Urogenital System. PUMC Dept. of Anat. Hist. & Embry. 钱晓菁 XIAO-JING QIAN Dept. of Anatomy, Histology & Embryology Peking Union Medical College

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1 Urogenital System 钱晓菁 XIAO-JING QIAN Dept. of Anatomy, Histology & Embryology Peking Union Medical College

2 intermediate mesoderm urogenital ridge mesonephric ridge genital ridge

3 I. Urinary System 1. kidney & ureters 2. bladder & urethra 3. suprarenal glands

4 1. kidney & ureters 1) pronephros (4W) 2) mesonephros (4W-3M) 3) metanephros (5W- ) develop in craniocaudal sequence

5 1) pronephros rudimentary & nonfunctional 4W beginning, cervical region nephrotomes ( 生肾节 ) pronephric tubule pronephric ducts 4W end pronephros regress pronephric ducts persist

6 2) mesonephros interim kidneys nephrogenic cord ( 生肾索 ) (1) mesonephric tubules (2) mesonephric duct

7 (1) mesonephric tubules 4W late

8 (2) mesonephric duct (Wolffian) pronephric ducts mesonephric ducts fused with cloaca

9 3 th month end mesonephros degenerate a few persist, male genital system

10 3) metanephros (permanent kidney) (1) primordium (2) position changes of the kidney (3) changes in the blood supply

11 (1) primordium 5W i. ureteric bud (metanephric diverticulum) ii. metanephric blastema (metanephric mass of intermediate mesoderm) reciprocal induction

12 i. ureteric bud collecting system outgrowth from the mesonephric duct bifurcate ureter collecting tubules

13 ii. metanephric blastema excretory units derived from the caudal part of nephrogenic cord metanephric vesicles glomeruli nephrons metanephric tubules proximal end Bowman's capsule distal end contact with arched collecting tubule

14 bilateral renal agenesis oligohydramnios Potter s syndrome unilateral renal agenesis renal dysplasias duplication of the ureter multicystic dysplastic kidney

15 (2) position changes of the kidney ascent of the kidney pelvis rotation 90 abdomen (9w) hilum: ventrally anteromedially

16 (3) changes in the blood supply branches of the common lilac A. distal end of the aorta cranial arterial branches from the abdominal aorta disappear accessory renal A. renal arteries

17 ectopic kidneys pelvic kidney discoid kidney crossed renal ectopia

18 2. bladder & urethra 4-7W urorectal septum cloaca the urogenital sinus the anal canal

19 (1) urogenital sinus vesical part bladder pelvic part phallic part urethra

20 (2) bladder vesical part of urogenital sinus enlarge allantois urachus median umbilical ligament distal portions of the mesonephric ducts trigone

21 urachus median umbilical ligament allantois

22 urachal fistula, cyst, sinus

23 trigone

24 exstrophy of the bladder

25 (3) urethra pelvic part : prostatic & membranous urethra. : urethra phallic part : penile urethra : vestibule of vagina

26 3. the suprarenal glands mesoderm fetal cortex (5-6W) neural crest cells medulla

27 fetal cortex 5-6W regresses (1yr) medulla permanent cortex 8W zona glomerulosa zona fasciculata zona reticularis (3yr end)

28 II. Genital System sex determination (genetic sex) fertilization sex development 1. indifferent stage 2. different stage XY XX < 7W > 7W

29 1. indifferent stage primordium 1) gonads 2) genital ducts 3) external genitalia

30 1) gonads primordial germ cells coelomic epithelium (posterior abdominal wall) underlying mesenchyme gonadal ridge

31 (1) primordial germ cell 4W endoderm cells of yolk sac migration 6w gonadal ridge

32 (2) gonadal ridge coelomic epithelium 5-6w primitive sex cords underlying mesenchyme

33 2) genital ducts mesonephric ducts (Wolffian ~) paramesonephric ducts (Müllerian ~)

34 3) external genitalia genital tubercle phallus urogenital folds labioscrotal swellings urethral groove

35 2. different stage 1) male SRY (1) testis androgen (2) genital ducts (3) external genitalia (4) descent of the testes

36 (1) testis SRY gene + - testis ovary testis-determining factor (sex-determining region of the Y chromosome on Yp11)

37 (1) testis SRY gene indifferent gonad primordial germ cells the primitive sex cords mesenchyme testis spermatogonia Sertoli cells Leydig cells tunica albuginea

38 (2) genital ducts mesonephric tubules mesonephric duct ductuli efferentes testosterone Leydig cell ( 8W) ductus epididymis + ductus deferens

39 Sertoli cell antimüllerian hormone (AMH, MIH) paramesonephric ducts regress

40 (3) external genitalia 9-12w 5α- reductase testosterone dihydrotestosterone (DIT) phallus urogenital folds labioscrotal folds penis ventral aspect of penis scrotum

41 defects in the male genitalia epispadias ( 尿道上裂 ) hypospadias ( 尿道下裂 )

42 (4) descent of the testes DIT gubernaculum ( 引带 ) vaginal process inguinal canal

43 testis descent posterior abdominal wall inguinal canal scrotum peritoneal sac vaginal process tunica vaginalis proximal part obliterated

44 failure of closure of the vaginal process congenital inguinal hernia hydrocele ( 鞘膜积液 ) cryptorchidism ( 隐睾 ) ectopic testes

45 2. different stage 2) female (1) ovary (2) genital ducts (3) external genitalia (4) descent of the ovaries

46 (1) ovary no SRY primitive sex cords 10W regress surface epithelium secondary sex cords (cortical cords) follicular cells oogonia 16W follicles mesenchyme stromal cells

47 (2) genital ducts mesonephric duct no testosterone paramesonephric duct no AMH regress develop

48 paramesonephric duct cranial open into body cavity middle lateral to mesonephric duct caudal fuse uterovaginal primordium caudal tip sinus tubercle

49 paramesonephric duct uterine tube uterovaginal primordium uterus upper portion of vagina

50 vagina upper (1/3) uterovaginal primordium lower (2/3) sinus tubercle induced sinovaginal bulbs (urogenital sinus) vaginal plate canalization vagina hymen

51 uterine and vaginal defects abnormal development of the uterus absent of the vagina & uterus failure of the sinovaginal bulbs development vaginal atresia imperforate hymen

52 (3) external genitalia genital tubercle clitoris urogenital folds labioscrotal swellings labia minora labia majora

53 (4) descent of the ovaries abdominal pelvic gubernaculum ovarian ligament round ligament of uterus

54 birth defects hermaphrodites ( 两性人 ) gonad? external genitalia true hermaphroditism pseudohermaphrodites female hermaphrodites male hermaphrodites

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