urogenital -...

Urogenital (Urinary & Reproductive system) the microscopic aspect

Staf pengajar

Laboratorium Anatomi - Histologi

Fakultas Kedokteran Universitas Brawijaya Copyright @dr.Bambang Soemantri, M.Kes

Reference

• Color Textbook of Histology, Leslie P. Gartner

• Bailey’s Textbook of Microscopic Anatomy, Douglas E. Kelly, PhD

The Urinary System

The Urinary system

• Paired Kidney

• A ureter for each kidney

• Urinary bladder

• Urethra

Kidney function

• Removes toxic by products of metabolism

• Regulate blood pressure, hemodinamic and acid base balance

• Endocrine function, release:

– Renin

– Erythropoietin

Kidney

Overview of Kidney’s microsopic Structure

Kidney has two region:

• Cortex – Superficial layer of the kidney

• Medulla – Contains 6 to 12 pyramid - shaped, pale striated

regions, the renal pyramids, separated by renal columns (of Bertin)

– Base of each pyramid is oriented toward cortex

– Renal papilla, apex of the pyramid, points toward the hilum

Anatomy of kidney

7

Anatomy of kidney

• Three type substances in the cortex

– Renal corpuscle

– Cortical labyrinth:

• the convoluted tubulus

– Medullary rays:

• straight portion of proximal and distal tubule, collecting duct

cortex

• Renal lobe

– A single pyramid with its overlying cortex and cortical columns

• Renal lobule

– Medullary ray with part of the cortical labyrinth surrounding it

The Nephron – 2 parts

• Renal corpuscle – filters blood plasma

– Glomerulus – capillary network

– Glomerular (Bowman’s) capsule – double-walled cup

surrounding glomerulus

• Renal tubule – filtered fluid passes into

– Proximal convoluted tubule (TCP)

– Loop of Henle (nephron loop)

– Distal convoluted tubule (TCD)

– Renal corpuscle and both convoluted tubules in cortex, loop of

Henle extend into medulla

– Distal convoluted tubule of several nephrons empty into single

collecting duct

The structure of nephrons and associated blood vessels

Renal Corpuscle • is composed of Glomerulus: supplied by afferent

arteriole and drain by efferent arteriole

• Bowman’s capsul:

– Viceral layer

– Parietal layer

Bowmann’s space: the space inside Bowmann’s capsule

Vascular pole: the region where the vessels enter and exit Bowmann’s capsule

Urinary pole: the region of continuation between the renal corpuscle and the proximal tubule

Renal corpuscle general view

Visceral layer of Bowmann’s capsule

• Epithelial cells of visceral layer are modified to podocytes

• Podocytes have numerous cytoplasmic extension: primary processes

• Each primary process bears many secondary process, known as pedicel

• Pedicel completely envelop the glomerular capillaries by interdigitating with pedicels from neighboring podocytes

• The openings between the pedicels are called filtration slits

Histology of a renal corpuscle

Filtration Membrane

Histology of a renal corpuscle

Tubular section

• Tubular section

(processes the filtrate)

– Proximal convoluted tubule (TCP)

– Loop of Henle

– Distal convoluted tubule (TCD)

(ends by joining collecting duct)

Proximal convoluted duct

• Confined to renal cortex

• Resorption of water, ions and solutes

Loop of Henle

• Descending limb ( pars recta)

• Thin segment

• Thick ascending limb

Distal convoluted tubule

• Confined to the renal cortex

• Begins near the vascular pole

• terminate by becoming continuous with arched collecting tubule

• Macula densa, a specialized group of cells on the side of tubule adjacent to the vascular pole

• Selective secretion and resorption of ions

Collecting duct

• Each receives urine from several nephrons

• Run straight through cortex into the deep medulla

• At papilla of pyramid* ducts join to form larger papillary ducts

• The papillary ducts minor calices

Collecting duct

Juxtaglomerular Apparatus

three component:

• Macula densa of the distal tubule

• Juxtaglomerular cells of the afferent glomerular arteriole

• Extraglomerular mesangial cells, between the afferent and efferent arterioles

Function • Regulation of blood pressure • Granule (jg cells) – modified muscle cells secreting

renin. • Macula densa – chemoreceptors which detect a low

sodium concentration in the ultrafiltraate.

26

The BLOOD VESSELS

Aorta gives off right and left renal arteries

Renal arteries divides into 5 segmental arteries as enters hilus of kidney

Segmentals branch into lobar arteries Lobars divide into interlobars Interlobars into arcuate in junction of medulla and cortex Arcuates send interlobular arteries into cortex Cortical radiate arteries give rise to glomerular arterioles

The Renal Pelvis and Ureter Cont. from calyces The walls consist of three coats:

• Inner mucosa : transitional epithelium

• Middle muscular: – Inner longitudinal – Outer circular layer – Lower part of the ureter, a

discontinuous outer longitudinal layer

• Outer fibrous: loose connective tissue

Urinary Bladder • Mucosa:

– Trasitional epithelium – Lamina propria

• Superficial: Dense irregular connective tissue

• Deeper : Loose connective tissue

• Muscular: – Inner longitudinaal – Middle circular – Outer longitudinal

• Adventitia: – Dense irregular connective

tissue – Adventitia

URINARY SYSTEM

BLADDER

transitional epithelium

Female urethra

• About 4 to 5 cm length and 4 to 6 in diameter

• Lined by

– transitional epithelium, near the bladder

– Stratified sq nonkeratinzed ep along the remainder of the length

• Lamina propria: fibroelastic

• Glands of Littre: mucous, along the entire length

Male Urethra • 15-20 cm long

• Three regions:

– Prostatic urethra : Lined by transitional ep

– Membranous urethra : Lined by stratified columnar ep interspersed with patches of pseudostratified columnar ep

– Spongy urethra (penile urethra) : Lined by stratified columnar ep interspersed with patch of pseudostratified columnar ep and squamous non keratinized ep. Navicular fossa lined by stratified squamous ep. Glands of Littre in LP

Reproductive System

Genetalia Masculina Consist of :

– Glands :

• Testis

• Accessory glands :

Seminal vesicles

Prostate gland

Bulbourethral glands

Glands of Littre

– Ducts :

• Intratesticular ducts

• The excretory genital ducts

– The external genetalia :

• Scrotum

• Penis

Testes – Male gonad

– Located in the scrotum

– Primary glands of the male reproductive system

– Have exocrine and endocrine function/Component :

• The exocrine component :

– Seminiferous tubules

– Product : spermatozoa

–Sperm production occurs only at 35° C

• The endocrine component :

– Interstitial cells of Leidig

–Product : testosterone

Glands

General organization

• Tunica vaginalis covered the antero lateral of the testes

• Tunica albuginea : capsule that thickens at the posterior surface to form mediastinum testis.

• The septa are extension of the mediastinum testis and divide it into approximately 250 lobules

• Each lobule contain one to four seminiferous tubule and loose connective tissue that contain interstitial cells of Leydig

Glands Testis

Glands

Testis

HISTOLOGY OF TESTIS

TUNICA VAGINALIS

TUNICA ALBUGINEA

SEMINIFEROUS TUBULES

SEMINIFEROUS EPITHELIUM

- complex stratified epithelium

containing two basic cell

populations:

(1) SPERMATOGENIC CELLS

(2) SERTOLI CELLS

Glands Testis

Seminiferous tubules

Inside the testis lobule

The walls have three layers :

• Tunica propria

• Basal lamina

• Seminiferous epithelium consist of :

–Spermatogenic cells

–Sertoli cells

Glands Testis

SEMINIFEROUS TUBULES

INTERSTITIAL

CONN. TISSUE

TESTIS H&E

SEMINIFEROUS TUBULES

Spermatogenic cells :

a. Spermatogonia : Small round cells near basal lamina

b. Primary spermatocytes :

• Closer to the lumen

• The largest germ cells present

• have a diploid chromosome (46,2N)

c. Secondary spermatocytes : The chromosomes number are haploid (23n)

d. Spermatids : next to the lumen

e. Spermatozoa

• Location : in the lumen

• Product of spermiogenesis

• Recognized by their long flagella

Seminiferous tubule Testis

Spermiogenesis : cytodifferentiation / transformation of spermatids spermatozoa.

Supporting (Sertoli’s) cells

Structure :

• Tall, columnar cells

• Lateral and apical cell membrane possess complex infoldings

Glands Testis

Interstitial Cells of Leydig

• Scattered among connective

tissue elements of the tunica

vasculosa

• Secrete testosteron

• Are polyhedral, single

nucleus, occasionally

binucleate.

• They have mitochondria with

tubular cristae, large

accumulation of SER and

Golgi apparatus

• The cytoplasma contains

crystals of Reinke

Glands

Accessory Genital Glands

Seminal vesicles :

• Each consist of highly coiled tubes about 15 cm long.

• Mucosa : highly folded with primary, secondary and tertiary branching

• Lumen : lined by pseudostratified columnar epithelium

• Each columnar cells has numerous short microvilli and a single flagellum

Seminal vesicles Prostate gland Bulbourethral glands Glands of Littre

Prostate gland

– collection of 30-50 branched

tubuloalveolar glands excretory

ducts prostatic urethra

– Corpora amylacea are prostatic

concretions, composed of

glycoprotein, which may become

calcified; their numbers increase

with age

– The prostatic secretion serves to

liquefy the coagulated semen after

it is deposited in the female genital

tract.

– Its synthesis and release are

regulated by dihydrotestosterone.

Accessory Genital Glands

Bulbourethral glands (Cowper’s gland)

– Are small 3 to 5 mm in diameter

– Is tubuloalveolar glands, lined by simple cuboidal epithelium

– The secretion product is a thick, slippery fluid containing galactose and sialic acid that plays a role in lubricating the lumen of the urethra

Glands of Littre

– Mucus-secreting

– found throughout the length of the penile urethra

Accessory Genital Glands

Genital ducts • Intratesticular genital ducts:

– Tubuli recti

– Rete testis

– Ductuli efferentes

• Extratesticular genital ducts :

– Epididymis

– Ductus deferens

– Ejaculatory duct

Tubuli recti

Ducts

Rete testis

Ducts

EPIDIDYMIS

EFFERENT

DUCTULES

Ducts

Genital ducts

• Ductus Deferens (vas Deferens)

– Is a thick walled muscular tube

– The lumen : small, irregular and lined by pseudodtratified epithelium

– Lamina propria with elastic fibers

– The three layers of smooth muscle is composed of inner and outer longitudinal layer, middle circular.

– The diameter increases near the termination to form the ampulla

Ducts

Ductus deferens Ducts

Ductus deferens

Penis General organization : its composed of three cylinders of erectile tissue,

– 2 corpora cavernosa : each of these two dorsal erectile tissue is penetrated by a deep artery and ensheated by a thick tunica albuginea

– 1 Corpus spongiosum (corpus cavernosum urethrae) : • This single, smaller, ventral cylinder is surrounded

by a thinner connective tissue sheath. • Its expanded distal tip is the glans penis. • The corpus spongiosum is penetrated along its

length by cavernous (penile) urethra. • The tip of the glans penis is pierced by the end of

the urethra.

The external genetalia

Penis

Erectile tissue.

• within each cylinder is an irregular network of fibrous connective tissue trabecular containing smooth muscle fibers

• The trabeculae form the supporting framework between the numerous endothelium-lined lacunae (vascular sinuses).

Penis

PENIS

CC CC

CS

URETHRA

Penis

Consist of :

– Internal genetalia :

• Ovary

• Oviduct

• Uterus

• Vagina

– External genetalia :

• Mons pubis

• Clitoris

• Labia major

• External urethral orifice

• Labia minora

– Mammary glands ----- related to reproductive hormonal activity

– Placenta ------- relationship with uterus

FEMALE REPRODUCTIVE SYSTEM

Ovary

• Functions :

– Exocrine : gemetogenesis

– Endocrine (steroidogenesis) :

• Estrogen: promote growth and maturation of sex organ including the mammary gland

• Progestogen : prepare the internal sex organs for pregnancy ( promoting secretors changes in the endometrium ). Progesterone also prepare the mammary gland for lactation

- thin connective tissue capsule

underlying germinal epithelium

TUNICA ALBUGINEA

GERMINAL EPITHELIUM

CORTEX

- surrounds the medulla and

contains maturing follicles

MEDULLA

- central connective tissue

containing vascular supply and

nervous innervation

Ovary

Ovary Histology

– The germinal epithelium

– Tunica albuginea :

dense connective tissue

– Connective tissue stroma

that houses ovarian

follicles in various stages

of development and

stromal cells

(= interstitial cells).

The ovarian cortex is consisted of :

Ovarian Follicles

• Evolve through four developmental stages : primordial, primary, secondary, and graafian

• Surrounded by stromal tissue and consist of

– Primary oocyte

– Follicular cells ( granulosa cells), arranged in a single or several layer around primary oocyte

follicular development based on growth of the follicle :

– Non growing, or primordial follicles

– Growing follicles :

• Unilaminar and multilaminar primary follicles : – the zona pellucida appears, separating the oocyte

from follicular cells.

– Stromal cells surrounding follicles theca folliculi

• Secondary (antral) follicles : fluid filled cavities appear among granulosa cells, cumulus oophorus which projects into the antrum corona radiata

• Graafian (mature) follicles : Extends through the entire cortex and Oocyte is displaced to one side of the follicle

Primary follicle

Growing follicles

Secondary (vesicular) follicle

1. antrum

a. liquor folliculi

2. cumulus oophorus

3. oocyte at maximal diameter

4. 1st meiotic division: secondary oocyte & 1st polar body (not visible)

Growing follicles

• Graafian Follicle

– Mature follicle, diameter 2.5 cm

– Extends through the entire cortex and causes a bulge on the outside of the ovary

– Antrum size increase greatly

Growing follicles

Follicular Atresia

• Degeneration of follicle that can occur at any stage

• Phagocytes take up dead oocyte fragments

• Common just after birth (loss of maternal hormones), puberty and pregnancy

• Apoptotic cell death, autolysis

• Follicle cells replaced by stromal cells

Corpus Luteum (Yellow body)

• Collapsed follicle undergoes reorganization

• Bleeding from the theca interna into follicular lumen

• CT from stroma invades follicular cavity

• Granulosa lutein cells: formed from granulosa cells

• Corpus luteum of menstruation :

– if fertilization does not occur, the CL of menstruation forms and degenerates after approximately 14 days

• Corpus luteum gravidarum.

– If pregnancy occurs, human chorionic gonadotropin (hCG) maintains the CL for 3 months

Corpus luteum – granulosa lutein cells

Corpus albicans.

Is dense CT scar, which replaces a degenerated CL

Large ones form after pregnancy and smaller ones after each ovulation

Older ovaries have many

Internal genetalia

Oviduct • Muscular tube 12 cm long

• Upper end opens into peritoneal cavity near ovary

• Lower end passes through the uterus wall

• 4 segments – intramural part in uterine wall

– isthmus is adjacent to uterine wall

– ampulla is dilated part

– infundibulum is funnel-shaped part near ovary with fimbriae

Internal genetalia

Oviduct Wall

• Mucosa – simple columnar epithelium – ciliated cell and nonciliated peg cell – cilia near ovary beat toward uterus – cilia near uterus beat toward ovary – lamina propria of loose connective tissue

• Muscularis – Inner circular layer – Outer longitudinal layer – Peristaltic movements

• Serosa/Adventitia – dense irregular connective tissue – vasculature

Internal genetalia

Uterus Gross anatomy

1. fundus

2. body

3. cervix

Internal genetalia

• Uterine tube histology - 3 cell layers

– internal mucosa (endometrium) - ciliated columnar epithelial cells and secretory cells

– middle muscularis (myometrium)

– outer serous membrane/adventitia – (perimetrium)

Continued Uterus

Endometrium

1. simple columnar epithelium

a. ciliated cells

b. secretory cells

2. lamina propria

a. loose CT

b. uterine glands

Internal genetalia

Continued Uterus

Myometrium

1. poorly organized layers

2. smooth muscle fibers

Internal genetalia

Menstrual Cycle A. Menstrual phase

• days 1-4

• begins with menstrual flow

• no fertilization

• corpus luteum degenerates

• coiled arteries constrict

• ischemia & necrosis of functionalis

• shedding of functionalis

Internal genetalia

Continued Menstrual Cycle

B. Proliferative phase

• days 5-14

• coincides with development of ovarian follicles

• Glands are straight and lined by a simple columnar epithelium.

• regeneration

Internal genetalia

Continued Menstrual Cycle

C. Secretory phase

• days 15-28

• begins after ovulation

• depends on corpus luteum secretions

• uterine glands become coiled and distended

• prepared to receive zygote

Internal genetalia

Placenta

Structure

1. chorionic villi

a. trophoblast layers

b. mesenchyme

c. fetal blood vessels

Internal genetalia

Continued structure Placenta

2. intervillous space

a. maternal circulation

Internal genetalia

Placenta

Function: placental barrier

a. trophoblast layers

b. basal lamina of trophoblast

c. mesenchyme

d. basal lamina of capillaries

e. endothelium of fetal capillary

Internal genetalia

3 parts of Uterus (cont.) 3) Cervix

• narrow portion that opens into vagina

• produces cervical mucus; (20-60 mL/day) – more receptive to

spermatazoa at or near ovulation

– otherwise the mucus plug keeps microbes out

• cervix, mucus – protect spermatazoa

– provide nutrients

– role in capacitation

• Cervical canal in cervix

– internal os

– external os

Internal genetalia

Squamous mucosa

(Exocervix) Columnar mucosa (Endocervix)

Transformation Zone

Nabothian cysts

CERVIX

Internal genetalia

Vagina

– Tubular, fibromuscular organ with mucous membrane

– Between bladder, rectum

• superiorly attached to uterus

• recess (fornix) forms around the attachment to the cervix

– Several functions • passage for menstrual flow, childbirth

• receives penis and semen

fornix

Internal genetalia Internal genetalia

• Vagina histology – Mucosa continuous with the uterus

• non-keratinized stratified squamous epithelium and connective tissue in folds (rugae)

– mucosal cells have large stores of glycogen

– upon decomposition produce organic acids lowers pH

• dendritic (APC) cells – (source for HIV attachment -- AIDS?)

– Muscularis • smooth muscle - outer circular, inner longitudinal layers

• stretches to receive penis and for accommodating childbirth

– Adventitia - areolar connective tissue

• Vaginal orifice - hymen – thin membrane

Internal genetalia

FEMALE REPRODUCTIVE SYSTEM

VAGINA

STRATIFIED SQUAMOUS EPITHELIUM

LAMINA PROPRIA

---------------- no glands ----------------

MUSCULARIS

INNER CIRCULAR

OUTER LONGITUDINAL

ADVENTITIA

MUCOSA

FEMALE REPRODUCTIVE SYSTEM

LABIA MINORUM

LABIA MINORUM H&E

Mammary glands

• These accessory glands of the skin are specialized to secrete milk

• Each glands are :

– compound tubuloalveolar glands,

– contains 15 to 25 lobes,

– Separated by adipose tissue and dense connective tissue

• Each lobe is drained by lactiferous duct, which exhibit terminal expansion or lactiferous sinus before opening independently on the nipple

Mammary Glands

• Organs of milk production located within mammae or breasts

– Consist of glandular lobes and adipose tissue

– Cooper’s ligaments support the breasts

Areola and the nipple

• Areola :

– is the circular, heavily pigmented skin in the center of the breast

– Its contains : sweat glands (of Montgomery)

• Nipple :

– A protuberance in the center of areola, covered by stratified squamous ep containing the terminal openings of the lactiferous duct

SELAMAT BELAJAR