VII.

Anatomy and Physiology

Female Reproductive System

The female reproductive system is made up of different body organs that produce haploid
female germ cells that can unite with another of the opposite sex in sexual reproduction to
produce an offspring. The female reproductive system has a more complex structure than the
male’s reproductive system. Not only does the female reproductive system function to produce
gametes or sex cells, but the body must also prepare to carry and nurture a growing fetus for
about nine months.

The structure of The Female Reproductive

The female reproductive organs are divided into two categories, the internal genitalia, and the
external genitalia. The internal reproductive organs are made up of the ovaries and duct
systems. These are located in the pelvic area between the urinary bladder and the rectum. The
female accessory ducts, within the vicinity of the ovary to the body exterior, are the fallopian
tubes, uterus, and the vagina. The uterus and the vagina are along the midline with the ovaries
attached on each side of the uterus. They carry out the needs of the reproductive cells and
supply nutrients to a developing fetus. These organs are held in place by a set of ligaments. The
broad ligament is the most visible as it spreads out on both sides of the uterus and is attached
to the ovaries and the fallopian tube. The external genitalia is made up of the mons pubis, labia
majora, clitoris, labia minora, urethra, vaginal orifice, and the perineum.
The Internal Genitalia

Ovaries

The ovaries flank the uterus on the side, it

is shaped like an almond but twice as big.
Each ovary is suspended in the pelvic
region by the suspensory ligament which
extends from each ovaries to the lateral
body wall and the ovarian ligament that
attaches the ovary superior part of the
uterus. The ovarian arteries, veins, and
nerves transverse suspensory ligament
and enters the mesovarium, folds of
peritoneum attaching the ovaries to the
posterior part of the broad ligament. The
outer part of the uterus is made up of
dense connective tissue and contains
ovarian follicles. Each Ovarian follicles
contains an unfertilized egg, the oocyte,
which is the female germ cell. The
surrounding cells are called follicle cells if a
single layer is present and granullosa cells if it is more than one. A lose connective tissue
makes up the inner ovary, where blood cells, lymphatic vessels and nerves are found. They are
also known as the female gonads, they are the primary reproductive organ of a female. They
function to serve a dual purpose which is; to produce the female gametes or ova and sex
hormones, estrogen and progesterone.
Oogenesis and Fertilization

At birth of a female infant, many of the 5

million oogenia, the cell form that develops
oocytes, starts to degenerate which begins
the oocyte formation in the ovaries.
Unlikein males the genetic materialis not
duplicated in females, meosis stops at the
1st mitotic division at prophase 1. The cells
at this stage are called Primary Oocytes.
These primary oocytes are 2 million at birth
and start to degenerate until puberty. It
decreases to about 400,000 and only
about 400 will completely develop and be
released from the ovaries. The release of
an oocyte from anovary is called Ovulation.
Before ovulation the primary oocyte
completes mitotic division resulting a
secondary oocyteand a polar body. The
secondary oocyte start the 2nd mitotic
division andstops in metaphase 2. After
ovulation secondary oocyte can be
fertilized by a sperm cell. Fertilization starts
at the time the sperm cell penetrates the
cytoplasm of the secondary oocyte. Then
the secondary oocyte completes the 2nd
mitotic division to form 2 cells, each
containing 23 chromosomes. One if these
cellshas a small cytoplasm and another
polar body that degenerates, in the other is
a larger cell the 23 chromosome from the
sperm join with the 23 from the female
germ cell to create a zygote. The zygote
undergoes mitotic division to form 2 cells,
which will divide into 4 cells, and so on.
The mass of calls formedis called
blastocyst and will implant to the uterine
wall that will develop into a new human being.
Follicle development

The primary oocytes available at

birth are enclosed by a primordial
follicle. As puberty starts, some of
the primordial follicles are changed
to primary follicles when the oocyte
becomes bigger and the thin layer
of granulosa cells expands and
cuboidal. Then layers of granulosa
cells form, and a layer of clear
material called the zona pellucida
settles around the primary oocyte.
Every 28 days, hormonal changes
allowing some of the primary
follicles to continue to develop. The
primary follicle becomes a
secondary follicle when fluid-filled spaces called vesicles form among the granulosa cells, and a
capsule called the theca forms around the follicle. The secondary follicle continues to enlarge,
and when the fluid-filled vesicles fuse to form a single, fluid-filled portion called the antrum, the
follicle is called the mature follicle, or graafian follicle. The primary oocyte is set aside and lies in
a mass of granulosa cells called the cumulus cells. The mature follicle forms a lump on the
surface of the ovary. During ovulation, mature follicle bursts, forcing a small amount of blood,
follicular fluid, and the secondary oocyte, enclosed by the cumulus cells, into the peritoneal
cavity. In most cases, only one of the follicles that begin to develop creating a mature follicle
and undergoes ovulation, white other follicles degenerate. After ovulation, the remaining cells of
the ruptured follicle are converted into a glandular structure called the corpus luteum. If
pregnancy happen, the corpus luteum expands in response to a hormone secreted by the
placenta called human chorionic gonadotropin hormone (hCG), If pregnancy does not occur, the
corpus luteum lasts for 10-12 days then starts to degenerate.

Fallopian Tubes

The fallopian tubes extend from the ovaries to the uterus. They open directly into the peritoneal
cavity near each ovary and receive the secondary oocyte. The opening of each uterine tube is
surrounded by long, thin processes called fimbriae. The fimbriae nearly enclose the exterior of
the ovary. Tight after the secondary oocyte is ovulated, it comes into contact with the surface of
the fimbriae. Cilia on the fimbriae surface carry the oocyte into the fallopian tube. Fertilization
usually happen in the part of the fallopian tube near the ovary, called the ampulla. The fertilized
oocyte travels to the uterus, where it attaches on the uterine wall, a process called implantation.
Uterus

The uterus is the size of a medium-sized pear, located in the pelvic cavity, anterior to the rectum
and posterosuperior to the bladder. It is a hollow, thick-walled, muscular organ that obtains,
keeps, and sustains a fertilized ovum. Anever been pregnant fertile woman’s uterus is about
the size and shape of an inverted pear, but it is usually larger in women who have carried
children. Normally, the uterus flexes anteriorly to some extent where it joins the vagina causing
the uterus as a whole to lean forward. Though, it is frequently turned backwards, in older
women. The main part of the uterus is called the body. The rounded portion superior to the
entrance of the uterine tubes is called the fundus, and the slightly narrowed part between the
body and the cervix is called the isthmus. The cervix of the uterus is its outlet, which extends
into the vagina inferiorly. The cavity of the cervix, called the cervical canal, communicates with
the vagina via the external os and with the cavity of the uterine body via the internal os. The
mucosa of the cervical canal has cervical glands that excrete mucus that fills the cervical canal
and covers the external os, blocking the spread of bacteria from the vagina into the uterus.
Cervical mucus also blocks sperm entry except at midcycle, when it becomes less viscous and
allows sperm to pass through. The wall of the uterus is composed of three layers; perimetrium is
the incomplete outermost serous layer, myometrium the bulky middle layer, composed of
interlacing bundles of smooth muscle. The myometrium contracts rhythmically during childbirth
to expel the baby from the mother’s body. endometrium, the mucosal lining of the uterine cavity,
it is where the fertilized egg implants.

Vagina

The vagina is the female organ ofcoitus; it receives the penis during intercourse. It also allows
menstrual flow and childbirth. The vagina extends from the uterus to the outside of the body.
The superior portion of the vagina is attached to the sides of the cervix, thus a part of the cervix
extends into the vagina. The wall of the vagina made of an outer muscular layer and an inner
mucous membrane. The muscular layer is smooth muscle and contains abundant elastic fibers.
Thus, it can increase in size to fit the penis during coitus, and stretch during childbirth. The
mucous membrane is moist stratified squamous epithelium that builds a protective surface
layer. Lubricating fluid passes through the vaginal epithelium into the vagina. In young females,
the vaginal opening is covered by a thin mucous membrane called the hymen. Rarely, the
hymen may completely close the vaginal orifice and it must be removed to allow menstrual flow.
More commonly, the hymen is perforated by one or several holes. The openings in the hymen
are usually expanded during the first sexual intercourse.
The External Genitalia

The female reproductive structures that lie

external to the vagina are called the external
genitalia. Also called the vulva or pudendum,
these structures includes the mons pubis, labia,
clitoris, and structures associated with the
vestibule.

Mons pubis----is a fatty, rounded area overlying

the pubic symphysis. After puberty, this area is
covered with pubic hair.

Labia majora----Running posteriorly from the

mons pubis are two elongated, haircovered fatty
skin folds,

labia minora----two thin, hair-free skin folds, homologous to the ventral penis.

Vestibule----contains the external openings of the urethra and the vagina. Flanking the vaginal
opening are the pea-size greater vestibular glands. These glands release mucus into the
vestibule and help to keep it moist and lubricated, facilitating intercourse.

Clitoris----a small, protruding structure composed largely of erectile tissue, which is similar to the
penis of the male. It is hooded by a skin fold called the prepuce of the clitoris, formed by the
junction of the labia minora folds. It is richly supplied with sensory nerve endings sensitive to
touch. It becomes swollen with blood and erect during tactile stimulation, contributing to a
female’s sexual arousal. The body of the clitoris has dorsal erectile columns called corpora
cavernosa attached proximally by crura.

Bulbs of the vestibule----lie along each side of the vaginal orifice and deep to the
bulbospongiosus muscles, are the homologues of the single penile bulb and corpus spongiosum
of the male. During sexual stimulation the bulbs of the vestibule engorge with blood. This may
help the vagina grip the penis and also squeezes the urethral orifice shut, which prevents
semen (and bacteria) from traveling superiorly into the bladder during intercourse.

Puberty

Puberty is maturation of the hypothalamus, typically starts around ages 11 and 13 and is completed by
age 16, is marked by menarche or the first episode of menstrual bleeding. During puberty, the vagina,
uterus, uterine tubes, and external genitalia starts to expand. Adipose tissue is settle in the breasts and
around the hips, causing them to enlarge and have an adult figure, pubic and axillary hair grows. The
development of sexual drive is also related to puberty. The changes related to puberty results from the
increased rate of estrogen and progesterone excretion by the ovaries.. After the onset of puberty, the
hypothalamus and anterior pituitary secrete more of GnRH, LH, and FSH. The normal cyclical pattern of
reproductive hormone secretion that happens during the menstrual cycle becomes established.
Menstrual

The uterus is receptive to implantation for only a short period each month. This brief interval is the time
when a developing embryo would normally begin implanting, six to seven days after ovulation. The
menstrual cycle is a cyclic changethat the uterine endometrium goes through each month as it responds
to the waxing and waning of ovarian hormones in the blood. These endometrial changes are
coordinated with the phases of the ovarian cycle, which are regulated by gonadotropins released by the
anterior pituitary. Changes in ovarian steroid hormone levels drive the events of the uterine cycle as
follows:

1. Days 1–5: Menstrual phase. In this phase, menstruation, the uterus sheds all but the deepest part of
its endometrium. The thick, hormone-dependent functional layer of the endometrium sheds from the
uterine wall, a process linked with bleeding for 3–5 days. The detached tissue and blood pass out
through the vagina as the menstrual flow. By day 5, the developing ovarian follicles produced more
estrogen.

2. Days 6–14: Proliferative (preovulatory) phase. The endometrium rebuilds itself: Under the influence if
increased estrogen levels, the basal layer of the endometrium creates a new functional layer. As the
new layer thickens, its glands epands and its spiral arteries multiply.Thus, the endometrium again
becomes velvety, thick, and well vascularized. At this phase, estrogens also induce the endometrial cells
to make progesterone receptors, preparing for interaction with progesterone., Rising estrogen levels
cause the thick and sticky cervical mucus ito thin and form passage that allow sperm to enter the uterus.
Ovulation, which takes less than five minutes, happen in the ovary at the end of the proliferative stage
(day 14) as response to the rapid release of LH from the anterior pituitary.

3. Days 15–28: Secretory (postovulatory) phase. This 14-day phase is the most constant timewise. During
this phase the endometrium prepares for an embryo to implant. Increasing the levels of progesterone
from the corpus luteum act on the estrogen-primed endometrium allowing the spiral arteries to
elaborate and converting the functional layer to a secretory mucosa. The endometrial glands expands,
coil, and begin secreting nutrients into the uterine cavity that will sustain the embryo until it has
implanted in the blood-rich endometrial lining. As progesterone levels rise, the cervical mucus becomes
viscous again, forming the cervical plug, which helps to block entry of sperm and pathogens or other
foreign materials. If fertilization has not occurred, the corpus luteum shed toward the end of the
secretory phase as LH blood levels decline. Progesterone levels fall, stripping the endometrium of
hormonal support, and the spiral arteries kink and go into spasms. Denied oxygen and nutrients, the
ischemic endometrial cells die and the glands regress, setting the stage for menstruation to begin on day
28. The spiral arteries constrict one final time and then suddenly relax and open wide. As blood gushes
into the weakened capillary beds, they fragment, causing the functional layer to slough off. The uterine
cycle starts over again on this first day of menstrual flow.