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Updated: 8/21/2022

Genital Embryology

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Questions
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Evidence
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  • Overview
    • Week 1-6
      • embryo is sexually indifferent
      • genetically male and female embryos are phenotypically the same
      • both male and female have mesonephric (Wolffian) ducts at this stage
    • Week 7
      • sexual differentiation occurs
    • Week 12
      • sex of embryo can be distinguished based on external genitalia
    • Week 20
      • phenotypical differentiation is complete
  • Male vs. Female Differentiation
    • Mesonephric (wolffian) duct
      • needs to be induced to develop
        • by testosterone from the Leydig cells of testes
      • forms male internal sexual organs: Seminal vesicles, Epididymis, Ejaculatory duct, Ductus deferens
    • Paramesonephric (müllerian) duct
      • default development but can be suppressed
      • forms female internal sexual organs: fallopian tube, uterus, upper 1/3 of vagina (lower 2/3 from urogenital sinus)
    • Female
      • default phenotypic differentiation
      • mesonephric duct degenerates and paramesonephric duct develops
    • Male
      • SRY gene (Y chromosome) produces testis-determining factor which is necessary for testes development
      • testes gives rise to
        • sertoli cells: produces Müllerian inhibitory factor suppressing the development of paramesonephric ducts
        • leydig cells: produces androgens stimulating development of mesonephric ducts
  • Male/Female Genital Homologues
      • Dihydrotestosterone Results in Developement
      • Common Precursor
      • Estrogen Results in Development
      • Glans penis
      • Genital tubercle
      • Glans clitoris
      • Corpus cavernosum and spongiosum
      • Genital tubercle
      • Vestibular bulbs
      • Bulbourethral glands (of Cowper)
      • Urogenital sinus
      • Greater vestibular glands (of Bartholin)
      • Prostate gland
      • Urogenital sinus
      • Urethral and paraurethral glands (of Skene)
      • Ventral shaft of penis (penile urethra)
      • Urogenital folds
      • Labia minora
      • Scrotum
      • Labioscrotal swelling
      • Labia majora
  • Female Genital Abnormalities
    • Unicornate Uterus
      • one paramesonephric fails to develop
    • Bicornuate Uterus
      • due to incomplete/partial fusion of the paramesonephric ducts
      • associated with urinary tract abnormalities and infertility
    • Uterus didelphys
      • no fusion between the two paramesonephric ducts resulting in a "double uterus"
    • Müllerian agenesis
      • failure of paramesonephric ducts to develop resulting in abnormalities of the upper portion of the vagina, cervix, uterus, and fallopian tubes
  • Male Genital Abnormalities
    • Hypospadias
      • failure of urethral folds to fuse
      • resulting in opening of penile urethra on inferior side of penis
      • susceptible to UTI's
      • surgery is recommended for treatment
    • Epispadias
      • faulty positioning of genital tubercle
      • resulting in penile urethra opening on superior side of penis
      • associated with exstrophy of the bladder
    • Cryptochidism
      • failure of testes to descend into scrotum (undescended testes)
      • testes can be found in inguinal canal or abdominal canal
      • can lead to infertility if both are undescended
      • observable within 3 months of birth
    • Hydrocele
      • processus vaginalis remains patent allowing fluid to flow in
      • resulting in a fluid filled sac in the scrotum
      • can differentiate from tumor by shining light through testes
      • hydrocele allows light to flow through whereas a tumor does not

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Questions (8)
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(M1.RP.17.4753) A 35-year-old female presents to her gynecologist complaining of vaginal discomfort. She reports that over the past two weeks, she has developed dyspareunia and feels as if there is a mass on the external aspect of her vagina. She is sexually active in a monogamous relationship. On physical examination, there is a 2 cm unilateral erythematous swelling on the right side of the posterolateral labia minora. Which of the following embryologic precursors gives rise to the most likely etiology of this patient's symptoms?

QID: 108748

Paramesonephric duct

12%

(30/243)

Genital tubercle

12%

(29/243)

Urogenital sinus

22%

(53/243)

Urogenital fold

35%

(84/243)

Labioscrotal swelling

15%

(37/243)

M 1 C

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(M1.EB.15.11) A 4-day-old healthy male infant is born with normal internal and external male reproductive organs. Karyotype analysis reveals a 46XY genotype. Production of what substance by which cell type is responsible for the development of the normal male seminal vesicles, epididymides, ejaculatory ducts, and ductus deferens?

QID: 101905

Testis-determining factor; Sertoli cells

11%

(26/244)

Testis-determining factor; Leydig cells

13%

(32/244)

Testosterone; Sertoli cells

10%

(24/244)

Testosterone; Leydig cells

39%

(94/244)

Mullerian inhibitory factor; Sertoli cells

26%

(63/244)

M 1 D

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(M1.EB.12.36) A 22-year-old G2P1 female presents to the clinic at the beginning of her third trimester for a fetal ultrasound. The sonographer is unable to visualize any of the structures arising from the mesonephric duct. This infant is at risk for malformation of which of the following?

QID: 101930

Fallopian tubes

9%

(29/334)

Uterus

13%

(43/334)

Upper 1/3 of vagina

16%

(52/334)

Lower 2/3 of vagina

8%

(27/334)

No malformation would be expected

54%

(181/334)

M 1 E

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(M1.EB.12.35) A newborn infant with karyotype 46, XY has male internal and external reproductive structures. The lack of a uterus in this infant can be attributed to the actions of which of the following cell types?

QID: 101929

Leydig

28%

(54/191)

Sertoli

65%

(124/191)

Theca

3%

(6/191)

Granulosa

3%

(5/191)

Reticularis

0%

(0/191)

M 1 E

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Evidence (6)
VIDEOS & PODCASTS (1)
EXPERT COMMENTS (17)
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