function:
• shock absorbance
• prevents adhesion of embryo to amnion
• allows fetal movement
@ fifth month, organ systems begins to function, fetus swallows the amniotic fluid, also
produces urine into it (which is mostly water – as mentioned b4 placenta filiters it out)
Fetal Circulation
• Introduction
• Throughout the fetal stage of development, the maternal blood supplies the fetus with O2
and nutrients and carries away its wastes.
o These substances diffuse between the maternal and fetal blood through the
placental membrane.
o They are carried to and from the fetal body by the umbilical blood vessels.
• Adaptations of fetal blood and vascular system.
• The concentration of hemoglobin in fetal blood is about 50 % greater than in maternal
blood.
• Fetal hemoglobin is slightly different chemically and has a greater affinity for O2 than
maternal hemoglobin.
o At a particular oxygen partial pressure, fetal hemoglobin can carry 20-30% more
O2 than maternal hemoglobin.
• In the fetal circulatory system, the umbilical vein transports blood rich in O2 and
nutrients from the placenta to the fetal body.
o The umbilical vein enters the body through the umbilical ring and travels along
the anterior abdominal wall to the liver.
About 1/2 the blood it carries passes into the liver.
The other 1/2 of the blood enters a vessel called the ductus venosus which
bypasses the liver.
o The ductus venosus travels a short distance and joins the inferior vena cava.
There, the oxygenated blood from the placenta is mixed with the
deoxygenated blood from the lower parts of the body.
This mixture continues through the vena cava to the right atrium.
o In the adult heart, blood flows from the right atrium to the right ventricle then
through the pulmonary arteries to the lungs.
In the fetus however, the lungs are nonfunctional and the blood largely
bypasses them.
o As the blood from the inferior vena cava enters the right atrium, a large
proportion of it is shunted directly into the left atrium through an opening called
the foramen ovale.
A small valve, septum primum is located on the left side of the atrial
septum overlies the foramen ovale and helps prevent blood from moving
in the reverse direction.
o The rest of the fetal blood entering the right atrium, including a large proportion
of the deoxygenated blood entering from the superior vena cava passes into the
right ventricle and out through the pulmonary trunk.
Only a small volume of blood enters the pulmonary circuit, because the
lungs are collapsed, and their blood vessels have a high resistance to flow.
Enough blood reaches the lung tissue to sustain them.
o Most of the blood in the pulmonary trunk bypasses the lungs by entering a fetal
vessel called the ductus arteriosus which connects the pulmonary trunk to the
descending portion of the aortic arch.
As a result of this connection, the blood with a relatively low O2
concentration which is returning to the heart through the superior vena
cava, bypasses the lungs.
At the same time, the blood is prevented from entering the portion of the
aorta that provides branches leading to the brain.
o The more highly oxygenated blood that enters the left atrium through the
foramen ovale is mixed with a small amount of deoxygenated blood returning
from the pulmonary veins.
This mixture moves into the left ventricle and is pumped into the aorta.
Some of it reaches the myocardium through the coronary arteries
and some reaches the brain through the carotid arteries.
o The blood carried by the descending aorta is partially oxygenated and partially
deoxygenated.
Some of it is carries into the branches of the aorta that lead to various parts
of the lower regions of the body.
The rest passes into the umbilical arteries, which branch from the
internal iliac arteries and lead to the placenta.
There the blood is reoxygenated.
• The Newborn
• The initial inflation of the lungs causes important changes in the circulatory system.
• Inflation of the lungs reduces the resistance to blood flow through the lungs resulting in
increases blood flow from the pulmonary arteries.
o Consequently, an increased amount of blood flows from the right atrium to the
right ventricle and into the pulmonary arteries and less blood flows through the
foramen ovale to the left atrium.
• In addition, an increased volume of blood returns from the lungs through the pulmonary
veins to the left atrium, which increases the pressure in the left atrium.
o The increased left atrial pressure and decreased right atrial pressure (due to
pulmonary resistance) forces blood against the septum primum causing the
foramen ovale to close.
o This action functionally completes the separation of the heart into two pumps–
right and left sides of the heart.
• The remnant of the umbilical vein becomes the round ligament of the liver and the
ductus venosum becomes the ligamentum venosum.
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39. Bones, muscles and ligaments of the pelvis. The blood
vessels and nerves of the pelvis. The bone tissue.
Gastrulation, early differentiation of the
intraembryonic mesoderm
Posted in Pelvis by Sahaja on January 9, 2009
39. Bones, muscles and ligaments of the pelvis. The blood vessels and nerves of the pelvis.
The bone tissue. Gastrulation, early differentiation of the intraembryonic mesoderm
Flash Cards:
Bones of Pelvis
Bones of Pelvis 2 - sciatic foramens
Anatomy: Bones, muscles and ligaments of the pelvis. The blood vessels and nerves of the
pelvis.
1. Pubic symphyis
2. Iliac crest
3. Ant sup iliac spine (attachment of inguinal lig, plus part of way to find McBurney’s
pt)
4. Greater/Lesser sciatic forament
5. sacral promontory
6. ischio pubic rami
7. inf pubic rami
8. obturator foramen
9. acetabulum
10. ischial spine
11. ischial tuberosities
Pelvic Girdle
Pelvic Outlet
• ant = inf border of pubic symphysis, arcuate ligament, inf pubic rami (making subpubic
angle)
• lat = ischial tuberosities, sacrotuberous ligaments
• closed off by pelvic and urogenital diaphragms
• piriformis – triangular shaped m, can identify b/c the tendon will go to gr. trochanter of
femur, and you will sciatic n emerge below it
• ob internus m – can identify b/c only n. running to obturator foramen on the inside of
pelvic cavity, will wrap around and cover the obturator foramen
• pelvic diaphragm = coccygeus + levator ani m – point to muscles that attach to coccyx
• UG diaphragm = deep transverse perineal m, fascia *may not be able to show this*
Major Ligaments of Pelvis — good time to mention what goes thru gr/lsr sciatic foramen
Greater Sciatic notch is split into 2 sciatic foramen via sacrospinous/ sacrotuberous ligament
• Piriformis
• sup/inf gluteal a/v/n
• sciatic n * show this*
• post femoral cut n
• int pudendal a/v
• pudendal n
NOTE – Piriformis m further separates the greater sciatic foramen into a supra/infrapiriformic
hiatus.
The only structures that go thru suprapiriformic hiatus = sup gluteal a/v/n (Supra
=superior)
CLINICAL NOTE – Because of the emergence of these structures, anasthesia can only be given
in the upper R quadrant of the gluteal region, so as not to paralyze any nerves, or harm blood
supply
• Ob internus
• Int pudendal a/v
• pudendal n
Remember: the pudendal structures come out of the greater sciatic foramen–> then turn around
the ischial spine –> back in thru lesser sciatic foramen –> to Alcock’s canal running in the fascia
over obturator int m in ischioanal fossa
A. Int Iliac a – @ bifurcation of common iliac a, in front of sacroiliac joint, crossed in front by
ureter @ pelvic brim
2. Lat sacral a – passes med, in front of sacral plexus, runs immediately to sacrum
- spinal br (goes thru ant sacral formina) => spinal meninges, roots of sacral n, musc/skin
overlying the sacrum
2. Int pudendal a – leaves pelvis thru gr sciatic foramen, b/w piriformis & coccygeis –>
perineum via lesser sciatic foramen
3. Umbilical a- v. tortous a, runs along lat pelvic wall & along the side of bladder
a) Prox part –> sup vesicle a => sup bladder
a of ductus deferens => DD, seminal vesicle, lower ureter, bladder
b)Distal part –> becomes obliterated, & goes forward as medial umbilical ligament
5.Inf vesical a (M, vaginal a in F) => prostate, fundus of bladder, DD, seminal vesicle, lower
ureter
7.Middle rectal a – run med => musc layer of lower rectum & upper anal canal, prostate gland,
ureter (seminal vesicles, vagina)
B. Median sacral a
unpaired a, arising from post aspect of abdominal aorta just before bifurcation
desc in front of sacrum => post rectum, end in coccygeal body as small vascular mass in front of
tip of coccyx
1.Sup gluteal n (L4-5) – leaves pelvis thru gr sciatic foramen, suprapiriformic hiatus
=> gluteus medius,minimus, tensor fascia lata
2.Inf gluteal n (L5-S2) - leaves pelvis thru gr. sciatic foramen => glut max m
7. Pudendal n (S2-S4)
leaves pelvis thru gr sciatic foramen below piriformis –> perineum, thru lesser sciatic foramen
=> bulbospongiosus, ischiocavernosus, sphincter urethrae, deep/sup transverse perineal m
8. Br to pelvis
• n to piriformis (S1-2)
• n to levator ani + coccygeus m (S3-4)
• n to sphincter ani
• pelvic splanchnic n
Gastrulation
3. Lateral Mesoderm
5. Cardiogenic region
Tagged with: cloacal membrane, gastrulation, intermediate mesoderm, lateral plate mesoderm,
para axial mesoderm, prechordal plate, primitive node, primitive pit, primitive streak, primtive
pit, somites, urogenital ridge
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38. The perineum. The formation of the placenta. The structure of the matured placenta.
Flash cards:
Perineum - Anatomy Topic Notecard - Right Click and select "View this Image" to see it larger
Anatomy Topic Notecard - Right Click and select "View this Image" to see it larger
Perineum 2 - Anatomy Topic Notecard - Right Click and select "View this Image" to see it larger
Perineum
diamond shaped space w/ same boundaries as pelvic outlet
inf to pelvic diaphragm (& UG diaphragm)
Borders
1. Skin
2. subcutaneous adipose tissue
3. Superficial perineal fascia
4. Superficial perineal space
o bulb/crura of penis/clitoris
o sup transverse perineal m
o ischiocavernosus m
o bulbospongiosusm
o a/v/n
5. UG diaphagm
o Inferior fascia of UG diaphragm = deep perineal fascia = perineal membrane
o deep transverse perineal m (post) + sphincter urethra (ant)
o superior fascia of UG diaphragm
6. Deep perineal space – ant continuation of ischio-anal fossa, has pudendal canal
7. Pelvic diaphragm
o inferior fascia of levator ani m
o levator ani m
o superior fascia of levator ani m
8. Lesser pelvis
NOTE = Inf fascia of UG diaphragm is the SAME AS deep perineal fascia is SAME AS =
perineal membrane
Urogenital Triangle
A. Superficial perineal space
b/w inf fascia of UG diaphragm & membranous layer of sup perineal fascia (Colles’)
1. Colles fascia
2. Perineal Membrane
Action of musc:
(M) = compress bulb of penis, stop venous return –> keep erection,
contraction of corpus spongiosum –> expel urine or semen
(F) = compress eretile tissue of bulb of vestibule –> constrict vaginal orifice
Bulbourethral Glands
lie b/w fibers of sphincter urethrae in deep perineal space
on post/lat side of membranous urethra
ducts pass thru inf fascia of UG diaphragm to open into bulbous part of penile urethra
b) Sphincter Urethrae m
Inf pubic ramus –> median raphe and perineal body
surrounds the body of membranous urethra in male
inf part = attached to ant/lat wall of vagina (F) = urethrovaginal sphincter that compresses
urethra and vagina
Anal Triangle
the Post triangle - everything posterior to the line b/w 2 ischial tuberosities
Ischioanal fossa
space lateral to rectum-anal canal, & medial to by levator ani & its fascia that lines the pelvis
Borders:
Contents:
• ischioanal fat
• inf rectal a/v/n (from int pudendal a, pudendal n)
• perineal br of post femoral cut n
On lateral wall, running through obturator fascia = Alcock’s canal aka pudendal canal
• contains pudendal n
• int pudendal a/v
Pelvic Diaphragm
= levator ani m + coccygeus m
divides pelvis into 2 compartments:
1. superior = w/ viscera
2. inf = ischiorectal fossa
Pelvic Diaphragm
Nerve Supply:
• Pudendal n (S2-4) -
o passes thru gr. sciatic foramen, b/w piriformis & coccygeus m –> crosses ischial
spine & enters perineum w/ int pudendal a
o thru lesser sciatic foramen –> pudendal canal
o Gives rise to:
inf rectal n – several br. in canal, crosses ischio-anal fossa => sphincter ani
ext m, skin around anus
perineal n – arises in canal
deep br => all perineal m
sup br => br to scrotum, labia majora
• Deep dorsal n - thru perineal mem b/w 2 layers => skin, foreskin, glans
o lies on dorsum of clitoris or penis
Blood Supply::
• Int pudendal a – leaves pelvis thru gr. sciatic foramen below piriformis & coccygeus m
–> enters perineum via lesser sciatic foramen around ischial spine
o Branches:
Inf rectal a - w/ in canal, thru wall of it, br => m and skin around anal
canal
perineal a – => superficial perineal m, transv perineal br, post
scrotal/labial br
a of bulb => bulb of penis, bulbourethral glands (M), vestibular bulbs &
gr vestibular glands (F)
urethral a – corpus spongiosum, glans of penis
deep a – pierce perineal mem –> run thru center of corpus cavernosum =>
erectile tissue of penis & clitoris
dorsal a – pierce perineal mem & pass thru suspensory lig of
penis/clitoris, runs along dorsum on each side of deep dorsal v and deep to
Buck’s fascia & superficial to tunica albuginea => glans & foreskin
• Ext pudendal a- from femoral a
o runs thru saphenous ring & passes med over spermatic cord (or round ligament of
uterus)
o => skin above pubis, penis, scrotum or labia majora
• Veins of pelvis
o deep dorsal v -
unpaired veins, that begins in sulcus behind glans & lies in dorsal
midline ,
deep to Buck’s fascia & sup to tunica albuginea –> leaves perineum thru
gap b/w arcuate pubic lig & transv. perineal lig –> suspensory lig, below
arcuate pubic ligament and drains into –> prostatic and pelvic venous
plexus
o sup dorsal v – runs toward pubic symphysis b/w sup & deep fascia in dorsum of
penis
divides into R & L br,
terminates in sup pudendal v –> drains into gr. saphenous v
Lymph Drainage:
1.
–> common iliac l.n. –> lumbar nodes
o follows int iliac v –> int iliac nodes –> lumbar nodes
o Int iliac nodes -rec upper part of rectum, vagina and other pelvic organs
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37. The anatomy, histology and development of the penis.
Posted in Pelvis by Sahaja on January 7, 2009
Anatomy of Penis
Anatomy Topic Notecard - Right Click and select "View this Image" to see it larger
Anatomy Topic Notecard - Right Click and select "View this Image" to see it larger
Penis
covered by sup/deep fascia of penis
• Fundiform lig – from linea alba & membranous layer of sup fascia of abdomen –> splits
into L& R parts –> encircles body of penis –> blends w/ superficial penile fascia –>
scrotum septum
• Suspensory lig of penis – pubis symphysis and arcuate pubic lig –> deep fascia of penis
or body of clitoris
o lies deep to fundiform lig
• Deep fascia of penis (Buck’s fascia) – continuation of deep perineal fascia, cont w/
fascia covering ext oblique m & rectus sheath
• Tunica albuginea – dense fibrous layer that envelopes both corpora cavernosa & corpus
spongiosum
o very dense around corpus cavernosa –> impede venous return & result in extreme
rigidity of structures when erectile tissue become engorged w. blood
o more elastic around spongiosum, therefore not turgid during erection, permist
passage of ejaculate
• Tunica vaginalis – double serous membrane, peritoneal sac @ end of process vaginalis
o covers front and sides of testis and epididymis
o closed sac derived from ab peritoneum, forming innermost layer of scrotum
o parietal layer = adjacent to int spermatic fascia
o visceral layer = adherent to testis & epididymis
Parts:
1. Root
inf ramus of pubis (crus) –> midline of UG diaphragm (bulb) –> penile urethra
located in superficial perineal pouch, b/w perineal membrane sup, and deep perineal fascia inf
Crus of penis = covered by ischiocavernosus m
Bulb of penis = covered by bulbospongiosus m
2. Body (shaft)
3 cavernosus bodies:
2 corpus cavernosa
1 corpus spongiosum
Corpus cavernosum:
3. Glans:
Blood supply:
• br of int pudendal a
o dorsal a – run in space b/w corpora cavernosa, lat to deep dorsal v
o deep a – peirce crura, run w/in corpora cavernosa
supply cavernosus spaces in erectile tissue of corpora cavernosa
gives branches called the helicine a
o a of bulb of penis – supply post corpus spongiosum, bulbourethral gland
• ext pudendal a - supply penile skin
• vein drainage
o dorsal v of penis in deep fascia –> prostatic venous plexus
o superficially, –> superficial dorsal v –> superficial ext pudendal v or lat
pudendal v
Lymph Drainage: superficial lymph nodes
Erection:
1. Deep a of penis –> br into helicine a, that run radially & open into
cavernae
2. Veins (which drain cavernae) are located in periphery of corpus
cavernosum, beside tunica albuginea
3. Helicine a have special smooth m valves = Ebner’s cushions, usually
closed & allows minute amount blood in, drained easily by veins
4. During sexual excitement, Ebner’s cushions open & blood suddenly flow
in and fill up cavernae
5. Blood influx compresses veins, so no blood is drained = ERECTION
6. @ end of erection, Ebner’s cushions close, blood flow dec & vein
compression release –> cavernae empty
Embryology of Penis
• The genital eminence, an external mound arising between the umbilicus and the tail, is
made up of the genital tubercle and the genital swellings.
• The urogenital sinus opens at the base of the genital tubercle, between the genital
swellings.
• These structures form identically in male and female embryos up to 7 weeks gestational
age.
• At 9 weeks of gestational age, and under the influence of testosterone, the genital tubercle
starts to lengthen.
• In addition, the genital swellings (also called the labio-scrotal folds) enlarge and rotate
posteriorly.
• As they meet, they begin to fuse from posterior to anterior.
• As the genital tubercle becomes longer, two sets of tissue folds develop on its ventral
surface on either side of a developing trough, the urethral groove.
• The more medial endodermal folds will fuse in the ventral midline to form the male
urethra.
• The more lateral ectodermal folds will fuse over the developing urethra to form the penile
shaft skin and the prepuce.
• As these two layers fuse from posterior to anterior, they leave behind a skin line: the
median raphe.
By 13 weeks, the urethra is almost complete. A ring of ectoderm forms just proximal to the
developing glans penis. This skin advances over the corona glandis and eventually covers the
glans entirely as the prepuce or foreskin.
grow towards each other and fuse during development to form the scrotum.
Tagged with: erection, penis
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36. The anatomy, histology and development of the ureter, urinary vesicle and
urethra.
Anatomy of the ureter, urinary vesicle and urethra.
Ureter
*retroperitoneal
General Info:
musc tube that transmit urine via peristaltic waves, leads from kidney
is the most posterior structure that emerges from hilus of kidney
25-30 cm long
enter bladder @ anteromedially, superior to levator ani
Topography:
2 parts – abdominal/pelvis
Abdominal
crossed by 3 structures: Topography
1. Gonadal a/v – in front
2. Psoas major – behind
3. Bifurcation of common iliac a w/ ureter in front of int iliac a
Female
Blood Supply:
• rec blood from aorta, renal, gonadal, common & int iliac, umbilical, sup/inf vesicle a,
middle rectal a
• Vesicle venous plexus –> int iliac v (sometimes, prostatic vesicle plexus)
Lymph Drainage: lumbar, common iliac, ext iliac, int iliac l.n
Urinary Bladder
*Infraperitoneal – lower in female
located in pelvis minor when empty
located full, can enter major pelvis –> even up to umbilicus
General Info:
• The features observable on the inside of the bladder are the ureter orifices, the trigone,
and the internal orifice of the urethra.
• The trigone is a smooth triangular region between the openings of the two ureters and the
urethra and never presents any rugae even when the bladder is empty – because this area
is more tightly bound to its outer layer of bladder tissue.
Outer surfaces of the Bladder: The upper and side surfaces of the bladder are covered by
peritoneum (also called “serosa”). This serous membrane of the abdominal cavity consists of
mesthelium and elastic fibrous connective tissue. “Visceral peritoneum” covers the bladder and
other abdominal organs, while “parietal peritoneum” lines the abdomen walls.
• ant = pubic bone, separated from ant ab wall & pelvis by rectopubic space
• inf/lat = obturator int m, levator ani m
• inf/post = rectum
Rectovesicle Pouch:
ant = bladder, seminal vesicle, DD
post = rectum
lat = rectovesicular fold
In male, pertioneum covers fundus, reflecting from upper post wall, and covers tip of seminal
vesicle
Parts of Bladder:
Blood Supply:
Innervation:
Urethra
From bladder –> opens @ perineum, urine emptied thru it
Male Urethra
Parts to it:
1. Prostatic urethra
3 cm long, and w/in prostate
widest part of urethra
covered w/ urothelium = transitional epithelium
The prostatic urethra begins at the neck of the bladder and includes all of the section that
passes through the prostrate gland. It is the widest and most dilatable part of the male urethral
canal.
Seminal colliculus
secretions of prostate, seminal vesicle, and bulbourethral glands mixes w/ spermatozoa from
testis = semen
2. Membranous urethra
1 cm long
passes thru UG diaphragm – here ext urethral sphincter seen
The membranous urethra is the shortest and narrowest part of the male urethra. This section
measures approx. 0.5 – 0.75 inches (12 – 19 mm) in length and is the section of the urethra that
passes through the male urogenital diaphragm.
The external urethral sphincter (muscle) is located in the urogenital diaphragm (as for the
female urethra).
The passage of urine along the urethra through the urogenital diaphragm is controlled by the
external urethral sphincter, which is a circular muscle under voluntary control (that is, it is
innervated by the somatic nervous system, SNS).
3. Penile urethra
enters bulbous part of penis
Pathway: turns up @ sharp angle (1st turn) –> runs along bulb of penis –> to pubic symphysis
–> bends down (2nd turn) –> corpus spongiosum –> runs down to tip of penis & opens @
navicular fossa
The spongy (penile) urethra is the longest of the three sections. It is approx. 6 inches (150 mm)
in length and is contained in the corpus spongiosum that extends from the end of the
membranous portion, passes through the penis, and terminates at the external orifice of the
urethra – which is the point at which the urine leaves the body.
Female urethra
At only about 1.5 inches (35 mm) long, the female adult urethra is shorter than the adult male
urethra (approx. or 8 inches, or 200mm). The female urethra is located immediately behind
(posterior to) the pubic symphysis and is embedded into the front wall of the vagina.
The urethra itself is a narrow membranous canal that consists of three layers:
1. Muscular layer – continuous with the muscular layer of the bladder, this extends the full
length of the urethra.
2. Thin layer of spongy erectile tissue – including plexus of veins and bundles of smooth
muscle fibres. Located immediately below the mucous layer.
3. Mucous layer – internally continuous with the bladder and lined with laminated
epithelium that is transitional near to the bladder.
After passing through the urogenital diaphragm (as shown in the diagram), the female urethra
ends at the external orifice of urethra – which is the point at which the urine leaves the body.
This is located between the clitoris and the vaginal opening.
The passage of urine along the urethra through the urogenital diaphragm is controlled by the
external urethral sphincter, which is a circular muscle under voluntary control (that is, it is
innervated by the somatic nervous system, SNS).
The female urethra is a much simpler structure than the male urethra because it carries only urine
(whereas the male urethra also serves as a duct for the ejaculation of semen – as part of its
reproductive function
upper 1/2 = prostatic urethra
lower 1/2 = “membranous”
@ lower part
goes through UG diaphragm
transverse perineal m wraps around to form = urethro vaginal sphincter
closely associated w/ ant wall of vagina
Process of Urination:
Initiated by (+) of stretch receptors in detrusor m in bladder in wall by inc volume of uring
innervated by S2-4 via pelvic splanchnic n
can be assisted by contraction of abdominal m = inc intra abdominal & pelvic pressures
Process:
1. SNS = (+) relaxation of bladder wall
contract inner sphincter –> (-) emptying
may stimulate detrusor m to prevent reflux of semen into bladder during ejaculation
4. @ end of urination
the ext urethral sphincter ( & bulbospongiosus m in male) contracts
expel the last few drops of urine from urethra
Histology of the ureter, urinary vesicle and urethra.
Structures to Identify:
General Info
• paired tubular structures that convey urine from kidney –> bladder
• lined w/ transitional epith to adapt to changing environment (fluid v no fluid)
Mucosa
• Epith = urothelium
o thick, with cells that change shape
• star shaped irregular lumen, made by mucosal folds, due to musc. contractions
• Note that lumen is long , narrow and star shaped, not circular *like DD
• 3 main cell types of Epith
o umbrella cells – come in contact with urine, and adjust accordingly, can be bi-
nucleated, shape change due to actin filaments
o piriform cells – underneath umbrella cells and above basal cells, can also adjust
morphologically
o basal cells – located at lowest layer of stratified epith
• LP = fibroelastic CT, denser near epith –> looser towards muscularis ext, with diffuse
lymph tissue = MALT
• No real muscularis mucosae
Muscularis Ext
• 3 layers:
o inner longitudinal layer
o middle circular layer
o outer longitudinal – but only in last 1/3 of ureter
• smooth m responsible for creating peristaltic contractions to convey urine through ureter
(30cm)
Adventia
Contracted Bladder - Our slide doesnt look like this, but this shows layers well
Structures to Identify:
• urothelium
• muscularis
• a/v
• CT
• mesothelium
• PNS ggl
General Info
• Receives urine from 2 ureters and under appropriate stimulation, will secrete it through
urethra
• lined by urothelium, which allows bladder to adjust to amount of urine
Mucosa
Muscularis Mucosae
Adventia
• Infraperitoneal
• fundus covered by peritoneum
• serosa/ subserosa can be present where peritoneal pres – superiorly –> simple squamous
= mesothelial cells
• SNS n fibers maybe
Beyond the serosa/adventitia covering of the bladder is perivesical fat. This is a layer of fat
surrounding bladder.
It's upside down - sorry
Structures to
Identify:
• lumen
• corpus spongiosum
• smooth m
• str columnar/ psuedo str columnar
• tunica albuginea
• urethral glands of Littre
• paraurethral ducts
• endo-epith glands
Mucosa
Corpus spongiosum
Ureter:
• intermediate mesoderm forms longitudinal ridge on post body wall = urogenital ridge
• part of UG ridge becomes nephrogenic cord –> urinary system
• nephrogenic cord develops into 3 structures: pronephros, mesonephros, metanephros
• metanephros further develops from ureteric bud and from grouping of mesoderm w/in
nephrogenic cord, metanephric mesoderm
• further development of ureteric bud –> becomes ureters
Urinary bladder:
• urinary bladder is formed from upper end of urogenital sinus, continuous w/ allantois
• allantois becomes fibrous cord = urachus * stays in adult as median umbilical lig
• lower end of mesonephric ducts –> post wall of bladder as trigone
• mesonephric ducts open into urogenital sinus below bladder
• transitional epith from endoderm
Urethra:
Female Urethra:
• female urethra is formed from lower end of urogenital sinus
• develops as endodermal outgrowths into surrounding mesoderm = urethral glands,
paraurethral glands
• end @ vestibule of vagina, also forms from urogenital sinus
• vestibule of vagina – develop endoderm growths = greater vestibular glands
• endoderm = epith
Male Urethra:
Tagged with: basal cells, corpus spongiosum, ducts of littre, infraper, piriform cells,
retroperitoneal, transitional epithelium, tunica albuginea, umbrella cells, Ureter, Urethra, Urinary
bladder, urothelium
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35. The anatomy, histology and development of the seminal vesicle and prostate gland.
Seminal Vesicle:
*Retroperitoneal, except the tip, which is intraperitoneal
General Info:
Topography:
Blood Supply:
Nerve Supply:
SNS - controls rapid contraction, during ejaculation - superior lumbar & hypogastric n
PNS - pelvic splanchnic n, inf hypogastric (pelvic) plexus
Ejaculatory Duct:
General Info:
Topography:
• ant = pelvic wall, musc fibers, has retroperitoneal fat in front of it, b/w it and pubic
symphysis
• post = seminal vesicle, ductus deferens, ampulla of rectum
• sup = bladder
• inf = urethral sphincter, deep perineal m, UG diaphragm, levator ani
Nerve supply:
Both PNS/SNS to contract smooth m
PNS – pelvic splanchnic n (S2-S4)
SNS – inf hypogastric plexus
Structures to Identify:
• prostatic glands
• capsule
• glandular epithelium
• smooth m
• excretory ducts
• prostatic stones
• CT stroma
General Info:
Prostatic Glands
The stroma encircles an area called the seminal collicus, that has no glands
At top of seminal collicus, is located the C shaped urethra, with the utricle underneath.
Ejaculatory ducts open on either side of utricle
*cant see uticle and ejaculatory ducts in slide, but need to know them theoretically
on the lateral sides of the collicus are the prostatic sinuses (the end of the C), where the ducts of
the glands open into.
Structures to Identify:
• epithelium
• LP
• 2 muscular layers = circular, longitudinal
• irregular large lumen, with mucosal folds
• ductus deferens, if seen
General Info:
Secretions contain:
• fructose
• other simple sugars
• amino acids
• ascorbic acids
• prostaglandins (originally discovered in prostate, IMP in inflammatory processes)
Cross section through region of ampulla of DD, so can see both DD and seminal vesicle
Ampulla muscular coat, tinner than rest of DD, and has secretory epithelium
Mucosa
Muscular Layer
Mesonephric duct forms = epididymis, ductus deferens, seminal vesicle, ejaculatory duct,
efferent ducts of testis
Tagged with: ejaculatory duct, infraperitoneal, Prostate, prostatic stones, semen, seminal
collicus, seminal vesicle, sperm, utricle
leave a comment
The anatomy, histology and development of the testis, epididymis and ductus deferens.
Scrotum:
cut pouch of thin pigmented skin and underlying tunica dartos, a facial layer cont w/ superficial
penile fascia and superficial perineal fascia
Function:
Structure
• divided into R & L compartments via scrotal septum (int) and scrotal raphe (ext)
• superficial dartos fascia – has no subcutaenous fat, like Scarpa’s fascia of the abdomen
Testis
* considered retroperitoneal
General Info:
Anim: http://highered.mcgraw-hill.com/olc/dl/120112/anim0043.swf
Blood supply:
testicular a (ab aorta)
drained by v of pampiniform plexus –> become testicular v
Lymph vessels in area –> sup inguinal nodes & lumbar nodes
Epididymis:
• formed by the many twists and turns made by the 1 epididymal duct
• lies of post surface of testis, – only place where testis not covered by tunica vaginalis
• has head, body, tail
o head – made up of 12-14 efferent ducts, leading from rete testis
o body – duct of epididymis
o tail – continous w/ ductus deferens
Ductus Deferens:
Function:
Pathway/Topography:
• begins in tail of epididymis –> asc w/ spermatic cord –> inguinal canal –> enter
retroperitoneal space @ deep inguinal ring –> desc to bladder
• int iliac a (DD runs in front)
• ureter (DD runs in front)
• no structure runs b/w peritoneum and DD
Blood supply: deferential a (usually inf vesicle a, sometimes sup vesicle a), joins testicular a
w/in scrotum,
Veins = v run w/ a
Spermatic Cord:
Pathway:
Deep inguinal ring lat to lat umbilical fold (w/ inf epigastric a/v inside)
–> thru inguinal canal –> exit @ superficial inguinal ring –> scrotum @ post border of testis
Because the testis form in abdominal cavity, and then descends into scrotal sac, the layers
of ab wall accompany this trip, and so the same layers can be seen in both spermatic cord,
and scrotum
2. Arteries
3. Pampiniform plexus - network of v around testicular a and ductus deferens –> ends as
testicular v, cools down blood that enters testis
4. Nerves
Blood supply:
Innervation:
• Ilioinguinal n
• pudendal n
• perineal br of post cut femoral n
• genital br of genitofemoral n
General Info:
Seminiferous Tubules
Interstitial Tissue
• a/v
• loose CT
• clusters of epithelial like cells of Leydig
o eosinophillic, round nucleus
o lipid droplets
o crystal of Reifkle = Rectangular, crystal-like inclusions in the interstitial cells of
the testis (Leydig cells) and hilus cells in the ovary.
o elaborate Smooth ER for enzyme production
o testosterone production
in early fetal life = help male gonads develop
in Puberty = sperm production, pubic hair growht
In Adult = maintenance of sex glands, spermatogenesis
Sertoli Cells = tall columnar, non replicating cells that rest on basal lamina, 5 functions
Pathway: Seminiferous tubules (convoluted/straight tubules) --> rete testis (in mediastinum
testis) --> Efferent ducts --> Epididymis ducts (tail, body, then head) --> ductus deferens
Pathway: Seminiferous tubules (convoluted/straight tubules) –> rete testis (in mediastinum
testis) –> Efferent ducts –> Epididymis ducts (tail, body, then head) –> ductus deferens
First 4 you can identify in this slide, each one has different epithelial lining and function
Straight tubules: short narrow ducts, with cuboidal lining epith , no spermatogenic cells
Epididymis:
Ductus efferentes
notice the star shaped lumen - efferent ducts
• star shaped lumen –> due to tall ciliated cells, and shorter non ciliated cells
• found nearer to mediastinum
• surrounded by CT
• form part of head of epididymis
• reabsorb fluid secreted from seminiferous tubules
• musc layer surrounds ducts to push sperm forward
Ductus epididymis
Epididymal ducts: PRINCIPAL CELLS, are elongated and located at the base. Another
population of cells has a rounder nucleus and can be found mainly at the base (called BASAL
CELLS)
*Slide easy to identify as you can also see many other structures with it, and also do not confuse
with ureter or urethra, this does not have urothelium, and the urethra’s lumen is long, and thin
and irregular. This lumen is wide, kinda circular, and irregular.
General Info:
• tiny narrow irregular lumen, with mucosal foldings into it = glandular diverticuli.
• thin mucosa – LP has collagen fibers, and elastic fibers
• THICK muscular layer
• no submucosa or musc mucosa
• adventia = no peritoneal relationship
Scrotum:
In 3rd week, mesenchyme cells in primitive streak –>go to cloacal membrane to form cloacal
folds
• Cranial (towards the head side, ant) to the cloacal membrane, the cloacal folds form
genital tubercle
• Caudally, cloacal folds become urethral folds ant, and anal folds post
On each side of urethral folds, genital swellings form –> later form scrotal swelling in male,
labia majora in female
Testis:
In order for males to become males, they have a specific gene = TDF, or testis determining
factor
Seminiferous cords have the primordial germ cells and Sertoli cells - that secret MIF (Mullerian
inhibiting factor), that supresses the development of the primary genital duct in female = the
paramesonephric duct or mullerian duct.
Mesoderm b/w seminiferous cords –> give Leydig cells that secrete testosterone
Mesoderm = Leydig, Sertoli cells, primordial germ cells, and CT stroma of testis
gubernaculum descends w/ testis in inguinal canal, and remnants of it hold the testis w/in the
scrotum in adult life
Peritoneum also follows testis into scrotal sac via inguinal canal, and form the tunica processus
vaginalis –> become the parietal and visceral layers of tunica vaginalis
Mesonephric duct forms = epididymis, ductus deferens, seminal vesicle, ejaculatory duct,
efferent ducts of testis
Tagged with: ductuli efferentes, ductuli epididymis, ductus deferens, Leydig cell, mediastinum
testis, rete testis, seminiferous tubules, Sertoli cell, tunica albuginea
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33. The anatomy and development of the female external genital organs. The histology of
the vagina.
Mons Pubis:
Labia Majora:
b) Body
c) Glans
Vestibule
Vaginal orifice
Blood supply:
Nerve supply:
PNS = inc vaginal secretion, excitation of clitoris, erection for tissue in bulbs of vestibule
Vagina:
General Info:
• upper end divided into 4 fornices = 1 ant, 1 post, 2 lat that surround vaginal portion of
cervix
o ant fornix = shallowest, touches fundus of bladder
o post fornix = deepest and touches rectouterine pouch, covered w/ peritoneum
of rectum post
o lat fornix = uterus, uterine a/v – w/in broad lig of uterus
Various Views of Vagina - Topography, internal structure, etc
Topography:
• ant = urethra in urethrovaginal septum, space b/w vagina and septum = urethrovaginal
space
• post = loops of SI (sup), rectum via rectovaginal septum
• lat = contact cervix of uterus (sup)
• inf = levator ani m, UG diaphragm, perineal body
supported by:
• upper part = levator ani m, transverse cervical lig, pubocervical lig, sacrocervical lig
o (ligaments together = paracolpium of vagina)
o fibers merge w/ fibers of paraproctium(post) and paracysticum (ant)
• middle part = UG diaphragm
• lower part = perineal body
Blood supply:
• vaginal a (uterine a)
• vaginal br of int pudendal a (inf part of vagina), middle rectal a (middle part of
vaginal), int iliac a
Venous drainage = vaginal venous plexus –> pelvic venous plexus –> int iliac v
Lymph Drainage:
• The vagina is related anteriorly to the uterus and bladder and is fused with the urethra.
Posteriorly, the vagina is related to the recto-uterine pouch, the rectum and the perineal
body. The lateral fornix of the vagina is related to the ureter and uterine artery. At its
upper aspect the vagina fuses with the uterus, so that it encloses the vaginal part of the
cervix.
Stuctures to Identify:
General Info:
• no glands here – all lubrication done by cervical glands and Bartholin’s glands at
entrance
• epithelium thickens and secretes glycogen under influence of estrogen
• Vaginal bacteria changes the glycogen into lactic acid — acidity protects the vaginal
canal from pathogens
Epith
Vaginal pale epithelium, notice the lymphocytes and Langerhan's cells at base of epith, as well as
CT papilla
LP
• aka semi cavernous tissue = b/c a/v similar to cavernous tissue of penis
• dense reg CT filled with elastic tissue for stretching of vaginal wall
• MALT, lymph nodules, a/v
• underlying submucosa interweaves with it
• no definitve border between LP and submucosa = NO muscularis mucosae
Muscular Layer
Adventia
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32. The anatomy, histology and development of the uterine tube and uterus.
Uterus:
Location: b/w bladder (ant) and rectum (post), above and leads to vagina
General Info:
7-8 cm long, 5-7 cm wide, 2-3 cm wide
2 main parts = corpus (upper 2/3) and cervix (lower 1/3) , connected via isthmus
• Cervix protrudes into vagina @ angle of 60-70 degress = anteversion ( angle b/w vagina
and cervical canal)
• Body inclines forward and bends over fundus of bladder, attached to cervix w/ angle of
another 60 degrees = anteflexion ( angle b/w jxn of cervix and body)
Topography:
Parts:
Cervical portion:
has 2 areas:
Vaginal portion – protrudes into vagina,surrounded by vaginal fornices
Supravaginal portion – embedded into CT of visceral pelvic fascia (via parametrium), in direct
contact w/ broad ligament (myometrium)
Cervical Canal:
Epith of cervix isn’t shed in menstruation like the epith of rest of uterus = simple columnar, # of
glands inc in this area – they secret the mucus to make mucus plug
keeps closed until few hours before birth – then begins to dilate to allow head thru – this is due to
high amt of collagen and smooth M in cervix
Cervix doesn’t have real myometrium, called it, but really has less smooth m and more elastic
fibers compared to rest of uterus
NOTE: (Please do not be confused by the 50 names out there for the same thing)
Corpus
Isthmus
Wall of Uterus
Perimetrium = outer layer, peritoneum & underlying subserosa
Myometrium = middle musc layer, has sublayers
Endometrium = innermost layer, layer removed during menstruation
1. Broad ligament of uterus - 2 layers of peritoneal covering, from lat margin of uterus –>
lat pelvic wall
o holds uterus in position
o contains: uterine tube, a/v, round ligament, ovarian ligament proper, urete,
uterovaginal n. plexus, lymph vessels
2. Mesovarium - fold of peritoneum that connects ant surface of ovary w/ post layer of
broad ligament
3. Mesosalpinx – fold of broad ligament that suspends the uterine tube
4. Mesometrium- fold of broad lig below mesosalpinx, and meso-ovarium, lat wall of
uterus –> pelvic wall
5. Proper Ovarian ligament – fibromusc cord from uterine end of ovary –> side of uterus
below uterine tube w/in broad lig
6. Suspensory ligament of ovary – band of peritoneum that runs sup/lat from end of ovary
–> pelvic wall, has ovarian a/v, lymph vessels
7. Lat/Transverse Cervical (Cardinal) Lig of Uterus (aka ligament of Mackenrodt’s) –
fibromuscular condensations of pelvic fascia from cervix (hence, cervical) & lat fornix of
vagina –> pelvic wall, run w/in parametrium of uterus
8. Parametrium – fibrous CT that runs w/in mesometrium, connects uterus to lat pelvic
wall
9. Paracolpium – fibrous CT that connects the lat wall of vagina –> lat pelvic wall, fibers
merge w/ those of para cysticum (for bladder)
10. Pubocervical ligament – firm bands of CT from post surface of pubis –> cervix of
uterus
11. Sacrocervical(uterine) ligament – firm fibromuscular bands of pelvic fascia from lower
end of sacrum –> to cervix, upper end of vagina *palpable in rectal exam
12. Pubovesical ligament – pelvic fascia bands from neck of bladder (or prostate in male) –
> pelvic bone
13. Rectouterine ligament – holds cervis back and up and sometimes elevate a shelf-like
fold of pertioneum (recto-uterine folds – called sacro-genital folds in male)
o isthmus of uterus –> post wall of pelvis, lat to rectum
Ligament relations of Uterus & Uterine tube
Connective tissue ligaments of female pelvis
• ant = bladder
• post = uterus
• lat = vesicouterine folds
• ant = uterus
• post = rectum
• lat = rectouterine folds
• floor = post fornix of vagina, in direct contact w/ ampulla of rectum *can be felt there via
rectal exam
CLINICAL NOTE: This is deepest point of peritoneal cavity in female, any excess peritoneal
fluid will collect there
blood in pouch can indicate the presence of ectopic pregnancy
Pouces and ligaments/Topography of Female Pelvis
Lymph Drainage:
1. Fundic region = aortic nodes via ovarian lymph vessels
2. Corpus = ext iliac and sup inguinal nodes
3. Cervix = int iliac and sacral nodes
Uterine Tube:
non united part of Mullerian duct (embryo)
Location: from horn of uterus –> ends in ampulla @ uterine end of ovaries
Function:
• carries fertilized or unfertilized ovum from ovary to uterus, for Implantation
• via action of the cilia on its epithelium, and contraction of musc wall, also carries sperm
towards the ovary
• Connects uterine cavity w/ peritoneal cavity
• Fertilization occurs in ampulla or infundibulum of uterine tube
Parts:
1. Infundibulum – funnel-shaped distal portion over end of ovary
2. Ambulla – FERTILIZATION
4. Uterine part
202. What is the epithelium of the a.) cervical canal and b.) vaginal portion of the uterus?
simple columnar mucous producing epithelium, with scatterd ciliated cells,
stratified squamous non keratinizing epithelium.
205. List those structures that help to fix the uterus in its original position!
Vagina, pelvic and urogenital diaphragms, round lig., ovarian lig., vesicouterine fold,
rectouterine fold, thickenings of the visceral pelvic fascia, broad lig., parametrium.
206. Which lymph nodes receive lymph from the a.) fundus, b.) body and c.) cervix of the
uterus?
aortc, external iliac, superficial inguinal lymph nodes,
external iliac lymph nodes,
internal iliac and sacral lymph nodes.
Structures to Identify:
General Info:
Endometrium
Epith
LP
Stratum Functionalis
Stratum Basalis
Myometrium
• is the thickest layer of the uterine wall
• composed of 3 undefined layers of smooth muscle bundles: you see cross, oblique,
longitudinal sections.
• the smooth muscle bundles in the inner+ outer layers are predominantly oriented parallel
to the long axis of the uterus.
• muscle separated by interstitial CT
• lots of a/v. —> tunica media of arteries merges with smooth m of the myometrium
• arcuate a in myometrium = vascular zone
o separates the uteine wall into three zones – Supra vascular, vascular, and
perivascular below.
o 6- 10 arcuate arteries coming from the uterine artery that anastomose in the
myometrium
Perimetrium
• adventia/serosa
• on sup surface of uterus, covered with peritoneum –> serosa
• In other surfaces of uterus, is infraperitoneal –> covered with adventia
• If adventia, can possibly see ggl cells and nerve cells
• at the end of the menstrual phase, the endometrium consits of a thin band of CT(about 1
mm) thick, containing the basal portion of the uterine gland+lower portion of the spiral
arteries. = stratum basale the layer, that was sloughed off was the stratum functionale.
• Stromal, endothelial+ epithelial cells in the stratum basale proliferate rapidly, following
changes can be seen:
• Epithelial cells in the basal portion of the glands reconstitute the glands & migrate to
cover the denuded endometrial surface.
• Stromal cells: proliferate, secrete collagen, & ground substance
• Spiral arteries lenghten, as the endometrium is reestablished, these arteries are only
slightly coiled+ do not extend into the upper third of the endometrium.
• Continous until 1 day after ovulation, which occurs at about day 14, of a 28- day cycle.
• At the end of this phase, the endometrium has reached a thickness of about 3 mm.
• The glands have narrow lumina+ relatively straight, but have a slightly wavy appearance.
• Accumulation of glycogen are present in the basal portion of the epithelial cells.
See the white space between the cells of stroma? And the twisted glands? = Secretory Phase
Uterus
Structures are the same as listed above, with some key differences
Endometrium
• Stratum functionalis -
o MUCH thicker,
o uterine glands are now larger and wavy, not oval shaped –> increase size due to
secretion within
inside of glands are pale because secretions are mostly carbs
o arteries are also more coiled , and become more prominent in this layer
increase in volume, to prepare for menstruation, the next phase
• Stratum basalis -
o less cells in interstitial tissue, more white space between cell
o the increased interstitial fluid between the cells is called Interstitial EDEMA
o more WBC, monocytes, neutrophils, granulocytes
o straight a in this layer —> coiled arteries in fuctional layer
• Stromal cells become decidual cells –> preperation for formation of placenta
Myometrium
Menstrual phase *Dont need to know for test, just theory to understand *
• CORPUS LUTEUM produces hormones for about 10 days if fertilization does not occur.
• As hormone levels rapidly decline, changes occur in the blood supply to the stratum
functionale.
• Periodic contractions of the walls of the spiral arteries, lasting for several hours, cause the
stratum functionale.
Periodic conctraction of the walls of the spiral arteries, stratum functionale to become
ischemic.◊lasting for several hours
• Glands stop secreting+ the endometrium shrinks in heigh as the stroma becomes less
edematous.
• After about 2 days, extended periods of arterial contraction, with only brief periods of
blood flow, cause disruption of the surface epithelium+ rupture of the blood vessels.
• When spiral arteries close off, blood flows into the stratum basale, but not in the stratum
functionale.
• Blood, uterine fluid+ sloughing stromal+ epithelial cells from the stratum functionale
constitute the vaginal discharge.
• As patches of tissue separate from the endometrium, the torn ends of veins, arteries+
glands are exposed.
• In the absence of fertilization, cessation of bleeding would accompany the growth+
maturation of new ovarian follicels.
• The epithelial cells would rapidly proliferate+ migrate to restore the surface epithelium as
the proliferative phase of the next cycle begins.
• In the absence of ovulation( a cycle refered to as an anovulatory cycle), a corpus luteum
does not form, and progesterone is not produced.
• In the absence of progesterone, the endometrium does not enter the secretory phase until
menstruation.
Structures to Identify
• endometrium with glands = decidua basalis
• myometrium
• chroion frondosum (primary villi)
• embryonic cavity
• primary, secondary, tertiary villi
• chorion leave
• decidua capsularis, marginalis, parietalis
• a/v
General Info:
This slide is not as difficult as it may seem. Look at the picture to the right to first familairize
yourself with the layers listed.
First look for a long white tube with a thick wavy over covering –> this is the embryonic
(amniotic) cavity.
Villi
• Villi are projections from the decidua that house branches of the uterine a/v, and contain
fetal blood
• they project into the space between the decidual layers.
• maternal blood surrounds them in intervillous space
• Free gas exchange occurs between the villi and intervillous space
• 2 types of villi: anchoring villi (attached to chorion), floating villi (free floating)
• made from trophoblast cells – which makes two layers of cells – syncytiotrophoblast
(outer) & cytotrophoblast (inner)
• Primary villus
o 2 layers of trophoblast cells only
• Secondary villus
o 2 layers with extra embryonic mesoderm in w/in
o light center - look for white space in center
o may have small a/b near the center
• Tertiary villus
o the largest ones
o only syncytiotrophoblast layer, much bigger, with a/v near periphery
Structures to Identify:
• simple columnar epithelium
• peg cells (right ovulation, might not be there)
• LP
• muscular layer
• a/v
• mesothelium (cells of perimetrium)
• adipocytes
•
• Epith and LP of Uterine Tube, with ciliated and peg cells shown
Epith
L.P.
• With descent of the ovary, the first 2 parts develop into the uterine tube+ the caudal parts
fuse, to form the uterine canal.
• When the second part of the paramesonephric ducts moves mediocaudally, the urogenital
ridges gradually come to lie in a transverse plane.
• DUCTS fuse in the midline, a broad transverse pelvic fold is established.
• BROAD LIGAMENT OF THE UTERUS: fold, which extends from the lateral sides of
the fused paramesonephric ducts toward the wall of the pelvis.
• The uterine tube lies in its upper border, and the ovary lies on its post. Surface.
• UTERORECTAL POUCH+ UTEROVESICAL POUCH are devided by the uterus+
broad ligaments
• CORPUS+ CERVIX of the uterus coming from the fused paramesonephric ducts.
• MYOMETRIUM(= muscular coat of the uterus)+ Peritoneal covering(perimetrium) =
layer of mesenchyme
Tagged with: amnionic cavity, chorion frondosum, chorion leave, chorionic cilli, Corpus luteum,
cytotrophoblast, decidua, decidua basalis capsularis, endometrium, fallopian tube,
infraperitoneal, interstitial edema, lacuna, luteal phase, Menstrual cycle, mesonephric duct,
myometrium, peg cells, perimetrium, radial arteries, secretory phase, spinocellular CT, spiral
arteries, stratum basalis, stratum functionalis, stromal cells, syncytiotrophoblast, uterine tube,
Uterus
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Anatomy of Ovary
General Info:
surface covered w. germinal epithelium, which is modified peritoneal covering from
development
Location: in ovarian fossa, in post part of broad ligament, @ lat wall of pelvis, located @
bifurcation point of common iliac a on both sides, @sacro-iliac joint
Topography:
• The suspensory ligament of the ovary extends from the tubal end of ovary to the
lateral wall of the pelvis. It contains the ovarian blood vessels and nerves.
• Farre line: a whitish line marking the insertion of the mesovarium at the hilum of the
ovary.
Venous drainage:
• veins draining ovary make a pampiniform plexus (like the one around the testis), that run
w/in broad ligament
• Ovarian v – R –> IVC
• L –> L renal v
Lymph drainage: vessels follow ovarian a/v and join vessels from uterine tube and fundus of
uterus –> lumbar lymph plexus
Nerve Supply:
• SNS and aff fibers –> run w/ ovarian a/v —> make connections w/ pelvic plexus –>
ovarian n plexus
• PNS: from pelvis splanchnic n –> same route w/ ovarian vessels
Histology of Ovary
• primoridal follicle
• germinal epithelium
• primary follcile
• secondary follicle
• tertiary (grafiaan) follicle
• corpus luteum
• corpus hemorroidal
• corpus fibricans
• corpus albicans
• cumulus oophorus
• corona radiata
• zona pellucida
• theca internta
• theca externa
• granulosal cells
• stromal tissue (spino cellular tissue)
General Info
Cortex
• process beings with premordial follicle and ends with ovulation of oocyte into uterine
tube
• occurs under influence of FSH
• In fetal life, oocytes divid mitotically, creating HUGE # of oogonia (not so in life)
• As female goes thru puberty, ovaries begin process of reproductive activity characterized
by growth and maturation of oocytes and surrounding follicles, meaning that the size of
follicles can te4sll how close we are to creating mature oocyte.
• follicular cells enlarge and become cuboidal = now called granulosa cells,these cells
later form the corona radiata
• zona pellucida starts to appear – non cellular layer between corona and oocyte itself
o Glycoprotein rich zone (ZP 1, 2, 3 )
o <!--[if !supportLists]--> <!--[endif]--> Zone of contact and communication
between oocyte microvilli and granulosa cell processes.<!--[endif]-->
o Develop gap junctions
• oocyte itself becomes bigger
primary follicle
Seconday follicle -
secondary follicle
Oocyte stops growing thanks to OMI (Oocyte Maturation Inhibitor), secreted by the granulosa
cells.
Oocyte maturation
• Oocytes stay in primary follicle phase for 15-20 years in prophase I of 1st Meiotic
division
• Completion of 1st stage of Meiosis occurs only before the ovulation in the Graafian
follicle.
• Primary oocyte (4n) splits into –> Secondary oocyte + 1st polar body
• Secondary oocyte is arrested in metaphase of 2nd meiotic division
• completed only if seconday oocyte is penetrated by spermatogonia, in which case the
seondary oocyte –> final oocyte + 2nd polar body
Medulla
General Info:
Follicular atresia – at any point of follicular development, it can degenerate and then be
absorbed via phagocytosis
Corpus Luteum – formed after ovulation of a mature follicle and collapse of its wall
After ovulation, hemorrhage into the remains of the follicle usually occurs resulting in a
structure called a corpus hemorrhagicum. This transitory structure develops into a
corpus luteum.
In most species LH from the pituitary gland initiates this luteinization and stimulates
the granulosa cells to secrete progesterone. The granulosa cells undergo hyperplasia
(proliferation), hypertrophy (enlargement) and are transformed into granulosa lutein
cells. In several species, including the human, the accumulation of a yellow lipid
pigment (lutein) and other lipids marks the transition to granulosa lutein cells. The
cells of the theca interna are also transformed into lipid-forming cells called theca lutein
cells. The resulting structure is highly vascular. If fertilization occurs, the corpus luteum
persists and secretes progesterone.
If fertilization does not occur, the corpus luteum degenerates and is replaced by
connective tissue forming a corpus albicans.
• theca lutein cells - formed from theca interna cells, located in periphery of corpus
luteum, and w/it its fold
• granulosa lutein cells – hypertrophic granulosa cells (over grown)
• Theca externa CT pierces the walls of it.
• Later stage of it:
o lutein cells shrink
o pyknosis of the nuclei
o fibrous center
o CT replaces luteal cells to form temporary fibrous capsule — eventually forms
corpus albicans
Embryology of Ovary
Development of Ovaries:
Descent of Ovaries:
all that was listed above occurs in abdominal cavity, and then descent into pelvic cavity
involves gubernaculum – a fibrous tissue that runs from:
Tagged with: atresia, corpus albicans, Corpus luteum, cumulus oophorus, Follicle-stimulating
hormone, follicles, follicular liquor, germinal epithelium, Grafiaan follicle, granulosa cells, line
of Farre, Menstrual cycle, Ovary, primordial follicle, spinocellular tissue, theca interna and
externa, theca lutein
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This site was made for the Anatomy, Histology, Embryology class in 2nd yr, 1st semester at the
University of Debrecen. All theoretical topics are listed as described on the website of the
Anatomy department.
We combined Practical class notes, Moore, Board Review Series textbooks of Gross Anatomy
and Embryology, Langman’s, DiFiore’s, as well as the Lab manual for Histology at
Semmelweiss. We believe it to be all inclusive of the material you will need for your test. We
made them for ourselves, but since people asked for them, and emailing them seemed next to
impossible, we decided to post them here.
To see all the topics we’ve done so far, scroll down and click on the Category you would like
to see: Head & Neck, Thorax, Abdomen, & Pelvis.
Added a search box in the sidebar, so you can search for the item you want.
But the best way to find the topic that you want?
Scroll down and click on the “Link to Topics” Page. There is the list of all topics. If a link
to your topic of choice exists, we’ve started/finished it, else we’re working on it. There!
That’s easier, isn’t it?
We’ve added pictures, links, and animations where we have found them.
(P.s. If you find mistakes, or want to add info, or find something we missed, please comment
below the post in question, and we will fix or add it. )
We are adding more info by the day, so check back in with us!
contact: sahaja.parsa[at]gmail.com
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• Links to Topics
Categories
• Abdomen
• Head & Neck
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Recent Posts
• 40.Autonomic innervation of the abdominal and pelvic organs. The cartilage tissue. Fetal
membranes. Umbilical cord. Amniotic fluid. Fetal circulation.
• 39. Bones, muscles and ligaments of the pelvis. The blood vessels and nerves of the
pelvis. The bone tissue. Gastrulation, early differentiation of the
intraembryonic mesoderm
• 38. The perineum. The formation of the placenta. The structure of the matured placenta.
• 37. The anatomy, histology and development of the penis.
• 36. The anatomy, histology and development of the ureter, urinary vesicle and urethra.
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