Anatomy & Physiology Of

Female Reproductive System

Dr. Aida Abd El-Razek
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.
I ntroduction
External Female Structures
Collectively, the external
female reproductive
organs are called the
Vulva.
External Female Structures
Mons Pubis.
Labia Majora & Minora.
Clitoris.
Vestibule.
Perineum
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 & Minora
The labia Majora are two rounded,
fleshy folds of tissue that extended
from the mons pubis to the perineum.

It is protect the labia minora, urinary
meatus and vaginal introitus.

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.
Internal Female Structures
Vagina
Uterus
Fallopian tubes
Ovaries
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 is the wider part about
5 cm in length.

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).

Final maturation of gamete post
ovulate oocyte maturation, sperm
capicitation.
Fluid environment for early
embryonic development.

Transport of fertilized and
unfertilized ovum to the uterus.

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
Structure of the ovaries
Cortex
Medulla
Hilum
Ovaries and Relationship
to Uterine Tube and Uterus
Figure 2814
Function of the ovary
Secrete estrogen & progesterone.

Production of ova
Uterus

The uterus is a hollow, pear shaped
muscular organ.

The uterus measures about 7.5 X 5
X 2.5 cm and weight about 50 60
gm.
Its normal position is anteverted
(rotated forward and slightly
antiflexed (flexed forward)

The uterus divided into three
parts
1. Body of the uterus
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. I sthmus
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.

Layers of the uterus
Perimetrium.
Myometrium.
Endometrium.
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 myometrium
contains three types of
smooth muscle fiber
Longitudinal fibers (outer layer)
Which are found mostly in the
fundus and are designed to
expel the fetus efficiently
toward the pelvic outlet during
birth.
Middle layer figure-8 fibers
These fiber contract after
birth to compress the blood
vessels that pass between
them to limit blood loss.
Inner layer circular fibers
Which 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
Anatomical relation of the
uterus
Anterior------------Bladder
Posterior-----------The rectum and
Douglas pouch
Lateral------------- The broad ligaments
,F. T& ovaries
Superior-----------The intestines.
Inferior------------- The Vagina
The Function of the uterus
Menstruation ----the uterus
sloughs off the endometrium.

Pregnancy ---the uterus support
fetus and allows the fetus to grow.
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.

The upper end is blind and called
the vaginal vault.
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.
Anatomical relation of the vagina
Anterior------------Urethra and bladder
Posterior-----------Perineal body
&rectum and Douglas pouch
Lateral------------- Pelvic floor muscles
Superior-----------The cervix.
Inferior------------- The vulva
Functions of the vagina
To 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 Pelvis Is Composed of 4
bones:
1. Two hip bones.
2. Sacrum.
3. Coccyx.
1. Two hip bones.

Each or hip bone is composed
of three bones:
*Ilium
*Ischium
*Pubis
*I lium
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 J oints
There are four pelvic joints:
* One Symphysis pubis
* Two sacro-iliac joints
* One sacro-coccygeal joint
Ligaments
A total of 10 ligaments
stabilize the uterus within the
pelvic cavity.
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.




Cyclical Changes in Endometrium
Basilar zone remains relatively constant
Functional zone undergoes cyclical changes:
in response to sex hormone levels
produce characteristic features of uterine cycle
Appearance of Endometrium
during Uterine Cycle
Figure 2820
2 4 6 8 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase
Luteal Phase
Progesterone
Estrogen
FSH
LH
The Uterine Cycle
Also called menstrual cycle
Is a repeating series of changes in
endometrium
Lasts from 21 to 35 days:
average 28 days
Uterine Cycle
Responds to hormones
of ovarian cycle:
Menses and proliferative
phase:
occur during ovarian
follicular phase
Secretory phase:
occurs during ovarian
luteal phase
2 4 6 8 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase Luteal Phase
Progesterone
Estrogen
FSH
LH
Menses
Is the degeneration of functional
zone:
occurs in patches
Is caused by constriction of
spiral arteries:
reducing blood flow, oxygen,
and nutrients
2 4 6 8 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase Luteal Phase
Progesterone
Estrogen
FSH
LH
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

Menstruation
Is the process of
endometrial
sloughing
Lasts 17 days
Sheds 3550 ml
blood
2 4 6 8 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase Luteal Phase
Progesterone
Estrogen
FSH
LH
The Proliferative Phase
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 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase Luteal Phase
Progesterone
Estrogen
FSH
LH
The Secretory Phase
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



2 4 6 8 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase Luteal Phase
Progesterone
Estrogen
FSH
LH
Menarche
The first uterine cycle
Begins at puberty (age 1112)
Menopause
The termination of uterine cycles
Age 4555
Amenorrhea
Primary amenorrhea:
failure to initiate menses
Transient secondary amenorrhea:
interruption of 6 months or more
caused by physical or emotional stresses
The Vagina
Is an elastic, muscular tube
that xtends between cervix
and vestibule
7.59 cm long and highly
distensible
Cervix:
projects into vaginal
canal
Fornix:
is shallow recess
surrounding cervical
protrusion
3 Functions of the Vagina
.1 Passageway for elimination of menstrual fluids
.2 Receives spermatozoa during sexual intercourse
.3 Forms inferior portion of birth canal
The Vaginal Wall
Contains a network of blood vessels:
and layers of smooth muscle
Is moistened by:
secretions of cervical glands
water movement across permeable epithelium
The Hymen
Is an elastic epithelial fold:
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
Have same embryological origins as corpus
spongiosum of penis
The Mammary Glands
Figure 2823a
Secrete milk to nourish an
infant (lactation)
Are specialized organs of
integumentary system
Are controlled by:
hormones of reproductive
system
placenta
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
Mammory glands consist of
lobes:
each containing several
secretory lobules
separated by dense connective
tissue
Suspensory Ligaments of the Breast
Bands of connective tissue
Originate in dermis of
overlying skin
Areolar tissue separates:
mammary gland complex
from underlying pectoralis
muscles
Mammary gland ducts leave
lobules, converge, and form
single lactiferous duct in each
lobe
Female Reproductive Cycle Hormonal Control

Involves secretions of pituitary gland and gonads
Forms a complex pattern that coordinates ovarian and uterine
cycles
2 4 6 8 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase Luteal Phase
Progesterone
Estrogen
FSH
LH
Follicular Development
Begins with FSH stimulation
Monthly:
some primordial follicles
develop into primary follicles
As follicles enlarge:
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


2 4 6 8 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase Luteal Phase
Progesterone
Estrogen
FSH
LH
Estrogen Synthesis
Androstenedione is converted to testosterone
Enzyme aromatase converts testosterone to estradiol
- CH
Estrone and estriol are synthesized from
androstenedione -CH
.1 Stimulates bone and muscle growth
.2 Maintains female secondary sex characteristics, ie
body hair distribution and adipose tissue deposits
.3 Affects central nervous system (CNS) activity
(especially in the hypothalamus, where estrogens
increase the sexual drive)
.4 Maintains functional accessory reproductive glands
and organs
.5 Initiates repair and growth of endometrium


Estrogen Function
.1 maintains secondary sex characteristics
.2 maintains uterine walls for pregnancy.


Progesterone Function
Hormones and Body Temperature
Monthly hormonal fluctuations affect core body
temperature:
during luteal phase:
progesterone dominates
during follicular phase:
estrogen dominates
basal body temperature decreases about 0.3C
Basal Body Temperature
The resting body temperature
Measured upon awakening in morning
Hormonal Regulation of the
Female Reproductive Cycle
Figure 2826a, b
2 4 6 8 10 12 14 16 18 20 22 24 26 28
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Follicular Phase Luteal Phase
Progesterone
Estrogen
FSH
LH