Reproductive System

Zainuri Sabta N Departemen Anatomi FK UII

The reproductive system

The reproductive system becomes active after puberty. During puberty the reproductive organs mature to create a fertile individual capable of reproducing. The primary sex organs produce the sex cells (egg/sperm) and sex hormones. The accessory sex organs are all the components involved in maintaining the sex cell and assisting in the process of fertilization. Gametes (oocytes and spermatozoa) are the descendants of primordial germ cells that originate in the wall of the yolk sac in the embryo and migrate to the gonadal region.

Organ reproduksi MASCULINA

(organa genitalia masculina/virilia)
organa genitalia externa: penis et scrotum Organa genitalia interna: testis; epididimis; ductus deferens, ductus ejaculatorius Glandula : gld. vesicalis; prostata, bulbouretralis

Organa reproduksi: produksi sel gamet (spermatosoan et semen); organ genital : untuk berkelamin/kopulasi
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Scrotum: kantong kulit, terkandung testis kanan et kiri di caudal ossis pubis
Raphe scroti: garis di linea mediana (berlanjut ke raphe penis) Rambut terminal pubis: pubes Kulit scrotum: pigmen Tela subcutanea: serabut otot polos: tunica dartos Kontraksi otot polos kerutan kulit, mengecil Septum scroti- membagi kanan et kiri

Fungsi scrotum: tempat testis, memelihara suhu: spermatogenesis

Isi scrotum: kedua testis, epididimis et ductus deferens Letak testis kanan lebih tinggi dari yang kiri Suhu luar dingin berkerut, testis naik; suhu luar panas : scrotum melemah testis menjauh badan Vasektomi; memotong vas deferens

penis

Penis:

Alat kopulasi (bersetubuh) Dibedakan: glans penis, corpus penis dan radix penis Kulit penis: preputium pada glans (frenulum); phimosis lubang preputium sempit Circumsitio/dorsumsitio:k otoran smegma

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 Copulatory organ
Proximal region = root Middle shaft = body Distal region = glans penis Body = three large tubes of tissue Corpora cavernosa penis: paired dorsal tubes with large arterial bloodflow Normally gated by the sympathetic nervous system Corpus spongiosum penis: single tube that encases the spongy urethra Glans penis = expanded distal end of the corpora spongiosum penis Prepuce is very loosely attached to corpora spongiosum penis

Penis

Penis
Erectile tissues:
2 corpora cavernosa; 1 corpus spongiosum surrounding urethra encased in tunica albugenia NOkey player in arterial relaxation during erection

Penis

Nervous system control of erection and ejaculation Brain communicates sexual stimulus to erection reflex center in sacral part of spinal cord Spinal cord nerves send signals to erectile tissue in penis arteries dilate blood pools in erectile tissues leading to erection Spinal cord nerves send signals that result in contraction of inner structures (epididymis, vas deferens, seminal vesicles, prostate) Semes washes past bulbourethral gland into urethra (emission); sensation of urethral filling is returned to erection complex Spinal cord nerves send signals that result in contraction of muscles at base of penis, leading to rhythmic contractions (ejaculation)

Penis:

The head of the penis (glans) has a covering, called the foreskin (prepuce/praeputium). There is some natural variation in the length of the foreskin . This covering folds in on itself, forming a double layer. The foreskin is not a `flap' of skin on the end of the penis, and it is not `useless skin.

Penis: The foreskin has twelve known functions

1. to cover and bond with the synechia so as to permit the development of the mucosal surface of the glans and inner foreskin. 2. to protect the infant's glans from feces and ammonia in diapers. 3. to protect the glans penis from friction and abrasion throughout life. 4. to keep the glans moisturized and soft with emollient oils. 5. to lubricate the glans. 6. to coat the glans with a waxy protective substance. 7. to provide sufficient skin to cover an erection by unfolding. 8. to provide an aid to masturbation and foreplay. 9. to serve as an aid to penetration. 10. to reduce friction and chafing during intercourse. 11. to serve as erogenous tissue because of its rich supply of erogenous receptors. 12. to contact and stimulate the G-spot of the female partner

The foreskin
The foreskin contains sensory receptors called Meissner corpuscles (similar to nerve endings in the fingertips) are there to provide pleasure, as well as fine sensory perception. This seems to help a man to enjoy sex longer without ejaculating prematurely, because he can more easily tell when he is approaching the threshold of orgasm.

The circumcised penis

Following circumcision, the foreskin of the penis has been cut away. The main indications for this include:
1. Phimosis resistant to treatment with steroid cream. 2. Recurrent foreskin infections (balanitis). 3. Religion issues

The surface of the glans has developed a thick, dry layer of keratin (toughened skin), which makes it less sensitive to unwanted stimulation, but also less sensitive to the more subtle qualities of lovemaking.

The circumcised penis

All circumcised men have an annular scar on the shaft of the penis. The location of the scar varies, from near the head to far down the shaft. For some men, so much skin has been removed that erection becomes difficult and even painful.

The ridged bands

The ridged bands, which are like horseshoes only in that they curve forward underneath toward the point where the frenulum attaches. There are some 20 concentric ridged bands which rub over the corona. Each ridge has Meissner's corpuscles, which respond to pressure, and they produce the sexual pleasure which no individual has a right to take away from another individual
Stimulation of the frenulum and ridged band results in intense pleasurable feelings during arousal. Sensations from these structures during intercourse or masturbation are thought to be the primary trigger of orgasm in the intact male.

Stimulation of the glans

We believe that stimulation of the glans is most significant in the later stages of sexual intercourse, when penetration is deepest and emotions are running at their highest. Sensations from the glans contribute to the quality of the sensual experience. They are also apparently capable of triggering orgasm on their own, as would be the case in a circumcised man.

Effects of penile reduction surgery (circumcision) on sexual intercourse

Although still pleasurable for the man, intercourse without the participation of the prepuce lacks the gliding mechanism. The only source of stimulation is the glans rubbing against the wall of the vagina. The sensations from the specialised receptors of the frenar band, frenulum and inner foreskin layer are missing. If the surgery was performed on an infant, by adulthood a relatively thick keratin layer will have formed on the normally skinless mucosal surface of the glans, which further reduces the stimulation. If the circumcision was performed as an adult, the keratin layer will form, and the sensitivity of the glans will gradually be reduced over time.

Erection process
The most important components of the physical erogenous stimulation of the penis during foreplay and intercourse are the sensations from the foreskin, frenulum/frenar band, and glans The foreskin has an inner and outer layer. The outer foreskin layer contains nerve endings which respond to gentle touching during the early stages of sexual arousal. This helps to trigger an erection. The nerves of the inner and outer foreskin contribute to the experience of penile stimulation, up to and including orgasm. These receptors are stimulated by stretching, or when the foreskin rolls over the surface of the glans during intercourse or masturbation.

The gliding mechanism

The prepuce is a highly innervated and vascularized genital structure. During intercourse the loose skin of the intact penis slides up and down the shaft of the penis, stimulating the glans and the sensitive erogenous receptors of the foreskin itself. This is known as the `gliding mechanism that contributes greatly to sexual pleasure. Also, since more of the loose skin of the penis remains inside the vagina, the woman's natural lubrication is not drawn out

B. Testes:
Oval shape organs made up of thousands of seminiferous tubules where the sperm is produced. It responds to follicle stimulating hormone that signals sperm production. When the sperm is in its last stages of maturation it moves to the epididymus. 1. Gross anatomy: about 1 x 4 inches, complete surrounded by a fibrous capsule and partially enclosed by a serous membrane that develop when the testes traveled outside the body into the scrotum. The fibrous capsule divides the testicles into wedge-like compartments called lobules that are filled with seminiferous tubules. They are innervated by an abundant about of visceral sensory nerves that make them very sensitive to pain. The high sensitivity serves for protection and in sexual arousal.

Scrotum:

a sac located outside of the abdominal cavity, made up of a thin layer of smooth and skeletal muscle and skin. It is divided into left and right by a septum to form different compartments for the testicles. The scrotum keeps the testicles outside the body so they can be 3 degrees cooler than normal core temperature. The muscles of the scrotum contract to bring the testicles closer to the body in cooler conditions. In warm conditions they relax to allow the skin to stretch and maximize cooling.

C. Reproductive duct system is males: This section discusses the tubules through which sperm travel to exit the body. Epididymis: organ that arches over the posterior lateral side of the testis. If you uncoil the epididymis is can be as long as 6meters or 20 feet! During the twenty days the sperm spend here they complete maturation and gain the ability to swim and fertilize. During ejaculation smooth muscle contracts to send mature sperm to the ductus deferns. Ductus deferens: also known as the vas deference, it runs superior to the testicles, enters the abdominopelvic cavity, runs posterior to the bladder, passes by the seminal vesicle, form the ampulla and ejaculatory duct, and finally leads into the prostatic urethra. Spermatic cords: a tube of fascia holding blood vessels, nerves, and the ductus deference. See page 672 figure 24.2. Urethra: As discussed in the previous chapter the urethra and men carries both sperm and urine. During ejaculation the sphincter muscles close off the bladder so urine is not released into the semen. The urethra is divided into the prostatic urethra (section passing through prostrate gland), the membranous urethra (urogenital diaphragm) and the spongy urethra (penile). Urethral glands along the spongy urethra secrete a lubricating solution before ejaculation.

D.

Accessory glands: These glands produce substances that increases the chances of sperm survival once it is outside the body. These secretions in addition to sperm form semen. Seminal vesicles: paired glands located posterior to the bladder. During ejaculation smooth muscle contract to help secrete a fluid that contains fructose (sugar), nutrients, prostagladins to stimulate the urethra to contract, substances that suppress the immune system against sperm in females, enzymes the enhance sperm mobility, and enzymes that thicken the ejaculate. Prostate gland: the size of a chestnut, also has smooth muscle that contracts to assist in the release of prostatic secretion. This is a milky white fluid that has substances to enhance sperm mobility and thicken ejaculate. It is susceptible to tumors and sexually transmitted diseases (STDs). Bulbourethral glands: secrete a mucus substances that lubricates and neutralizes the acid from urine in the male urethra.

The female reproductive system:

These organs produce the ova (eggs), sex hormones, and provide an environment for internal fertilization and development of the fetus. They undergo changes according to the menstrual cycle. Mammary glands are considered part of this system because they nourish the infant.

Organ reproduksi wanita

Organ genitalia feminima/muliebria)
Fungsi: 1. menghasilkan sel gamet (ovum), 2. tempat fertilisasi, 3. pertumbuhan embrio dan fetus, 4. persalinan, et menyusui

berkembang biak/menghasilkan keturunan

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System reproduksi et genitalia feminina

Organ genitalia dibedakan: Organ genitalia externa vulva (vestibulum vagina: mons pubis, labia mayora, labia minora, clitoris) Organ genitalia interna: vagina, uterus, tuba et ovarium

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Pelvis et tulang pelvis wanita

Tulang pelvis: coxae kanan et kiri dan sacrum Ciri-ciri tulang pelvis wanita:
angulus subpubicum lebar, fossa iliaca mendatar, crista iliaca tipis, spina ischiadica pendek

Persendian: sacroiliaca (fibrosa), symphysis pubis

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ABDOMINOpelvis

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Cavum douglass: excavatio rectouterina

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1. Clitoris 2. Labia majora 3. Hymen 4. Perineum 5. Hood of the clitoris (also called prepuce) 6. Labia minora 7. Urethral orifice - or urethral opening (where you pee out of) 8. Opening of the vagina

Clitoris
Embryonic/fetal analog of penis--contains erectile tissues Very sensitive to stimulation--many nerve endings May retract and become less evident when erect Located in front of urethral opening

Labia
Labia majora (outer lips)-swell during sexual stimulation Labia minora (minor lips)-swell and change color during sexual stimulation

Organ genitalia externa: Alat kelamin wanita bagian luar:pudendum femininum

Vulva: Mons pubis (bantalan lemak di depan, cranial simphysis pubis) Labium majus pudendi (lipatan kutaneus, di luar ditutup rambut, sebelah dalam lunak, tanpa rambut) Commisura labiorum anterior et posterior (pertemuan labium majus dexter et sinister) Fissura pudendalis/rima pudendi Labium minus pudendi (lipatan kutaneus tipis, tanpa rambut, kaya kelenjar lemak)

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Frenulum labiorum pudendi (pertemuan labia minora, di depan commisura posterior) Vestibulum vaginae (ruang ditutupi labia minora) Fossa vestibuli vaginae (bagian vestibulum di antara frenulum et introitus vaginae) Bulbus vestibuli (jaringan erektil pada pangkal labia majora) Orificium/introitus vaginae (lubang masuk vagina) Gld. Vestibularis minor (kelenjar tubuler mukosa simpleks di dekat uretra)

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Struktur pada pudendum femininum

Gld. Vestibularis major (Bartholinni), kelenjar mukosa sebesar kacang polong, di sebelah posterior diafragma urogenitale, bermuara pada vestibulum di antara labium minus et hymen/carunculae hymenalis Uretra feminina: ostium urethrae externum, terletak 23cm di bawah klitoris; dilengkapi gld. Urethralis (ke lumen urethra)et paraurethralis (dekat ostium)

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clitoris

penis rudimenter, pada pangkal labia minora, tanpa uretra, dan corpus spongiosum; dibedakan crus, corpus et glans; corpus terdiri dari 2 corpus cavernosum; glans tutup clitoris seperti jagung; frenulum lipatan ganta mendekatkan ke labia minora; preputium pertemuan kedua labia minora di atas klitoris
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Perineum, diafragma urogenitalis et diafragma pelvis

Perineum segmen di antara anus et genitalia Trigonum urogenitale et analis Raphe perinealis sutura kulit di linea mediana Diafragma pelvis- basis muskularis pelvis yang sebagian besar disusun oleh m. levatoris ani Diafragma urogenetalisdinding fibromuskuler yang menyebar antara rami os pubis inferior kanan et kiri

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Episiotomi pemotongan bagian perineum untuk memperlebar jalan lahir pada persalinan

M. ischiocavernosus: dari ramus os ischium terletak pada crus clitoris/penis melekat pada tunica albuginea corpus clitoris/penis M. bulbospongiosus /bulbocavernosus dari corpus perinealis dan raphe medianum ke dorsum penis (pria), melengkung di sekitar bulbus vestibuli (wanita)

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Organ genitalia interna: vagina

Vagina: saluran datar, panjang 10cm, ostium sampai masuk sampai uterus Fornix vaginae: recessus di antara portio vaginalis cervicis dan dinding vagina, dibedakan: anterior (dangkal), posterior (tempat ejakulat, erat dengan cavum peritoneal), lateral

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Vagina

Dinding vagina : paries anterior et posterior Lapisan: tunica mucosa, tunica muscularis, et tunica spongiosa (dari dalam ke luar) Lapisan mukosa: epitel squamosa kompleks non keratinisasi kaya glikogen, rugae vaginae Lapisan muskuler otot polos tipis Lapisan spongiosa : pleksus spongiosus vaskuler pada mukosa sbg columna rugarum anterior et posterior

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Introitus vagina et hymen

Hymen : lipatan kutaneus, terutama dari posterior vagina sebagian menutup pintu masuk vagina Bentuk: semilunaris, anularis, cribriformis, unperforantus darah mensis tertampung incisi Carunculae hymenalis: sisa-sisa hymen coitus et persalinan Hymenoplasti

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Uterus et cervix uteri

Uterus: metra panjang 7,5cm Dibedakan: fundus uteri: kubah uterus Corpus uteri: antara cervix et fundus Cervix uteri: sepertiga bawah uterus (2,5cm) Isthmus uteri: bagian antara corpus et cervix Cavitas uteri: berlapis mukosa Portio supravaginalis cervicis: bagian supravaginalis dari cervix
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Dinding uterus

Lapisan dinding uterus: dari luar perimetrium, myometrium et endometrium Perimetrium peritoneum ligamentum latum (uterus ke dinding pelvis) Myometrium otot tebal, spiral- hipertrofi - uterus gravid Endometrim lapisan mukosa stratum basale et fungsionale (siklus mensis)

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Cavitas uteri

Cavitas uteri: tempat nidasi et pertumbuhan janin; IUD (intra uterin device) Osteum uteri internum et externum Canalis cervicis Plica palmata- lipatan mukosa mirip palm pada mukosa canalis cervicis

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Fixator uterus Ligamentum latum ke dinding lateral pelvis Ligamentum cardinale uteri pada cervix Ligamentum teres uteri dari angulus tuba ke depan mengikuti canalis inguinalis ke labia majora Posisi cervix-uterus 9canalis cervicis et cavitas uteri- antefleksi-anteversio

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Tuba uterina (Fallopi; salpinx) et ovarium

Tuba uterina; saluran penghubung antra regio ovarii dengan cavitas uteri10 cm Dibedakan: ostium uterinum, pars uterina, isthmus, ampula, infundibulum, fimbria, ostium abdominalis cavitas peritonialis Ampula: fertilisasi

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Struktur tuba et penggantung

Tuba

difiksasi oleh mesosalpinx Dinding tuba: tunica serosa (peritonium), tunica muscularis, tunica mukosa (epitel kolumner bersilia, selglandular, plica tubariae mucosae) Fertlisatio: di ampula nidasi di isthmus: Kehamilan extrauterin
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ovarium
Gonad, intraperitoneal, bentuk amandel Panjang 2,5 4,5cm, tebal 0,5 1cm Bagian-bagian: Hilum ovarii: tempat keluar masuk vasa st melekat mesovarium Facies medialis et lateralis Margo liber tepi bebas (berlawanan dg hilum) Extremitas tubariakutub superior ke arah tuba uterina Extremitas uetrina kutub inferior ke uterus

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Kapsula organ: tunica albuginea Epitelium geminativum lapisan epitelial Cortex: kulit pematangan folikel Stroma: isi jaringan ikat Medulla: area sentral kaya dengan vaskularisasi Fixator ovarium: Ligamentum ovarii proprium mesovarium

Struktur ovarium

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3. Uterine cycle: also called the menstrual cycle, it relates to changes occurring in the endometrium of the uterus that are induced by female sex hormones.

Menstrual phase: (days 1-5) during this phase the endometrium is shed Proliferative phase: (days 6-14) during this phase the endometrium builds a new stratum functionalis as it responds to rising estrogen levels. As the layer thickens glands release a clear sticky mucus secretion that assist the sperm in finding the egg.

Secretory phase: (days 15-28) during this point the stratum functionalis is highly vascularized and there is secretion of glycoproteins to support a developing embryo in case fertilization occur. These changes are a response to progesterone released by the corpus luteum in the ovary. If there is no fertilization the progesterone levels drop signaling changes that cause death of the stratum functionalis. The arteries constrict cutting out blood supply and suddenly open again but the weak capillaries fragment and the menstrual phase begins again.

Glandula mammae

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Letak, bentuk et struktur mammae

Payudara/mamma: tersusun: jaringan glandularis (glandula mamma), jaringan ikat (erektil) et lemak Bentuk : ras, sesuai pertumbuhan (mulai pubertas)dan fungsi: menyusui: kolustrum; tua: atrofi Letak: fascia superficialis di pectoral antara axilla dan sternum setinggi costa II-III s/d VI VII.

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Struktur mama

Dibedakan: papilla mammae, areola mammae dan corpus mammae Papilla mammae: lubang-lubang ductuli lactiferi dengan otot polos Areola mammae: area melingkar berpigmen pada papilla mammae,dg satu cincin kecil berisi 10 15 glandulae areola (montgomery) sudorifera tipe apokrinsekret sedikit bau khas

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Mammae dan perubahan hormonal wanita

Corpus mammae- corpus glandulae mammae dg lemak ; 15 20 lobi conicales dg ductus lactiferi(ductus excretorius) diameter 1,2- 2mm membuka ke papilla (mirip sekat buah jeruk) Di dekat papilla: sinus lactiferi Gld mamma dipengaruhi hormonal: (:estrogen et progesteron) saat siklus mensis, kehamilan dan menyusui); siklus perangsangan sexual

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Respon seksual wanita

Tahap : gairah, plateau, orgasmus et resolusi Tahap gairah: putting tegang, mamma membesar, klitoris membesar et panjang, labia majora membuka et mendatar, labia minora megembang et meluas keluar, tonus otot skelet , denyut nadi, tekanan darah naik; vagina sekresi gld. mukosa-basah, uterus et cervix menjauhi vagina, 2/3 vagina dalam mengembang/memanjang

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III. Pregnancy and childbirth: This section briefly describes the evens that occur in the womans body during fertilization, pregnancy, and childbirth. A. Pregnancy: occurs once an egg is successfully fertilized and successfully implants.

1. Events leading to fertilization: Sperm swims from the vagina through the cervix, through the uterine wall until it reaches the oocyte in the uterine tubes. When burrows into the zona pellucida of the oocyte enzymes digest it way to allow the sperm to reach the egg. The plasma membranes fuse and sperm nucleus enters the oocytes cytoplasm. This initiates the cortical reaction in which the egg destroys other sperm receptors so no other sperm binds and fertilizes the egg. When the male and female chromosomes come together fertilization has been completed and the zygote will begin to divide. Once it is large enough and has formed a blastocyst it enters the uterus to implant.

Development of External Genitalia

Development of External Genitalia

Development of External Genitalia

Homologous Sex Organs

During embryonic development, the male & female sex organs are initially the SAME
Easy way to think about this concept:
Males = sex organ progenitors descend out of the pelvic cavity Female = sex organ progenitors remain within the pelvic cavity Undifferentiated Male Female Gonad Genital swelling Urogenital folds Testis/testes Scrotum Spongy urethra Ovary/ovaries Labia majora Labia minora

Genital tubercle
Prepuce

Penis
Foreskin Glans

Clitoris
Clitoral hood Clitoral glans