Female reproductive system (summary of the external and internal structures). A reference lecture note for nursing students and graduate nurses in clinical practice.

1. INTRODUCTION TO
ANATOMY / PHYSIOLOGY
OF THE FEMALE
REPRODUCTIVE SYSTEM.
MR K SANNEH:
LECTURER:
SCHOOL OF NURSING & MIDWIFERY
GAMBIA COLLEGE.

2. INTRODUCTION
• The Female Reproductive System can be divided into two aspects:-
• THE EXTERNAL GENITALIA
• INTERNAL GENITALIA

3. THE EXTERNAL GENITALIA

4. THE EXTERNAL GENITALIA
• This is sometimes referred to as the VULVA which comes from the Greek word volvere
(meaning to wrap around) or the PUDENDUM.
• The external Genitalia is composed of the following structures:-
• THE MONS PUBIS (mons Veneris)
• THE LABIA (Majora & Minora),
• THE CLITORIS,
• HYMEN.
• THE URETHRAL.
• All these structures are contained in what is referred to as THE VESTIBLE.

5. THE EXTERNAL GENITALIA
THE MONS PUBIS
• The Mons pubis is sometimes referred to as the “mountain on the pubis”
or Mons Veneris.
• It is a fatty, rounded area lying over the symphysis pubis.
• It protects the pubic bone.
• After puberty, this area is covered with pubic hair.

6. THE EXTERNAL GENITALIA
THE LABIA MAJORA
• These are two elongated hair-covered folds running
posteriorly from the Mons pubis.
• It encloses the vestibule which contains the external
openings of the urethra and vagina.
• Within the vestibule are a pair of glands called the
Bartholin’s Glands (Greater vestibular glands) and the
Skene’s Glands (lesser vestibular glands).
• These two glands secret mucus which lubricates the vagina
& increase sexual arousal.

7. THE EXTERNAL GENITALIA
THE LABIA MINORA
• These are two delicate hair-free folds enclosed in the labia majora.
• They lie medially to the labia majora.
• Their folds protects the vagina, urethra, and clitoris.
• They are highly vascularized and are quite sensitive to touch and pressure.

8. THE EXTERNAL GENITALIA
THE CLITORIS
• The clitoris is a small, protruding structure that corresponds to the male penis.
• Like the penis, it is hooded by a prepuce and is composed of very sensitive
erectile tissue that becomes swollen with blood during sexual excitement.
• Its main function is for sexual pleasure. Its tip is visible but internally, it branches
into two forks and extends into the rim of the vagina.
• It measures about 4cm long.

10. THE EXTERNAL GENITALIA
THE HYMEN
• The Hymen is a thin fold of mucus membrane that separates the lumen of the
vagina from the urethral sinus.
• Sometimes, it may wholly or partially cover the vaginal orifice.
• It can be easily ruptured during strenuous exercise, trauma or sexual intercourse.
• Its “intactness” has been considered a guarantor of virginity in most cultures.
• However, it is a poor indicator to determine whether a woman has actually engaged
in sexual intercourse.

11. THE HYMEN

12. THE EXTERNAL GENITALIA
• THE URETHRAL ORIFICE
• The female urethra lies just below the clitoris.
• Although it is not related to sex or reproduction, it is included in the
vulva.
• It is actually used for the passage of urine.

13. THE INTERNAL GENITALIA
• The Female internal Genitalia is composed of the :-
• VAGINA,
• UTERUS,
• FALLOPIAN TUBES (OVIDUTS) and the
• OVARIES.

14. THE INTERNAL GENITALIA
1. THE VAGINA
• The vagina is a collapsible, muscular, hollow tube that extends from the
vestibule or vaginal opening to the cervix of the uterus.
• It is situated between the urinary bladder and the rectum.
• Its wall is lined with squamous epithelium and abundant blood vessels that
lie in transverse folds called RUGAE.
• It is about 7.5cm – 8cm long.

15. THE VAGINA Cont’d..
• It contains muscular layer that allow the vagina to extend
and contract.
• It also contain a mucus membrane which keeps the vagina
protected and moist.
• At the upper end of the vagina, the uterine cervix projects
into the vagina in a portion that appear cup-shaped called
VAULT.
• This forms angles on either sides between the cervix and
vagina called FORNICES.

16. THE VAGINA Cont’d..
• There are 4 Fornices
(arch): ANTERIOR,
POSTERIOR and TWO
LATERAL FORNICES.

17. STRUCTURE OF THE VAGINA
• The vagina is made up 3 layers:-
1. THE OUTER LAYER:- Is of smooth, muscle fibrous tissue that lies in circular & longitudinal
nature.
• It also contain blood vessels, nerves and lymphatics.
2. THE MIDDLE LAYER:- Is of elastic connective tissue or muscle. It also contain numerous
blood vessels that gives the vagina pink color.
3. THE INNER LAYER:- Is of mucus, squamous epithelium.
• It is like the modified skin made in small transverse folds called Rugae.
• This rugae allows for stretching and enlargement of the vagina during delivery.
• It also enhance penetration and help with stimulation of penis in coitus.

18. THE VAGINA Cont’d..
RELATIONS OF THE VAGINA
• Anteriorly – Urethra & base of bladder, each occupying 1.2cm of the length of vagina.
• The lower 1/3 of the posterior vaginal wall is related to the perineum.
• The middle 1/3 is related to the rectum.
• The upper 1/3 is related to the Pouch of Douglas ( is the furthest point of the
abdominopelvic cavity in women, it is a site where infection and fluids typically collect. The
recto-uterine pouch is used in the treatment of end-stage renal failure in patients who are
treated by peritoneal dialysis.).
• Above the vagina, is the cervix of uterus
• Laterally, is the pelvic fascia, uterus & levator ani muscles.

19. THE VAGINA Cont’d.
BLOOD SUPPLY TO THE VAGINA
• The descending branch of the uterine artery, vaginal artery and branches of
the pudendal arteries supply blood to the vagina.
• VENOUS DRAINAGE is from the corresponding veins.
• NERVE SUPPLY is from the sympathetic nerves of Lee-Frankenhauser’s plexus
(gangliated autonomic plexus).
• Ganglion (a structure containing a number of nerve cell bodies)

20. THE VAGINA Cont’d.
FUNCTION OF THE VAGINA
• Is the canal for passage of menstrual flow.
• Allows reception of the penis during coitus.
• Is the final passage of the fetus during normal delivery.
• Secrets glycogen (stored carbohydrates )and lubricating fluid to facilitate
penetration during coitus.
• Secrets a bacilli called Doderlien’s bacilli (gram-positive bacterium) that helps
to maintain the normal flora of the vagina.

21. THE VAGINA Cont’d
• FUNCTIONS Cont’d
• The bacilli interacts with the secreted glycogen to produce lactic acid.
• The lactic acid helps to maintain an acidic PH of 4-5 in the vagina.
• The acidity also reduces vaginal susceptibility to infection.

22. 2. THE UTERUS
• The Uterus is a thick-walled, hollow, muscular organ attached to the upper
end of the vagina.
• It appears inverted and pear-
shaped.
• It is located in the true pelvis,
between the bladder and the
rectum.
• The size of the uterus depends on the woman’s developmental and obstetric
status.

24. THE UTERUS Cont’d
• An average non-pregnant nulliparous woman’s uterus is about
7.5cm long, 5cm wide and 2.5cm thick.
• The cavity of the uterus is triangular in shape.
• The uterus is composed of two main parts:-
THE CORPUS(Body) and CERVIX.
• These two sections are separated by a region called ISTHMUS.
• The Isthmus forms the lower segment of the uterus during
pregnancy and labour.
• It measures 0.6cm to 1cm long.

25. THE UTERUS Cont’d.
THE CORPUS (Body)
• The Corpus is the body of the uterus. The upper segment of the corpus is
dome-shaped called FUNDUS.
• The corpus measures 5cm – 6cm long.
• The Uterine wall is composed of 3 layers:-
• THE OUTER LAYER is called the Perimetrium (perineum). It separates the uterus
from the abdominal cavity. It is made up of serous fibrous tissue.

26. THE UTERUS Cont’d.
• THE MIDDLE LAYER is called the Myometrium. It is a thick muscular layer of
about 1.5cm thick.
• It is made up of smooth muscle fibers that are arranged in opposing
directions.
• This arrangement facilitates the arrest of bleeding after delivery.
• THE INNER LAYER is called Endometrium. It is composed of mucus
membrane and a single layer of columnar cells. It contains numerous glands
that secrets mucus.

27. THE UTERUS Cont’d.
THE CERVIX
• The cervix lies below the Isthmus of the uterus. It is about
2.5cm long. It contains two openings.
• The Internal Os (opening) is the upper boundary that
leads into the uterine wall.
• The External Os (opening) is the lower boundary that
projects into the vagina.
• The cervix as a whole is about 2.5 to 3cm long.

28. THE UTERUS Cont’d..
• BLOOD SUPPLY:- Is from the uterine and partly from ovarian arteries.
• VENOUS RETURN:- is from the uterine veins, vaginal veins, ovarian veins
and vertebral plexus.
• NERVE SUPPLY:- Is from the pelvic autonomic nerve of Lee-Frankenhauser’s
plexus.

29. FUNCTIONS OF THE UTERUS
• It responds to hormonal stimulation.
• Prepares to receive and nurture the products of conception
• Helps to expel the products of conception

30. THE UTERUS

31. THE FALLOPIAN TUBES
• The Fallopian tubes are also called OVIDUCTS. They are two tubes which
extend from the cornu (horn) of the uterus to the ovaries.
• Each tube is about 10cm – 11cm long.
• They have a small lumen (hole) which
communicates with the uterine cavity
medially, and opens into the peritoneal
cavity laterally.

32. THE FALLOPIAN TUBE

33. THE FALLOPIAN TUBES Cont’d.
DIVISIONS OF THE FALLOPIAN TUBES
• Each Fallopian tube is divided into 4 portions:-
• THE INTESTITIAL PORTION is the narrowest also called Intramural. It measures 1cm – 2cm long.
• THE ISTHMUS is also a narrow portion of about 2cm – 3cm long. It extends from the cornu of
the uterus.
• THE AMPULLA is the dilated portion of about 5cm long. It extends from the isthmus to the area
called INFUNDIBULUM.
• The Ampulla is where fertilization takes place.
• The Infundibulum is the last portion and appear wide. It is about 2.5cm long. It is composed of
finger-like processes called FIMBRAE. This structure help to propel the ova towards the uterus.

34. THE FALLOPIAN TUBES Cont’d..
FUNCTIONS OF THE TUBES
• They create room for fertilization
• Designed to transport and Propel the ova towards to the site
of fertilization in the uterus.

35. THE FALLOPIAN TUBES Cont’d.
•BLOOD SUPPLY:- Is from the uterine and ovarian arteries
•VENOUS RETURN is from corresponding veins
•NERVE SUPPLY is from the ovarian plexus.

36. THE OVARIES
• The Ovaries are the female sex glands found on either sides of the uterus.
• Each ovary is a solid of about 3.5cm long and about 1.5cm – 2.5cm thick.
• Each ovary weighs about 4 -8gms.
• The ovaries are attached to the back of the broad ligaments by the Mesovarium.
• The point of attachment of the Mesovarium to the uterus is called HILUM.
• All nerves & blood vessels entering and leaving the ovary pass through the hilum.

37. THE OVARIES Cont’d.
STRUCTURE OF THE OVARY
• Each ovary has 3 zones.
• THE OUTER ZONE is called the cortex. It is composed of stroma of the
connective tissue. It contains the Graafian follicles ( fluid-filled structure),
nerves and blood vessels.
• THE MIDDLE LAYER is called the Medulla. It is also composed of
connective tissue and numerous blood vessels and follicles.

38. THE OVARIES Cont’d.
BLOOD SUPPLY is from the ovarian arteries and uterine arteries
VENOUS RETURN is from the corresponding veins
NERVE SUPPLY is from the 10th thoracic nerve.

39. FUNCTIONS OF THE OVARIES
- Production of ova for conception.
- Produces the female sex hormones called Progesterone & Oestrogen.
- The hormones initiates the development of female secondary sexual
characteristics.
- The hormones also play a role in sexual desire in women.
- They are responsible for the development of feminine characteristics such as
shyness, excessive growth of scalp and armpits.
- The hormones also help to maintain pregnancy.

40. THE END
•THANK YOU