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PLENARY

DISCUSSION
1.5.1
Group 11
Trise Anestesia M.
Gabriela Novellya
Nadhira Edrian
Deri Kurnia Ilahi
Dwi Putri Amelia
Githa Permatasar
Millenia Calista
Nadhifah Salsabila
Nadhifa Naura R
Muhammad Fatkhi
Learning Objective

Embryology of genitalia system


Anatomy of male and female genitalia system
Anatomy of pelvis
Histology of male and female genitalia system
Abnormalities of genital system
HISTOLOGY OF
MALE GENITAL
SYSTEM
Histology of testes
Tunica albuginea-
dense white fibrous capsule
composed of dense irregular
connective tissue,
forming septa that divide each testis
into series internal compartments
called lobules.
Spermatogenesis in seminiferous tubules
Seminiferous tubules

Stratified germinal epithelium


Surrounded by a layer CT with fibroblast and an inner basement
membrane (bm).
Consist: Supporting (Sertoli cell)
Slender, elongated cells with irregular outlines that extend from the bm.
Primary spermatocytes
Spermatocytes
Spermatids
Spermatogenesis

Process where the spermatogenic cells in the seminiferous tubules


divide, differentiate, and produce sperm.
3 phases
Mitotic division of spermatogonia
Meiotic division of spermatocytes, somatic chromosome no.
spermatids
Spermiogenesis morphological transformation spermatids sperm.
Sertoli cells

Supportive cells in the seminiferous tubules located among the


spermatogenic cells
Fx: physical support, protection and nutrition of the developing sperm
(spermatids)
Phagocytosis of cytoplasm developing sperm (spermatids)
Produce and release ABP.
Seminiferous tubule, straight
tubules, rete testis & ductuli
efferentes
Ductuli efferentes of the ductus epididymis
Histology of vas
deferens
Vas deferens

A narrow and irregular lumen with longitudinal


mucosal folds.
Psuedostratified columnar epithelium with stereocilia.

Thin lamina propria


consists of compact colagen fibers and fie net work of elastic fibers.

Thick muscularis
3 SM layers
Inner longitudinal
Middle circular
Outer longitudinal

Adventitia.
Abundant of blood vessels
Ampulla of the vas deferens

Terminal portion of the vas deferens enlarges into an


ampulla
Lumen of ampulla larger than vas deferens.
Numerous irregular branching mucosal folds
Deep glandular diverticula or crypts
Simple columnar or cuboidal epithelium.

Lamina propria
3 layers of SM
Thin inner longitudinal
Thick middle circular
Thin outer longitudinal
Ampulla of the vas deferens
Accessory reproductive glands

Seminal vesicles
Yellowish viscous fluid high in fructose
Energy source for sperm motility
Produce most fluid found in semen

Prostate gland
Porduce thin, watery slightly acidic fluid
The enzyme fibrinolysin liquefies the semen after ejaculation.

Bulbourethral glands
Produce clear, viscid, mucus-like secretion during erotic stimulation
As lubricant for thr penile urethra.
Histology of seminal vesicle
Glandular epithelium of seminal vesicles normally
varies
low pseudostratified, low columnar or cuboidal.
Prostate gland & prostate
urethra
Prostate gland
Prostetic urethra
Psuedostratified epithelium
Glandular acini vary in size
Lumina of acini normally wide and irregular
Protrusion of epithelium-covered connective tissue folds
Proteinaceous secretions sometimes prostatic concretions.
Glandular epithelium simple-columnar or psuedot Fibromuscular
stroma

Characteristic feature of prostate gland


SM bundles and CT fibers blend together in the stroma throughout the
gland.
ratified, cells lightly stain, some region squamous or cuboidal.
Histology of prostate gland
Histology of the Bulbourethral gland
HISTOLOGY OF
FEMALE GENITAL
SYSTEM
ovary

Epithelial germ epithelial layer of cabbage


Tunica albugenia dense connective tissue collagen irregular
Cortex and medulla does not expressly limit
Ovarian cortex ovarian follicles (different stages) and connective
tissue stroma
Medulla large blood vessels, lymph vessels and nerve fibers, fewer
cells and the interstitial cells of the hilum
Uterine tube
The tunica mucosa
- Epithelium layer of the thorax, the highest in the region ampulla
- Consists of ciliated cylindrical cells (most in fimbrie and ampulla) and
secretory cells without cilia
- Lamina propria
The tunica muscularis
- The smooth muscle, circular stratum (in), longitudinal (outer)
The tunica serosa
- Continuation of the visceral peritoneum
Uterine
The endometrium
A mucous membraneThe thickness and structure depending on the area
covered and the relevant period of the menstrual cycle
Layers: Stratum functional (released during menstruation) & Sratum basal
Myometrium
Is the thickest layer of muscle, 3 layers of smooth muscle (longitudinal-
longitudinal-circular)
Change if she is pregnant
Perimetrium
Fundus area: is covered by visceral peritoneum, so that the tunica
serosaOther areas are tunica adventitia
Cervix utery
Mucous membrane.
A layer of cylindrical epithelium: a couple of ciliated cells and secretory cells.
Stratified epithelium flattened: external surface of the portio vaginalis.
The lamina propria.
Dense connective tissue, a lot of collagen fibers.
15% of smooth muscle cells.
Containing a large gland: cervikalis uterine glands (serous nature). becoming
mucoid pd pregnancy
vagina

Mucous membrane:
Squamous stratified epithelium was horned (150-200 m),containing
glycogen.
The lamina propria:
Loose connective tissue, fiber fibroelastis & woven blood vessels.
The tunica muscularis:
2 layers of smooth muscle (longitudinal outside, circular inside).
The tunica adventitia:
Many blood vessels, nerve fibers and fiber fibroelastis
External genitalia
Labia majora
fat, hair follicles, sebaceous glands, sweat glands.
Labia minora
connective tissue rich in blood vessels, contains elastin fibers, sebaceous
glands, hair follicles (-)
Vestibule
Bartholin's glands, small glands vestibule
Clitoris
many sensory nerve fibers, korpuskulum Meissner & korpuskulum Pacini
ABNORMALITIES
OF GENITALIA
SYSTEM
The Abnormalities
The appliance Reproduction in Women
1. The abnormalities of the
vulva and vagina: 3. Congenital Anomalies related
a. Hymen Infervorata to bleeding /menses:
b. Atresia labia minora a. Amenore
c. Hipoplasia vulva b. Hipermenore
d. Septum Vagina c. Hipomenore
e. Aplasia and Atresia d. Metroragia
Vagina
f. Cysts Vagina 4. Outer genital cancer :
e. Cervical Cancer
2. Congenital Anomalies on f. Ovarian Cancer
the uterus: g. Vagin CancerA
g. Uterus duplex (uterus
didelphys) 5. Endometriosis
h. Uterus (duplex) bikornis 6. Dilation Oviduk
i. Uterus bicornis unicollis 7. On infertility
j. Uterus septus and 8. Pregnant Wine
subseptus 9. Diabetes mellitus pus
k. Uterus arcuatus 10. Syphilis
11. Condiloma Accuminata
The disorder
Related to the
bleeding and
menses.
A. Amenore
AmenoreIs not a primary menses until the age of 17 years with or without
secondary sexual development.
AmenoreSecondary is not of menses for 3 - 6 months or more on the people who
have been experiencing menstrual cycle.
Hipermenore:The amount of menstrual bleeding many, change the bandage 5-6
times per day, and ever 6-7 days. The disorder is the cause of the uterus, blood
abnormality, and functional disorders.
Hipomenore:Few menstrual bleeding, change the bandage 1-2 times per day, and
ever 1-2 days. The cause is the lack of estrogen & progesterone, stenosis himen,
stenosis cervical cancer fundus, sinekia fundus (Asherman syndrome).
Metroragia:Bleeding from the vagina that is not related to the menstrual cycle is
the cause of the organic disorder (polyps endometrium, carcinoma endometrium,
cervical carcinoma), functional disorder and the use of exogenous estrogen.
Outer Genital
Cancer.
a. Cancer of the vagina
Cancer of the vagina is not known to cause may be due to
irritation caused by the virus. Treatment with chemotherapy and
laser surgery.

b. Ovarian Cancer
Symptoms can be a muscle ache in the pelvis, changes the
function of the digestive tract, or experience abnormal vaginal
bleeding. Treatment with chemotherapy and surgery. This cancer
usually attack women who have had menopause (50 years old
up).

c. Cervical Cancer
Occurs when the growth of abnormal cells in all cervical
epithelial layer. On the stage of information, cancer has
symptoms bleeding after menopause and whiteness or out
yellowish fluid - kuningan, smell and mixed with the blood.
Treatment with the lifting up of the uterus, oviduk, ovarian, one
third of the top of the vagina and the lymph nodes pelvis.
CancerThisMany attacked the women on the age of 40 years.
Cervical Cancer Ovarian Cancer

Cancer UTERUS
Endometriosis.
Endometriosis is a condition where the network outside the
uterus endometrium, namely can grow around the ovarian,
oviduk, or line outside of the womb.
GejalA : Abdominal pain, kidneys pain, andThe pain of
whenMenstruation.
As a result of : It is difficult for pregnancy.
Handling of :Giving drugs, laparoscopy, or surgicalThe
laser.

Possible locations endometriosis :


A. Endometriosis interna : in other uterus for example
cervical cancer.
B. Endometriosis externa : outside the uterus.
C. Adenomiosis : endometrium in miometrium lappisan.
D. Endometrioma : endometrium in ovarian - cysts brown.
E. In the organs / other places for example on the surface of
The pathogenesis endometrium is explained by some of the theory including:

The theory of histogenesis : endometriosis occurred due to regurgitation/sour


epithelial tuba menstruation - implants endometrium on the abnormal cellular
network. The determination of factors that are expected to abnormal tissue is
regurgitation/sour menstruation blood / menses retrograd (menstruation blood
that does not come out through the cervix flows to tuba - ovarian and out to the
peritoneum cavity) then growing up because the organ that occupied does not
hold a rejection reaction (because not foreign objects / antigen).

The theory of histogenesis : transplantation, lymphatic metastasis / vascular. The


factor of the determination is a response to low immunologic functions genetic
factors, status of steroid hormone and growth hormone.

The theory of metaplasia coelomik : describe the growth of the endometrium in


the vagina even though there is no relationship between the two undergo
vascularisation. The primary is expected to come from the remaining network
that there since the embryonic development (channels Muller). So also on the
organs come from other Muller channels.

The theory of induction : continued from the theory of metaplasia, estimated


endogenous biochemical factors induces the development of peritoneal cells
that do not differentiate into the networkEndometrium.
ENDOMETRIOSIS
Vaginal infections,
Channel Constriction
Oviduk, Condiloma
Accuminata, on
infertility and Pregnancy
Wine.
Vaginal infections
Symptoms include a white discharge and arising itches.
This infection attack women aged productive especially
married. The cause is the result of intimate relationships.

The channel constriction oviduk


This disorder is a built-in factors, but there is also
successful due to certain germs infections. The narrow
oviduk channel will make the sperm is difficult to reach
in the channel, causing fertilization difficult to happen.

Condiloma Accuminata
Condiloma accuminata disease caused by the human
papilloma virus. This disease is marked by the
appearance of a wart that can exaggerate and can
eventually cause cervical cancer.
On infertility
For women, fertility marked with the attainment of
the fruit of the egg cell once in a month. If in the
way of life of every month the egg cell which is
ready to be fertilized, women are categorized as
less fertile or barren. In women on infertility caused
by cervical mucous abnormalities, the existence of
the tumor, an obstruction on the egg channel,
menses not regularly and because obesity.

Pregnant women of wine (Mola Hidalidosa)


Pregnant women of wine is a pregnancy that does
not contain the fetus but contains bubbles mola
and thrombosis. Pregnant wine can cause pain or
death because bleeding, radioactive uterine wall by
DysgenesiOVariu
m.
Although the structure of the normal chromosome
sometimes the image as on dysgenesi XO. Whether ovarian
prier not formed or later underwent degeneration is not
known. With its own ovarian hormone is very less and this
resulted in the appliance warts that infantile.
The symptoms :-Usually patients with short course.
-Pterygium colli.
-Genetalia infantile.
- Secondary hair and growthMamae no.
-Primary Amenore.
The therapy:PEmberian esterogen.

Syphilis,Gonorhoe,
AndHerpes
Genitalis.
Syphilis
Syphilis caused by bacteriaTreponema pallidum,This
disease can be transmitted through sexual relations,
blood transfusion, or microscopic injury. The symptoms
is wound on the testicles, spots or red spots on the
body, neurologic disorder, heart, nerve vessels and the
skin.

Gonorhoe (Diabetes pus)


The disease is gonorhoe venereal disease caused by
bacteriaNeisseria gonorrhoeae. Venereal disease can
be transmitted through free sex. Symptoms include is
out the white liquid, pain on when urination, on the
male urethra mouth swollen and quite red.

Herpes Genitalis
Is a disease caused by virus herpes simpleks. The
symptoms are the scab in groups on the testicles, lost
The
AbnormalitiesThe
Vulva.

a. Hymen Infervorata
The Himen not bumps. The blood can be
accumulated in the vagina, uterus and tuba.
Treatment with himenektomi.

B. Atresia labia minora


The second Atresia urogenitalis labium minus
due to the membrane that did not disappear.
There is a hole for the expenditure of the blood
of menstruation and diabetes behind which
unite over. Still might be pregnant.

c. Hipoplasia vulva
Found at the same time with the outer genital
interna less developed. Occurs on the
circumstances, infatilisme hipoestrogenisme.

The
AbnormalitiesThe
Vagina.
Septum Vagina
Septum vagina occurs as a result of the fusion of the
disturbance or second kanalisasi hypercornification
muleri. On the delivery can be torn or need to be
shorn and bound when bleeding.

Aplasia and Atresia Vagina


The failure of perkemabangan hypercornification
Muller, vagina is formed and the pit of the vagina
only recesses kloaka.

Cysts Vagina
The remaining ducts garner in anterolateral vagina.
Treatment with the lifting up of the uterus and
oviduk.
Congenital
AnomaliesOnUter
us.
a. Uterus duplex (uterus didelphys): the channel Muller
not unite so that there were two uterus and two of the
vagina.
b. Uterus (duplex)b ikornis
: uterus is 2 but the wall of the cervix that medial united.
Can cause abnormalities like layout of sungsang layout
that could not be diversi.
c. Uterus bicornis unicollis: corpus fundus 2 but cervik
only one.
d. Uterus septus and subseptus: there is a complete
septum on the uterus or some. Can cause nevertheless,
congenital anomalies or layout retention third.
e. Uterus arcuatus: unity happened but done remains the
width
Congenital anomalies
and disease on
Reproductive
SystemPria.
Hipogonadisme

Drop Was the function of the testis caused by disruption of


the interaction of hormones such as hormones androgen
and estrogen. This disorder caused infertility, impotence,
and there were no signs of kepriaan. Treatment can be
done with hormone therapy.

Kriptorkidisme

IsThe failure of one or both of the testes to descend from


the abdominal cavity into skrotum at the time of the baby.
Treatment can be done with the gift of the hormone human
chorionic gonadotropin to stimulate testoteron.
Urethritis
PEradanganThe urethra with symptoms of itch on the
penis and frequent urination. The causes are Chlamydia
trachomatis, Ureplasma urealyticum, or herpes virus.

Prostatitis
ProstatitisIs inflammation of prostate cancer that is often
accompanied by inflammation of the urethra. Symptoms
include a swelling that may inhibit the urethra so that arise
pain when urination. The cause can be either the bacteria
such as Escherichia coli or not bacteria.

Epididimitis
MRecognizableFrequent infections in the male reproductive
tract. The causes are E. coli and Chlamydia.

Orkitis
MRecognizableInflammation of the testis caused by viruses
epidemika. If happened on adult male can cause infertility.
PROSTATITIS
Impotence:A condition of the penis that is not able to
doErectile Disfunction(tense) or maintain dysfunction,
so that it is difficult to doKopulasi(fertilization
practices). Usually impotence caused by hormonal
factors, namely thermal throttling function of the
hormone testosterone, also can be caused by
psychological factors or emotional someone, of diabetes
mellitus, addictions alcohol, and nervous system
disorders.

The barrenness of / Infertility


In normal circumstances, a man who experienced the
ejaculate remove fluid semen or sperm as much as 4
milliliters of each time. In 4 ml sperm is contained 120
million tail sperm. This number has the opportunity to be
able to fertilize the egg cell. When the womb sperm
under the number 120 million in each ejaculate, already
including not fertile or barren category. In men infertility
occurs because of diseases such as impotence,
Prostate Cancer
Prostate cancer is cancer that attacked the prostate.
This causes the cancer cells in the prostate gland grow
abnormally and out of control. Prostate cancer usually
attack men aged 60 years to top.

Anorkidisme
Anorkidisme is a disease where the testis totals only one
or not at all.

Hyperthropic prostate cancer


Hyperthropic prostate cancer is the prostate gland
enlargement that usually happens on the age of the age
of more than 50 years. The Cause has not been clearly
understood.

Syphilis
Prostate Cancer
Abnormal sex chromosome
complexes
XXX, XXY
Number of X chromosome appears to be
unimportant in sex determination
If a normal Y chromosome is present the embryo
develops as a male. If Y chromosome or its testis
determining region is absent female development
occurs
Turner syndrome (45X)
Congenital malformations:Determination of
fetal sex

Ambiguous genitalia: if there is normalsexual differentiation, int and


ext genitalia are consistent with the chromosome complement
True hermaphroditism: having ovarian and testicular tissue either in
the same or opposite gonads (70 % are 46 XX, 20 % 46 XX/46 XY
mosaicism, 10 % 46XY)
Female pseudohermaphroditism: 46 XX, having ovaries, resulting from
the exposure from excessive androgens of female fetus. Virilization of
ext genitalia occurs. Common cause is congenital adrenal hyperplasia,
rare cause may be maternal masculinizing tumor.
Male pseudohermaphroditism: 46XY having testis, with no sex
chromatin. Int and ext genitalia are varible caused by inadequate
production of testosterone and MIF by testes.
Female pseudohermaphroditism (caused by congenital
adrenal hyperplasia)
Congenital malformations:Determination of
fetal sex

Androgen insensitivity syndrome (testicular feminization):


Normal appearing females with the presence of testes and
46XY chromosomes. They are medically and legally female.
There is resistambce to the action fo testosterone at the
cellular receptor
Mixed gonadal dysgenesis: very rare, having chromatin
negative nuclei (sex chromatin negative), a testis on one
side, an undifferentiated gonad on the other side. The int
genitalia are female, but may have male derivatives. The
ext genitalia may vary from female to male.
Androgen insensitivity syndrome (testicular
feminization):46XY
Congenital anomalies of uterus and vagina
Double uterus (uterus didelphys): results from failure of
fusion of the inferior parts of the paramesonephric ducts. It
may be associated with double or single vagina.
Bicornuate uterus: One paramesonephric duct is retarded
in its growth and does not fuse with other one.
Bicornuate uterus with rudimentary horn: the rudimentary
horn may not communicate with uterine cavity
Unicornuate uterus: One paramesonephric duct fails to
develop; resulting in a uterus with one uterine tube.
Absence of vagina and uterus: Reslts from the failure of
sinovaginal bulbs to develop.
Vaginal atresia: Failure of the canalization of the vaginal
plate.
Imperforate hymen: Failure of perforation of the inferior
end of the vaginal plate
Uterine
anomalies
A. Normal uterus
and vagina
B. Double uterus
C. Double uterus
with single
vagina
D. Bicornuate
uterus
E. Bicornuate
uterus with a
rudimentary left
horn
F. Septate uterus
G. Unicornuate
uterus
Congenital anomalies of hymen
Congenital anomalies of penis
Hypospadias: most common anomaly of the penis. The
external urethral orifice is on the ventral surface of the
glans penis (penile hypospadias). Resulting from
inadequate production of androgens by the fetal testes/or
inadequate receptor sites for the hormone
Epispadias: The urethra opens on the dorsal surface of the
penis; often associated with extrophy of the bladder;
resulting from inadequate ectodermal-mesodermal
interactions during development of genital tubercle
Agenesis of external genitalia: Absence of penis or clitoris;
resulting from the failure of development of genital
tubercle.
Bifid penis and double penis: vary rare, often associated
with extrophy of the bladder or urinary anomalies; results
when two genital tubercles develop.
Micropenis: The penis is so small that it is almost hidden by
the suprapubic pad of fat. It results from a fetal testicular
failure.
Hypospadias
Agenesis of external genitalia
Congenital anomalies of descent of the testes

Cryptorchidism or undescended testis: occurs in 30 % of


premature, 3-4% of full-term males. It may be uni or
bilateral. Failure of descent in the first year causes atrophy
of testes. It may be in the abdominal cavity or anywhere
along the descent path, usually in the inguinal canal. It
may be caused by teh defficiency of androgen production
in testes.
Ectopic testes: After traversing the inguinal canal, the
testis may deviate from its usual path of descent and
lodge in various abnormal locations.