Female Reproductive System

The Female Reproductive System

  

Produces gametes (ova) Prepares to support a developing embryo Undergoes changes according to the menstrual cycle

Parts of the Female Reproductive System

    

OVARIES

OVARIAN CYCLE

FALLOPIAN (UTERINE) TUBES UTERUS VAGINA EXTERNAL GENITALIA

The Ovaries
    

Small, almond-shaped organs, each 1 x 1 Within the peritoneal cavity on the posterior body wall Covered by a superficial epithelium called the VISCERAL PERITONEUM. Held in place by mesentery called MESOVARIUM Also held in place by ligaments

BROAD LIGAMENT: where the mesentery attaches to the fallopian tube; this is an extension of the mesovarium. SUSPENSORY LIGAMENT: holds up fallopian tube OVARIAN LIGAMENT: connects ovary to the uterus

Ovarian arteries arterial supply through the mesentery to the ovary

The Female Reproductive System

Figure 24.11a

Female Internal Reproductive Organs

Figure 24.10

Uterine horn (cat); humans have uterine (fallopian) tube Broad ligament

Ovary

INTERNAL STRUCTURE OF THE OVARY

OVARIES
   

The ovary is lined with the superficial epithelium (visceral peritoneum). Under that is a layer of thin, dense connective tissue = TUNICA ALBUGINEA. Internal to that is the OVARIAN CORTEX, which is where the developing eggs are. Internal to that is the OVARIAN MEDULLA, which is loose connective tissue with veins, arteries, nerves, and lymphatics.

Ovary
Medulla Cortex Tunica albuginia

Primary follicle Secondary follicle Graafian follicle

OVARIAN (sex) CYCLE

 

This is the process of egg development on a monthly basis. Eggs develop during fetal development. A woman is born with almost all the eggs she will ever have. She is born with about 450,000 OOCYTES. The typical (diploid) cells of the body have 46 chromosomes; the gamete (oocyte and sperm cells) have 23 chromosomes.

Primary Follicle
  

The oocyte is surrounded by a group of cells called FOLLICULAR CELLS. The whole structure is called the PRIMARY FOLLICLE. At puberty there is a change in hormones which causes development of some of these oocytes.
Primary Follicle Oocyte Follicular cells

The Ovarian Cycle



Ovulation occurs about halfway through each ovarian cycle

Oocyte exits from one ovary



Enters the peritoneal cavity

Is swept into the uterine tube

Luteal Phase occurs after ovulation

Remaining follicle becomes a corpus luteum

 

Secretes progesterone Acts to prepare for implantation of an embryo

Secondary follicles with oocyte Primary follicles with oocyte

The Ovarian Cycle

Graafian follicle with oocyte

oocyte

corpus luteum

Figure 24.13

The average ovarian cycle is 28 days.

  

Day 1 This is the first day of menstruation. The primary follicle begins to develop. The female sex cycle begins on the first day of menstruation.

OVARIAN CYCLE
  

Day 1-7 The oocyte grows, especially the follicle cells, which grow and divide. The adenohypophysis secretes FSH (follicle stimulating hormone). This causes 20-30 eggs to be stimulated in both ovaries.

Day 1

Day 7

SECONDARY FOLLICLE


It has now become a SECONDARY FOLLICLE, which starts to produce the hormone ESTROGEN. Estrogen causes a build up the lining of the uterus and also inhibits the development of the follicles.

Day 7: SECONDARY FOLLICLE



 

Its like a race that lasts a week; the first one to reach this stage of maturation wins, the rest of the maturing follicles die do there is only one follicle remaining. In some races, there can be a tie, so if that happens here, you get multiple births. So the secondary follicle has knocked out its competition and keeps on growing.

Secondary follicles with oocyte Primary follicles with oocyte

The Ovarian Cycle

Graafian follicle with oocyte

oocyte

corpus luteum

Figure 24.13

Day 14: GRAAFIAN FOLLICLE

   

The follicle is fully mature = GRAAFIAN FOLLICLE. The oocyte is surrounded by a ring called the CORONA RADIATA. It is then surrounded by a space = ANTRUM, which contains a clear fluid. The antrum is surrounded by the follicular cells.

Day 14

Oocyte

Graafian Follicle
oocyte

Coronada radiata antrum Follicular cells

Ovary

Coronada radiata oocyte antrum

Ovary
Medulla Cortex Tunica albuginia

Primary follicle Secondary follicle Graafian follicle

OVULATION


 

The mature follicle is still producing estrogen. It has become so big that it forms a blister on the outside of the ovary. The adenohypophysis secretes another hormone called LH (leuteinizing hormone). LH causes fluid to rapidly flow into the antrum, which then expands and pops, which also breaks through the tunica albuginia. The egg and corona radiata are released into the peritoneum. This process is called OVULATION. Can be some pain.

Ovulation

OVULATION


The follicle cells that are leftover remain in the ovary and are called the CORPUS LUTEUM (yellow body). After a pregnancy the corpus luteum disintegrates into a white scar called the CORPUS ALBICANS (white body). In autopsy, you can see how many of these scars are present to determine the number of pregnancies she had.

The Ovarian Cycle

CORPUS ALBICANS

corpus luteum

Figure 24.13

Day 14-21
 

The egg takes a few days to make its way down to the uterus. The follicular cells continue to grow and make estrogen, which continues to build the uterus lining so its ready for the egg by the time it gets there.

Ovarian Cycle
     

Day 23 If no fertilization, the egg starts to break down. Day 27 There is no more estrogen. Day 28 Menstruation starts as the uterine lining breaks down Day 1

OVARIAN REFLEX


A woman is only fertile when the egg is released, but there is an OVARIAN REFLEX which is ovulation in response to sex (not necessarily with orgasm). There is no safe time to have unprotected sex because even during menstruation the sperm can still live in the female body for 10 days.

NOTE:
   

The functional unit of the Liver is the lobule And the functional unit of the Kidney is the nephron And the functional unit of the Lung is the alveolus And the functional unit of the Ovary is the follicle

FUN FACT
    

Is possible for a baby to have five parents: (1) sperm donor (2) egg donor (3) surrogate mother (4) and (5) adoptive mother and father

INFERTILITY

One of the most common causes of infertility in women is STD (sexually transmitted disease). Also, Fat is needed to have the menstrual cycle. Skinny and athletic women may not menstruate.

FERTILITY PILLS


Women who have trouble conceiving take fertility pills = FSH, which causes 100 follicles to develop, 4-5 of which may mature multiple births.

BIRTH CONTROL PILLS



 

Birth Control Pills are made of estrogen, so they inhibit the development of the follicles, but the uterine lining still grows. They are taken for 3 weeks, then one week is taken off to allow for menstruation. Some of the new estrogen pills can cause a period only every 3 months instead, but there are side effects.

BIRTH CONTROL
 

Implantable birth control = NORPLANT, etc, releases tiny amount of estrogen continually. Women that have irregular cycles can take BCP to regulate them.

MORNING-AFTER PILL


The "morning-after" birth control or "emergency contraception," is available by prescription at most drug stores and is sold under the names Preven or Plan B. This method involves a woman taking a higher than usual dose of the same hormones used in birth control pills within 72 hours (ideally, 24 hours) of unprotected sex.

MORNING-AFTER PILL
 

It greatly reduces the chance of pregnancy by preventing implantation of any fertilized egg. You should not, however, be relying on "morningafter" birth control as your regular form of contraception. It can cause side effects, and the high doses of hormones should not be taken regularly. It is also not as effective as other forms of birth control, and does not protect against sexually transmitted diseases in any way.

COMPLICATIONS
   

The second most dangerous thing a woman can do to herself is get pregnant. 5 in a million die from BCP complications. 100 in a million die from pregnancy complications. The first most dangerous thing is getting into a car without a seat belt.

Estrogen


 

The estrogen allows for deposition of subcutaneous fat, which is what gives women their curves. In pregnancy, the breasts get larger, the mammary glands get bigger. Fat is needed to have the menstrual cycle. Skinny and athletic women may not menstruate.

Birth Control Pills

    

Stop BCP 6-12 months before planning conception. Unprotected sex twice a week for a year = 90% chance of pregnancy. If not, may have fertility problem. BCP are 99% effective. So are condoms if they were used correctly (squeeze the air out of the tip and only use KY Jelly for lubrication); if not, only 85% effective. Solution = put the woman in charge of the condom, and the failure rate drops dramatically.

BREAST CANCER
 

In breast cancer, the cancer cells usually originate from the milk ducts. When the breast gets cancer, the skin of the breasts dimple because the suspensory ligaments of the breast are involved.

Fertilization


If the egg is fertilized, the corpus luteum grows until the pregnancy is over and then disintegrates into the CORPUS ALBICANS, which is a scar that can be seen on autopsy; reveals the number of pregnancies she had.

Dermoid Cyst

FALLOPIAN (UTERINE) TUBES



The ovary is in the peritoneal cavity, surrounded by the peritoneum, with an egg releasing. The fallopian tube has FIMBRIAE (fingers) that surround the ovary. When the egg is released, it goes into the peritoneal cavity, but the CILIA that line the fallopian tube create a current that drags the egg in.

Fallopian Tube

FALLOPIAN (UTERINE) TUBES



The fallopian tubes are about 10cm long (3), but only 7/10cm in diameter, and the actual lumen where the tube enters the uterus is tiny.

The Uterine Tubes

Figure 24.11a

The Uterine Tubes



The uterine tube is made of the INFUNDIBULUM (funnel), the AMPULLA (most of the tube), and the ISTHMUS (the part of the tube closest to the uterus). The ampulla is where fertilization usually occurs. If the egg implants outside of the uterus or on the external surface of the wall of the uterus, it is called an ECTOPIC PREGNANCY. The most common location for an ectopic pregnancy is the uterine tubes.

The Uterine Tubes

Figure 24.11a

ECTOPIC PREGNANCY


  

The egg is normally fertilized in the fallopian tube, goes down into the uterus and implants there. If it implants anywhere else, it is called an ECTOPIC PREGNANCY. If it implants in the fallopian tube = TUBAL PREGNANCY, a type of ectopic pregnancy. The uterine tube is the most common location for an ectopic pregnancy. Ectopic pregnancies are fatal to the mother and embryo, but nowadays there are few deaths of the mother because it is very painful, so she will go to the ER and they will do surgery.

ECTOPIC PREGNANCY


A woman who goes into the ER with abdominal pain will always get a pregnancy test. The egg can also implant into the wall of the peritoneal cavity; also fatal.

PELVIC INFLAMMATORY DISEASE

 

Sperm swim out of the opening of the fallopian tube and into the peritoneal cavity. That means any STD can also enter there, causing PELVIC INFLAMMATORY DISEASE (PID), which is when it spreads to the ovaries. It could then continue to all organs in the pelvis EXCEPT those organs which are retroperitoneal (Kidney, ureter, and urethra).

PID
 

It includes salpingitis (inflammation of the uterine tube). A womans peritoneal cavity is open to the external world; thats why the lumen of the fallopian tube has to be so narrow, and the cervix also has mucous for protection.

PID


The most common cause of PID and infertility in women is STD, usually Chlamydia or gonorrhea. The inflammation and scarring closes off the fallopian tube; although PID does not inhibit ovulation, it can lead to sterility.

BIRTH CONTROL


TUBAL LIGATION is a method of birth control where a piece of the fallopian tube is cut out, and theres no way for the sperm to reach the egg. It is more complicated and involves the abdominal cavity, so it is done less often than a vasectomy. Again, only 1 in a million grows back.

Birth Control


The least effective method of birth control is withdrawing the penis before ejaculation. Statistics say that there is a 30% chance of pregnancy with this method.

UTERUS
    

FUNDUS BODY (largest gross region of the uterus) CERVIX CERVICAL CANAL VAGINA

UTERUS
Endometrium

UTERUS


It is held in place by by the ROUND LIGAMENT and mesentery = the BROAD LIGAMENT. When a woman stands upright, the uterus sits on top of the urinary bladder

The Female Reproductive System

Figure 24.11a

The Uterus

Figure 24.10

Layers of the Uterus



ENDOMETRIUM (two layers)

STRATUM FUNCTIONALE STRATUM BASALE: the deeper layer, can divide and grow to replace itself.

UTERUS


Superficial to the stratum basale is the stratum functionale, which undergoes the changes during menses. It has lots of UTERINE GLANDS and blood vessels.

The Uterine Wall

Figure 24.18b

UTERUS


The stratum functionale develops with the hormone cycle, which causes it to grow, along with its glands and blood vessels. When the hormones stop, the stratum functionale breaks down, leaving only the stratum basale.

UTERUS


Deep to the endometrium is the MYOMETRIUM, made of smooth muscles which contract during birth. The PERIMETRIUM (Or Epimetrium) is the name of the visceral perineum.

UTERUS
Endometrium

The Menstrual Cycle

Structural and hormonal changes

Figure 24.19a, b

The Menstrual Cycle

Figure 24.19c, d

ENDOMETRIOSIS


 

Pieces of the endometrium are supposed to fall down the vagina, but sometimes its cells go up the fallopian tube and enter the peritoneal cavity. They can lodge anywhere; on top of the fundus, even on the lung pleura. One lady got a collapsed lung every month!

ENDOMETRIOSIS


  

These cells still respond to hormone changes, grow, and break down and die, causing pain during menstruation. Its difficult to diagnose because the pain goes away before the doctor appointment. The symptoms vary, depending on the location. Treatment is to give hormones to prevent menses.

FIBROIDS


These are benign tumors like scar tissue in the myeometrium. They can get large and be painful, especially during contraction of menses and pregnancy. Fibroids are the most common reason for hysterectomy (surgical removal of the uterus).

HYSTERECTOMY
 

HYSTERECTOMY comes from the Greek hysteria. It was thought that only women get hysterical because they have a uterus. Now we know thats not true. They get hysterical because they have ovaries! The surgery involves going through the abdominal wall, cut the broad ligament and fallopian tubes, and yank the uterus out through the vagina.

VAGINA
 

The function is to receive the penis and sperm. Its about 9 cm long. It is lines by mucosa made of non-keratinized stratified squamous epithelium, therefore its function is to protect against abrasions.

VAGINA


 

Below the mucosa is a LAMINA PROPRIA with some glands (most secretions are from the uterus). It has lots of ELASTIC FIBERS since it has to stretch during the birth process. The vagina also has RUGAE.

The Vagina

Figure 24.11a

The Vagina

Figure 24.10

VAGINA


There is a muscularis layer around it which allows for PERISTALSIS during orgasm and menses, which helps sperm move into the uterus. Surrounding that is an ADVENTITIA layer which is dense connective tissue with elastic fibers. This attaches the vagina to surrounding structures.

FUN FACT OR FICTION:

Will yogurt cure a yeast infection if you put it "inside"?

HYMEN
 

At the vaginal opening the mucosa extends into the VAGINAL ORIFICE = HYMEN. If the hymen covers the whole thing, cant get the menstrual flow out, so it will need surgery. Some women are born with a small hymen, so there is not much bleeding at the first intercourse. Some have a hymen so thick, it needs surgery before penetration.

Hymen

Hymen

Normal Hymen

Small Hymen

Large Hymen

EXTERNAL GENITALIA = VULVA

  

 

Parts of the vulva MONS PUBIS is a pad of adipose tissue above the pubic symphysis, covered with pubic hair. LABIA MAJORA is an extension on either side of the vestibule, also with pubic hair. It is the female equivalent of the scrotum. LABIA MINORA is medial to the labia majora. They are thin folds of tissue and erectile tissue. CLITORIS (equivalent of the penis), which also has erectile tissue. The clitoris is covered by a PREPUCE and has a CORPORA CAVERNOSA.

The External Genitalia and Female Perineum

Figure 24.20

EXTERNAL GENITALIA = VULVA



VESTIBULE is the area bounded by the lamina minora.

URETHRAL ORIFICE VAGINAL ORIFICE VESTIBULAR GLANDS (secrete mucus during sexual arousal for lubrication.)

Figure 24.21

Childbirth


 

During childbirth the vaginal orifice enlarges, so it will either stretch or tear at the posterior portion. If it tears, the vagina and the anus can be connected by the tear = bad. The surgeon can do an angled cut away from the anus, through the muscle = EPISIOTOMY.

EPISIOTOMY


A purpose of an episiotomy during childbirth is to minimize tearing of the central tendon and muscles of the pelvic floor.

After childbirth


Even if there was no tearing during childbirth, afterwards there can be weak muscles so external urethral sphincter can become incompetent; so can the external anal sphincter. Treatment/prevention is exercises for the muscles there and the external urethral sphincter.

PROLAPSED UTERUS


Also, weak muscle can decrease the support of the uterus, which can then prolapse and fall out through the vagina = PROLAPSED UTERUS.

The Mammary Glands

  

Breasts modified sweat glands Glandular structure undeveloped in non-pregnant women Milk production starts after childbirth

The Mammary Glands

Figure 24.22a, b

Reproductive System Cancers in Females

  

Ovarian cancer arises from cells in the germinal epithelium Endometrial cancer arises from the endometrium of the uterus Cervical cancer slow-growing, arises from epithelium at the tip of the cervix

Reproductive System Cancers in Females

   

Breast cancer Second most common cause of cancer deaths in women 97% occurs in women over 50 Usually arises from cells in the milk ducts When the skin is dimpled from breast cancer, the suspensory ligaments of the breast are causing the dimpling. Treatment

Surgical removal of the mass (lumpectomy) Radiation therapy Administration of selected hormones Chemotherapy

Puberty
  

Period of life between ages 10-15 Reproductive organs grow to their adult size Events of puberty occur in the same sequence in all individuals

Age at which events of puberty occur varies widely

Puberty


Female secondary sex characteristics

Budding breasts (around age 11) Menarche the first menstruation Other estrogen-induced secondary sex characteristics
   

Increase in subcutaneous fat Widening and lightening of the bones of the pelvic girdle Appearance of axillary and pubic hair Estrogen-induced growth spurt from age 12-17

Menopause
  

Female reproductive peak late 20s Around age 35 rate of follicle degeneration increases Ovulation and menstruation cease age 4654

Ovaries stop secreting estrogen

Reproductive organs and breasts begin to atrophy

Modern myths
The suggestion that douching immediately following intercourse works as a contraceptive is untrue. if anything, douching spreads semen further towards the uterus. Having sex in a hot tub does not prevent pregnancy, but may contribute to vaginal infections. Although some sex positions may encourage pregnancy, no sexual positions prevent pregnancy. Having sex while standing up or with a woman on top will not keep the sperm from entering the uterus. The force of ejaculation and the ability of sperm to swim overrides gravity. Sneezing or urinating after sex are also completely ineffective, they do not prevent pregnancy and are not forms of birth control.