URINARY SYSTEM

1. Functions of kidneys
Renal function involves specific activities:

■ Filtration, by which water and solutes in the blood leave the vascular space and enter the
lumen of the nephron.

■ Tubular secretion, by which substances move from epithelial cells of the tubules into the
lumens, usually after uptake from the surrounding interstitium and capillaries

■ Tubular reabsorption, by which substances move from the tubular lumen across the
epithelium into the interstitium and surrounding capillaries.

2. Histological structure of kidneys

The kidney is divided into an inner medulla and outer cortex

The medulla consists of 10-18 medullary pyramids. From the base of each medullary pyramid
the medullary rays penetrate the cortex. The cortex is the peripheral part lying between the
capsule and the bases of renal pyramids.The cortical tissue surrounding each medullary
pyramid is a renal lobe, and each medullary ray forms the center of a conical renal lobule.A part
of cortex projects inwards between the renal pyramids and forms the renal columns of
Berlin.

Nephron: Each kidney is composed of 1-4 millions nephrons—- the structural and functional
units .Each nephron consists of:

1) dilated portion, the capsule of the renal corpuscle,

2) proximal convoluted tubule,

3) proximal straight tubule (thick descending limb of Henle’s loop),

4) thin descending limb of Henle’s loop,

5) thin ascending limb of Henle’s loop,

6) distal straight tubule (thick ascending limbs of Henle’s loop), 7) distal convoluted tubule.

3. Describe features of kidney blood supply (sequence of vessels)

■ Renal arteries branch to form smaller arteries between the renal lobes, with interlobular
arteries entering the cortex to form the microvasculature; venous branches parallel the arterial
supply.

■ In the cortex afferent arterioles enter capillary clusters called glomeruli, which are drained by
efferent arterioles, instead of venules, an arrangement that allows higher hydrostatic pressure in
the capillaries.

■ The efferent arterioles from cortical glomeruli branch diffusely as peritubular capillaries, while
those from juxtamedullary glomeruli branch as long microvascular loops called vasa recta in the
medulla.

4. Define the nephron, name its main parts and types of nephrons based on
their location

Functional units of the kidney are the nephrons, numbering about 1 million, each with a renal
corpuscle and a long renal tubule, and a system of collecting ducts.

■ The renal corpuscle has a simple squamous parietal layer of the glomerular (Bowman)
capsule, continuous with the proximal tubule, and a specialized visceral layer of podocytes
surrounding the glomerular capillaries.

■ Podocytes extend large primary processes that curve around a capillary and extend short,
interdigitating secondary processes or pedicels, between which are narrow spaces called slit
pores.

■ The elevated pressure in the capillaries forces water and small solutes of blood plasma
through the glomerular filter into the capsular (or urinary) space inside the glomerular capsule.

■ In each glomerulus the filter has three parts: the finely fenestrated capillary endothelium; the
thick (330 nm) fused basal laminae of type IV collagen and other proteins produced by the
endothelial cells and podocytes; and the slit pores between the pedicels, covered by thin
filtration slit diaphragms.

■ From the renal corpuscle, filtrate enters the long nephron tubule that extends through both the
cortex and medulla, with epithelial cells for both reabsorption and secretion of substances into
the filtrate.

■ The first tubular part, the proximal convoluted tubule (PCT), is mainly cortical, has simple
cuboidal cells with long microvilli

5. Describe the structure of the Bowman’s capsule

■ The renal corpuscle has a simple squamous parietal layer of the glomerular (Bowman)
capsule, continuous with the proximal tubule, and a specialized visceral layer of podocytes
surrounding the glomerular capillaries.
■ Podocytes extend large primary processes that curve around a capillary and extend short,
interdigitating secondary processes or pedicels, between which are narrow spaces called slit
pores.

■ The elevated pressure in the capillaries forces water and small solutes of blood plasma
through the glomerular filter into the capsular (or urinary) space inside the glomerular capsule.

■ In each glomerulus the filter has three parts: the finely fenestrated capillary endothelium; the
thick (330 nm) fused basal laminae of type IV collagen and other proteins produced by the
endothelial cells and podocytes; and the slit pores between the pedicels, covered by thin
filtration slit diaphragms

6. Define the process of filtration

■ Filtration, by which water and solutes in the blood leave the vascular space and enter the
lumen of the nephron. Filtration, therefore, occurs through a structure with three parts:

■ The fenestrations of the capillary endothelium, which blocks blood cells and platelets

■ The thick, combined basal laminae, or GBM, which restricts large proteins and some organic
anions

■ The filtration slit diaphragms between pedicels, which restrict some small proteins and
organic anions

Filtrate is produced in the corpuscle when blood plasma is forced under pressure through the
capillary fenestrations, across the filtration membrane or GBM surrounding the capillary, and
through the filtration slit diaphragms located between the podocyte pedicels.

7. Filtration barrier (components, functions)

The glomerular filtration barrier consists of three layered components: the fenestrated capillary
endothelium, the glomerular basement membrane (GBM), and filtration slit diaphragms between
pedicels. The major component of the filter is formed by fusion of the basal laminae of a
podocyte and a capillary endothelial cell.

8. Mesangial cells (types, functions)

Mesangial cells are specialized pericytes which contain contractile proteins and may act
as macrophages. They are an unusual example of phagocytic cells derived from
smooth muscle and not monocytes.

9. Define the process of reabsorption and secretion

■ Tubular secretion, by which substances move from epithelial cells of the tubules into
the lumens, usually after uptake from the surrounding interstitium and capillaries
 ■ Tubular reabsorption, by which substances move from the tubular lumen across the
epithelium into the interstitium and surrounding capillaries.

10. Describe the structure and function of the nephron proximal convoluted
tubules

PCT are located in Cortex Simple cuboidal epithelium; cells well-stained, with numerous
mitochondria, prominent basal folds and lateral interdigitations; long microvilli, lumens often
occluded. Its major functions are Reabsorption of all organic nutrients, all proteins, most water
and electrolytes; secretion of organic anions and cations, H+, and NH4+.

11. Describe the structure and function of the loop of Henle

Loop of henle is located in the medulla, which has squamous thin descending and ascending
limbs; the latter extends as a thick ascending limb (TA L ) back into the cortex. It is composed
of Simple squamous epithelium; few mitochondria .It has a function of Passive reabsorption of
Na+ and Cl–.

12. Describe the structure and function of the nephron distal convoluted tubules

DCT is in the cortex. It is Simple cuboidal epithelium; cells smaller than in PCT, short microvilli
and basolateral folds, and more empty lumens. Its function is to Reabsorption of electrolytes.

13. Describe the structure and function of the collecting ducts

Principal cells: Most abundant, cuboidal to columnar; pale-staining, distinct cell membranes.
Location:Medullary rays and medulla . Function: Regulated reabsorption of water & electrolytes;
regulated secretion of K+

Intercalated cells: Few and scattered; slightly darker staining. Location:Medullary

rays.Reabsorption of K+ (low-K+ diet); help maintain acid-base balance

14. Hormonal regulation of reabsorption in collecting ducts

15. Cells of juxtaglomerular apparatus, their location and functions

16. Mechanism of renin action (how it regulated blood pressure)

17. Structure of the ureter

 18. Structure of the urinary bladder

19. Embryonic development of the urinary system

MALE REPRODUCTIVE SYSTEM

1. Describe the sequence of seminiferous ducts

Seminiferous tubules → Rete testis → Vasa efferentia → Epididymis → Vas deferens →
Ejaculatory duct → Urethra → Urethral meatus

Each tubule is actually a loop linked by a very short, narrower segment, the straight tubule, to the rete
testis, a labyrinth of epithelium-lined channels embedded in the mediastinum testis. About 10-20 efferent
ductules connect the rete testis to the head of the epididymis . Each seminiferous tubule is lined with a
complex, specialized stratified epithelium called germinal or spermatogenic epithelium. The basement
membrane of this epithelium is covered by fibrous connective tissue, with an innermost layer containing
flattened, smooth muscle-like myoid cells, which allow weak contractions of the tubule.

2. Structure of convoluted seminiferous tubules

A distinct connective tissue capsule, a layer of flattened myoid cells, and a basement membrane surround
seminiferous tubules. The seminiferous epithelium is an unusual, complex stratified epithelium with two
cell populations: spermatogenic (or germ) cells and non proliferating Sertoli cells. In a seminiferous
tubule, germ cells are at various stages of spermatogenesis. The cells closest to the basement
membrane with spherical nuclei are spermatogonia. Larger cells with spherical nuclei but with
distinctive spaghetti-like chromatin are primary spermatocytes. The haploid secondary spermatocytes are
seldom seen; almost as soon as they form they divide and produce spermatids. During a transformation
period, spermatids attach to the relatively few Sertoli cells, which are tall and pillar-like. The bases of the
Sertoli cells rest on the basement membrane; the free ends of the cells extend radially and reach the
lumen. Spermatids, which are known as early and late, do not divide but mature into spermatozoa,
which are released into the lumen and carried into efferent ducts.

3. Spermatogenesis (definition, stages, sequence of cells, duration)

Spermatogenesis begins at puberty with proliferation of stem and progenitor cells called spermatogonia
(Gr. sperma + gone, generation), small round cells about 12 μm in diameter.

These cells occupy a basal niche in the epithelial wall of the tubules, next to the basement membrane and
closely associated with Sertoli cell surfaces.

1.The spermatogenic progenitor cells, called spermatogonia, are diploid cells containing 46 chromosomes
(23 pairs). Mitotic divisions of these cells produce new spermatogonia and cells called primary
spermatocytes which are committed to meiosis.

2. Each new primary spermatocyte transiently disassembles the tight junctions of the blood-testis barrier
and moves from the tubule’s basal compartment to the adluminal compartment. At the same time these
cells replicate their DNA, enter meiosis I, and undergo synapsis. The first meiotic division produces two
haploid secondary spermatocytes each with 23 chromosomes.

3.Meiosis II is rapid as chromatids in the secondary spermatocyte chromosomes separate into two
smaller haploid cells, the spermatids.

4. Near the lumen but still embedded in Sertoli cells, the spermatids differentiate and undergo the
morphological changes required to become motile and capable of fertilization.

4. Spermiogenesis (definition, stages)

Spermiogenesis, the final phase of sperm production, is the temperature-sensitive process by which
spermatids differentiate into spermatozoa, which are highly specialized to deliver male DNA to the ovum.
Spermiogenesis is commonly divided into four phases:

■ In the Golgi phase the cytoplasm contains a prominent Golgi apparatus near the nucleus,
mitochondria, paired centrioles, and free ribosomes. Small pro-acrosomal vesicles from the Golgi
apparatus coalesce as a single membrane-limited acrosomal cap close to one end of the nucleus. The
centrioles migrate to a position farthest from the acrosomal cap one acts as a basal body, organizing the
axoneme of the flagellum which is structurally and functionally similar to that of a cilium.

■ In the cap phase the acrosomal cap spreads over about half of the condensing nucleus. The acrosome
is a specialized type of lysosome containing hydrolytic enzymes, mainly hyaluronidase and a trypsin-like
protease called acrosin. These enzymes are released when a spermatozoon encounters an oocyte and
the acrosomal membrane fuses with the sperm’s plasma membrane. They dissociate cells of the corona
radiata and digest the zona pellucida, both structures that surround the egg. This process, the acrosomal
reaction, is one of the first steps in fertilization.

■ In the acrosome phase the head of the developing sperm, containing the acrosome and the
condensing nucleus, remains embedded in the Sertoli cell while the growing axoneme extends into the
lumen of the tubule. Nuclei become more elongated and very highly condensed, with the histones of
nucleosomes replaced by small basic peptides called protamines. Flagellum growth continues as the tail
and mitochondria aggregate around its proximal region to form a thickened middle piece where the ATP
for flagellar movements is generated.

■ In the maturation phase of spermiogenesis,unneeded cytoplasm is shed as a residual body from each
spermatozoon and remaining intercellular bridges are lost. Mature but not yet functional or mobile sperm
are released into the lumen of the tubule.

5. Structure and function of Sertoli (sustentacular) cells

Sertoli cells are tall pyramidal cells. The bases of the Sertoli cells rest on the basal lamina, apical ends
extend into the lumen of the seminiferous tubule.Functions of Sertoli cells.

1.support, protection, and nutrition of the developing spermatozoa;

2.phagocytosis of cytoplasmic fragments, which form during spermatogenesis is;

3.secretion of:
A. into the seminiferous tubules a fluid that Shows in the direction of the genital ducts and is used for
sperm transport;

B. androgen binding protein that serves to concentrate testosterone in the seminiferous tubule; it is
necessary for spermatogenesis; sexual steroids - estrogens and testosterone;

C.peptides inhibin and activin, which suppress and activate FSH synthesis and release in the anterior
pituitary gland: Antimullerian hormone that promotes the normal development of the male reproductive
system.

Sertoli cells are bound together by tight junctions between their lateral processes at the level of
spermatogonia.

Lateral processes of Sertoli cells divide the seminiferous epithelium into 2 compartments:

1. basal (abluminal) compartment and adluminal compartment.

The basal compartment contains spermatogonia and has free access to materials found in the blood. The
adluminal compartment contains spermatocytes, spermatids and spermatozoa.

6. Structure and function of Leydig (interstitial) cells

The principal cells of interstitial tissue are the interstitial, or Leydig, cells, which have the
characteristic of steroid-secreting cells. Leydig cells are rounded in shape, have a centrally located nuclei
and an eosinophilic cytoplasm. These cells produce the male steroid hormone testosterone, which is
responsible for the development of male reproductive tissues such as the testis and prostate as well as
promoting secondary sexual characteristics such as increased muscle and bone mass and hair growth.

7. Intratesticular ducts

The intratesticular ducts are the straight tubules (or tubuli recti), the rete testis, and the efferent ductules ,
all of which carry spermatozoa and liquid from the seminiferous tubules to the duct of the epididymis. The
loops of seminiferous tubules join the rete testis by the short straight tubules, which are lined initially only
by Sertoli cells. These empty into the rete testis, an interconnected network of channels lined with
cuboidal epithelium and supported by connective tissue of the mediastinum. The rete testis drains into
about 20 efferent ductules lined by an unusual epithelium in which groups of non-ciliated cuboidal cells
alternate with groups of taller ciliated cells and give the tissue a characteristic scalloped appearance. The
nonciliated cells absorb some of the fluid secreted by the Sertoli cells of seminiferous tubules. This
absorption and the ciliary activity create a fluid flow that carries sperm passively out of the testis toward
the epididymis. A thin layer of circularly oriented smooth muscle cells in the walls of efferent ductules aids
the movement of sperm into the duct of the epididymis.

8. Histological structure and functions of the epididymis

The long, coiled duct of the epididymis, surrounded by connective tissue, lies in the scrotum along the
superior and posterior sides of each testis. About 4-5 m in length, it includes a head region where the
efferent ductules enter, a body, and a tail opening into the ductus deferens. Passage of sperm through
the duct of the epididymis normally takes 2-4 weeks, during which spermatozoa undergo maturation and
acquire the ability to fertilize. Important changes within sperm while passing through the epididymis
include:
■ Development of the competence for independent forward motility,

■ Maturation of the acrosome, and

■ Biochemical and organizational changes within the cell membrane.

Fluid within the epididymis contains glycolipid “decapacitation factors” that bind the plasma membranes of
sperm and block acrosomal reactions and fertilizing ability until these. factors are removed as part of the
capacitation process in the female reproductive tract.The epididymal duct is lined with pseudostratified
columnar epithelium consisting of columnar principal cells, with characteristic long stereocilia, and small
round stem cells. The principal cells secrete glycolipids and glycoproteins, but also absorb most of the
remaining water and remove residual bodies or other debris not removed earlier by Sertoli cells. The duct
epithelium is surrounded by a few layers of smooth muscle cells, arranged as inner and outer longitudinal
layers as well as a circular layer in the tail of the epididymis.

At ejaculation peristaltic contractions of this muscle move the sperm rapidly along the duct and empty the
epididymal tail and distal body regions.

9. Differences between epithelial lining of efferent ductules and ductus epididymis

Location Epithelium Support tissue Function(s)

10. Histological structure of the ductus deferens

ductus (or vas) deferens, a long straight tube with a thick, muscular wall and a relatively small lumen,
continues toward the prostatic urethra where it empties. its mucosa is slightly folded longitudinally, the
lamina propria contains many elastic fibers, and the epithelial lining is pseudostratified with some cells
having sparse stereocilia. The very thick muscularis consists of longitudinal inner and outer layers and a
middle circular layer. The muscles produce strong peristaltic contractions during ejaculation, which rapidly
move sperm along this duct from the epididymis.

11. Histological structure of seminal vesicles

The two seminal vesicles consist of highly tortuous tubes, each about 15-cm long, enclosed by a
connective tissue capsule. The unusual mucosa of the tube displays a great number of thin, complex
folds that fill much of the lumen. The folds are lined with simple or pseudostratified columnar epithelial
cells rich in secretory granules. The lamina propria contains elastic fibers and is surrounded by smooth
muscle with inner circular and outer longitudinal layers that empty the gland during ejaculation. The
seminal vesicles are exocrine glands in which production of their viscid, yellowish secretion depends on
testosterone. Fluid from seminal vesicles typically makes up about 70% of the ejaculate and its
components include the following:

■ Fructose, a major energy source for sperm, as well as inositol, citrate, and other metabolites;
■ Prostaglandins, which stimulate activity in the female reproductive tract; and

■ Fibrinogen, which allows semen to coagulate after ejaculation.

12. Histological structure of prostate (classification of glands, age changes)

The prostate gland is a dense organ that surrounds the urethra below the bladder. The prostate is a
collection of 30-50 tubuloacinar glands embedded in a dense fibromuscular stroma in which smooth
muscle contracts at ejaculation . Ducts from individual glands may converge but all empty directly into the
prostatic urethra, which runs through the center of the prostate. The glands are arranged in three major
zones around the urethra:

■ The transition zone occupies only about 5% of the prostate volume, surrounds the superior portion of
the urethra, and contains the periurethral mucosal glands.

■ The central zone comprises 25% of the gland’s tissue and contains the periurethral submucosal glands
with longer ducts.

■ The peripheral zone, with about 70% of the organ’s tissue, contains the prostate’s main glands with still
longer ducts.The tubuloacinar glands of the prostate are all lined by a simple or pseudostratified columnar
epithelium and produce fluid that contains various glycoproteins, enzymes, and small molecules such as
prostaglandins and is stored until ejaculation. A clinically important product of the prostate is prostate-
specific antigen (PSA), a 34-kDa serine protease that helps liquefy coagulated semen for the slow release
of sperm after ejaculation. Small amounts of PSA also leak normally into the prostatic vasculature;
elevated levels of circulating PSA indicate abnormal glandular mucosa typically due to prostatic
carcinoma or inflammation.Small spherical concretions, 0.2-2 mm in diameter and often partially calcified,
are normally present in the lumens of many prostatic tubuloacinar glands. These concretions, called
corpora amylacea, containing primarily deposited glycoproteins and keratan sulfate, may become more
numerous with age but seem to have no physiologic or clinical significance. The prostate is surrounded by
a fibroelastic capsule, from which septa extend and divide the gland into indistinct lobes. Like the seminal
vesicles, the prostate’s structure and function depend on the level of testosterone.

13. Embryonic development of male reproductive system

The testes develop retroperitoneally in the dorsal wall of the embryonic abdominal cavity and are moved
during fetal development to become suspended in the two halves of the scrotal sac, or scrotum, at the
ends of the spermatic cords. During migration from the abdominal cavity, each testis carries with it a
serous sac, the tunica vaginalis, derived from the peritoneum. This tunic consists of an outer parietal layer
lining the scrotum and an inner visceral layer, covering the tunica albuginea on the anterior and lateral
sides of the testis.

FEMALE REPRODUCTIVE SYSTEM

1. Histological structure of the ovary

Ovaries are almond-shaped bodies approximately 3-cm long, 1.5-cm wide, and 1-cm thick. Each ovary is
covered by a simple cuboidal epithelium, the surface (or germinal) epithelium, continuous with the
mesothelium and overlying a layer of dense connective tissue capsule, the tunica albuginea,like that of
the testis. Most of the ovary consists of the cortex, a region with a stroma of highly cellular connective
tissue and many ovarian follicles varying greatly in size after menarche. The most internal part of the
ovary, the medulla, contains loose connective tissue and blood vessels entering the organ through the
hilum from mesenteries suspending the ovary. There is no distinct border between the ovarian cortex and
medulla.

2. Types of follicles, differences between them, structure of the mature

(Graafian) follicle
3. The ovarian follicles consist of one oocyte surrounded by follicular cells.They are three
types of ovarian follicles:
I. Primordial follicles.
II. Growing follicles:
a) Primary, b) Secondary.

III. Mature (tertiary, preovulatory, Graafian) follicles.

The primordial follicles are found in the peripheral part of the cortex. Primordial follicle consists of the
oocyte in prophase of the first meiotic division surrounded by a single layer of squamous follicle cells.
The outer surface of the follicle cells is bounded by a basal lamina.

The primary follicle consists of the oocyte surrounded by a single layer of cuboidal or columnar follicular
(granulosa) cells. A homogeneous, deeply staining, acidophilic refractive layer called zona pellucida
(glycoproteins between the oocyte and granulosa cells) becomes visible. Zona pellucida is secreted
by growing oocyte and follicular cells.

Late primary follicles: The continued proliferation of granulosa cells will result in the formation of
the stratified epithelium surrounding the oocyte. Connective tissue cells surrounding the follicle form
concentric sheaths, the theca folliculi.

Secondary follicles: Small fluid-filled spaces become visible between the granulosa cells. These spaces
enlarge and fuse to form the follicular antrum. The oocyte is now located eccentric in the follicle, and is
surrounded by granulosa cells.Theca folliculi further differentiates into two layers.

> Theca interna is a layer of steroid -producing secretory cells. These cells have luteinizing hormone
(LH) receptors. In response to LH stimulation, they secrete androgens that are the precursors of
estrogens.

> Theca externa is the outer layer of connective tissue. Mature (tertiary, preovulatory, Graafian) follicle
increases further in size (is about 2,5 cm in diameter) and bulges from the surface of the ovary. Oocytes
adhere to cumulus oophorus.

4. Define the ovulation and describe the regulation of this process

Ovulation is a hormone-mediated (LH of the pituitary gland) process of liberation of the secondary oocyte
by the rupture of Graafian follicle into the peritoneal cavity.Ovulation takes place in the middle of the
menstrual cycle, on the 14th day of a 28-day cycle.

Ovulation involves movement of a very large, dominant graafian follicle to the ovary surface to form a
bulge, completion of meiosis I, and release of a polar body from the oocyte.
■ Rupture of the follicle and ovarian coverings releases the secondary oocyte, arrested now in metaphase
II, and a layer of attached granulosa cells that make up the corona radiata.

■ Cells of the granulosa and thecal layers left in the ovary after ovulation are reorganized under the
influence of luteinizing hormone (LH) to form the endocrine gland called the corpus luteum.

■ The cells of the corpus luteum are granulosa lutein cells, producing estrogen and comprising 80% of the
gland, and theca lutein cells producing progesterone.

■ LH levels drop about 2 weeks after ovulation, causing the corpus luteum to lose activity, degenerate,
and be removed by macrophages, leaving a temporary collagen-filled region called a corpus albicans.

5. Define the yellow body and stages of its formation

After ovulation, the follicular wall, composed of the granulosa and theca cells, is transformed into the
temporary endocrine gland called corpus luteum.

Development of the corpus luteum includes 4 stages:

I. The cells of the granulosa and theca interna proliferate; blood vessels from theca interna
rapidly grow into the granulosa layer.

II. The cells of the granulosa and theca interna (luteal cells) increase in size and become filled
with yellow pigment lutein, and demonstrate features associated with steroid-secreting cells
(abundant sER and mitochondria).

III. Cells of corpus luteum secrete female sexual hormones:

1. granulosa lutein cells, derived from the granulosa cells, secrete progesterone;

2. Theca lutein cells, derived from the cells of theca interna layer, secrete androgens and
estrogens.These hormones stimulate the growth and secretory activity of the endometrium, to
prepare it for the implantation of the zygote.

IV. Degeneration and involution of the corpus luteum after pregnancy or menstruation. White
scar, the corpus albicans, is formed. It slowly disappears over a period of several months.

Types of the corpus luteum

1. If the oocyte is not fertilized, the corpus luteum stops secreting progesterone and remains only
for 14 days; in this case it is called the menstrual corpus luteum.

2. If the oocyte is fertilized and implantation occurs, the trophoblast cells of the blastocyst secrete the
hormone human chorionic gonadotropin (hCG). Human chorionic gonadotropin signals the corpus
luteum to continue progesterone secretion, thereby maintaining the endometrium of the uterus and
providing an area rich in blood vessels in which the zygote(s) can develop. In this case the corpus luteum
is called the corpus luteum graviditatis. Corpus luteum graviditatis measures 5 cm. Its function begins to
decline after 8 weeks of pregnancy, although it persists throughout pregnancy.

6. Ovogenesis (phases, time points)

 7. Histological structure of the uterus

The uterus is a pear-shaped organ that receives the morula from the uterine tube.The wall of the uterus is
formed of 3 layers: I. mucosa (endometrium), II. muscularis (myometrium) III. serosa (perimetrium)
Endometrium consists of:

1) simple columnar epithelium that contains ciliated and secretory cells;

2) lamina propria contains simple tubular glands (the uterine glands);

Endometrium can be divided into two zones:

1) The basal layer is not sloughed off during menstruation but functions as a regenerative zone for
the functional layer after its rejection; it is supplied by straight arteries.

2) The functional layer 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; it is supplied by spiral arteries.
Myometrium is composed of 3 layers of smooth muscle tissue. The middle layer contains numerous
large blood vessels and is called stratum vascularis. The inner and outer layers contain smooth
muscle bundles oriented parallel to the long axis of the uterus.

Outer layer is either serosa (perimetrium, the serous membrane enveloping the fundus and ventral
and dorsal surfaces of the uterus) or adventitia consisting of loose connective tissue. Parametrium is
the loose connective tissue around the uterus.

8. Histological structure of the uterine tube

The uterine tubes are paired muscular tubes about 12 cm long, which connect the peritoneal cavity
with the cavity of the uterus. They receive and transport ovum to the uterus and provide the
necessary environment for fertilization and initial development of the zygote. The wall of the oviduct is
composed of three layers: I.mucosa, II.muscularis, III. serosa

I. Mucosa has longitudinal folds and consists of:

1) epithelium is simple columnar and contains two types of cells:

• ciliated cells, wave of the cilia of these cells is directed toward the uterus;

« nonciliated, secretory, peg cells which produce the fluid that provides nutrition for the ovum.

2) lamina propria is composed of loose connective tissue;

II. Muscularis consists of 2 sublayers of smooth muscle tissue (outer -

longitudinal and inner-circular);

III. Serosa is covered by mesothelium.

9. Phases of menstrual cycle (respective changes in the structure of the ovary,

uterus and hormonal concentration)

The menstrual (uterine) cycle is a continuum of developmental stages. in the functional layer of the
endometrium, normally repeats every 28 days. Menstrual cycle has 3 successive phases :

I. Menstrual II. Proliferative III. Secretory

Menstrual phase (1-4 days): At the end of the secretory phase ovarian hormone levels rapidly
decrease; the walls of the spiral arteries contract, closing off the blood flow and producing ischemia (local
anemia), which results in death (necrosis) of their walls and of the functional layer of the endometrium. At
this time, blood vessels above the constrictions rupture, and bleeding begins. The average blood
loss in the menstrual phase is 35 to 50 mL. Only the basal layer containing basal parts of uterine
glands are left. Proliferation of the gland cells and their migration to the surface initiate the proliferative
phase.

Proliferative phase (5-14 days) is initiated under the influence of estrogens. The lost epithelium is
regenerated from the basal portions of the uterine glands. At the end of the proliferative phase the
endometrium is 2 -3 mm thick, the glands are straight tubules with narrow lumens.
Secretory phase (15-28 days) of the menstrual cycle is regulated by progesterone of the corpus
luteum. The glands become highly coiled and secrete glycoproteins that will be the major source
of embryonic nutrition before implantation occurs. In this phase, the endometrium reaches its
maximum thickness (5mm) as a result of the accumulation of secretions and the edema of the stroma.
The last few days of this period is called ischemic phase.

10. Histological structure of mammary gland

The mammary glands are modified apocrine sweat glands of the skin. The inactive adult mammary
gland is composed of 15 -25 irregular lobes separated by a fibrous band of' interlobular connective
tissue and fat. Each lobe contains an individual gland. The lobes radiate from the mammary papilla, or
nipple. The lobes are subdivided into lobules. The excretory duct of each lobe, also called lactiferous
duct, has an opening on the nipple. Beneath the areola each has a dilated portion, the lactiferous
sinus, which functions as a reservoir for the milk. The epithelial lining of the duct shows a gradual
transition from a single layer of columnar or cuboidal cells to two layered epithelium and finally to stratified
squamous nonkeratinized epithelium. Branches o f the lactiferous duct are lined with a simple cuboidal
epithelium. The lactiferous duct has a two layered epithelium - basal cells are cuboidal whereas the
superficial cells are columnar. Lactiferous sinuses are lined by stratified squamous nonkeratinized
epithelium.The lobules contain the secretory units (alveoli), which are lined by a cuboidal or columnar
epithelium (secreting cells - lactocytes). The myoepithelial cells surround the base of the alveolar
secretory cells and the bases of the cells of the larger ducts, causing them to contract and eject the milk
from the alveoli. Secreting cells contain abundant granular endoplasmic reticulum, mitochondria, Golgi
apparatus, lysosomes. Milk proteins are secreted by merocrine secretion, milk lipids are secreted by
apocrine secretion.

11. Histological structure of the cervix

The cervix lies at the base of the uterus and serves to protect it from bacterial infiltration. It is the site of an
important epithelial transition. The upper cervix (endocervix) is lined by a simple columnar epithelium that
contains mucous-secreting cells. In contrast, the lower cervix (ectocervix) is lined by a stratified squamous
epithelium. The transition point between these two epithelia is known as the external os. Note how the
underlying layers of the cervix are composed primarily of collagenous and elastic connective tissue rather than
smooth muscle fibers.

12. Histological structure of the vagina

The wall of the vagina (L., vagina, sheath, scabbard) lacks glands and consists of a mucosa, a muscular
layer, and an adventitia. The epithelium of the vaginal mucosa is stratified squamous, with a thickness of
150-200 μm in adults. Stimulated by estrogens, the epithelial cells synthesize and accumulate glycogen.
When the cells desquamate, bacteria metabolize glycogen to lactic acid, causing a relatively low pH
within the vagina, which helps provide protection against pathogenic microorganisms. The lamina propria
of the mucosa is rich in elastic fibers, with numerous narrow papillae projecting into the overlying
epithelium. The mucosa normally contains lymphocytes and neutrophils in relatively large quantities.
Mucus in the vagina is produced by the cervical glands. During sexual arousal lubricating mucus is also
provided by glands at the vaginal vestibule, including the paired greater vestibular glands (of Bartholin),
which are homologous to the male bulbourethral glands. The muscular layer of the vagina is composed
mainly of two indistinct layers of smooth muscle, disposed as circular bundles next to the mucosa and as
thicker longitudinal bundles near the adventitial layer. The dense connective tissue of the adventitia is rich
in elastic fibers, making the vaginal wall strong and elastic while binding it to the surrounding tissues. This
outer layer also contains an extensive venous plexus, lymphatics, and nerves.
 13. Embryonic development of the female reproductive system

1.First, the gonads develop through an indifferent stage before differentiating into the testes and the
ovaries.
2.Second, the sexual differentiation of the genital ducts is dependent on the presence or absence of
testosterone and Anti-Müllerian Hormone, which both influence the outcome of the mesonephric ducts
and the paramesonephric ducts.
3.Third, the sexual differentiation of the external genitalia is also dependent on hormonal secretions or
lack of.
4.Last, the descent of the gonads is mainly directed by the shortening of the gubernaculum.

The rudimentary gonads can differentiate into either the testes or the ovaries. The sexual differentiation
of the gonads is genetically determined, but the rudimentary gonads first develop through an indifferent
stage, during which neither male or female characteristics are apparent. The formation of the indifferent
gonads is only induced upon the arrival of the primordial germ cells.

During the fifth week of gestation, primordial germ cells migrate from the walls of the yolk sac (near the
allantois) via the dorsal mesentery into each side of the posterior body wall. The primordial germ cells
stimulate the coelomic epithelium to thicken, forming a pair of longitudinal ridges known as the genital
ridges. These genital ridges, located ventromedial to the developing mesonephric kidneys, are the first
physical appearance of both the male and female gonads.

During the sixth week of gestation, the surface epithelium of the genital ridge proliferates and gives rise
to the primitive sex cords, which are made up of somatic support cells, surround individual primordial
germ cells. The primitive sex cords remain connected to the surface epithelium. From this point on, the
presence of a Y or X chromosome will dictate the subsequent sexual differentiation of the gonads. The
undifferentiated gonads consist of a pair of genital ridges which contain primordial germ cells that are
enveloped by the primitive sex cords.

In the absence of a Y chromosome (XX), the primitive sex cords do not continue to proliferate. Instead,
they degenerate into irregular cell clusters. The primordial germ cells differentiate into oogonia, which
proliferate and enter their first meiotic division to form primary oocytes. These meiotic oocytes stimulate
the surface epithelium to give rise to a second generation of cords, the cortical sex cords. These cortical
sex cords proliferate and split into clusters of follicle cells (or granulosa cells). Each oocyte then becomes
surrounded by follicle cells and together, they form the primordial follicles of the ovary.