Gynecological Anatomy & Physiology

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Gynecological Anatomy & Physiology

Gynecological Anatomy & Physiology

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  • 1.
    • Gynecological Anatomy & Physiology
  • 2.  
  • 3. REPRODUCTIVE AND SEXUAL HEALTH
    • PUBERTAL DEVELOPMENT:
    • Puberty is the stage of life at which the secondary sex changes
    • Girls - age 10 to13 years
    • Theory: must reach a critical weight of approx. 95lbs (43kgs)
    • Boys - age 12 to 14 years
      • The role of Androgen- hormones responsible for :
        • Muscular development
        • Physical growth
        • Increase sebaceous gland secretion (acne)
      • “ Testosterone -1° androgenic hormone”
      • In girls, testosterone influences the development of
      • labia majora, clitoris, and axillary & pubic hair latter termed as (adrenarche)
  • 4. REPRODUCTIVE AND SEXUAL HEALTH
    • Secondary sex characteristic of boys occurs in order:
        • increase in weight
        • growth of testes
        • growth of face, axillary, and pubic hair
        • voice changes
        • penile growth
        • increase in height
        • spermatogenesis
    • Secondary sex characteristic of girls occurs in order:
    • 1. growth spurt
    • 2. increase in the traverse diameter of the pelvis
    • 3. breast development (thelarche)
    • 4. growth of pubic hair (adrenarche)
    • 5. onset of menstruation (menarche 12.5 y/o ave.)
    • 6. Ovulation occurs 1 – 2 years after menarche
    • 7. growth of axillary hair (adrenarche)
    • 8. vaginal secretion
  • 5. FEMALE REPRODUCTIVE SYSTEM: GYNECOLOGY
    • External Structures
      • Mons pubis/ Mons veneris – pad of adipose tissues, which lives over the symphysis pubis, which protects the surrounding delicate tissue from trauma.
      • Labia majora – longitudal folds of pigmented skin extending from the mons pubis to the perineum. Contains the Bartholin’s gland that secretes yellowish mucus that acts as a lubricant during sexual activity.
      • Labia minora – soft longitudal skin folds between the Labia majora.
      • Glans clitoris – erectile tissue located at the upper end of Labia minora; primary site of sexual arousal.
  • 6. FEMALE REPRODUCTIVE SYSTEM:
    • External Structures continue
      • 5. Vestibule – a narrow space seen when labia minora are separated that also contains the vaginal introitus, Bartholin’s gland and urethral meatus.
      • 6. Urethral Meatus – small opening bet, the clitoris and vaginal orifice for the purpose of urination.
      • 7. Vaginal orifice/introitus/opening – external opening of the vagina that contains the hymen.
      • 8. Hymen – a membranous tissue ringing the vaginal introitus
      • 9. Perineum – tissue between the anus and vagina. Site of episiotomy
      • The external genitalia’s blood supply:
      • Arteries: a. pudental artery b. inferior rectus artery.
      • Vein: Pudendal vein
  • 7.  
  • 8.  
  • 9. FEMALE REPRODUCTIVE SYSTEM:
    • B. Internal Structures
    • Ovaries – female sex glands located on each side of the uterus with two ovaries (4 x 2 x 1.5 cm thick).
      • Ovaries are formed with 3 principal divisions:
      • a. A protective layer of surface epithelium
      • b. The cortex filled with the ovarian and graafian follicle
      • c. The central medulla containing nerves, blood vessels, lymphatic tissue and some smooth muscle tissue
      • Fxn: - Ovulation (release of ovum) and Secretion of hormones like estrogen and progesterone .
      • Estrogen - help to prevents osteoporosis, and atherosclerosis
      • and potential risk for breast cancer endometrial cancer
  • 10. FEMALE REPRODUCTIVE SYSTEM:
    • B. Internal Structures continue
    • 2. Fallopian Tubes – 4 inches (10 cm) long from each sides of the fundus;
    • Divided on four separate part:
      • 1. Intramural portion- most proximal (1cm in length)
      • 2. Isthmus portion- extremely narrow (2cm)
      • Important: tubal ligation
      • 3. Ampulla- longest portion (5cm) and widest part
      • Function: site of fertilization
      • 4. Infundibular portion- funnel shape with Fimbrae (2cm) finger like projections.
      • Function: responsible for the transport of mature ovum from ovary to uterus.
  • 11.  
  • 12.  
  • 13. FEMALE REPRODUCTIVE SYSTEM:
    • B. Internal Structures continue
    • 3. Uterus – hollow pear-shaped muscular organ.
      • Size: 3 inches long (5-7cm), 2 inches wide(5cm) and 1 inch thick (3x2x1)
      • Wt: 60 gms. in non pregnant Location: lower pelvis
      • Parts: Corpus, Isthmus, and Cervix
      • Position: anteverted and anteflexed
      • Layers: perimetrium, myometrium and endometrium
      • Function:
      • 1. to receive the ova to fallopian tube place for implantation and nourishment during fetal growth furnish protection to a growing fetus
      • 2. aids in labor and delivery
    • Cervix (2-5cm long)
    • Internal cervical os -an impt. relationship in estimating the External cervical os level of dilatation of the fetus in the birth canal before birth.
  • 14.  
  • 15.  
  • 16.  
  • 17.  
  • 18.  
  • 19.  
  • 20. FEMALE REPRODUCTIVE SYSTEM:
    • Uterus continue
    • Nerve Supply:
      • Efferent (motor) nerve- spinal ganglia (T5 to T10)
      • Afferent (sensory) nerve - hypogastric plexus (T-11 & T-12)
      • Impt: Controlling pain in labor ( Epidural anesthesia)
    • Uterine Ligaments:
      • 1. Broad Ligaments – fr. the sides of uterus to pelvic walls
      • 2. Round Ligaments – fr. sides of uterus to mons pubis.
      • 3. Cardinal and uterosacral ligaments- provides middle support
      • 4. Pelvic muscular floor ligaments- provide lower support
  • 21.  
  • 22.  
  • 23.  
  • 24. FEMALE REPRODUCTIVE SYSTEM:
    • 3. Vaginal Canal – 3-4 inch long dilatable canal between the bladder and the rectum; contains rugae that permits stretching without tearing.
    • Anterior Vaginal wall- 6-7 cm (anterior fornices)
    • Posterior Vaginal wall- 8-9 cm (posterior fornices)
      • Function: 1. passageway for menstrual discharges
      • 2. receives penis during intercourse and
      • 3. serves as birth canal.
      • - lined with stratified squamous epithelium
      • - Bulbocavernosus : a circular muscle acts as voluntary sphincter (Kegel exercises)
    • Blood supply to the vagina:
    • Arteries: vaginal artery branch of internal iliac artery
    • Vein: pudental vein
  • 25. FEMALE REPRODUCTIVE SYSTEM:
    • Vagina continue …
    • The external genitalia’s blood supply : mainly from the
    • a. pudental artery and
    • b. a portion of inferior rectus artery.
    • Nerve supply: has both parasympathetic & sympathetic
    • (S-1 to S-3 levels)
      • Nerve supply of the anterior portion: (L1)
      • a. Ilio-inguinal nerves b. Genito-femoral nerves
      • Nerve supply of the posterior portion: (S3)
      • Pudendal nerves
    • “ This is the reason why one type of anesthesia used for childbirth is called Pudendal block.”
  • 26.  
  • 27.  
  • 28.  
  • 29. MALE REPRODUCTIVE SYSTEM: ANDROLOGY
    • A. External Structures
      • 1. Penis : the male organ of copulation; a cylindrical shaft consisting of:
      • a. corpora cavernosa - t wo lateral columns of erectile tissue
      • b. corpus spongiosum - encases the urethra
        • -The glans penis , a cone-shaped expansion of the corpus spongiosum that is highly in express males.
        • - Erection is stimulated by parasympathetic nerve
      • Scrotum : a pouch hanging below the penis that contains the testes .
      • 3. Testes: two solid ovoid organs 4-5 cm long and 2-3 wide , divided into lobes containing
      • Seminiferous tubules - produce spermatozoa.
      • Leydig cells - testosterone production .
  • 30.  
  • 31.  
  • 32. MALE REPRODUCTIVE SYSTEM:
  • 33. MALE REPRODUCTIVE SYSTEM: A. External Structures continue SPERMATOZOA are produced by: Hypothalamus Control by GnRH (+/-) feedback Anterior Pituitary gland FSH / LH Testes FSH - release of Androgen Binding Protein (ABP) which promote SPERMATOGENESIS LH - release of Testosterone. “ Spermatozoa does not survive at body temperature. They usually survive 1°F lower than body temperature”.
  • 34. MALE REPRODUCTIVE SYSTEM:
    • B. Internal Structures
      • 1. Epididymis: serves as reservoir for sperm storage and maturation. Approximately 20 ft. it takes 12-20 days for the sperm to travel the length of Epididymis.
      • A total of 64 days before they reach maturity.
      • (“Treatment= 2 months” ).
        • Aspermia - (absence of sperm)
        • Oligospermia- if < 20 million sperm/ ml
      • 2. Vas deferens: a duct extending from epididymis to the ejaculatory duct and seminal vesicle, providing a passageway for sperm. (sperm mature).
        • Varicocele- varicosity of internal spermatic cord
        • Vasectomy (male birth control)
      • 3. Seminal vesical: are two convoluted pouches that lie along the lower portion of the bladder and empty into the urethra by the way of ejaculatory ducts
  • 35. MALE REPRODUCTIVE SYSTEM: B. Internal Structures continue 4. Ejaculatory duct: the canal formed by the union of the vas deferens and the excretory duct of the seminal vesicle, which enters the urethra at the prostate gland. 5. Prostate Gland: located just below the urinal bladder. Secretes alkaline and most of the seminal fluid. 6. Bulbourethral glands or Cowper’s Gland: adds alkaline fluid to the semen. 7. Urethra: the passageway for both urine and semen, extending from the bladder to the urethral meatus . (8 inches in long)
  • 36. MALE REPRODUCTIVE SYSTEM:
    • B. Internal Structures continue
    • SEMEN:
      • Is a thick whitish fluid ejaculated by the male during orgasm, contains spermatozoa and fructose-rich nutrients.
      • During ejaculation, semen receives contributions of fluid from
      • Prostate gland (60%)
      • Seminal vesicle (30%)
      • Epididymis ( 5%)
      • Bulbourethral gland (5%)
      • Average pH = 7.5
      • The average amount of semen released during ejaculation is 2.5 -5 ml . It can live with in the female genital tract for about 24 to 72 hours .
      • (50-200 million/ml of ejaculation ave. of 400 million/ ejaculation )
      • 90 seconds- cervix
      • 5 mins.- end of fallopian tube
  • 37.  
  • 38.  
  • 39.