Paper - The Internal Genital Organs of a Female Foetus of 15 cm Length: Difference between revisions
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In order to reach a true understanding .of the various malformations of the genital tract, it is important to accumulate descriptions of specimens which appear to be normal. Such an investigation has been made upon the internal genital organs of a female foetus of about 4 months’ development, and the results are set forth in the following paper. | |||
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The Fallopian Tubes | ==The Fallopian Tubes== | ||
From the reconstruction the tubes differ somewhat | |||
in measurement. That on the right is 1-12 cm. in length and varies in breadth | in measurement. That on the right is 1-12 cm. in length and varies in breadth | ||
from 0-02 to 0-08 cm.; the fimbriated extremity makes up 0-14 cm. of its length. | from 0-02 to 0-08 cm.; the fimbriated extremity makes up 0-14 cm. of its length. | ||
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Felix (1), cannot be made out. | Felix (1), cannot be made out. | ||
Caudal to the mesovarium the common urogenital mesentery passes forwards and distally to fuse with the connective tissue surrounding the inner | |||
end of the tube. Its point of attachment is about 2 mm. lateral to the median | |||
sulcus on the cranial aspect of the body of the uterus. The future body will | |||
therefore come to include the inner 1 mm. of the present Fallopian tube. | |||
==The Body of the Uterus== | |||
Regarding that part of the uterus proximal to | |||
the level at which the ducts of Gartner enter, we find that the anterior and | |||
posterior walls are relatively thick. The walls are formed by a continuation | |||
of the two coats already described in the wall of the tube. At this level they | |||
become widely separated by a third zone which makes up a considerable | |||
thickness of the wall. In this, densely packed clusters of cells are found. The | |||
nuclei of the cells of this zone are directed for the most part at right angles | |||
to the cavity of the uterus. Into this zone strands of cells turn inwards from | |||
the outer circular zone. The presence of these strands suggests that this middle | |||
zone represents part of the muscular coat of the fully formed uterus. No | |||
sharp demarcation exists between these three portions of the uterine wall. | |||
No fully formed smooth muscle bundles are present, but the nearest approach | |||
to this is found in the circular zone. N agel (3), (4) found smooth muscle arranged | |||
in bundles in embryos of 15-22 cm. length. This muscle appeared first under | |||
the peritoneal coat. | |||
The cavity enclosed by these walls forms in transverse section a narrow | |||
wavy slit as the anterior and posterior uterine walls are for the most part in | |||
apposition. The epithelial lining is similar to that in the tube, although again | |||
it is absent in places. | |||
==The Cervix== | |||
This part, besides being marked off by the relative uniformity | |||
of the width of its cavity and by the width of its lateral walls (fig. 3, B), differs | |||
from the body in some details. This portion, instead of forming an oval in | |||
transverse section, is almost circular. The arrangement of the cells of the middle | |||
layer of the wall is more irregular than in the body. The increase in depth of | |||
the wall of this part is due to an increase in the outer two layers of the wall, | |||
i.e. in those layers which will go to form the muscular coat of the cervix. | |||
The epithelium lining the cervix is similar in appearance to that present | |||
in the tube and body of the uterus, and here also at certain levels is absent. | |||
In the middle line into the upper part of the cervical canal there is a longitudinal bulging of the anterior wall. Opposite this prominence there is a longitudinal groove in the posterior wall. This prominence represents possibly the | |||
first commencement of the arbor vitae. No evidence is found in this specimen | |||
of the secondary folds of mucous membrane, which are described by Felix (1) | |||
as arising from the base of depressions in the wall of the cervix in embryos | |||
of about 150 mm. The lower end of the cavity of the cervix forms a narrow | |||
transverse slit. | |||
==The Vagina== | |||
Distal to this portion having a narrow slit-like lumen, there is a sudden widening of the genital canal, and a thinning of the walls (fig. 3, C). | |||
This foetus resembles those described by both Van Eckeren (5) and Mihalkovicz (6). These observers considered that this dilatation was the first sign of | |||
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Fleming AM. The Internal Genital Organs of a Female Foetus of 15 cm Length (1927) J Anat. 61:232–246. PMID 17104136
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The Internal Genital Organs of a Female Foetus of 15 cm Length
By Amy M. Fleming, B.SC., M.B., CH.B. (Glas.)
From the Pathological Department of the Royal Samaritan Hospital for Women, Glasgow
In order to reach a true understanding .of the various malformations of the genital tract, it is important to accumulate descriptions of specimens which appear to be normal. Such an investigation has been made upon the internal genital organs of a female foetus of about 4 months’ development, and the results are set forth in the following paper.
When this foetus was obtained, I was making a study of the peripheral innervation of the uterus in certain mammals. This led me to think that a description of the distribution of the nerve-tissue in this specimen might be of value. The specimen was obtained from a patient who died somewhat suddenly from Hyperemesis Gravidarum. The autopsy was carried out less than 12 hours after death. The contents of the pelvis were removed intact. The uterus was then opened, and the foetus extracted. The foetus looked quite fresh, no signs of maceration being evident. From vertex to breech it measured 15 cm. The pelvic bones and lower part of the vertebral column Were dissected out carefully, and without damage to the contents of the foetal pelvis. The peritoneal cavity was then opened from in front, and the foetus divided across a short distance proximal to the internal genital organs. Unnecessary portions of the anterior abdominal wall and of the muscles of the back were then removed, leaving as complete a block as possible of the organs within the lower abdomen and pelvis. This block was fixed in Kaiserling’s formalin solution, and a complete series of 2872 paraffin sections each 10 microns thick was prepared. These are numbered from the cranial extremity backwards. While the unsectioned block was in xylol, the vessels and other structures showed up so beautifully that a freehand drawing was made of the upper part of the specimen at this stage (fig. 1). The block includes the rectum posteriorly, the bladder anteriorly (portions only of the ureter being distinct on either side), and between these the genital organs. The ovaries are shaped like bay leaves, lying with their long axes horizontal. They lie proximal to and immediately above the Fallopian tubes. They extend from just within the upturned lateral end of the tube to a short distance medial to the opening of the tube into that portion of the uterus which will form the future body. The anterior surface, as indicated in the drawing, is not smooth, but shows a horizontal groove, from which side branches run as shallow sulci towards the proximal and distal borders. The tube on either side passes out from the uterus to terminate in a curve around the lateral extremity of the ovary. In its course it is thrown into small rounded curves encountered in all planes. Relative to its length, the duct is narrower than is the adult Fallopian tube. Other details will be described later.
The drawing shows that the utero-vaginal tube consists of a long cylindrical portion a little narrower than the rectum surmounted by a short broader part which widens out proximally, and which laterally is continued into the tubes. On the cranial extremity of the upper portion a shallow medial sulcus is seen, but no evidence of the presence of a sulcus is found on the anterior surface. There is no indication on the external surface whether the line of demarcation between the distal narrow and the proximal wide portion corresponds to the dividing line between the future body and the cervix, or between the cervix and the vagina.
The blood vessels show up particularly well. On the right-hand side, the loose tissue in which they lie had been slightly damaged during the manipulations of the block, and as a result the proximal portions of the Vessels were displaced outwards. For this reason, their course is not shown in the drawing. With the exception of a few reserved for special staining methods, the sections were stained with haematoxylin and eosin. Microscopically the preservation is good.
A flat reconstruction of the genital tract (fig. 2) shows its outline, the lumen being indicated by a dotted line. Remnants of Gartner’s ducts, in those parts of their course near to the utero-vaginal canal and to the tubal portion of the uterus, are seen. The tubes are long and narrow, and show the multiple curves already mentioned, but naturally only those apparent in one plane. The free end of the tube has a fimbriated extremity. Its opening faces posteriorly. From the margins of the opening strands of connective tissue are continued laterally in the edge of the mesosalpinx and also towards the ovary. At the other end, the tubes enlarge to form the tubal portion of the body of the uterus. In the reconstruction, the sulcus or the cranial extremity of the uterus at this stage of development is 0-4 mm. deep.
There is no median septum in the cavity. The formation of a single roughly symmetrical uterine cavity has kept pace with the union of the tubes to form the tubal portion of the body of the uterus. The unpaired portion of the generative tract is at this stage divisible into three portions. (1) The most proximal part is somewhat triangular in form, its base forming the future fundus of the uterus. (2) A cylindrical portion with thicker walls and a narrower cavity. (3) A long portion narrower in its proximal than in its distal half and possessing a relatively thin wall. The opening of this portion into the urogenital sinus is still closed by a solid mass of tissue. No sharp line of demarcation is present between these three portions. In length their cavities measure approximately 1-4 mm., 2-8 mm., and 5-6 mm. respectively. Diagrams illustrating the contour of a section from each of these three portions are seen in
Fig. 1, Drawing of upper part of block while in xylol. b = bladder, o = ovary, r = rectum, t=Fallopian tube, ur = ureter, ut = uterus, v = blood vessels.
Fig. 2. Flat reconstructions of the genital tract from the serial section: for description see text. The levels from which Fig. 3 (A, B, 0) are taken are indicated.
Fig. 3. The region of the transition between the triangular proximal portion and the remainder is marked externally by the entrance of the ducts of Gartner into the uterine substance. This is therefore probably the dividing line between that portion of the uterine mucous membrane developed from the uterine portion of the tubes and that developed from the utero-vaginal canal. These three portions are taken to correspond with the body of the uterus, cervix and vagina respectively, and later, histological evidence in support of this IS given.
The Fallopian Tubes
From the reconstruction the tubes differ somewhat in measurement. That on the right is 1-12 cm. in length and varies in breadth from 0-02 to 0-08 cm.; the fimbriated extremity makes up 0-14 cm. of its length. The corresponding measurements on the left are 0-92 cm., 0-02 to 0-04 cm. and 0-14 cm. Both tubes pass outwards until opposite the lateral extremity of the ovary they curve upwards and finally terminate by a distinct inclination backwards, thus ending behind the ovary. Each tube possesses a canal patent throughout its entire length. The lining epithelium consists of cells whose protoplasm stains deeply. The nuclei are oval, intensely stained and large relative to‘ the size of the cells. In places the epithelium is in the form of a single layer which is definitely columnar in parts. In places no epithelium is recognisable because the walls of the tube are almost in apposition; but a potential lumen is always apparent. .
The lumen in its simplest form in cross-section has the appearance of a
four-rayed star. In this specimen the two ventral and the two dorsal folds
producing this formation are not (as described by Felix (1) in Keibel and Mall
in a 50 mm. head~foot length embryo) due almost entirely to difference in
height of epithelium, but at this stage are formed of embryonic connective
tissue. Towards the outer end of the tube, besides these primary folds, there
are secondary ones varying in size and shape.
Regarding the remainder of the wall of the tube, the two coats are distinct
which Felix (1) describes in a foetus of 80 mm. trunk length. In my specimen,
however, they are approximately equal in thickness. Muscle fibres in the
adult sense cannot be recognised. Both coats are well vascularised. The inner
has irregularly arranged cells with faintly stained protoplasm and oval deeply
stained nuclei. The spindle cells of the outer coat form circular layers. The
two coats become ill-defined as they are traced towards the outer end of the
tube. The inner coat I regard as the forerunner of the stroma of the mucosa
and the outer band as destined to form the muscular layer. This is in agreement
with Felix (1) and, in the case of the outer band, with Bryce (2), who, however,
makes no statement as to the fate of the inner coat.
The tissue of the entire tube is not sharply demarcated from that of the
broad ligament. In the boundary zone between run the main vessels of supply
to the tube. Near this, the layers, recognisable as serous and subserous by
Felix (1), cannot be made out.
Caudal to the mesovarium the common urogenital mesentery passes forwards and distally to fuse with the connective tissue surrounding the inner
end of the tube. Its point of attachment is about 2 mm. lateral to the median
sulcus on the cranial aspect of the body of the uterus. The future body will
therefore come to include the inner 1 mm. of the present Fallopian tube.
The Body of the Uterus
Regarding that part of the uterus proximal to the level at which the ducts of Gartner enter, we find that the anterior and posterior walls are relatively thick. The walls are formed by a continuation of the two coats already described in the wall of the tube. At this level they become widely separated by a third zone which makes up a considerable thickness of the wall. In this, densely packed clusters of cells are found. The nuclei of the cells of this zone are directed for the most part at right angles to the cavity of the uterus. Into this zone strands of cells turn inwards from the outer circular zone. The presence of these strands suggests that this middle zone represents part of the muscular coat of the fully formed uterus. No sharp demarcation exists between these three portions of the uterine wall. No fully formed smooth muscle bundles are present, but the nearest approach to this is found in the circular zone. N agel (3), (4) found smooth muscle arranged in bundles in embryos of 15-22 cm. length. This muscle appeared first under the peritoneal coat.
The cavity enclosed by these walls forms in transverse section a narrow
wavy slit as the anterior and posterior uterine walls are for the most part in
apposition. The epithelial lining is similar to that in the tube, although again
it is absent in places.
The Cervix
This part, besides being marked off by the relative uniformity of the width of its cavity and by the width of its lateral walls (fig. 3, B), differs from the body in some details. This portion, instead of forming an oval in transverse section, is almost circular. The arrangement of the cells of the middle layer of the wall is more irregular than in the body. The increase in depth of the wall of this part is due to an increase in the outer two layers of the wall, i.e. in those layers which will go to form the muscular coat of the cervix.
The epithelium lining the cervix is similar in appearance to that present
in the tube and body of the uterus, and here also at certain levels is absent.
In the middle line into the upper part of the cervical canal there is a longitudinal bulging of the anterior wall. Opposite this prominence there is a longitudinal groove in the posterior wall. This prominence represents possibly the
first commencement of the arbor vitae. No evidence is found in this specimen
of the secondary folds of mucous membrane, which are described by Felix (1)
as arising from the base of depressions in the wall of the cervix in embryos
of about 150 mm. The lower end of the cavity of the cervix forms a narrow
transverse slit.
The Vagina
Distal to this portion having a narrow slit-like lumen, there is a sudden widening of the genital canal, and a thinning of the walls (fig. 3, C). This foetus resembles those described by both Van Eckeren (5) and Mihalkovicz (6). These observers considered that this dilatation was the first sign of
Cite this page: Hill, M.A. (2024, April 19) Embryology Paper - The Internal Genital Organs of a Female Foetus of 15 cm Length. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Paper_-_The_Internal_Genital_Organs_of_a_Female_Foetus_of_15_cm_Length
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