FEMALE REPRODUCTIVE SYSTEM

CECILLE W. BARRERA
NCM 102 2009-2010

FEMALE INTERNAL REPRODUCTIVE SYSTEM

The primary sex organs are the ovaries which produce eggs (ova) and the female sex hormones estrogen and progesterone. These sex hormones increase at puberty and decrease after menopause.

Both male and female reproductive systems have gonads: ovaries in females (which produce oocytes) and testes in males (which produce sperm).

Both systems have gonads that produce gametes and sex hormones, and both systems are latent until puberty. However, males have continuous sperm production after puberty while females have a relatively fixed number of ova released periodically.

The primary sex organs are the ovaries. The accessory sex organs include the uterine tubes (Fallopian tubes), uterus, vagina, clitoris, and mammary glands

Vesicouterine pouch

The parietal peritoneum dips down between the uterus and the bladder to form the vesicouterine pouch. It also dips down between the uterus and the rectum to form the rectouterine pouch (Douglas cul-de-sac)

Menstrual Cycle

First Phase
Hypothalamus
GnRH Transmitted to Anterior Pituitary Gland (Adenohypohysis) Stimulates the production of Gonadotropic Hormone FSH & LH (In the ovary) Maturation of oocytes (Primordial follicles) by FSH inside (the follicle is a protective sac or thin layer of cells in the ovary) Production of clear fluid (Follicular Fluid) which contains high level of Estrogen & some Progesterone

2nd Phase

Ovulation
(release of mature ovum from the ovary-Grafian follicle) Decrease of FSH & Increase LH LH is responsible for production of Lutein, which is turn Increase the level of Progesterone with some Estrogen Fills empty follicle termed as Corpus Luteum (yellow body)

Ischemic Phase
Conception No Conception

Final Phase
Unfertilized Ovum atropines after 4-5 days & the Corpus Luteum will be replaced by while fibrous tissue (Corpus Albicans)

MENTRUATION

Estrogen responsible for secondary female characteristics Progesterone responsible for preparation of uterus for implantation Follicle Stimulating Hormone (FSH) responsible for maturation of ovum Luteinizing Hormone (LH) responsible for ovulation & growth of uterine lining during secondary half of menstrual cycle.

Uterine Changes during Menstrual Cycle

1. First Phase/Proliferative/Follicular/Post Mentrual Phase

Following the menstrual flow, the endometrium or lining of the uterus is very thin Ovarybegins to form estrogen under the direction of Pituitary FSH Endometrium proliferates increasing in thickness & continues during 1st half of menstrual cycle (approx. 5-14 days

2. Second Phase/Progestational/Luteal/Pre-Menstrual Secretory Phase Following ovulation , the formation of progesterone in Corpus Luteum (under the direction of LH) causes the glands of the uterine endometrium to become cocksrew or twisted. Endometrial lining appears to be spongy velvet because of increase capillaries

3. Ischemic Phase Unless fertilization occurs, the corpus luteum regress after 8-10 days Decrease production of Estrogen & Progesterone level Endometrium degenerates (approx. 24-25 day of the cycle). The capillaries rupture with minute hemorrhage & endometrium sloughs off 4.Menses & Final Phase Blood from ruptured capillaries, fragments of endometrial tissue, microscopic atrophied unfertilized ovum is discharged The only external marker of the cycle.

Note that the sperm cells must migrate against the flow created by the cilia in the Fallopian tube.

Fertilization occurs within the Fallopian tubes (oviducts, uterine tubes, or salpinges) AMPULLA- site of Fertilization

Fallopian tube

Infundibulum

fimbriae

If implantation occurs outside the uterus, an ectopic pregnancy occurs. An egg getting stuck in the Fallopian tube (tubal pregnancy) is a common site for such ectopic pregnancies. See the clinical view

Ectopic pregnancy

The uterus is a thick-walled muscular organ shaped like an inverted pear. It is where an egg normally implants.

Note layers to uterine wall

Bi-manual pelvic exam to palpate uterus

Uterine prolapse

Pap smear being collected from cervix with the help of a circular speculum

of the cervix

Douglas cul-de-sac

Syringe inserted into vagina with the help of a speculum and forceps

Culdocentesis

-to remove fluid to diagnose Pelvic Inflammatory Disease (PID).

Normal hysterosalpingography

Abnormal hysterosalpingography showing blocked Fallopian tubes.

Note inflation with carbon dioxide gas.

FEMALE EXTERNAL REPRODUCTIVE SYSTEM

The vagina is the copulatory organ of the female

Sperm deposited in the vagina quickly encounter the egg in the Fallopian tube so fertilization can occur.

Female external genitalia (vulva)

The vagina is about 3.6 inches long and extends from the vaginal orifice to the cervix. The uterus attaches at nearly a 90 degree angle

Vagina

Note that females, unlike males, have an open road from their vagina all the way to their peritoneal cavity. This makes PID more likely. FINISH

START

Pelvic inflammatory disease (PID) is a common cause of infertility and ectopic pregnancies because it either narrows or blocks the Fallopian tubes.

A wet suit should be worn to prevent contaminated lake water being propelled by hydrostatic pressure up the vagina, uterus, and Fallopian tubes into the peritoneal cavity when a female water skier falls. The is also a concern in high velocity water slides. Pelvic inflammatory disease could result.

FEMALE BREAST (Mammary Glands)

Mammary glands are the glands within the breast.

The nipple contains erectile tissue and is surrounded by the pigmented areola.

During pregnancy the areola becomes darker and enlarges, presumably to become more conspicuous to a nursing infant.

Each mammary gland is composed of 15-20 lobes, each with its own drainage pathway to the nipple

Milk is produced in the alveoli in the lobes of a lactating female, which is then collected into tiny ducts. These ducts merge into lactiferous ducts, each of which expand into a lactiferous sinus near the nipple. The milk is then ejected from the nipple.

Stimulation of the maternal nipple is essential in promoting production and release of milk.

Inverted nipple

Normal nipple

In mammography the breast is compressed to thin it out and then x-rays are employed to detect abnormalities early.