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Lect. 14 female reproductive

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Lect. 14 female reproductive

  2. 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. 3. INTRODUCTION • The Female Reproductive System can be divided into two aspects:- • THE EXTERNAL GENITALIA • INTERNAL GENITALIA
  5. 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.
  7. 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.
  9. 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. 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.
  12. 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. 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. 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.
  17. 17. THE INTERNAL GENITALIA • The Female internal Genitalia is composed of the :- • VAGINA, • UTERUS, • FALLOPIAN TUBES (OVIDUTS) and the • OVARIES.
  19. 19. 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.
  20. 20. 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.
  21. 21. 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.
  22. 22. 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.
  23. 23. 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.
  24. 24. 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. 26. 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.
  27. 27. 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. 29. 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.
  30. 30. 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.
  31. 31. 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.
  32. 32. 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.
  33. 33. 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.
  34. 34. 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.
  35. 35. 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.
  36. 36. 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.
  37. 37. 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
  38. 38. THE UTERUS
  40. 40. 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.
  41. 41. 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.
  42. 42. 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.
  43. 43. 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.
  45. 45. 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.
  46. 46. 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.
  47. 47. 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.
  48. 48. 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.
  49. 49. 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.
  50. 50. 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.
  51. 51. 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.
  52. 52. 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.
  53. 53. 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.
  54. 54. 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.
  55. 55. 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.
  56. 56. 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.
  57. 57. 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).
  58. 58. 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.
  59. 59. 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.
  60. 60. 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.
  61. 61. 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.
  62. 62. 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.
  63. 63. 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.
  64. 64. 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."
  65. 65. 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.
  66. 66. 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.
  67. 67. THE END •THANK YOU