Y2S2 P1 Female Reproductive Anatomy
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Questions and Answers

What type of epithelium is found in the ectocervix?

  • Non-keratinized stratified squamous epithelium (correct)
  • Keratinized stratified squamous epithelium
  • Simple columnar epithelium
  • Simple cuboidal epithelium

    • Which structure separates the endocervical canal from the uterus?

  • External os
  • Uterine cavity
  • Cervical canal
  • Internal os (correct)

    • What is the main arterial supply of the cervix?

  • Pelvic artery
  • Vaginal artery
  • Uterine artery (correct)
  • Ovarian artery

    • Which layer of the uterus undergoes significant changes during pregnancy?

    <p>Myometrium</p> Signup and view all the answers

    Which part of the endometrium is sloughed off during menstruation?

    <p>Functionalis</p> Signup and view all the answers

    The uterus is described as being anteverted. What does this indicate?

    <p>It is rotating forward with respect to the vagina</p> Signup and view all the answers

    What type of glands are found in the lamina propria of the endometrium?

    <p>Simple tubular glands</p> Signup and view all the answers

    Which plexus is responsible for innervating both the cervix and the uterus?

    <p>Uterovaginal plexus</p> Signup and view all the answers

    What is the primary function of the vulva?

    <p>Protects the internal reproductive tract from infection</p> Signup and view all the answers

    Which structures are derived from the labioscrotal swellings?

    <p>Labia majora</p> Signup and view all the answers

    What is the primary type of muscle found in the fibromuscular layer of the vagina?

    <p>Smooth muscle</p> Signup and view all the answers

    Which artery does NOT contribute to the arterial supply of the vagina?

    <p>Ovarian artery</p> Signup and view all the answers

    What is the role of Bartholin's glands in female reproductive anatomy?

    <p>Secreting lubricating mucus during sexual arousal</p> Signup and view all the answers

    Which nerve is responsible for providing somatic innervation to the inferior fifth of the vagina?

    <p>Deep perineal nerve</p> Signup and view all the answers

    What are the components of the four layers of vaginal histology?

    <p>Stratified squamous epithelium, elastic lamina propria, fibromuscular layer, adventitia</p> Signup and view all the answers

    Which part of the female anatomy serves as the natural reservoir for semen after ejaculation?

    <p>Posterior fornix</p> Signup and view all the answers

    Which lymph nodes are involved in the drainage of the vagina?

    <p>Superficial inguinal nodes, internal iliac nodes, external iliac nodes</p> Signup and view all the answers

    What is the embryological origin of the clitoris?

    <p>Genital tubercle</p> Signup and view all the answers

    During the follicular phase, what is the primary hormonal influence on the endometrium?

    <p>Estrogen</p> Signup and view all the answers

    Which segment of the fallopian tube is the widest?

    <p>Ampulla</p> Signup and view all the answers

    What type of epithelium lines the mucosa of the fallopian tube?

    <p>Simple columnar</p> Signup and view all the answers

    What morphological change occurs to the endometrial glands during the luteal phase?

    <p>Production of glycogen-rich vacuoles</p> Signup and view all the answers

    Which ovarian structure is formed from the ruptured follicle after ovulation?

    <p>Corpus luteum</p> Signup and view all the answers

    What is the primary function of ciliated cells in the fallopian tube?

    <p>Propelling the oocyte towards the uterus</p> Signup and view all the answers

    What is the diameter of a primordial follicle?

    <p>30 µm</p> Signup and view all the answers

    How many follicles approximately enter the growth phase each cycle in a normal ovary?

    <p>20</p> Signup and view all the answers

    Which part of the ovary contains the majority of the ovarian follicles?

    <p>Cortex</p> Signup and view all the answers

    What is the primary drainage route for the left ovarian vein?

    <p>Left renal vein</p> Signup and view all the answers

    What phase of follicle development includes the formation of the zona pellucida?

    <p>Secondary follicle</p> Signup and view all the answers

    What role does the corpus albicans play in the ovarian cycle?

    <p>Serves as a visible scar after degeneration of the corpus luteum</p> Signup and view all the answers

    Which segment of the fallopian tube is primarily responsible for fertilization?

    <p>Ampulla</p> Signup and view all the answers

    What is the role of the endocervical canal in the female reproductive system?

    <p>It secretes mucus that helps protect the uterus.</p> Signup and view all the answers

    Which anatomical feature distinguishes the ectocervix from the rest of the cervix?

    <p>Projection into the vaginal canal.</p> Signup and view all the answers

    Which of the following components is found in the myometrium of the uterus?

    <p>Smooth muscle tissue.</p> Signup and view all the answers

    What is the significance of the basalis layer of the endometrium?

    <p>It undergoes cellular proliferation after menstruation.</p> Signup and view all the answers

    What does the term 'anteflexed' signify about the position of the uterus?

    <p>The uterus is tilted forward in relation to the cervix.</p> Signup and view all the answers

    Which of the following best describes the external os of the cervix?

    <p>It separates the cervix from the vagina.</p> Signup and view all the answers

    Which lymphatic drainage pathway is associated with both the uterus and cervix?

    <p>Iliac, sacral, aortic, and inguinal lymph nodes.</p> Signup and view all the answers

    What type of muscle makes up the myometrium in the uterus?

    <p>Smooth muscle.</p> Signup and view all the answers

    What is the function of the labia minora in female reproductive anatomy?

    <p>They fuse to form the hood of the clitoris.</p> Signup and view all the answers

    Which nerve primarily provides sensation to the posterior region of the vulva?

    <p>Pudendal nerve</p> Signup and view all the answers

    What is the primary histological layer that makes up the vagina?

    <p>Stratified squamous epithelium</p> Signup and view all the answers

    Which structure provides lubrication during sexual arousal?

    <p>Bartholin’s glands</p> Signup and view all the answers

    Which area encloses the openings for the vagina and urethra?

    <p>Vestibule</p> Signup and view all the answers

    What structure connects the vagina to the uterus?

    <p>Cervix</p> Signup and view all the answers

    Which part of the vagina serves as a natural reservoir for semen after ejaculation?

    <p>Posterior fornix</p> Signup and view all the answers

    What type of muscle forms the fibromuscular layer of the vagina?

    <p>Smooth muscle</p> Signup and view all the answers

    What is the primary arterial supply to the vagina?

    <p>Uterine artery</p> Signup and view all the answers

    Which nerve is involved in the parasympathetic innervation of the clitoris?

    <p>Cavernous nerve</p> Signup and view all the answers

    What is the defining characteristic of the spongiosum layer of the endometrium?

    <p>It contains mesenchymal-type cells and extracellular matrix.</p> Signup and view all the answers

    During which phase does the endometrium thicken from 2 to 9 mm due to estrogen?

    <p>Follicular phase</p> Signup and view all the answers

    Which segment of the fallopian tube connects to the uterine cavity?

    <p>Isthmus</p> Signup and view all the answers

    What type of cells primarily make up the mucosa of the fallopian tube?

    <p>Simple columnar epithelium with ciliated and secretory cells</p> Signup and view all the answers

    What is the primary role of the cilia in the fallopian tube?

    <p>Propelling the oocyte towards the uterus</p> Signup and view all the answers

    Which hormone primarily prevents mitotic activity during the luteal phase?

    <p>Progesterone</p> Signup and view all the answers

    What is the approximate diameter of primary follicles in the ovary?

    <p>75 µm</p> Signup and view all the answers

    What type of connective tissue surrounds the outer cortex of the ovary?

    <p>Fibrous connective tissue</p> Signup and view all the answers

    What occurs to the corpus luteum if there is no pregnancy?

    <p>It develops into the corpus albicans.</p> Signup and view all the answers

    The entrance of the fallopian tube is surrounded by which structure?

    <p>Fimbriae</p> Signup and view all the answers

    What facilitates the capacity of spermatozoa in the fallopian tube?

    <p>Secretory cells producing a nutrient-rich fluid</p> Signup and view all the answers

    Which type of follicles are characterized by the formation of the zona pellucida?

    <p>Secondary follicles</p> Signup and view all the answers

    In which part of the ovary do follicles primarily develop?

    <p>Outer cortex</p> Signup and view all the answers

    What anatomical feature connects the ovarian arteries to their respective veins?

    <p>Inferior vena cava</p> Signup and view all the answers

    Study Notes

    Vulva

    • The vulva, also known as the pudendum, refers to the external female genitalia.
    • Its functions include sensation during intercourse, directing urine flow during micturition, and protecting the internal reproductive tract from infection.
    • The mons pubis is a subcutaneous fat pad anterior to the pubic symphysis, formed by the fusion of the labia majora.
    • The labia majora are two hair-bearing external skin folds that extend posteriorly to the posterior commissure, a depression over the perineal body.
    • The labia minora are two hairless skin folds located within the labia majora. They fuse anteriorly to form the hood of the clitoris and extend posteriorly on either side of the vaginal opening, merging into a fold of skin known as the fourchette.
    • The vestibule is the area enclosed by the labia minora, housing the openings of the vagina and urethra.
    • Bartholin's glands are located on either side of the vaginal orifice and secrete lubricating mucus during sexual arousal.
    • The clitoris, located under the clitoral hood, is composed of erectile corpora cavernosa tissue that engorges during arousal.

    Vulva: Neurovasculature

    • Arterial supply comes from the internal and external pudendal arteries.
    • Venous drainage occurs through the pudendal veins and tributary labial veins.
    • Lymphatic drainage flows to the superficial inguinal nodes.
    • Innervation:
      • Sensation: Anteriorly, the ilioinguinal nerve and genitofemoral nerve (genital branch) provide sensation. Posteriorly, the pudendal nerve (perineal branch) and posterior cutaneous nerve of the thigh are responsible.
      • Parasympathetic (PNS): Cavernous nerves from the uterovaginal plexus innervate the clitoris and vestibule.

    Vagina

    • The vagina is a distensible muscular tube extending posterosuperiorly from the external vaginal orifice to the cervix.
    • It's situated anterior to the bladder and urethra, posterior to the rectouterine pouch, rectum and anal canal, and laterally to the ureters and levator ani muscle.
    • Appears as an H shape in the sagittal plane.
    • The posterior fornix (horn/dome) serves as a natural reservoir for semen after ejaculation.

    Vagina: Histology

    • Composed of four layers:
      • Stratified squamous epithelium
      • Elastic lamina propria
      • Fibromuscular layer of smooth muscle, with an inner circular and outer longitudinal arrangement.
      • Adventitia, a fibrous outer layer.

    Vagina: Neurovasculature

    • Arterial supply: Uterine artery and vaginal artery (branches of the internal iliac artery).
    • Venous drainage: Vaginal venous plexus → uterine veins → internal iliac vein.
    • Lymphatic drainage:
      • Superior - external iliac nodes
      • Middle - internal iliac nodes
      • Inferior - superficial inguinal nodes.
    • Innervation:
      • Autonomic (SNS and PNS): Uterovaginal plexus (subsidiary of the inferior hypogastric plexus).
      • Inferior 1/5th: Somatic innervation from the deep perineal nerve (branch of the pudendal nerve).

    Cervix

    • The lower portion of the uterus connecting the vagina to the main body.
    • Anatomically and histologically distinct from the uterus.
    • Ectocervix:
      • The portion projecting into the vagina.
      • Non-keratinized stratified squamous epithelium.
      • Separated from the endocervical canal by the external os (opening).
    • Endocervical canal/endocervix:
      • Proximal part of the cervix.
      • Mucus-secreting simple columnar epithelium.
      • Separated from the uterus by the internal os.

    Cerviz: Neurovasculature

    • Arterial supply: Uterine artery.
    • Venous drainage: Uterine vein.
    • Lymphatic drainage: Iliac, sacral, aortic, and inguinal lymph nodes.
    • Innervation: Uterovaginal plexus.

    Uterus

    • A thick-walled muscular organ connected distally to the vagina and laterally to the uterine tubes.
    • Divided into three parts:
      • Fundus: Top of the uterus, above the entry point of fallopian tubes.
      • Body: Site of blastocyst implantation.
      • Cervix: Lower part of the uterus connecting to the vagina.

    Uterus: Anatomical Position

    • Located posterior superior to the bladder and anterior to the rectum.
    • Anteverted: Rotated forward with respect to the vagina.
    • Anteflexed: Flexed anteriorly with respect to the cervix.

    Uterus: Neurovasculature

    • Arterial supply: Uterine artery.
    • Venous drainage: Uterine vein.
    • Lymphatic drainage: Iliac, sacral, aortic, and inguinal lymph nodes.
    • Innervation: Ovarian and uterine plexus (from the inferior hypogastric plexus).

    Uterus: Layers

    • Outer serosa/adventitia:
      • Depending on the area of the uterus, it can be either:
        • Serosa: Connective tissue and visceral peritoneum.
        • Adventitia: Connective tissue only.
    • Myometrium: Thick layer of smooth muscle, normally about 2 cm thick. It grows significantly during pregnancy due to hypertrophy and hyperplasia.
    • Endometrium: Inner mucosal layer.

    Endometrium

    • Consists of an epithelium and lamina propria:
      • Epithelium: Simple columnar epithelium with ciliated and secretory cells.
      • Lamina propria: Contains simple tubular glands in connective tissue.
    • Subdivided into:
      • Functionalis: Part sloughed off during menstruation and replaced each cycle. It can be further divided into two layers:
        • Zona compacta (superficial).
        • Spongiosum layer (deep).
      • Basalis: Part retained after menstruation, proliferates, and provides a new epithelium and lamina propria for endometrial renewal. Bases of glands lying deep within the basalis are the source of cells regenerating the endometrium.
        • Have different morphologies depending on the stage of the menstrual cycle.
        • Between them is connective tissue stroma containing mesenchymal-type cells and extracellular matrix.

    Endometrium Stages

    • Follicular/proliferative phase: Estrogen causes mitotic activity in the glands and stroma, increasing endometrial thickness from 2 to 9 mm.
    • Luteal/secretory phase: Progesterone restricts mitotic activity, causing endometrial glands to produce and secrete glycogen rich vacuoles, leading to:
      • Stromal edema
      • Stromal cell enlargement
      • Spiral arterioles development - lengthening and coiling.

    Fallopian Tubes

    • Fertilization occurs in the ampullary region of the fallopian tube.
    • Implantation occurs in the uterus but may implant ectopically.
    • The entrance of the fallopian tube is surrounded by fimbriae.
      • An ovary is not directly connected to the fallopian tube.
      • During ovulation, hormones activate the fimbriae, causing them to swell with blood and sweep an oocyte into the fallopian tube.
      • Cilia sweep the ovum into the fallopian tube.
      • 50% of cells in the fimbriae have cilia.
    • The fallopian tube can be divided into four segments:
      • Fimbria
      • Infundibulum: Funnel-shaped opening near the ovary.
      • Ampulla: Widest section of the tube.
      • Isthmus: Narrowest section connecting to the uterine cavity.
    • Neurovasculature: Same as the cervix and uterus.

    Fallopian Tubes: Layers

    • The wall of the fallopian tube has three layers:
      • Mucosa: Simple columnar epithelium with ciliated cells and secretory cells.
        • Cilia propel the oocyte towards the uterus.
        • Secretory cells produce a secretion promoting sperm capacitation and providing nutrients for the ovum.
      • Lamina propria: Loose connective tissue.
      • Muscularis: Inner circular and outer longitudinal layers of smooth muscle.

    Ovary

    • Female gonads that develop within the abdomen and descend through the inguinal canal.
    • Paired organs attached to the posterior surface of the broad ligament by the mesovarium.

    Ovary: Structure

    • Surface: Simple cuboidal epithelium.
    • Outer cortex: Connective tissue stroma and ovarian follicles.
    • Inner medulla: Lots of connective tissue and a rich neurovascular supply.

    Ovary: Neurovasculature

    • Arterial supply: Ovarian arteries (from the abdominal aorta).
    • Venous drainage: Ovarian veins.
      • Left ovarian vein → left renal vein.
      • Right ovarian vein → IVC.
    • Lymphatic drainage: Para-aortic lymph nodes.
    • Innervation: ANS: Ovarian and uterine plexus (from the inferior hypogastric plexus).

    Ovary: Detailed Structure

    • Almond-shaped, covered by visceral peritoneum.
    • Simple/cuboidal outer epithelium with an underlying tunica albuginea.
    • Subdivided into:
      • Cortex (outer): Consists mainly of ovarian follicles at various stages of development.
        • Follicle: A single oocyte surrounded by one or more layers of granulosa cells.
        • Approximately 200,000 per ovary in a normal woman.
        • Approximately 20 follicles enter growth phase each cycle.
        • The remainder of the cortex consists of connective tissue stroma with fibroblasts.
      • Medulla (inner): Loose connective tissue stroma with a rich vascular bed. Large follicles may extend into the medulla.

    Follicles

    • Primordial follicles: Primary oocyte surrounded by a simple squamous epithelium of stromal cells/pre-granulosa cells.
      • 30 µm in diameter.
      • Found at the periphery of the cortex.
    • Primary follicles: Grows to about 75 µm in diameter.
      • Epithelium becomes simple cuboidal epithelium.
      • Pre-granulosa cells → granulosa cells.
    • Secondary follicles: Zona pellucida forms between the follicle and granulosa cells.
      • Granulosa becomes a stratified cuboidal epithelium.
    • Early antral follicles: Exhibits the beginnings of the antrum formation (space filled with fluid).
      • Begins to synthesize and secrete estrogen.
      • Implanted in the uterine lining.
        • Surrounding the oocyte is the cumulus oophorus.
        • Surrounding the follicular cells are the thecal cells, which produce estrogen.
    • Antral follicle: Complete formation of the antrum.
    • Graafian/mature/tertiary/pre-ovulatory follicle: Development of a dominant follicle.
      • Corona radiata present.
      • Restriction of blood flow to the oocyte can cause the follicle to rupture and be ovulated from the ovary.

    Corpus Luteum and Corpus Albicans

    • After ovulation, the ruptured follicle is retained in the ovary as the corpus luteum.
      • Secretes predominantly progesterone and estrogen.
      • Develops a rich blood supply.
    • If there is no pregnancy, the corpus luteum degenerates into the corpus albicans (fibrous tissue gradually reabsorbed in the ovary, leaving a visible white scar-like tissue).

    Vulva

    • The vulva (pudendum) is the female external genitalia.
    • Functions include sensation during intercourse, urine direction during micturition, and protecting the internal reproductive tract from infection.
    • Structures:
      • Mons pubis: Subcutaneous fat pad anterior to the pubic symphysis. Fusion of the labia majora.
      • Labia majora: Two hair-bearing skin folds, extending posteriorly to the posterior commissure (depression over perineal body). Derived from labioscrotal swellings.
      • Labia minora: Two hairless skin folds within the labia majora, fused anteriorly to form the clitoral hood and extending posteriorly either side of the vaginal opening. Merge posteriorly into a skin fold called the fourchette.
      • Vestibule: Area enclosed by labia minora, containing the openings of the vagina and urethra.
      • Bartholin's glands: Secrete lubricating mucus during arousal, located either side of the vaginal orifice.
      • Clitoris: Located under the clitoral hood, formed from erectile corpora cavernosa tissue, engorged during arousal. Embryologically derived from the genital tubercle.

    Vulva Neurovasculature

    • Arterial supply: Internal and external pudendal arteries.
    • Venous drainage: Pudendal veins (and tributary labial veins).
    • Lymphatic drainage: Superficial inguinal nodes.
    • Innervation:
      • Sensation:
        • Anterior: Ilioinguinal nerve and genitofemoral nerve (genital branch).
        • Posterior: Pudendal nerve (perineal branch) and posterior cutaneous nerve of the thigh.
      • PNS:
        • Clitoris and vestibule: Cavernous nerves (from uterovaginal plexus).

    Vagina

    • Distensible muscular tube extending posterosuperiorly from the external vaginal orifice to the cervix.
    • Anatomical relations:
      • Anterior: Bladder and urethra.
      • Posterior: Rectouterine pouch, rectum, and anal canal.
      • Lateral: Ureters and levator ani muscle.
    • Structures:
      • H shape in the sagittal plane.
      • Posterior fornix: Natural reservoir for semen after ejaculation.
      • Anterior fornix.
    • Histology (4 layers):
      • Stratified squamous epithelium.
      • Elastic lamina propria.
      • Fibromuscular layer of smooth muscle:
        • Inner circular.
        • Outer longitudinal.
      • Adventitia: Fibrous outer layer.

    Vagina Neurovasculature

    • Arterial supply: Uterine artery and vaginal artery (branches of internal iliac artery).
    • Venous drainage: Vaginal venous plexus -> uterine veins -> internal iliac vein.
    • Lymphatic drainage:
      • Superior: External iliac nodes.
      • Middle: Internal iliac nodes.
      • Inferior: Superficial inguinal nodes.
    • Innervation:
      • Autonomic (SNS and PNS): Uterovaginal plexus (subsidiary of inferior hypogastric plexus).
      • Inferior 1/5 receives somatic innervation: Deep perineal nerve (branch of pudendal nerve).

    Cervix

    • Lower portion of the uterus, connecting the vagina to the main body of the uterus. Anatomically and histologically distinct from the uterus.
    • Structure:
      • Ectocervix: Portion of the cervix projecting into the vagina.
        • Non-keratinized stratified squamous epithelium.
        • Separated from the endocervical canal by the external os (orifice).
      • Endocervical canal/ endocervix: Proximal part of the cervix.
        • Mucus-secreting simple columnar epithelium.
        • Separated from the uterus by the internal os.

    Cervix Neurovasculature

    • Arterial supply: Uterine artery.
    • Venous drainage: Uterine vein.
    • Lymphatic drainage: Iliac, sacral, aortic, and inguinal lymph nodes.
    • Innervation: Uterovaginal plexus.

    Uterus

    • Thick-walled muscular organ connected distally to the vagina and laterally to the uterine tubes. Divided into 3 parts:
      • Fundus: Top of the uterus, above the fallopian tube entry point.
      • Body: Site of blastocyst implantation.
      • Cervix: Lower part of the uterus linking to the vagina.
    • Anatomical position: Posterior superior to the bladder and anterior to the rectum.
      • Anteverted: Rotated forward with respect to the vagina.
      • Anteflexed: Flexed anteriorly with respect to the cervix.

    Uterus Neurovasculature

    • Arterial supply: Uterine artery.
    • Venous drainage: Uterine vein.
    • Lymphatic drainage: Iliac, sacral, aortic, and inguinal lymph nodes.
    • Innervation: Ovarian and uterine plexus (from inferior hypogastric plexus).

    Uterus Layers

    • Outer serosa/ adventitia:
      • Depending on the uterus area, it can be:
        • Serosa: Connective tissue and visceral peritoneum.
        • Adventitia: Connective tissue only.
    • Myometrium: Thick layer of smooth muscle.
      • Normally about 2 cm thick.
      • Grows significantly during pregnancy due to hypertrophy and hyperplasia.
    • Endometrium: Inner mucosal layer.

    Endometrium

    • Consists of an epithelium and lamina propria:
      • Epithelium: Simple columnar epithelium with ciliated and secretory cells.
      • Lamina propria: Contains simple tubular glands in connective tissue.
    • Subdivided into:
      • Functionalis: Part sloughed off during menstruation and replaced each cycle. Can be further subdivided into two other layers:
        • Zona compacta (superficial).
        • Spongiosum layer (deep).
      • Basalis: Part retained after menstruation, which proliferates and provides a new epithelium and lamina propria for endometrial renewal. Bases of glands deep within the basalis are the source of regeneration.
        • Have different morphology depending on the stage of the menstrual cycle.
        • Between them, there is connective tissue stroma containing mesenchymal-type cells and extracellular matrix.

    Endometrial Phases

    • Follicular/ proliferative phase: Estrogen causes mitotic activity in the glands and stroma, increasing endometrial thickness from 2 to 9 mm.
    • Luteal/ secretory phase: Progesterone restricts mitotic activity, causing endometrial glands to produce and secrete glycogen-rich vacuoles, leading to:
      • Stromal edema.
      • Stromal cell enlargement.
      • Spiral arterioles development: Lengthening and coiling.

    Fallopian Tubes

    • Fertilization occurs in the ampullary region.
      • Implantation occurs in the uterus, but may implant ectopically.
    • The fallopian tube entrance is surrounded by fimbriae.
      • An ovary is not directly connected to the tube.
      • When ovulation occurs, hormones activate the fimbriae, causing them to swell with blood and sweep the oocyte into the tube.
        • Cilia sweep the ovum into the fallopian tube.
        • 50% of fimbria cells have cilia.
    • The fallopian tube can be divided into 4 segments:
      • Fimbria.
      • Infundibulum: Funnel-shaped opening near the ovary.
      • Ampulla: Widest section of the tube.
      • Isthmus: Narrowest section connecting to the uterine cavity.
    • Neurovasculature: Same as the cervix and uterus.

    Fallopian Tube Wall

    • Wall of the fallopian tube: 3 layers.
      • Mucosa: Simple columnar epithelium, with ciliated cells and secretory cells.
        • Cilia propel the oocyte towards the uterus.
        • Secretory cells produce a secretion that promotes capacitation of spermatozoa and nutrient functions for the ovum.
      • Lamina propria: Loose connective tissue.
      • Muscularis: Inner circular and outer longitudinal layers of smooth muscle.

    Ovary

    • Female gonads develop within the abdomen and descend through the inguinal canal.
      • Paired organs attached to the posterior surface of the broad ligament by the mesovarium.
    • Structure:
      • Surface: Simple cuboidal epithelium.
      • Outer cortex: Connective tissue stroma and ovarian follicles.
      • Inner medulla: Lots of connective tissue and a rich neurovascular supply.

    Ovary Neurovasculature

    • Arterial supply: Ovarian arteries (from abdominal aorta).
    • Venous drainage: Ovarian veins.
      • Left ovarian vein -> Left renal vein.
      • Right ovarian vein -> IVC.
    • Lymphatic drainage: Para-aortic lymph nodes.
    • Innervation: ANS: Ovarian and uterine plexus (from inferior hypogastric plexus).

    Ovary Structure Breakdown

    • Almond-shaped.
    • Simple/ cuboidal outer epithelium with an underlying tunica albuginea.
    • Subdivided into:
      • Cortex (outer): Mostly consists of ovarian follicles at various stages of development.
        • Follicle: Oocyte surrounded by 1 or more layers of granulosa cells. Approximately 200,000/ ovary in a normal woman.
          • Approximately 20 follicles enter the growth phase each cycle.
        • Remainder of the cortex: Connective tissue stroma with fibroblasts.
      • Medulla (inner): Loose connective tissue stroma with a rich vascular bed. Large follicles may extend into the medulla.
    • The ovaries are covered by visceral peritoneum.

    Follicles

    • Primordial follicles: Primary oocyte surrounded by a simple squamous epithelium of stromal cells/ pre-granulosa cells. 30 µm in diameter. Found at the periphery of the cortex.
    • Primary follicles: Grows to about 75 µm in diameter. Epithelium becomes simple cuboidal epithelium. Pre-granulosa cells -> granulosa cells.
    • Secondary follicles: Zona pellucida forms between the follicles and granulosa cells. Granulosa becomes a stratified cuboidal epithelium.
    • Early antral follicles: Exhibits the beginnings of the antrum formation (space filled with fluid). Begins to synthesize and secrete estrogen. Implanted in the uterine lining.
      • Surrounding the oocyte is the cumulus oophorus.
      • Surrounding the follicular cells are the thecal cells which produce estrogen.
    • Antral follicle: Complete formation of the antrum.
    • Graafian/ mature/ tertiar/ pre-ovulatory follicle: Development of a dominant follicle. Corona radiata present. Restriction of blood flow to the oocyte can cause the follicle to rupture and be ovulated from the ovary.

    Corpus Luteum and Corpus Albicans

    • After ovulation, the ruptured follicle is retained in the ovary as the corpus luteum.
      • Secretes predominantly progesterone and estrogen.
      • Develops a rich blood supply.
    • If there is no pregnancy, the corpus luteum degenerates into the corpus albicans (fibrous tissue that is gradually reabsorbed in the ovary, leaving a visible white scar-like tissue).

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