Anatomy & Physiology Of Female Reproductive System Dr. Aida Abd El-Razek

Anatomy & Physiology Of Female Reproductive System

Dr. Aida Abd El-Razek

Learning Objectives

Define the terms listed.Identify the female external

reproductive organs.Explain the structure of the bony

pelvis.Explain the functions and structures

of pelvic floor.

Introduction

External Female Structures

Collectively, the external female reproductive organs are called the

Vulva.

External Female Structures

Mons Pubis.Labia Majora & Minora.Clitoris.Vestibule.Perineum

Mons Pubis

Is rounded, soft fullness of subcutaneous fatty tissue, prominence over the symphysis pubis that forms the anterior border of the external reproductive organs.

It is covered with varying amounts of pubic hair.

Labia Majora & Minora

The labia Majora are two rounded, fleshy folds of tissue that extended from the mons pubis to the perineum.

It is protect the labia minora, urinary meatus and vaginal introitus.

Labia Minora

It is located between the labia majora, are narrow.

The lateral and anterior aspects are usually pigmented.

The inner surfaces are similar to vaginal mucosa, pink and mois.

Their rich vascularity.

Clitoris.

The term clitoris comes from a Greek word meaning key.

Erectile organ.It’s rich vascular, highly sensitive

to temperature, touch, and pressure sensation

Vestibule.

Is oval-shaped area formed between the labia minora, clitoris, and fourchette.

Vestibule contains the external urethral meatus, vaginal introitus, and Bartholins glands.

Perineum

Is the most posterior part of the external female reproductive organs.

It extends from fourchette anteriorly to the anus posteriorly.

And is composed of fibrous and muscular tissues that support pelvic structures.

Internal Female Structures

VaginaUterusFallopian tubesOvaries

Fallopian tubes

The two tubes extended from the cornu of the uterus to the ovary.

It runs in the upper free border of the broad ligament.

Length 8 to 14 cm average 10 cmIts divided into 4 parts.

1. Interstitial partWhich runs into uterine cavity,

passes through the myometrium between the fundus and body of the uterus. About 1-2cm in length.

2. Isthmus

Which is the narrow part of the tube adjacent to the uterus.

Straight and cord like , about 2 – 3 cm in length.

3. Ampulla

Which is the wider part about 5 cm in length.

Fertilization occurs in the ampulla.

4. Infundibulum

It is funnel or trumpet shaped.Fimbriae are fingerlike processes, one

of these is longer than the other and adherent to the ovary.

The fimbriae become swollen almost erectile at ovulation.

Functions

Gamete transport (ovum pickup, ovum transport, sperm transport).

Final maturation of gamete post ovulate oocyte maturation, sperm capicitation.

Fluid environment for early embryonic development.

Transport of fertilized and unfertilized ovum to the uterus.

OvariesOval solid structure, 1.5 cm in thickness,

2.5 cm in width and 3.5 cm in length respectively. Each weights about 4–8 gm.

Ovary is located on each side of the uterus, below and behind the uterine tubes

Structure of the ovaries

CortexMedullaHilum

Ovaries and Relationship to Uterine Tube and Uterus

Figure 28–14

Function of the ovary

Secrete estrogen & progesterone.

Production of ova

Uterus

The uterus is a hollow, pear shaped muscular organ.

The uterus measures about 7.5 X 5 X 2.5 cm and weight about 50 – 60 gm.

Its normal position is anteverted (rotated forward and slightly antiflexed (flexed forward)

The uterus divided into three parts

1. Body of the uterus

The upper part is the corpus, or body of the uterus

The fundus is the part of the body or corpus above the area where the fallopian tubes enter the uterus.

Length about 5 cm.

2. Isthmus

A narrower transition zone.Is between the corpus of the uterus

and cervix.During late pregnancy, the isthmus

elongates and is known as the lower uterine segment.

3 .Cervix

The lowermost position of the uterus “neck”.

The length of the cervix is about 2.5 t0 3 cm.

The os, is the opening in the cervix that runs between the uterus and vagina.

The upper part of the cervix is marked by internal os and the lower cervix is marked by the external os.

Layers of the uterus

Perimetrium. Myometrium. Endometrium.

1. Perimetrium

Is the outer peritoneal layer of serous membrane that covers most of the uterus.

Laterally, the perimetrium is continuous with the broad ligaments on either side of the uterus.

2. Myometrium

Is the middle layer of thick muscle.

Most of the muscle fibers are concentrated in the upper uterus, and their number diminishes progressively toward the cervix.

The myometrium contains three types of smooth muscle fiber

Longitudinal fibers (outer layer)

Which are found mostly in the fundus and are designed to expel the fetus efficiently toward the pelvic outlet during birth.

Middle layer figure-8 fibers

These fiber contract after birth to compress the blood vessels that pass between them to limit blood loss.

Inner layer circular fibers

Which form constrictions where the fallopian tubes enter the uterus and surround the internal os

Circular fibers prevent reflux of menstrual blood and tissue into the fallopian tubes.

Promote normal implantation of the fertilized ovum by controlling its entry into the uterus.

And retain the fetus until the appropriate time of birth.

3. EndometriumIs the inner layer of the uterus.It is responsive to the cyclic

variations of estrogen and progesterone during the female reproductive cycle every month.

The two or three layers of the endometrium are:

*Compact layer

*The basal layer

*The functional or Sponge layer this layer is shed during each menstrual period and after child birth in the lochia

Anatomical relation of the uterus

Anterior------------BladderPosterior-----------The rectum and

Douglas pouchLateral------------- The broad

ligaments ,F. T& ovariesSuperior-----------The intestines. Inferior------------- The Vagina

The Function of the uterus

Menstruation ----the uterus sloughs off the endometrium.

Pregnancy ---the uterus support fetus and allows the fetus to grow.

Labor and birth---the uterine muscles contract and the cervix dilates during labor to expel the fetus

VaginaIt is an elastic fibro-muscular tube

and membranous tissue about 8 to 10 cm long.

Lying between the bladder anteriorly and the rectum posteriorly.

The vagina connects the uterus above with the vestibule below.

The upper end is blind and called the vaginal vault.

The vaginal lining has multiple folds, or rugae and muscle layer. These folds allow the vagina to stretch considerably during childbirth.

The reaction of the vagina is acidic, the pH is 4.5 that protects the vagina against infection.

Anatomical relation of the vagina

Anterior------------Urethra and bladderPosterior-----------Perineal body

&rectum and Douglas pouchLateral------------- Pelvic floor musclesSuperior-----------The cervix. Inferior------------- The vulva

Functions of the vagina

To allow discharge of the menstrual flow.

As the female organs of coitus.To allow passage of the fetus from

the uterus.

Support structures

The bony pelvis support and protects the lower abdominal and internal reproductive organs.

Muscle, Joints and ligaments provide added support for internal organs of the pelvis against the downward force of gravity and the increases in intra-abdominal pressure

Bony Pelvis

Bony Pelvis Is Composed of 4 bones:

1. Two hip bones.

2. Sacrum.

3. Coccyx.

1. Two hip bones.

Each or hip bone is composed of three bones:

*Ilium *Ischium *Pubis

*Ilium

It is the flared out part.The greater part of its inner

aspect is smooth and concave, forming the iliac fossa.

The upper border of the ilium is called iliac crest

*IschiumIt is the thick lower part.It has a large prominence

known as the ischial tuberosity on which the body rests while sitting.

Behind and little above the tuberosity is an inward projection the ischial spine.

2. Sacrum

Is a wedge shaped bone consisting of five vertebrae.

The anterior surface of the sacrum is concave

The upper border of the first sacral vertebra known as the sacral promontory

3 .Coccyx.

Consists of four vertebrae forming a

small triangular bone.

Pelvic JointsThere are four pelvic joints:

* One Symphysis pubis

* Two sacro-iliac joints

* One sacro-coccygeal joint

Ligaments

A total of 10 ligaments stabilize the uterus within the

pelvic cavity.

Four paired ligamentsBroad, round, uterosacral, cardinalTwo single ligaments anterior

(pubocervical) and posterior (rectovaginal)

Types of Pelvis

1. Gynecoid, or normal female pelvis is round and adapted for the function of childbirth. Its inlet, cavity, and outlet are in better proportion, the pubic arch is wide and the coccyx is more movable than android pelvis.

2. Android pelvis or male type pelvis which has a heart-shaped outlet

3. anthropoid, which oval shaped.

4. platypelloid, which has a wide transverse outlet, kidney shaped.

Blood SupplyThe uterine blood supply is

carried by the uterine arteries, which are branches of the internal iliac artery. These vessels enter the uterus at the lower border of the broad ligament, near the isthmus of the uterus.

Cyclical Changes in Endometrium

Basilar zone remains relatively constantFunctional zone undergoes cyclical changes:

–in response to sex hormone levels–produce characteristic features of uterine cycle

Appearance of Endometrium during Uterine Cycle

Figure 28–20

2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH

The Uterine Cycle

Also called menstrual cycleIs a repeating series of changes in

endometriumLasts from 21 to 35 days:

–average 28 days

Uterine Cycle Responds to hormones of ovarian cycle :

Menses and proliferative phase:

–occur during ovarian follicular phase

Secretory phase:–occurs during ovarian

luteal phase

2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH

Menses Is the degeneration of functional zone:

–occurs in patchesIs caused by constriction of

spiral arteries:–reducing blood flow, oxygen,

and nutrients2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH

Weakened arterial walls rupture releasing blood into connective

tissues of functional zoneDegenerating tissues break

away, enter uterine lumen Entire functional zone is lost

through cervical os and vagina

Menstruation Is the process of endometrial

sloughingLasts 1–7 daysSheds 35–50 ml

blood

2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH

The Proliferative PhaseEpithelial cells of uterine glands multiply and spread across endometrial surface restore

integrity of uterine epitheliumFurther growth and

vascularization completely restores functional zoneOccurs at same time as enlargement of primary and secondary follicles

in ovaryIs stimulated and sustained by

estrogens secreted by developing ovarian follicles

2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH

The Secretory PhaseEndometrial glands enlarge increase secretion

Arteries of uterine wall elongate and spiral through

functional zone Begins at ovulationPersists as long as corpus

luteum remains intactPeaks about 12 days after

ovulationGenerally lasts 14 days

2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH

Menarche The first uterine cycleBegins at puberty (age 11–12)

MenopauseThe termination of uterine cyclesAge 45–55

AmenorrheaPrimary amenorrhea:

–failure to initiate menses

Transient secondary amenorrhea:–interruption of 6 months or more–caused by physical or emotional stresses

The Vagina Is an elastic, muscular tube that xtends between cervix

and vestibule7.5–9 cm long and highly

distensible

Cervix:–projects into vaginal

canal

Fornix:–is shallow recess

surrounding cervical protrusion

3 Functions of the Vagina.1Passageway for elimination of menstrual fluids

.2Receives spermatozoa during sexual intercourse

.3Forms inferior portion of birth canal

The Vaginal Wall

Contains a network of blood vessels:–and layers of smooth muscle

Is moistened by:–secretions of cervical glands–water movement across permeable epithelium

The Hymen Is an elastic epithelial fold:–that partially blocks entrance to vagina–ruptured by sexual intercourse or tampon usage

Vaginal Muscles2 bulbospongiosus muscles:

–along either side of vaginal entrance–cover vestibular bulbs

Vestibular BulbsAre masses of erectile tissue:

–on either side of vaginal entrance

Have same embryological origins as corpus spongiosum of penis

The Mammary Glands

Figure 28–23a

Secrete milk to nourish an infant (lactation)

Are specialized organs of integumentary system

Are controlled by:–hormones of reproductive

system–placenta

Mammory glands lie in pectoral fat pads deep to skin of chest

Nipple on each breast:–contains ducts from mammary

glands to surfaceAreola:

–reddish-brown skin around each nipple

Mammory glands consist of lobes:

–each containing several secretory lobules

–separated by dense connective

tissue

Suspensory Ligaments of the BreastBands of connective tissueOriginate in dermis of

overlying skinAreolar tissue separates:

–mammary gland complex –from underlying pectoralis

muscles

•Mammary gland ducts leave lobules, converge, and form single lactiferous duct in each lobe

Female Reproductive Cycle Hormonal Control Involves secretions of pituitary gland and gonadsForms a complex pattern that coordinates ovarian and uterine

cycles

2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH

Follicular Development Begins with FSH stimulationMonthly:

–some primordial follicles develop into primary follicles

As follicles enlarge:–thecal cells produce

androstenedione Is a steroid hormone, an

intermediate in synthesis of estrogens and androgens, and

absorbed by granulosa cells and converted to estrogens

2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH

Estrogen SynthesisAndrostenedione is converted to testosteroneEnzyme aromatase converts testosterone to estradiol

- CHEstrone and estriol are synthesized from

androstenedione -CH

.1Stimulates bone and muscle growth

.2Maintains female secondary sex characteristics, ie body hair distribution and adipose tissue deposits

.3Affects central nervous system (CNS) activity (especially in the hypothalamus, where estrogens

increase the sexual drive)

.4Maintains functional accessory reproductive glands and organs

.5Initiates repair and growth of endometrium

Estrogen Function

.1maintains secondary sex characteristics

.2 maintains uterine walls for pregnancy.

Progesterone Function

Hormones and Body TemperatureMonthly hormonal fluctuations affect core body

temperature:–during luteal phase:

progesterone dominates

–during follicular phase:estrogen dominatesbasal body temperature decreases about 0.3°C

Basal Body Temperature The resting body temperatureMeasured upon awakening in morning

Hormonal Regulation of the Female Reproductive Cycle

Figure 28–26a, b

2 4 6 8 10 12 14 16 18 20 22 24 26 28

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Follicular Phase Luteal Phase

ProgesteroneEstrogen

FSH

LH