This document provides an overview of the female reproductive system in three chapters. Chapter 1 covers anatomy, including the bony pelvis, external and internal genital organs. Chapter 2 discusses female reproductive physiology, including puberty, the menstrual cycle, and menopause. It explains the hormonal regulation of the ovarian and uterine cycles. Chapter 3 will discuss clinical skills for examining the female reproductive system. The goal is for students to understand the anatomy and physiology of the female reproductive and endocrine systems.

1. 杨冬梓 Dongzi Yang Memorial Hospital of Sun Yat-Sen University 中山大学 附属孙逸仙纪念医院妇产科 Welcome to the course of Obstetrics & Gynecology

2. Chapter 1-2 Female reproductive system 女性生殖系统 Obstetrics & Gynecology

3. Female reproductive system  Organization (Anatomy)  Functions （ Physiology ）  Visualize the anatomical structure of the female reproductive system.  Describe the hormones that regulate the female reproductive system.  Explain the sequence of events during the menstrual cycle. Contents After learning these two chapters, you should be able to :

4. Chapter 1: Anatomy of the female reproductive system  Adjacent organs  The blood ,nerve, and lymphatic supplies to the pelvic structures (self-study)  The pelvic structures  External and internal genitalia Be familiar with Comprehend

5. Female reproductive system The Pelvis  Structures  Dividing line  Types External genital organs Internal genital organs  Vagina  Uterus  Fallopian tubes (oviducts)  Ovaries

6. Anterior view Posterior view Bony pelvis

7. 《 supper mom’s body 》

8. Bony pelvis: Structures ilium sacrum pubis coccyx ischium 左右耻骨 Os pubis 左右坐骨 Os ischium 左右髂骨 Os ilium 左右 髋骨 Os coxae (Innominate bone) 4 or 5 caudal or coccygeal vertebrae 尾骨 Os coccyx 5 or 6 sacral vertebrae 骶骨 Os sacrum

9. Bony pelvis: Joints Joints cartilaginous symphyseal Sacro-coccygeal joint Symphysis pubica synovial joint Sacro-iliac joint Sacro-iliac joint Sacro-coccygeal joint Symphysis pubica

10. Bony pelvis: The Ligaments 骶结节韧带 Lig. sacrotuberale attached to the ilium,sacral vertebrae and the ischial tuberosity 骶棘韧带 Lig. sacrospinale extending from the sacrum and coccyx to the spine of the ischium

11. Bony pelvis: The greater pelvis (false pelvis) The lesser pelvis (true pelvis) subpubic angle (pubic arch)

12.  O utline ： connet the promontory of the sacrum with the superior margin of the pubis （耻骨联合上 缘、 髂耻缘及骶岬上缘的连线）  I nlet  O utlet  Female pelvic cavity: broader and shallower Bony pelvis: Planes

13. The pelvic inlet 13-14cm 12.5cm 11.5cm Diameters of the pelvic inlet Transverse diameter Oblique diameter The anteroposterior diameter

14. The pelvic outlet 10-12cm 9cm The diameters of the pelvic outlet The anteroposterior diameter The transverse diameter of the outlet

15. Types of pelvis Gynecoid Android Anthropoid platypelloid The female pelvic inlet is oval; The pelvic cavity is broader and shallower, The bony wall of the pelvic canal are more vertical Subpubic angle is broader in the female pelvis.

16. Female external genital organs anatomy Physiology

17. External genital organs Mons pubis clitoris Urethral orifice Vaginal orifice vestibule Labia majora Labia minora Vulva (The female urogenital triangle) External genitalia anus Hymen 处女膜

18.  阴道 (vagina)  子宫 (uterus)  输卵管 (fallopian tubes)  卵巢 (ovaries) Female internal genital organs

19. Internal genital organs: Vagina fornix

20. fornix

21. Internal genital organs: Uterus Fundus uteri Cavitas uteri Canalis cervicis uteri Corpus uteri cervix

22. Internal os External os Transition zone

23. Lateral view of the pelvic viscera

24. Ligaments Round ligament Broad ligament Cardinal ligament Uterosacral ligament

25. Lateral view of the pelvic viscera

26. 输卵管 ureter 卵巢 ovaties 子宫圆韧带 round lig. Laparoscopic view

27. Internal genital organs: Fallopian tube or Oviduct Ovary ampulla isthmus ovary infundibulum

28. Internal genital organs: Ovary Ovary

29. 尿道 Urethra 膀胱 bladder 输尿管 ureters 直肠 rectum 阑尾 appendix Adjacent organs

30. Lateral view of the pelvic viscera

31. Superior view of the abdominal cavity

33. Self - Study  Blood vessels, lymphatic drainage, and nerves  Pelvic floor Neuropathways in Parturition Pelvic Area Enlarged

34.  Why do obstetricians care about the diameters of the inlet of pelvis when a woman delivers ？ Problem- base learning (PBL)  In IVF-ET, the pathway of oocyte retrieval is by the way of the pouch of the Douglas, why ？

35. Chapter 2 Female reproductive physiology 女性生殖生理 Obstetrics & Gynecology

36.  Adrenarche, growth spurt  Thelarche, secondary sexual charateristics  Menarche Puberty  The cessation of menstruation and ovulation Age 45-55 years Menopause 1 10 20 30 40 50 60 70 age(year) infant The reproductive life of women menarche reproduction menopause Puberty and Menopause

37. The number of oocytes in the ovary from birth to menopause

38. Puberty : from the onset of active gonads to the final maturation Reproduction ： menstrual cycle ； ovarian cycle and uterine cycle Menopause: the cessation of gonads function From puberty to menopause

39. Ovarian cycle Follicular phase ovulation Luteal phase Uterine cycle (endometrial cycle) Proliferative phase Secretory phase Menses Menstrual cycle physiology Normal menstrual cycle

40. Menstrual cycle physiology

41. Menstrual cycle regulation

42. Oogenesis Fertility menstuation Hypothalamus- pituitary- ovary (HPO) axis

43. ovary LH FSH Pituitary E 2 、 P (-) I Inhibin (-) Hypothalamus GnRH

44. Thecal cells Granulosa cells the basement membrane The two-cell two gonadotrophin theory

45. The two-cell two gonadotrophin theory

46. Ovarian sex steroids ( Hormones ) act with adrenal angrogen to promote pubic and axillary hair growth during puberty Androgens, e.g. endrostenedione 1. Maintenance of the uterine endometrium. 2. Stimulation of the uterine secretions Progestogens, e.g. progesterone 1. Development of the reproductive organs and secondary sexual characteristics. 2. Proliferation of the functional layer of uterus endometrium. Oestrogens, e.g. oestradiol

47. Problem- base learning (PBL)  Base on the two-cell two gonadotrophin theory, if LH elevated continually, which hormone will be increased ？  In a woman with irregular menstrual cycle, what do you firstly suspect?

48. NOVAK Gynecology （ the14rd edition ） ,Jonathan S. Berek ， Lippincott Williams & Wilkins ,2007 Anatomy.2 nd edition , Dykes, Ameerally, Mosby. 2003 Sanders, Debuse: Endocrine & Reproductive systems . Mosby. 2002 References

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