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Female Reproductive System

Histology Department
Introduction
Enam besar fungsi:
Produksi gamet betina, ova yang
Penerimaan dari gamet laki-laki,
spermatozoa yang
Penyediaan lingkungan yang sesuai
untuk fertilisasi ovum oleh
spermatozoa
Penyediaan lingkungan untuk
perkembangan janin
Sebuah alat untuk pengusiran janin
dikembangkan untuk lingkungan
eksternal
Gizi bayi yang baru lahir
Tiga unit struktural
berdasarkan
fungsi:
Indung telur
Saluran kelamin
Payudara
Introduction
INTERNAL PARTS :
OVARIES
OVIDUCT
UTERUS
VAGINA
EXTERNAL PARTS :
OPENING OF THE VAGINA
LABIA (MAJORA & MINORA)
VESTIBULE
CLITORIS
CATATAN: WALAUPUN TIDAK organ kelamin,
kelenjar susu aksesori ADALAH ORGAN PENTING
DARI saluran reproduksi wanita.
Anatomi INTEGRASI UNTUK REPRODUKSI
ANATOMICAL INTEGRATION FOR
REPRODUCTION

Pembuahan
DAN PENGEMBANGAN
MEMBERIKAN DAN EXIT
Picture taken from Basic
Histology Text & Atlas , 10th
edition, L. Carlos Junquira MD,
Jose Carneiro MD, Robert O.
Kelley PhD, Lange Medical
Books, Mc Graw-Hill , 2003.
Ovary
KOTOR ANATOMI
APROXIMATION CLOSE ATAS saluran telur
BADAN dipasangkan Oval YANG LIE ON
SETIAP SISI ATAS DARI RAHIM
Diadakan di POTITION ATAS RAHIM oleh
ligamen
2 .anatomi yang berbeda DAERAH
DIJAMIN OLEH mesotelium YANG
BERKELANJUTAN DENGAN YANG DARI
MESOVARIUM ATAS, ATAS sel skuamosa
MENJADI CUBOIDAL DAN BENTUK epitel
permukaan ovarium epitel germinal = (JANGKA
LAMA)
Meduler-sangat vaskular, CT, limfatik dan saraf
Korteks-folikel, CT, DAN BEBERAPA OTOT
HALUS
Tunica albuginea UNTUK MEMISAHKAN DARI
epitel korteks
Histology of
Ovary
Bagian dari indung telur
dengan korteks &
meduler daerah.
H & E noda.
Pembesaran rendah
Picture taken from Basic Histology
Text & Atlas , 10th edition, L.
Carlos Junquira MD, Jose
Carneiro MD, Robert O. Kelley
PhD, Lange Medical Books, Mc
Graw-Hill , 2003.
Daerah kortikal dari indung telur
1.Ovary dikelilingi oleh epitel
germinal & oleh tunika albuginea
2.Groups folikel primordial, masing-
masing dibentuk oleh oosit dikelilingi
oleh lapisan sel
3.follicular datar, yang hadir dalam
jaringan ikat indung telur (stroma).
Giemsa stain. Pembesaran rendah.
Picture taken from Basic Histology Text &
Atlas , 10th edition, L. Carlos Junquira MD,
Jose Carneiro MD, Robert O. Kelley PhD,
Lange Medical Books, Mc Graw-Hill , 2003.
Perkembanga
n folikel
Ovarian follicle
Primordial
follicles
1.Located di korteks hanya di bawah
tunika albuginea.
2.One lapisan sel folikel rata mengelilingi
oosit (sekitar 30 m diameter).
3.the inti oosit diposisikan eksentrik dalam
sel.
Tampaknya sangat ringan dan berisi
Nukleolus terkemuka.
Sebagian besar dari agregat organel oosit
di tengah sel, di mana mereka
membentuk tubuh vitelline (mungkin tidak
terlihat dalam salah satu persiapan yang
tersedia).
Pararosaniline
toluidine blue (PT)
stain.
Low magnification.
Picture taken
from Basic
Histology Text &
Atlas, 10th
edition, L. Carlos
Junquira MD,
Jose Carneiro
MD, Robert O.
Kelley PhD,
Lange Medical
Books, Mc Graw-
Hill , 2003.
Dibentuk oleh:
sebuah oosit &
satu lapisan
dari cuboidal
sel granulosa


Formed by:
An Oocyte &
flat follicular
cells


The primary follicle
Morfologi Tahap pertama yang menandai awal pematangan
folikel
Sel oosit sebelumnya rata sekitar sekarang membentuk
epitel cuboidal atau kolumnar sekitar oosit.
Sitoplasma mungkin memiliki penampilan granular (sel
granulosa).
Perkembangan lanjutan dari sel-sel akan menghasilkan
pembentukan epitel berlapis (dengan membran basal
berbeda) yang mengelilingi oosit.
The zona pellucida (glikoprotein antara proses interdigitating
dari oosit dan sel granulosa) menjadi terlihat.
sel parenkim dari ovarium sekitar folikel tumbuh menjadi
terorganisir di bungkus konsentris, yang folliculi teka.
Secondary follicle
ruang kecil berisi cairan menjadi terlihat antara sel granulosa sebagai
folikel mencapai diameter sekitar 400 m.
Memperbesar ruang tersebut dan sekering untuk membentuk antrum
folikuler (fitur mendefinisikan dari folikel sekunder).
oosit ini sekarang terletak eksentrik di folikel di oophorus kumulus, mana
dikelilingi oleh sel granulosa.
The teka folliculi membedakan dengan pertumbuhan lanjutan dari folikel
menjadi teka internasional dan teka eksterna.
_Vascularization Dari teka internasional meningkatkan
_The sel berbentuk gelendong atau polyhedral dalam lapisan ini mulai
memproduksi estrogen.
_The Teka eksterna mempertahankan karakteristik dari jaringan ikat yang
sangat seluler dengan sel otot polos.
Oosit sekunder dari folikel mencapai diameter sekitar 125 m.
Folikel sendiri mencapai diameter sekitar 10-15 mm.
An antral follicle:
Oocyte surrounded by granulosa cells
of corona radiata & supported by
cumulus oophorus.
The remaining granulosa cells form
wall of follicle & surround large antrum.
A theca surrounds the whole follicle.
A small part of wall of
antral follicle:
Antrum
Granulosa cells
Thecas interna & externa
A basement membrane
separates the granulosa
layer from the theca interna.
PT stain. High magnification.
Mature or tertiary or preovulatory or
Graafian follicle
Increases further in size (in particular in
the last 12h before ovulation).
The Graafian follicle forms a small
"bump" on the surface of the ovary, the
stigma (or macula pellucida).
The stigma is characterised by a thinning of
the capsule and a progressive restriction of the
blood flow to it.
Prior to ovulation the cumulus oophorus
separates from the follicular wall.
The oocyte : floating freely in the follicular
antrum.
It is still surrounded by granulosa cells which
form the corona radiata.
The follicle finally ruptures at the stigma
and the oocyte is released from the ovary
Atresia
Atresia adalah nama untuk proses degeneratif
dimana oosit (dan folikel) binasa tanpa telah diusir
oleh ovulasi.
Hanya sekitar 400 oosit ovulasi - sekitar 99,9% dari
oosit yang mana hadir pada saat pubertas
mengalami atresia.
Atresia mungkin efek oosit pada semua tahap dari
"hidup mereka" - baik sebelum lahir dan postnatally.
Pada bulan keenam kehamilan sekitar 7 juta oosit
dan oogonium yang hadir dalam ovarium.
Pada saat lahir jumlah ini berkurang menjadi sekitar
2 juta. Dari jumlah tersebut hanya sekitar 400,000
bertahan hingga pubertas.
Atresia juga modus penghancuran pematangan
folikel yang dimulai selama Siklus (10-15) tetapi yang
tidak berovulasi.
Atresia adalah operasi sebelum pubertas untuk
menghilangkan folikel yang mulai jatuh tempo
selama periode ini (tidak ada yang berovulasi).
Mengingat bahwa atresia folikel mempengaruhi pada
berbagai tahap perkembangan mereka jelas bahwa
proses tersebut dapat mengambil cukup beragam
penampilan histologik
Characteristic of FOLLICLE ATRESIA
1. Loss of cells of corona radiata
2. Oocyte floating free
within antrum
3. Death of granulosa cells,
many of which are seen
loose in antrum
PT stain.
Medium magnification
Picture taken from Basic Histology Text &
Atlas , 10th edition, L. Carlos Junquira MD,
Jose Carneiro MD, Robert O. Kelley PhD,
Lange Medical Books, Mc Graw-Hill , 2003.
The Corpus luteum
The wall of the follicle collapses into a folded structure
(characteristic for the corpus luteum).
Vascularization increases
Connective tissue network is formed.
Theca interna cells and granulosa cells triple in size
and start accumulating lutein within a few hours after
ovulation (granulosa lutein cells and theca lutein cells
and produce progesterone and oestrogens)
Hormone secretion in the corpus luteum ceases within
14 days after ovulation if the oocyte is not fertilised (the
corpus luteum degenerates into a corpus albicans -
whitish scar tissue within the ovaries).
Hormone secretion continues for 2-3 month after
ovulation if fertilisation occurs.
Corpus luteum

Corpus Luteum
Corpus Luteum Corpus albicans
Corpus albicans
Oviduct
-Fungsi: sebagai sarana bagi oosit,
dari ovarium ke rahim.
-Histologis:
_the saluran telur terdiri dari:
1 a mukosa dan muskularis.
2 peritoneal Permukaan saluran
telur dibatasi oleh serosa dan
jaringan ikat yg terletak di bawah.
Oviduct
mukosa yang
Dibentuk oleh epitel silia dan sekresi
beristirahat pada lamina propria yang sangat
selular.
Jumlah sel silia dan sel sekretori bervariasi di
sepanjang saluran telur (lihat di bawah).
Aktivitas Sekretori bervariasi selama siklus
menstruasi, dan beristirahat sel sekretori juga
disebut sebagai pasak-sel.
Beberapa substansi yang dikeluarkan
diperkirakan memelihara oosit dan embrio
sangat awal.
The muskularis
Terdiri dari lapisan otot dalam lingkaran dan
lapisan longitudinal luar.
Lapisan longitudinal dalam hadir di tanah
genting dan bagian intramural (lihat di bawah)
saluran telur.
tindakan otot peristaltik tampaknya lebih
penting untuk pengangkutan sperma dan oosit
dari tindakan dari silia.
Oviduct
1 infundibulum: berbentuk corong (hingga 10 mm diameter) akhir saluran
telur.
- Finger ekstensi seperti margin nya, fimbriae, adalah erat diterapkan
pada ovarium.
- Sel berbulu mata yang sering. silia mengalahkan mereka ke arah
2 ampula saluran telur.
- Lipatan mukosa, atau plicae, dan lipatan sekunder yang timbul dari
plicae yang membagi lumen ampula ke dalam bentuk yang sangat
kompleks.
- Pemupukan biasanya terjadi di ampula tersebut.
3 tanah genting ini adalah bagian sempit (2-3 mm) dari bagian-bagian
saluran telur yang terletak dalam rongga peritoneal.
- Mukosa lipatan kurang kompleks dan muskularis yang tebal. Lapisan,
dalam otot longitudinal hadir di tanah genting dan
4 intramural bagian dari saluran telur, yang menembus dinding rahim.
mukosa adalah halus, dan diameter bagian dalam saluran sangat kecil.
Uterine Tube
Three layers:
Mucosa
Muskularis
Serosa
Wall of an oviduct

Sangat melipat
mukosa
menunjukkan
bahwa daerah ini
dekat dengan
ovarium. PT stain
Pembesaran
rendah.

Oviduct Epithelial
sel berbulu mata
berkontribusi
terhadap
pergerakan oosit
atau konsepsi ke
uterus
PT noda.
Pembesaran tinggi.
Picture taken from Basic
Histology Text & Atlas , 10th
edition, L. Carlos Junquira MD,
Jose Carneiro MD, Robert O.
Kelley PhD, Lange Medical
Books, Mc Graw-Hill , 2003.
Oviduct
The Uterus
The uterus is divided into
1. Body (upper two-thirds) and
2. Cervix
The walls of the uterus are composed of
a
Mucosal layer (the endometrium)
A fibromuscular layer (the myometrium).
The peritoneal surface of the uterus is
covered by a serosa

Phases on Menstrual Cycle
UTERUS
Myometrium
The muscle fibres of the uterus form
layers with preferred orientations of
fibres (actually 4), but this is very
difficult to see in most preparations.
The muscular tissue hypertrophies
during pregnancy, and GAP-junctions
between cells become more frequent.
The Uterus
Endometrium
Consists of a simple columnar epithelium
(ciliated cells and secretory cells) and an
underlying thick connective tissue stroma.
The mucosa is invaginated to form many
simple tubular uterine glands.
The glands extend through the entire
thickness of the stroma.
The stromal cells of the endometrium are
embedded in a network of reticular fibres.
The endometrium is subject to cyclic
changes that result in menstruation. Only the
mucosa of the body of the uterus takes part
in the menstrual cycle
The Uterus
The Uterus
Endometrium
The endometrium can be divided into two zones
based on their involvement in the changes during
the menstrual cycle: the basalis and the
functionalis.
The basalis is not sloughed off during
menstruation but functions as a regenerative
zone for the functionalis after its rejection.
The functionalis is the luminal part of the
endometrium. It is sloughed off during every
menstruation and it is the site of cyclic changes in
the endometrium. These cyclic changes are
divided into a number of phases: proliferative (or
follicular), secretory (or luteal), and menstrual.
The surface epithelium & uterine glands are
embedded in a lamina propria made of very
loose connective tissue.
PT stain. Medium magnification.
Straight uterine glands in deep endometrium
during proliferative phase. Smooth muscle of
myometrium is also seen. H&E stain. Medium
magnification
Uterine glands during luteal phase
uterine glands become tortuous and their
lumen is filled with secretions. Some
edema is present in the connective tissue.
H&E stain. Medium magnification.
Inset: High magnification.
Cervix
TRANTITIONAL EPITHELIUM (T zone) GOES FROM SQUAMOUS (ectocervix)
TO SECRETING (UTERINE GLANDS) COLUMNAR EPITHELIUM (endocervix).
VISCOUS OF MUCUS GLANDS CHANGES WITH MENSTRUAL CYCLE
CERVIX TO VESTIBULE
MULTILAYERED
MUCOSAL
FOLDS OF STRATIFIED EPITH
NOT KERATINIZED BUT KERATOHYALIN GRANULES MAY
BE VISIBLE
NO GLANDS BUT CELLS ARE HIGH IN GLYCOGEN
MUCUS COMES FROM CERVICAL GLANDS
MUSCULARIS-SMOOTH MUSCLE
ADVENTITIAL
Cervix
Normal endocervix: epithelium
composed of one layer of mucin
secreting cells with few reserve
cells (arrow).
Structure of the ectocervix:
CT=connective tissue, BM=basement
membrane, L1=basal cells (1 layer),
L2=parabasal cells (2 layers),
L3=intermediate cells (around 8 layers),
L4=superficial cells (5 or 6 layers) and
L5=exfoliating cells
Ectocervix
Structure of the ectocervix - details of
basal, parabasal & intermediate layers:
connective tissue, basal cells (one layer),
parabasal cells (two layers), intermediate
cells (some layers) with inter-cellular
bridges. The N/C ratio of basal & parabasal
cells is high
Structure of the ectocervix :
details of the superficial layers :
superficial cells (5 or 6 layers). The
N/C ratio is very low and the axis of
cells is parallel to the basement
membrane
Transformation Zone
Transformation zone: normal
squamous epithelium (red star),
squamous metaplasia (green star) with
some remaining endocervical cells (blue
arrow)
Transformation zone: squamous
epithelium islet in the endocervix
area.
All cervix pictures downloaded from :
http://screening.iarc.fr/atlasglossdef.p
hp?key=Normal+endocervix&img
Different types of squamous cells - A: superficial cells
(arrows); B: intermediate cells; C: parabasal cells; D:
metaplastic cells. (obj. 20x)
Cervix Cells & paps smear
Vagina
The vagina is a fibromuscular tube with a wall consisting of three layers:
Mucosa
The stratified squamous epithelium (deep stratum basalis, intermediate
stratum spinosum, superficial layers of flat eosinophilic cells which do
contain keratin but which do not normally form a true horny layer) rests on
a very cellular lamina propria (many leukocytes). Towards the muscularis
some vascular cavernous spaces may be seen (typical erectile tissue).
Muscularis
Inner circular and outer longitudinal layers of smooth muscle are present.
Inferiorly, the striated, voluntary bulbospongiosus muscle forms a
sphincter around the vagina.
Adventitia
The part of the adventitia bordering the muscularis is fairly dense and
contains many elastic fibres. Loose connective tissue with a prominent
venous plexus forms the outer part of the adventitia.
Stratified squamous epithelium of
vagina supported by a dense connective
tissue. The cytoplasm of these epithelial
cells is clear because of accumulated
glycogen.
PSH stain. Medium magnification.
Vagina
Female Accessory Reproductive Glands -
Mammary Glands
The mammary glands are modified glands of the skin (resembles that of sweat
glands).
Compound branched alveolar glands, which consist of 15-25 lobes separated by
dense interlobar connective tissue and fat (Each lobe contains an individual gland)
The excretory duct of each lobe, also called lactiferous duct, has its own opening on
the nipple.
The lactiferous duct has a two layered epithelium - basal cells are cuboidal whereas
the superficial cells are columnar.
Beneath the nipple, the dilated lactiferous duct forms a lactiferous sinus , which
functions as a reservoir for the milk.
Branches of the lactiferous duct are lined with a simple cuboidal epithelium.
The secretory units are alveoli, which are lined by a cuboidal or columnar
epithelium.
A layer of myoepithelial cells is always present between the epithelium and the
basement membrane of the branches of the lactiferous duct and the alveoli.
Breast
Mammary Gland
Pregnancy
Placenta
Placenta
Placenta
Placenta
The placenta may be usefully understood as
a "parasite" feeding on blood from the
endometrium (Imagine scooping out a portion
of the endometrium).
The resulting bowl will fill with blood from
broken vessels in the endometrial stroma.
Now lay a cover over the bowl, and imagine
many "roots" extending down from the cover
into the blood-filled hollow (the roots can
absorb oxygen and nutrients from the blood
in which they are bathed).
Placenta
The cover is the chorionic plate of the placenta.
The "roots" are the chorionic villi.
Both the placenta and the chorionic villi are entirely fetal tissue (orange in the
diagram above).
"Anchoring villi" attach the placenta to the endometrium.
Smaller branching villi extend out into the intervillous space.
Fetal circulation passes down the umbilical cord, though vessels in the villi,
and back up the umbilical cord.
Maternal blood "spills" from open endometrial arteries (the spiral arteries) into
the intervillous space (pink in the diagram above), and returns into endometrial
veins.
The chorionic villi are surrounded and bathed by "lakes" of maternal blood.
Within the intervillous space, maternal blood is not contained by blood vessels
The surface of the chorionic villi is an epithelial layer, the fetal
syncytiotrophoblast, which has the ability to grow invasively into the maternal
endometrium. The syncytiotrophoblast also has microvilli on the surface for
absorbing nutrients from maternal blood.
Beneath the syncytiotrophoblast (i.e., toward the core of the villus), is the
cytotrophoblast, a layer of cuboidal cells which eventually disappear. (The
cytotrophoblast also forms trophoblast columns, masses of cells filling the ends
of anchoring villi.)
Maternal endometrial stromal tissue adjacent to the placenta differentiates into
large decidual cells (so named because the outer layer of the endometrium is
shed at birth along with the placenta). Decidual cells may intermix with fetal cells
in the cytotrophoblast. The boundary between maternal and fetal tissue is
immunologically interesting.
Umbilical Cord
The umbilical cord is simply a conduit carrying fetal blood
between the fetus and the placenta. It normally contains
two arteries and one vein, surrounded by extensive
mesenchymal tissue ("Wharton's jelly").
Consists of so-called "mucous" or mesenchymal
connective tissue, also called Wharton's jelly (widely
scattered mesenchymal fibroblasts within soft, jelly-like
ground substance of hyaluronic acid and chondroitin
sulfate)
Surrounded by a thin stratified squamous epithelium and
including typically two arteries and one vein. [The
second vein in this image presumably represents one
portion of a double U-shaped bend in this single
vein.] The arteries lack internal and external elastic
layers.
Umbilical Cord