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FEMALE REPRODUCTIVE SYSTEM (II) Marylee M Kott, MD Learning Objectives : Same as Female Reproductive System I in addition to: Identify the various components of the ovary. Learn the stages of the developing follicles and the corresponding morphologic features. Reading : Gartner and Hiatt pp 343-365; Klein and McKenzie, pp 287-299 A. THE FALLOPIAN TUBE (OVIDUCT): 1. Anatomy: Extends from the area of its corresponding ovary anteriorly and medially to its terminus in the posterosuperior aspect of the uterine fundus. At the ovarian end opens into the peritoneal cavity and is composed of about 25 irregular finger- like extensions, the fimbriae . The fimbriae attach to the expanded end of the tube, the infundibulum , which is about 1 cm long and 1 cm in diameter distally. The infundibulum narrows gradually to 4 mm in diameter and merges medially with the ampullary portion of the tube, which extends about 6 cm, passing anteriorly as it loops around the ovary. At a point characterized by relative thickness of the muscular wall, the isthmic portion begins and extends some 2 cm from the uterus. Within the myometrium, the interstitial portion extends as a 1 cm intramural segment until it joins the extension of the endometrial cavity at the uterotubal junction. 2. Histologically the fallopian tube is composed of three layers: a. The mucosal layer : lies directly on the muscularis. consists of a luminal epithelial lining and a scant underlying lamina propria. The number of mucosal folds (plicae) increases from about six in the interstitial portion to a dozen or more in the isthmus. In the ampulla, the plicae are frond-like and delicate with both secondary and tertiary branches present; the infundibular plical pattern is similar. The mucosa is lined by a simple columnar epithelium which is composed of the ciliated, secretor y, and the intercalary or peg cells. A few lymphocytes are also present in the lining. The epithelium exhibits changes associated with the menstrual cycle. During the proliferative phase, as a response to increased estrogen levels, the cilia increase in number and height. During the secretory phase the cilia decrease in number and height while the secretory cells actively secrete into the lumen. The lamina propria contains vessels and spindle or angular stromal cells which may become decidualized in about 10% of pregnancies. b. The muscularis is composed of smooth muscle bundles roughly arranged into inner circular and outer longitudinal layers. c. The serosa : composed of a flat mesothelial lining covering the tube. i. Walthard rests are urothelial metaplastic foci (arising from the mesothelial cells) commonly found in the serosa of the fallopian tube and rarely in the ovarian surface epithelium and pelvic peritoneum. They are solid but may become cystic.
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B. THE OVARY: 1. Anatomy: Paired pelvic organs which lie on either side of the uterus close to the lateral pelvic
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This note was uploaded on 12/25/2010 for the course NEUROBIOLO MSI taught by Professor Rogerj.bick during the Spring '10 term at University of Texas Health Science Center at San Antonio.

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