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23 Female Reproductive System


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23 Female Reproductive System

  1. 1. The female and male reproductive systems ensure the sexual maturation of each individual and produce cells necessary to propagate the next generation.
  2. 2. The reproductive systems of the male and female have some basic similarities and some specialized differences . Most of the reproductive organs of both sexes develop from similar embryonic tissues and are therefore homologous .
  3. 3. Note homology
  4. 4. Both male and female reproductive systems have gonads : ovaries in females (which produce oocytes) and testes in males (which produce sperm). In addition, these gonads also produce sex hormones.
  5. 5. Female Male Fertilization occurs when the male sperm meets the female oocytes in the female Fallopian tubes
  6. 6. The sexual union between a male and female is known as: copulation, coitus, or sexual intercourse .
  7. 7. Puberty is associated with activation of the male and female reproductive systems to a functional state: males can produce sperm and females experience first menstrual bleeding (menarche). Puberty is initiated by hormones secreted by the hypothalamus and by the anterior pituitary gland.
  8. 8. 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.
  9. 9. Females have a “relatively” fixed number of ova released periodically after puberty and before menopause.
  10. 10. In both males and females, the perineum , is a diamond-shaped area between the thighs. Note the anterior triangle (urogential triangle), which contains the urethral and vaginal orifices in the female and the base of the penis and scrotum in males. The posterior triangle (anal triangle) is the location of the anus in both sexes.
  11. 11. Sagittal section through the female pelvis
  12. 12. 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) Vesicouterine pouch
  13. 13. Douglas’ cul-de-sac
  14. 14. Culdocentesis to remove fluid to diagnose Pelvic Inflammatory Disease (PID). uterus Syringe inserted into vagina with the help of a speculum and forceps
  15. 15. The primary sex organs are the ovaries. The accessory sex organs include the uterine tubes (Fallopian tubes), uterus, vagina, clitoris, and mammary glands
  16. 16. The ovarie s are solid, ovoid structures positioned in the upper pelvic cavity on both sides of the uterus. They are slightly larger than an almond.
  17. 17. A double fold of the peritoneum, called the mesovarium , attaches to each ovary and secures it to the broad ligament .
  18. 18. Each ovary is anchored to the posterior aspect of the broad ligament by an ovarian ligament , which is the superior portion of the round ligament of the uterus .
  19. 19. The suspensory ligaments attach to the lateral edge of each ovary and project superolaterally to the pelvic wall. Blood vessels of suspensory ligament Each suspensory ligament contains an ovarian artery, ovarian vein, nerves, and smooth muscle.
  20. 20. Fertilization occurs within the Fallopian tubes (oviducts, uterine tubes, or salpinges)
  21. 21. Note sperm normally encountering the egg in the Fallopian tube . This view also demonstrates that ovulation occurs within the peritoneal cavity .
  22. 22. Broad ligament Each Fallopian tube is supported by a specific portion of the broad ligament
  23. 23. fimbriae Fallopian tube Infundibulum
  24. 24. The inner lining of the Fallopian tube ( mucosa ) is coated with cilia that propel the egg towards the uterus. The muscular wall of the Fallopian tube ( muscularis ) also carries out peristaltic contractions to aide egg movement. The serosa covers the outside of the Fallopian tube .
  25. 25. Note that the sperm cells must migrate against the flow created by the cilia in the Fallopian tube.
  26. 26. 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
  27. 27. The uterus is a thick-walled muscular organ shaped like an inverted pear. It is where an egg normally implants.
  28. 28. Normally (see below), the uterus is angled anterosuperiorly across the superior surface of the bladder, a position referred to as anteverted . If the uterus was tilted posteriorly towards the rectum, it would be called retroverted .
  29. 29. The uterus provides a site for implantation of the pre-embryo, nourishes the developing embryo/fetus, expels the fetus at birth, and sheds its inner lining every month if pregnancy does not occur.
  30. 30. Note indicated anatomic regions of the uterus
  31. 31. Pap smear being collected from cervix with the help of a circular speculum
  32. 34. of the cervix Read the clinical view in the text
  33. 35. The uterus is supported by the muscles of the pelvic floor , the round ligaments, the transverse cervical ligaments, and by the uterosacral ligaments.
  34. 36. Note round ligament passes through inguinal canal and inserts into labia majora
  35. 38. Uterine prolapse
  36. 39. The broad ligament , despite its name, is not a strong support for the uterus. Rather, it is a peritoneal drape over the uterus.
  37. 40. Arterial blood supply to the ovaries is via the ovarian arteries
  38. 41. Note layers to uterine wall
  39. 42. Parietal peritoneum The perimetrium , the outer surface of the uterus, is actually the parietal peritoneum
  40. 43. Note layers to uterine wall
  41. 44. Read about endometriosis in the clinical view in the text
  42. 45. Endometrial tissue in peritoneal cavity (endometriosis)
  43. 46. The vagina (Latin for “sheath” or “scabbard”) is the organ that receives sperm during intercourse and also is the exit during menstruation and parturition.
  44. 47. Vagina 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
  45. 48. Sperm deposited in the vagina quickly encounter the egg in the Fallopian tube so fertilization can occur. The vagina is the copulatory organ of the female
  46. 49. START FINISH Note that females , unlike males, have an open road from their vagina all the way to their peritoneal cavity . This makes PID more likely.
  47. 50. Pelvic inflammatory disease (PID) is a common cause of infertility and ectopic pregnancies because it either narrows or blocks the Fallopian tubes.
  48. 51. 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 .
  49. 52. Vaginal rugae The inner lining of the adult female vagina is slightly acidic
  50. 53. male female Vaginal rugae allow considerable stretching of the vagina during coitus. The vagina of an adult female is normally acidic because of the normal flora bacteria that thrive in the vagina.
  51. 54. The vaginal orifice may be partially, or completely, obstructed by a thin membrane called the hymen (maidenhead).
  52. 55. Different appearances of the hymen . It may be torn by activities unrelated to intercourse and an intact hymen is NOT a sure indication of virginity. If desired, it can easily be removed by minor surgery in a doctor’s office.
  53. 56. Retained menstruation by an imperforate hymen (hematocolpos ) in a female who has just reached puberty
  54. 57. Excision of an imperforate hymen to allow menstrual blood to escape in a female who has reached puberty.
  55. 58. Female external genitalia (vulva)
  56. 59. Note homology between the penis and clitoris and between the scrotum and the labia majora.
  57. 60. Note labia majora, labia minora, and clitoris.
  58. 61. The vaginal vestibule is the region between the labia minora where the vagina, the urethra and Bartholin’s glands open.
  59. 62. Note the bulb of the vestibule which becomes erect during sexual intercourse
  60. 63. The clitoris is a small erectile body located at the anterior region of the labia minora. It is homologous to the male penis.
  61. 64. Close up of exposed clitoris
  62. 65. Female circumcision
  63. 66. Female genital mutilation with clitoris possibly removed and labia sewed shut (female circumcision) Opening left for menstrual blood to escape.
  64. 68. Mammary glands are the glands within the breast .
  65. 69. Changes in female breasts with age.
  66. 70. The nipple contains erectile tissue and is surrounded by the pigmented areola.
  67. 71. During pregnancy the areola becomes darker and enlarges , presumably to become more conspicuous to a nursing infant.
  68. 72. Intense focus
  69. 73. Intense focus followed by action
  70. 74. Note suspensory ligaments (suspensory ligaments of Cooper)
  71. 75. Each mammary gland is composed of 15-20 lobes, each with its own drainage pathway to the nipple
  72. 76. 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.
  73. 77. Stimulation of the maternal nipple is essential in promoting production and release of milk . Read about lactation and after pains in your text if you desire.
  74. 78. Breast cancer . Read the clinical view in your text
  75. 79. In mammography the breast is compressed to thin it out and then x-rays are employed to detect abnormalities early.
  76. 80. Abnormal lump detected the x-rays employed with mammography.
  77. 81. Types of mastectomies . In the older women who are present in the cadaver lab, radical mastectomies are common. Hopefully, this will become less common in the future.
  78. 83. A 45-year-old female physician who died of metastatic breast cancer (note bilateral radical mastectomy). Observe the numerous tumors that are easily seen under the skin and rupturing through the skin.
  79. 84. After reconstruction Before reconstruction following radical mastectomy.
  81. 87. Suspensory ligaments of Cooper extend between lobules, but are NOT that supportive.
  82. 88. Uterine prolapse
  83. 89. Uterine prolapse
  84. 92. 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.
  85. 93. Secondary sex characteristics are features that are not essential for the reproductive process, but generally are considered to be sexual attractants. Examples are body physique, pattern of body hair, breast development, etc.
  86. 94. Venous drainage is identical to that seen with the testes. Note the right ovarian vein drains directly into the inferior vena cava while the left ovarian vein drains into the left renal vein.
  87. 95. Blood is brought to the vaginal walls by branches of the internal iliac artery.
  88. 99. Females are more prone to dysfunctions and diseases of the reproductive organs than males.
  89. 100. Gynecology is the specialty concerned with dysfunction and diseases of the female reproductive system. Obstetrics deals with pregnancy and childbirth. Many doctors do both (OB/GYN)
  90. 103. Normal hysterosalpingography Abnormal hysterosalpingography showing blocked Fallopian tubes .
  91. 105. Mons pubis Note inflation with carbon dioxide gas.
  92. 106. Sterilization of the female (tubal ligation)
  93. 107. Breast self-exam for lumps
  94. 109. right
  95. 110. Ectopic pregnancy
  96. 111. Pus from gonorrhea exiting cervix
  97. 177. Bi-manual pelvic exam to palpate uterus
  98. 178. Bi-manual pelvic exam to palpate uterus
  99. 179. Inverted nipple Normal nipple
  100. 196. Read interest item about radical mastectomies used to control severe breast cancer.
  101. 197. Figure
  102. 198. Figure 28.01
  103. 199. Figure 28.02
  104. 200. Figure 28.03ab
  105. 201. Figure 28.07a
  106. 202. Figure 28.09
  107. 203. Figure 28.03c
  108. 204. Figure 28.p864
  109. 205. Figure 28.p868
  110. 206. Figure 28.p870