Professional Documents
Culture Documents
Learning Objectives
Define
the terms listed. Identify the female external reproductive organs. Explain the structure of the bony pelvis. Explain the functions and structures of pelvic floor.
Introduction
Mons Pubis
Is rounded, soft fullness of subcutaneous fatty tissue, prominence over the symphysis pubis that forms the anterior border of the external reproductive organs. It is covered with varying amounts of pubic hair.
labia Majora are two rounded, fleshy folds of tissue that extended from the mons pubis to the perineum.
It
Labia Minora
It
is located between the labia majora, are narrow. The lateral and anterior aspects are usually pigmented. The inner surfaces are similar to vaginal mucosa, pink and mois. Their rich vascularity.
Clitoris.
The
term clitoris comes from a Greek word meaning key. Erectile organ. Its rich vascular, highly sensitive to temperature, touch, and pressure sensation
Vestibule.
Is
oval-shaped area formed between the labia minora, clitoris, and fourchette. Vestibule contains the external urethral meatus, vaginal introitus, and Bartholins glands.
Perineum
Is
the most posterior part of the external female reproductive organs. It extends from fourchette anteriorly to the anus posteriorly. And is composed of fibrous and muscular tissues that support pelvic structures.
Uterus
Fallopian Ovaries
tubes
Fallopian tubes
The
two tubes extended from the cornu of the uterus to the ovary. It runs in the upper free border of the broad ligament. Length 8 to 14 cm average 10 cm Its divided into 4 parts.
1. Interstitial part
Which
runs into uterine cavity, passes through the myometrium between the fundus and body of the uterus. About 1-2cm in length.
2. Isthmus
Which
is the narrow part of the tube adjacent to the uterus. Straight and cord like , about 2 3 cm in length.
3. Ampulla
Which
Fertilization
occurs in the
ampulla.
4. Infundibulum
It
is funnel or trumpet shaped. Fimbriae are fingerlike processes, one of these is longer than the other and adherent to the ovary. The fimbriae become swollen almost erectile at ovulation.
Functions
Gamete
transport (ovum pickup, ovum transport, sperm transport). maturation of gamete post ovulate oocyte maturation, sperm capicitation.
Final
Fluid
environment for early embryonic development. of fertilized and unfertilized ovum to the uterus.
Transport
Ovaries
Oval
solid structure, 1.5 cm in thickness, 2.5 cm in width and 3.5 cm in length respectively. Each weights about 48 gm.
Ovary
is located on each side of the uterus, below and behind the uterine tubes
Medulla
Hilum
Figure 2814
Production
Uterus
The
uterus is a hollow, pear shaped muscular organ. uterus measures about 7.5 X 5 X 2.5 cm and weight about 50 60 gm.
The
Its
normal position is anteverted (rotated forward and slightly antiflexed (flexed forward)
The
upper part is the corpus, or body of the uterus The fundus is the part of the body or corpus above the area where the fallopian tubes enter the uterus. Length about 5 cm.
2. Isthmus
A
narrower transition zone. Is between the corpus of the uterus and cervix. During late pregnancy, the isthmus elongates and is known as the lower uterine segment.
3. Cervix
The
lowermost position of the uterus neck. The length of the cervix is about 2.5 t0 3 cm.
The
os, is the opening in the cervix that runs between the uterus and vagina. The upper part of the cervix is marked by internal os and the lower cervix is marked by the external os.
1. Perimetrium
Is
the outer peritoneal layer of serous membrane that covers most of the uterus.
Laterally,
the perimetrium is continuous with the broad ligaments on either side of the uterus.
2. Myometrium
Is
the middle layer of thick muscle. Most of the muscle fibers are concentrated in the upper uterus, and their number diminishes progressively toward the cervix.
The
are found mostly in the fundus and are designed to expel the fetus efficiently toward the pelvic outlet during birth.
fiber contract after birth to compress the blood vessels that pass between them to limit blood loss.
form constrictions where the fallopian tubes enter the uterus and surround the internal os Circular fibers prevent reflux of menstrual blood and tissue into the fallopian tubes.
Promote
normal implantation of the fertilized ovum by controlling its entry into the uterus. And retain the fetus until the appropriate time of birth.
3. Endometrium
Is
the inner layer of the uterus. It is responsive to the cyclic variations of estrogen and progesterone during the female reproductive cycle every month.
The two or three layers of the endometrium are: *Compact layer *The basal layer *The functional or Sponge layer this layer is shed during each menstrual period and after child birth in the lochia
Pregnancy
Labor
and birth---the uterine muscles contract and the cervix dilates during labor to expel the fetus
Vagina
It
is an elastic fibro-muscular tube and membranous tissue about 8 to 10 cm long. Lying between the bladder anteriorly and the rectum posteriorly.
The
vagina connects the uterus above with the vestibule below. upper end is blind and called the vaginal vault.
The
The
vaginal lining has multiple folds, or rugae and muscle layer. These folds allow the vagina to stretch considerably during childbirth.
The
reaction of the vagina is acidic, the pH is 4.5 that protects the vagina against infection.
allow discharge of the menstrual flow. As the female organs of coitus. To allow passage of the fetus from the uterus.
Support structures
The
bony pelvis support and protects the lower abdominal and internal reproductive organs.
Muscle,
Joints and ligaments provide added support for internal organs of the pelvis against the downward force of gravity and the increases in intra-abdominal pressure
Bony Pelvis
Bony
*Ilium
It
is the flared out part. The greater part of its inner aspect is smooth and concave, forming the iliac fossa. The upper border of the ilium is called iliac crest
*Ischium
It
is the thick lower part. It has a large prominence known as the ischial tuberosity on which the body rests while sitting.
Behind
and little above the tuberosity is an inward projection the ischial spine.
2. Sacrum
Is
a wedge shaped bone consisting of five vertebrae. The anterior surface of the sacrum is concave The upper border of the first sacral vertebra known as the sacral promontory
3. Coccyx.
Consists of four vertebrae forming a small triangular bone.
Pelvic Joints
There
Ligaments
total of 10 ligaments stabilize the uterus within the pelvic cavity.
A
Four
paired ligaments Broad, round, uterosacral, cardinal Two single ligaments anterior (pubocervical) and posterior (rectovaginal)
Types of Pelvis
1. Gynecoid, or normal female pelvis is round and adapted for the function of childbirth. Its inlet, cavity, and outlet are in better proportion, the pubic arch is wide and the coccyx is more movable than android pelvis.
2. Android pelvis or male type pelvis which has a heart-shaped outlet 3. anthropoid, which oval shaped. 4. platypelloid, which has a wide transverse outlet, kidney shaped.
Blood Supply
The
uterine blood supply is carried by the uterine arteries, which are branches of the internal iliac artery. These vessels enter the uterus at the lower border of the broad ligament, near the isthmus of the uterus.
Figure 2820
LH
FSH
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase
Luteal Phase
Estrogen Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26 28
LH
FSH
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Secretory phase:
Follicular Phase
Estrogen
Luteal Phase
Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Is the degeneration of functional zone: occurs in patches Is caused by constriction of spiral arteries: reducing blood flow, oxygen, and nutrients
Weakened arterial walls rupture releasing blood into connective tissues of functional zone Degenerating tissues break away, enter uterine lumen Entire functional zone is lost through cervical os and vagina
Menses
LH
FSH
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase
Luteal Phase
Estrogen Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Menstruation
LH
FSH
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase
Estrogen
Luteal Phase
Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Epithelial cells of uterine glands multiply and spread across endometrial surface restore integrity of uterine epithelium Further growth and vascularization completely restores functional zoneOccurs at same time as enlargement of primary and secondary follicles in ovary Is stimulated and sustained by estrogens secreted by developing ovarian follicles
2 4 6 8
FSH
10 12 14 16 18 20 22 24 26 28
Follicular Phase
Estrogen
Luteal Phase
Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Endometrial glands enlarge increase secretion Arteries of uterine wall elongate and spiral through functional zone Begins at ovulation Persists as long as corpus luteum remains intact Peaks about 12 days after ovulation Generally lasts 14 days
LH
FSH
2 4 6 8
10 12 14 16 18 20 22 24 26 28
Follicular Phase
Estrogen
Luteal Phase
Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26
Menarche Menopause
Amenorrhea
Primary amenorrhea:
failure to initiate menses interruption of 6 months or more caused by physical or emotional stresses
Is an elastic, muscular tube that xtends between cervix and vestibule 7.59 cm long and highly distensible
Cervix:
projects into vaginal canal
The Vagina
Fornix:
is shallow recess surrounding cervical protrusion
Is moistened by:
secretions of cervical glands water movement across permeable epithelium
The Hymen
that partially blocks entrance to vagina ruptured by sexual intercourse or tampon usage
Vaginal Muscles
2 bulbospongiosus muscles:
along either side of vaginal entrance cover vestibular bulbs
Vestibular Bulbs
Are masses of erectile tissue:
on either side of vaginal entrance
Figure 2823a
Mammory glands lie in pectoral fat pads deep to skin of chest Nipple on each breast:
contains ducts from mammary glands to surface
Areola:
reddish-brown skin around each nipple
Mammary gland ducts leave lobules, converge, and form single lactiferous duct in each lobe
Luteal Phase
Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Development
Begins with FSH stimulation Monthly:
some primordial follicles develop into primary follicles thecal cells produce androstenedione
Is a steroid hormone, an intermediate in synthesis of estrogens and androgens, and absorbed by granulosa cells and converted to estrogens
LH
FSH
2 4 6 8
As follicles enlarge:
10 12 14 16 18 20 22 24 26 28
Follicular Phase
Estrogen
Luteal Phase
Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26
Estrogen Synthesis
Androstenedione is converted to testosterone Enzyme aromatase converts testosterone to estradiol - CH Estrone and estriol are synthesized from androstenedione -CH
Estrogen Function
Stimulates bone and muscle growth Maintains female secondary sex characteristics, ie body hair distribution and adipose tissue deposits Affects central nervous system (CNS) activity (especially in the hypothalamus, where estrogens increase the sexual drive) Maintains functional accessory reproductive glands and organs Initiates repair and growth of endometrium
.1 .2
.3
.4
.5
Progesterone Function
maintains secondary sex characteristics maintains uterine walls for pregnancy.
.1 .2
FSH
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Luteal Phase
Progesterone
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Figure 2826a, b