Interesting lectures

1. PHYSIOLOGY OF THE
FEMALE
REPRODUCTIVE
SYSTEM.
PREPARED BY:-
MR. SAIHOU SANNEH
(FWACN, BSN&RH, RM,
RN)

2. KEY WORDS
• AMENORRHEA: Absence of menstruation.
• COITUS: Sexual intercourse.
• EMBRYO: A developing baby from the time
of fertilization to 11-12 weeks of gestation.
• GESTATION: Pregnancy.
• GRAVIDA: A woman who is pregnant or has
been pregnant.
• PARA: A woman who has given birth to a
baby who reached the stage of viability.
• PARTURITION: A woman in labour

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

4. LIST THE ORGANS THE
FORM THE EXTERNAL
GENITALIA

5. 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,
• THE LABIA (Majora & Minora),
• THE CLITORIS,
• HYMEN.
• THE URETHRAL.
• All these structures are contained in what is
referred to as THE VESTIBLE.

6. DESCRIBE THE MONS
VENERIS.

7. 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 on the symphysis
pubis.
• It protects the pubic bone from the impact of
sexual intercourse.
• After puberty, this area is covered with pubic
hair.

8. • DESCRIBE THE LABIA
MAJORA AND MINORA

9. THE EXTERNAL GENITALIA
THE LABIA MAJORA
• These are two elongated hair-covered folds or
lips running posteriorly from the Mons pubis.
• It encloses the vestibule which contains the
external openings of the urethra and vagina.
• Within the vestible are a pair of glands called the
Bartholin’s Glands or Greater vestibular glands,
one on either side.
• It also contains the Skene’s Glands.
• These two glands secret mucus which lubricates
the vagina & increase sexual arousal.

10. 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.

11. •DESCRIBE THE
CLITORIS

12. 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.

13. 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.

14. 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.

15. EXTERNAL GENITALIA

17. •LIST THE ORGANS
THAT FORM THE
INTERNAL GENITALIA

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

19. •DESCRIBE THE
VAGINA

20. 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.

21. 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.

22. THE VAGINA Cont’d..
• There are 4 Fornices: ANTERIOR,
POSTERIOR and TWO LATERAL
FORNICES.
STRUCTURE OF THE VAGINA
• The vagina is made up 3 layers:-
• THE OUTER LAYER:- Is of smooth,
muscle fibrous tissue that lies in circular &
longitudinal nature.
• It also contain blood vessels, nerves and
lymphatics.

23. THE VAGINA Cont’d..
• THE MIDDLE LAYER:- Is of elastic connective
tissue or muscle. It also contain numerous
blood vessels that gives the vagina pink
color.
• THE INNER LAYER:- Is of mucus, squamous
epithelium.
• It is like the modified skin made in small
transverse folds called Ruggae.
• This ruggae allows for stretching and
enlargement of the vagina during delivery.
• It also enhance penetration and help with
stimulation of penis in coitus.

24. THE VAGINA Cont’d..
RELATIONS OF THE VAGINA
• Anteriorly – Urethra & base of bladder, each
occuping 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.
• Above the vagina, is the cervix of uterus
• Laterally, is the pelvic fascia, uterus & levator
ani muscles.

25. 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.

26. •STATE THE
FUNCTIONS OF THE
VAGINA

27. 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 and lubricating fluid to facilitate
penetration during coitus.
• Secrets a bacilli called Doderlien’s bacilli that
helps to maintain the normal flora of the vagina.

28. 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.

29. •DESCRIBE THE
UTERUS

30. 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.

31. THE UTERUS Cont’d
• An average non-pregnant nulliparous woman’s
uterus is about 7.5cm long, 5cm wide and
2.5cm thick. (7.5 X 5 X 2.5)
• 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.

32. 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. It separates the uterus from
the abdominal cavity. It is made up of
serous fibrous tissue.

33. 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 Edometruim. It is
composed of mucus membrane and a single
layer of columnar cells. It contains numerous
glands that secrets mucus.

34. 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.

35. THE UTERUS Cont’d.
POSITION OF THE UTERUS
• The uterus when viewed from the side, it
bends forward on itself in a state of
anteflexion and situated at the level of the
internal os.
• It is inclined forward at an angle of 90
degrees to the vagina in an anteversion
state.
• Generally, the uterus appears retroverted
in about 10% of all women.

36. THE UTERUS Cont’d.
RELATIONS OF THE UTERUS
• INFRONT:- is related to the utero-vesical pouch
and urinary bladder.
• BEHIND:- To the Pouch of Douglas and coils of
the intestines.
• LATERALLY:- The broad ligaments, uterine
arteries and lower portion of the ureters.
• ABOVE:- The intestines
• BELOW:- The vagina.

37. 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.

38. THE UTERUS Cont’d..
SUPPORTS OF THE UTERUS
The uterus is supported by the following structures:-
The Vagina,Transverse cervical ligaments,
Utero-sacral ligaments, the round ligaments,
the broad ligaments, and the levator ani muscles
being inserted into the vagina.
• FUNCTIONS OF THE UTERUS
• It responds to hormonal stimulation.
• Prepares to receive and nuture the products of
conception
• Helps to expel the products of conception

40. THE UTERUS

42. • BRIEFLY DESCRIBE THE
FALLOPIAN TUBES

43. THE FALLOPIAN TUBES
• The Fallopian tubes are also called
OVIDUCTS. They are two tubes which
extend from the cornu 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.

44. 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.

45. THE FALLOPIAN TUBES Cont’d..
• 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.
• FUNCTIONS OF THE TUBES
• They create room for fertilization
• Propel the ova towards the uterus.

46. 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.

47. THE FALLOPIAN TUBE

48. 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.

49. 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,
nerves and blood vessels.
• THE MIDDLE LAYER is called the Medulla. It
is also composed of connective tissue and
numerous blood vessels and follicles.

50. 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.

51. 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.

52. THE OVARIAN HORMONES
Under the influence of the Anterior Pituitary
Gland, the ovaries secret 2 hormones called
Oestrogen & Progesterone.
It also secrets male androgens (Testosterone)
but in very small quantity.
During follicular phase, and under the
influence of the Follicle Stimulating Hormone
(FSH), Oestrogen is highly secreted by the
Graafian Follicles.
When oestrogen is at its peak, it stimulates the
secretion of Luteinizing hormone (LH) which
help in the formation of the Corpus Luteum.

53. THE OVARIAN HORMONES
The corpus luteum secrets both oestrogen &
progesterone and when the two hormones level
is ok, the anterior pituitary gland is inhibited from
producing the Luteunizing hormone.
The corpus luteum then degenerates causing a fall
in oestrogen & progesterone.
This causes the endometrium to break down
causing menstruation.
With a drop in oestrogen & progesteron level, the
anterior Pituitary gland is stimulated and FSH is
secreted, leading to ripening of the Graafian
Follicle and the production oestrogen thus, the
cycle begins again.

54. ACTION OF THE OVARIAN HORMONES.
THE OESTROGEN
In women, oestrogen induces sexual desire.
It plays a part in the development of sexual organs
like the vulva, vagina, uterus, breasts, etc.
It is responsible for feminine cues like shyness,
hair growth, etc
It maintains a healthy state of the vagina by
promoting the laying down of glycogen to
produce lactic acid.

55. ACTION OF THE OVARIAN
HORMONES.
• It increases the uterine vascularity by
causing hypertrophy of the myometrium.
• It increases the vascularity of the breasts
to bring about pigmentation of areola.
• It causes the growth of nipples.

56. ACTION OF THE OVARIAN
HORMONES.
THE PROGESTERONE
• This hormone actively helps to maintain
pregnancy.
• It works with the estrogen to maintain
similar actions done by the estrogen.

57. THE MENSTRUAL CYCLE
• There are three phases of the menstrual cycle.
• These phases occur as a result of the effects of
hormonal influence on the ovaries and uterus.
• As menarche approaches, the Luteinising
Hormone Releasing Hormone (LHRH) also
known as the Gonadotrophic Releasing
Hormone (Gn-RH) pulses and increase in
frequency and intensity.
• The pulses occur throughout the day rather than
solely at night.

58. THE MENSTRUAL CYCLE Cont’d.
• PHASE 1(Follicular or Menstrual Phase): This
phase begins on the first day of menstrual
bleeding (day 1). But the main event in this
phase is the development of follicles in the
ovaries.
• At the beginning of the follicular phase, the lining
of the uterus (endometrium) is thick with fluids
and nutrients designed to nourish an embryo.
• If no egg has been fertilized, estrogen and
progesterone levels are low. As a result, the top
layers of the endometrium are shed, and
menstrual bleeding occurs.

59. THE MENSTRUAL CYCLE Cont’d.
• About this time, the pituitary gland slightly
increases its production of follicle-stimulating
hormone.
• This hormone then stimulates the growth of 3 to 30
follicles and each follicle contains an egg.
• Later in the phase, as the level of this hormone
decreases, only one of these follicles (called the
dominant follicle) continues to grow.
• It soon begins to produce estrogen, and the other
stimulated follicles begin to break down.

60. THE MENSTRUAL CYCLE Cont’d.
• On average, the follicular phase lasts about 13
or 14 days.
• It ends when the level of luteinizing hormone
increases dramatically (surges). The surge
results in release of the egg (ovulation).

61. THE MENSTRUAL CYCLE Cont’d.
PHASE 2 (Ovulatory Phase or proliferative –
follicular phase): This phase begins when the
level of luteinizing hormone surges.
• Luteinizing hormone stimulates the dominant
follicle to bulge from the surface of the ovary and
finally rupture, releasing the egg.
• The level of follicle-stimulating hormone
increases to a lesser degree.
• The function of the increase in follicle-stimulating
hormone is not understood.
• The ovulatory phase usually lasts 16 to 32
hours. It ends when the egg is released.

62. THE MENSTRUAL CYCLE Cont’d.
• About 12 to 24 hours after the egg is released,
the surge in luteinizing hormone can be detected
by measuring the level of this hormone in urine.
• This measurement can be used to determine
when women are fertile.
• The egg can be fertilized for only up to about 12
hours after its release.
• Fertilization is more likely when sperm are
present in the reproductive tract before the egg
is released.
• Around the time of ovulation, some women feel
a dull pain on one side of the lower abdomen.

63. THE MENSTRUAL CYCLE Cont’d.
PHASE 3 (Secretory orLuteal Phase): This phase
begins after ovulation.
• It lasts about 14 days (unless fertilization occurs)
and ends just before a menstrual period.
• In this phase, the ruptured follicle closes after
releasing the egg and forms a structure called a
corpus luteum, which produces increasing
quantities of progesterone.
• The corpus luteum prepares the uterus in case
fertilization occurs.
• The progesterone produced by the corpus luteum
causes the endometrium to thicken, filling with
fluids and nutrients to nourish a potential fetus.

64. THE MENSTRUAL CYCLE cont’d.
• Progesterone causes the mucus in the
cervix to thicken, so that sperm or bacteria
are less likely to enter the uterus.
• Progesterone also causes body
temperature to increase slightly during the
luteal phase and remain elevated until a
menstrual period begins.

68. THE BREASTS .
• The human breasts are located over the pectoral
muscles of the chest wall.
• They do not actually contain any muscle tissue.
• They are made up of glandular, fatty and fibrous
tissues and have a number of different functional
parts:
• Areola (colored area around the nipple)
• Blood vessels and lymph vessels
• Ducts (milk passages)
• Fatty tissue
• Fibrous tissue that surrounds the lobules and ducts,
• Lobes, Lobules (milk gland) and Nipple.

69. THE BREASTS Cont’d.
• A layer of fatty tissue surrounds the breast
glands and runs throughout the entire breast.
This layer of tissue gives the female breast its
soft consistency.

70. THE BREASTS & MILK PRODUCTION
• Each breast has 15 to 20 sections (or "lobes")
beneath the nipple and areola, arranged in a
circular pattern that resembles a daisy.
• The Lobes are part of the milk production
system; each lobe contains many smaller milk-
producing glands called "lobules."
• Each lobule has tiny bulbs, called "alveoli."
When a woman is lactating, the alveoli produce
milk in response to hormonal signals.
• When milk is produced, the ducts transport it
from the lobules to the nipple. As each duct gets
closer to the nipple, it widens to form a sac
called an "ampulla."

71. THE BREASTS & MILK PRODUCTION Cont’d..
• The spaces between the lobules and the ducts are
filled with fatty tissue, connective tissue and
ligaments.
• As the milk production system is roughly the same
size in all women, breast size and shape depend
on the amount of fat in the breasts.
• Arteries and capillaries carry oxygen- and nutrient-
rich blood to the breasts.
• The axillary artery, which extends from the armpit,
supplies blood to the outer half of the breast.
• The internal mammary artery, which extends
down from the neck, supplies blood to the inner
part of the breast.

72. THE BREASTS & MILK PRODUCTION
Cont’d.
• The human breast also contains lymph vessels.
• The lymphatic system is part of the immune
system and contains blood vessels, lymph ducts
and lymph nodes.
• These work to fight off harmful or infectious
substances within your body.
• Clusters of lymph nodes are located under the
arm, above the collarbone, behind the
breastbone and in various other parts of the
body.

74. THE END
•THANK YOU