the uterus - pdfs.semanticscholar.org file–the inferior segment of the uterus centered by the...
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THE UTERUS
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The uterus • Hollow muscular organ
• 3 segments – the body
- the isthmus
- the cervix
The body and the isthmus have a common organization
The uterine wall is composed of 3 layers:
– Endometrium
– Myometrium
– Perimetrium
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Uter - Secţiune transversală, x4
Endometrium
Myometrium
Perimetrium
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The myometrium
• the thickest muscular layer
• smooth muscular fibers , arranged in 3 layers:
– longitudinal – outer and inner
– plexiform – middle
– numerous blood vessels, especially in the middle layer,
the media is continuous with myometrial fibers
• lymphatic vessels, nerves
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Endometrium
• simple columnar epithelium with
• columnar ciliated cells
• columnar secretory cells
• lamina propria • connective tissue
• blood vessels
• simple tubular glands
en
do
metriu
m
myo
metriu
m
Histology Atlas Junquira
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Endometrium
• Functionally divided into:
- Basal layer
- Functional layer
- spongy
- compact
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Menstrual phase
• Days 1-4
• The average time 3-4 days
• The plasma concentration of progesterone and
estrogens declines rapidly
• It occurs in the absence of fertilization
• Rupture of blood vessels in the upper portions
• Detaching the functional area of the endometrium
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Proliferative phase
• Days 5-14
• Influenced by estrogen secretion
• The endometrium grows in thickness
• The endometrial glands – columnar pseudostratified epithelium, straight structure and narrow lumen
• Spiral arteries grow near the surface of the endometrial epithelium
The end of
proliferative
phase
Day 14
The secretory
phase
Days 14-21
The end of
Secretory phase
Days 22-28
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The proliferative phase
Histology Atlas Junqueira
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The proliferative phase
muscular fibres
glands
Atlas
Junqueira
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The secretory phase
• Begins after ovulation (days 15-28)
• Influenced by progesterone secretion
• The endometrium grows in thickness
• The glands enlarge, become corkscrew shaped with wide lumen and mucous secretion
• The spiral arteries- grow and become more coiled
• In the end stromal edema appears
Junqueira Histology Atlas
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The secretory phase (luteal)
Junqueira Histology Atlas
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Faza Secretorie (Luteală)
glands
Functional layer
Basal layer
Functional histology H.G. Burkitt
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Cervix
– The inferior segment of the uterus centered by the cervical canal
– ectocervix
– endocervix
• Ectocervix – non-keratinized stratified squamous
epithelium
• Endocervix – simple columnar epithelium with
numerous branched tubular mucous glands
• Cervix structure – 75% connective tissue and 25%
smooth muscle tissue
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Cervix
Simple columnar
epithelium Endocervix Ectocervix
Stratified squamous
epithelium
Cervical gland cyst
Cervical glands
Functional histology H.G. Burkitt
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ENDOCERVIX/ECTOCERVIX JUNCTION
Functional histology H.G. Burkitt
junction
Endocervix
epithelium
crypts
mucus
Tubular mucous
glands
Nabothian cysts
chorion
Arteries and
veins
Ectocervix vaginal
epithelium
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The vagina
• Mucosa
– Non-keratinzed stratified squamous epithelium
– lamina propria– well vascularized with many elastic fibers
– without glands
• Muscularis
– smooth muscle fibers, inner circular layer and outer longitudinal layer
– inferior striated muscle fibers
• Adventitia
– dense connective tissue with numerous elastic fibers, blood vessels and nerves
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The vagina
Atlas histology Gartner
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BABEȘ/PAPANICOLAU Can establish the estro-progesteronic hormonal profile
Outer layer
Middle
layer
Inner layer
www.histology-world.com
section smear
Superficial
acidophilic
cells
Superficial
basophilic
cells
Intermedial
cells
Parabasal
cells
Basal cells
Neoplasmic
basal cells
Histologycal section
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Mature placenta
• Organ that ensure the maternal- fetal exchanges during pregnancy
• Basal plate
• Chorionic plate
• Villous system
www.histology.com
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Mature placenta • Components:
- chorionic plate
with umbilical
vessels,
- basal plate
- villous system
• The cotyledons are
delimitated by
intercotyledon septa
from basal plate.
• In the centre of the
cotyledon there is a
primary chorionic
villus connected to the
basal plate.
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Basal plate
Starting from intervillous space, includes:
•syncytiotrophoblast
•fibrous connective tissue
•fibrinoid
•the compact layer of functional endometrium - decidual
transformation
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Basal plate
Functional histology H.G. Burkitt
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Chorionic plate
• simple squamous epithelium facing the amniotic
cavity
• stromal connective tissue with umbilical vessels (two
arteries and one vein).
• the syncytiotrophoblast lining the intervillous space.
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VILLOUS SYSTEM Villous system contains the chorionic villi and
intervillous space.
The chorionic villi are clasified: primary, secondary or
tertiary
Structurally, the chorionic villi presents (from the
outside to the inside):
•Syncytiotrophoblast
•The basement membrane
•Villous stroma with branches of umbilical vessels (fetal)
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The cotyledon is delimitated by septa with a central primary villus.
www.oxford medicin.com
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The mammary gland
– compound tubulo-alveolar gland, apocrine
– composed of 15-20 lobes
• Each lobe is acting like an independent gland and
is composed of several glandular lobules.
• Each lobe ends in a lactiferous duct that opens in
the lactiferous sinus.
• Glandular lobules:
- outside – dense connective tissue
- inside – stroma
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The mammary gland
Inactive mammary gland Active mammary gland
Junqueira histology Atlas
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Inactive mammary gland
• Glandular lobule
• Small intralobular ducts (simple cuboidal
epithelium)+ rudimentary secretory
structure.
• Intralobular ducts - interlobular terminal
duct (simple cuboidal epithelium) -
lactiferous ducts (stratified cuboidal
epithelium)
Junqueira Histology Atlas
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Lactating mammary gland
• Parenchymal component prevails.
• Large acini with secretory cells- cytoplasm filled with lipid secretory granules
• Proliferation of intralobular alveoli at the ends of intralobular ducts.
• Intralobular and extralobular stroma is reduced.
www,oxford medicin.com
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Lactating mammary gland
http//:siumed.edu
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Ovary – general histological structure
• Cortex
• Medulla
• Hillock
medulla cortex
Ovarian follicles
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Ovary
Ovary, HE, 4x
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Ovarian cortex Germinal epithelium Tunica albuginea Stroma Ovarian follicles Corpus hemorrhagicum, luteum, corpus
albicans
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Ovary – ovarian stroma
• Connective tissue –
• Prominent cellular component - fibroblast – like cells
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Types of ovarian follicles
Pre-ovulation stage
• Primordial
• Growing follicles – early primary
– late primary
– secondary
• Mature(Graafian)
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Ovary – ovarian follicles
• Primordial follicle
– Oocyte I
– A single layer of squamous follicular cells
• Early primary follicle
– Oocyte I
– A single layer of cuboidal follicular cells
Ovary, HE, 40x
Primary
follicle
Primordial
follicle
Follicle
cells
Granulosa cells
oocyte
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Ovary – ovarian follicles
• Late primary follicle
– Oocyte I
– Zona pellucida
– Multiple layers of follicular cells = granulosa
– Basal lamina
– Theca folliculi • Interna - large, rounded and
epithelial-like
• Externa - smaller, fibroblast-like
Ovary, HE, 40x
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Ovary – ovarian follicles
Secondary follicle, HE, 40x
Secondary follicles
Oocyte I
Zona pellucida
Granulosa
Pockets of follicular fluid
within the granulosa
Basal lamina
Theca interna
Theca externa
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Ovary – ovarian follicles
• Mature(Graafian) follicles – Oocyte I
– Zona pellucida
– Granulosa cells: • Corona radiata
• Cumulus oophorus
• Granulosa
– Follicular antrum
– Basal lamina
– Theca interna
– Theca externa
Mature(Graafian) follicle, HE, 40x
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Ovary – Corpus luteum
• Granulosa lutein cells
• Theca lutein cells
• Connective-vascular septa
• Blood clot
Ovary – Corpus luteum, HE, 40x
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Ovary – corpus albicans
Ovary, corpus albicans, HE, 20x
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Ovarian Medulla • Loose connective
tissue –elastic fibers • Blood vessels • Lymphatic vesssels • Nerves • Interstitial cells–
estrogens • Ovarian hilar cells
(Leydig –like) – androgens
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Uterine tubes
• Muscle – membranous tube -10-12 cm long
• 4 segments:
– Intramural part
– Isthmus
– Ampulla
– Infundibulum - fimbriae
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The wall of the uterine tube
• Mucosa
– Longitudinal folds
– Simple columnar epithelium
– Lamina propria
• Muscularis
– 2 layers of smooth muscle cells-CI, LE
• Serosa
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Uterine tube
Folds
epithelium
Lamina
propria
Secretory
cells
Ciliated
cells