anatomyoffemalereproductiveorgans-150703094139-lva1-app6891.pptx

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1. ANATOMY OF FEMALE REPRODUCTIVE ORGANS

2. INTRODUCTION The reproductive organ in female are those which concerned with copulation, fertilization, growth and development of fetus and its subsequent exit to the outer world. The female reproductive organs can be subdivided into External genitalia Internal genitalia Accessory reproductive organs.

3. The female reproductive system is designed to carry out several functions. It produces the female egg cells necessary for reproduction, called the ova or oocytes . The system is designed to transport the ova to the site of fertilization. Conception , the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The next step for the fertilized egg is to implant into the walls of the uterus, beginning the initial stages of  pregnancy . If fertilization and/or implantation does not take place, the system is designed to menstruate . In addition, the female reproductive system produces female sex hormones that maintain the reproductive cycle

4. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 4 EXTERNAL GENTILIA The vulva refers to those parts that are outwardly visible The vulva includes: Mons pubis Labia majora Labia minora Clitoris Urethral opening Vaginal opening Perineum Individual differences in: Size Coloration Shape

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6. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 6 MONS PUBIS The triangular mound of fatty tissue that covers the pubic bone It protects the pubic symphysis During adolescence sex hormones trigger the growth of pubic hair on the mons pubis Hair varies in coarseness curliness, amount, color and thickness

7. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 7 LABIA MAJORA Referred to as the outer lips They have a darker pigmentation The Labia Majora : Protect the introitus and urethral openings Are covered with hair and sebaceous glands Tend to be smooth, moist, and hairless The labia majora contain sweat and oil-secreting glands Become flaccid with age and after childbirth

8. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 8 LABIA MINORA Referred to as the “inner lips” Made up of erectile, connective tissue that darkens and swells during sexual arousal Located inside the labia majora They are more sensitive and responsive to touch than the labia majora The labia minora tightens during intercourse

9. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 9 CLITORIS Highly sensitive organ composed of nerves, blood vessels, and erectile tissue It is made up of a shaft and a glans Becomes engorged with blood during sexual stimulation Key to sexual pleasure for most women Urethral opening is located directly below clitoris

10. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 10 VAGINAL OPENING INTROITUS Opening may be covered by a thin sheath called the hymen Using the presence of an intact hymen for determining virginity is erroneous Some women are born without hymens The hymen can be perforated by many different events

11. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 11 PERINEUM The muscle and tissue located between the vaginal opening and anal canal It supports and surrounds the lower parts of the urinary and digestive tracts The perinium contains an abundance of nerve endings that make it sensitive to touch An episiotomy is an incision of the perinium used during childbirth for widening the vaginal opening

12. 12 INTERNAL GENITALIA THE INTERNAL GENITALIA CONSISTS OF THE: VAGINA CERVIX UTERUS FALLOPIAN TUBES OVARIES

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15. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 15 VAGINA The vagina connects the cervix to the external genitals It is located between the bladder and rectum It functions : As a passageway for the menstrual flow For uterine secretions to pass down through the introitus As the birth canal during labor With the help of two Bartholin’s glands becomes lubricated during SI

16. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 16 CERVIX The cervix connects the uterus to the vagina The cervical opening to the vagina is small This acts as a safety precaution against foreign bodies entering the uterus During childbirth, the cervix dilates to accommodate the passage of the fetus This dilation is a sign that labor has begun

17. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 17 UTERUS Commonly referred to as the womb A pear shaped organ about the size of a clenched fist It is made up of the endometrium , myometrium and perimetrium Consists of blood-enriched tissue that sloughs off each month during menstrual cycle The powerful muscles of the uterus expand to accommodate a growing fetus and push it through the birth canal

18. Lies between rectum and bladder Weight: 50g-80g Divided into two portions by isthmus Normal position is ante version and ante flexion Parts- body or corpus, isthmus, and cervix Blood supply- uterine artery Nerve supply- sympathetic component T5 and T 6 (motor) and T 10 and L 1 (sensory) parasympathetic system on either side pelvic nerve which consist of both motor and sensory fiber S 2 , S 3 , S 4 .

19. The uterus is surported by the following ligaments Round ligament Broad ligament Cardinal ligament Utero -sacral ligament

20. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 20 FALLOPIAN TUBES Serve as a pathway for the ovum to the uterus Are the site of fertilization by the male sperm Often referred to as the oviducts or uterine tubes Fertilized egg takes approximately 6 to 10 days to travel through the fallopian tube to implant in the uterine lining

21. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 21 OVARIES The female gonads or sex glands They develop and expel an ovum each month A woman is born with approximately 400,000 immature eggs called follicles During a lifetime a woman release @ 400 to 500 fully matured eggs for fertilization The follicles in the ovaries produce the female sex hormones, progesterone and estrogen These hormones prepare the uterus for implantation of the fertilized egg

22. Other Sex Organs Any area can be arousing depending on the type of stimulation and the perceptions of the recipient Breasts (mammary glands) – modified sweat glands that produce milk; fatty tissue, 15 to 20 lobes, and milk-producing glands (alveoli) Nipple, areola Sucking stimulates pituitary gland to release prolactin (begin milk synthesis) and oxytocin (release of milk)

23. UNIT 3: FEMALE REPRODUCTIVE SYSTEM 23 BREASTS Organs of sexual arousal Contain mammary glands Consist of connective tissue that serves as support Each breast contain 15-25 clusters called lobes Each lobule is connected by ducts that open into the nipples The nipples are made up of erectile tissue The pigmented around the nipples are called the areola Breast size is determined primarily by heredity Size also depends on the existing fat and glandular tissue Breasts may exhibit cyclical changes, including increased swelling and tenderness prior to menstruation Benign breast changes refer to fibrocystic disease Lumps or masses that are noncancerous

24. 26 MENSTRUATION Menarch , the onset of menstruation signals the bodily changes that transform a female body Average age is 12.8 Amount of bleeding varies from woman to woman Expulsion of blood clots Blood color can vary from bright red to dark maroon Usually occurs every 25 to 32 days Women can experience fluid retention, cramping, mood swings, weight gain, breast tenderness, diarrhea, and constipation

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26. Females of reproductive age experience cycles of hormonal activity that repeat at about one-month intervals. With every cycle, a woman's body prepares for a potential pregnancy, whether or not that is the woman's intention. The term menstruation  refers to the periodic shedding of the uterine lining. The average menstrual cycle takes about 28 days and occurs in phases: the follicular phase, the ovulatory phase ( ovulation ), and the luteal phase. There are four major hormones (chemicals that stimulate or regulate the activity of cells or organs) involved in the menstrual cycle: follicle-stimulating hormone, luteinizing hormone,  estrogen , and progesterone.

27. FOLLICULAR PHASE OF THE MENSTRUAL CYCLE This phase starts on the first day of your period. During the follicular phase of the menstrual cycle, the following events occur: Two hormones, follicle stimulating hormone (FSH) and luteinizing hormone (LH) are released from the  brain  and travel in the blood to the ovaries. The hormones stimulate the growth of about 15 to 20 eggs in the ovaries each in its own "shell," called a follicle. These hormones (FSH and LH) also trigger an increase in the production of the female hormone estrogen. As estrogen levels rise, like a switch, it turns off the production of follicle-stimulating hormone. This careful balance of hormones allows the body to limit the number of follicles that mature. As the follicular phase progresses, one follicle in one ovary becomes dominant and continues to mature. This dominant follicle suppresses all of the other follicles in the group. As a result, they stop growing and die. The dominant follicle continues to produce estrogen.

28. OVULATORY PHASE OF THE MENSTRUAL CYCLE Tshe ovulatory phase, or ovulation, starts about 14 days after the follicular phase started. The ovulatory phase is the midpoint of the menstrual cycle, with the next menstrual period starting about two weeks later. During this phase, the following events occur: The rise in estrogen from the dominant follicle triggers a surge in the amount of luteinizing hormone that is produced by the brain. This causes the dominant follicle to release its egg from the ovary. As the egg is released (a process called ovulation) it is captured by finger-like projections on the end of the fallopian tubes ( fimbriae ). The fimbriae sweep the egg into the tube. Also during this phase, there is an increase in the amount and thickness of mucous produced by the cervix (lower part of the uterus). If a woman have intercourse during this time, the thick mucus captures the man's sperm, nourishes it, and helps it to move towards the egg for fertilization.

29. LUTEAL PHASE OF THE MENSTRUAL CYCLE The luteal phase of the menstrual cycle begins right after ovulation and involves the following processes: Once it releases its egg, the empty follicle develops into a new structure called the corpus luteum . The corpus luteum secretes the hormone progesterone. Progesterone prepares the uterus for a fertilized egg to implant. If intercourse has taken place and a man's sperm has fertilized the egg (a process called conception), the fertilized egg (embryo) will travel through the fallopian tube to implant in the uterus. The woman is now considered pregnant. If the egg is not fertilized, it passes through the uterus. Not needed to support a pregnancy, the lining of the uterus breaks down and sheds, and the next menstrual period begins.

30. PLACENTA The  placenta  is an  organ  that connects the developing  fetus  to the  uterine  wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. The placenta functions as a fetomaternal organ with two components: the  fetal placenta , or ( Chorion frondosum ), which develops from the same sperm and egg cells that form the fetus; and the  maternal placenta , or ( Decidua basalis ), which develops from the maternal uterine tissue

31. In humans, the placenta averages 22 cm (9 inch) in length and 2–2.5 cm (0.8–1 inch) in thickness (greatest thickness at the center and become thinner peripherally). It typically weighs approximately 500 grams . It has a dark reddish-blue or crimson color. It connects to the fetus by an  umbilical cord  of approximately 55–60 cm (22–24 inch) in length that contains two arteries and one vein.  The umbilical cord inserts into the chorionic plate (has an eccentric attachment). Vessels branch out over the surface of the placenta and further divide to form a network covered by a thin layer of cells. This results in the formation of villous tree structures. On the maternal side, these villous tree structures are grouped into lobules called cotyledons. In humans, the placenta usually has a disc shape.

32. Placental circulation Maternal placental circulation In preparation for implantation, the uterine endometrium undergoes ' decidualisation '.  Spiral arteries  in decidua are remodeled so that they become less convoluted and their diameter is increased. The increased diameter and straighter flow path both act to increase maternal blood flow to the placenta. The relatively high pressure as the maternal blood fills  intervillous space  through these spiral arteries bathes the fetal  villi  in blood, allowing an exchange of gases to take place. In humans and other hemochorial placentals , the maternal blood comes into direct contact with the fetal chorion , though no fluid is exchanged. As the pressure decreases between  pulses , the deoxygenated blood flows back through the endometrial veins. Maternal blood flow is approx 600–700 ml/min at term.

33. Fetoplacental circulation Deoxygenated fetal blood passes through  umbilical arteries  to the placenta. At the junction of umbilical cord and placenta, the umbilical arteries branch radially to form  chorionic arteries . Chorionic arteries, in turn, branch into  cotyledon arteries . In the villi , these vessels eventually branch to form an extensive arterio -capillary-venous system, bringing the fetal blood extremely close to the maternal blood; but no intermingling of fetal and maternal blood occurs ("placental barrier" [7] ). Endothelin  and  prostanoids  cause  vasoconstriction  in placental arteries, while  nitric oxide   vasodilation . [8]  On the other hand, there is no neural vascular regulation, and catecholamines have only little effect

34. Blood from the  placenta  is carried to the  fetus  by the  umbilical vein . About half of this enters the fetal  ductus venosus  and is carried to the  inferior vena cava , while the other half enters the  liver  proper from the inferior border of the liver. The branch of the  umbilical vein  that supplies the right  lobe  of the  liver  first joins with the  portal vein . The blood then moves to the  right atrium  of the  heart . In the fetus, there is an opening between the  right  and  left atrium  (the  foramen ovale ), and most of the blood flows through this hole directly into the left atrium from the right atrium, thus bypassing  pulmonary circulation . The continuation of this blood flow is into the left ventricle, and from there it is  pumped  through the  aorta  into the body. Some of the blood moves from the aorta through the  internal iliac arteries  to the umbilical arteries , and re-enters the  placenta , where  carbon dioxide  and other waste products from the fetus are taken up and enter the maternal circulation.

35. Some of the  blood  entering the right atrium does not pass directly to the  left atrium  through the  foramen ovale , but enters the  right ventricle  and is pumped into the  pulmonary artery . In the fetus, there is a special connection between the  pulmonary artery  and the aorta , called the  ductus arteriosus , which directs most of this blood away from the lungs (which aren't being used for  respiration  at this point as the  fetus  is suspended in  amniotic fluid ).

36. With birth, a change from parallel flow through the heart to a serial one gradually takes place. The following changes must occur: The gas exchange takes place in the baby's lungs. By cutting the umbilical cord, the placental circulation system is switched off. The fetal heart shunts become closed.

37. With the activation of breathing the lungs becomes distended, the capillary network dilated and their  resistance  is reduced drastically so that a rich flow of blood can take place. As a consequence, the pressure in the right atrium sinks in comparison with that of the left one. This  pressure turnaround  in the atria causes the septum primum to be pressed against the septum secundum and the  foramen secundum  becomes functionally  closed . Towards the end of the first year, it has also grown together in 99% of the babies -->  The shunt between the left and right atrium is closed .

38. On the other hand, with the cutting of the umbilical cord following birth, the placental low resistance area also disappears and the peripheral resistance increases in the systemic circulation. The pressure in the aorta is now higher than that in the truncus pulmonalis and the right-left shunt via the ductus arteriosus that is present before birth is turned around into being a  left-right shunt . The pO2 pressure in the aorta increases since the blood is now oxygenated directly in the baby's lungs. This increase in pO 2  triggers a contraction of the smooth musculature in the wall of the ductus arteriosus and thereby to a functional seal. After a few weeks or months this shunt via the  ductus arteriosus  is definitively obliterated and the remnant is known as the  ligamentum arteriosus .

39. Pulmonary and Systemic Vascular resistances pulmonary vascular resistance greatly decreases as a result of expansion of the lungs. loss of blood flow through the placenta doubles the systemic vascular resistance. Changes In The Fetal Circulation At Birth.

40. Blood coming from lung rise pressure in left atrium – close foramen ovale . Ductus arteriosus constricts within few hours after birth –functional closure (Mechanism unknown). Anatomical closure after 24-48hrs.

41. FUNCTIONS Nutrition The perfusion of the intervillous spaces of the placenta with maternal blood allows the transfer of nutrients and oxygen from the mother to the fetus and the transfer of waste products and carbon dioxide back from the fetus to the maternal blood supply. Nutrient transfer to the fetus occurs via both active and passive transport. Active transport systems allow significantly different plasma concentrations of various large molecules to be maintained on the maternal and fetal sides of the placental barrier. Adverse pregnancy situations, such as those involving maternal diabetes or obesity, can increase or decrease levels of nutrient transporters in the placenta resulting in overgrowth or restricted growth of the fetus

42. Excretion Waste products excreted from the fetus such as urea, uric acid and creatinine are transferred to the maternal blood by diffusion across the placenta. Immunity IgG antibodies  can pass through the human placenta, thereby providing protection to the fetus  in utero . [10] Furthermore, the placenta functions as a selective  maternal-fetal barrier  against transmission of  microbes  to the fetus. However, insufficiency in this function may still cause  mother-to-child transmission  of infectious diseases. In humans, aside from serving as the conduit for oxygen and nutrients for fetus, the placenta secretes hormones (secreted by syncytial layer/ syncytiotrophoblast of chorionic villi ) that are important during pregnancy

43. . Human Chorionic Gonadotropin ( hCG ) : hCG testing is proof that all placental tissue is delivered. hCG is present only during pregnancy because it is secreted by the placenta, which is present only [  during pregnancy. hCG also ensures that the corpus luteum continues to secrete progesterone and estrogen. Progesterone is very important during pregnancy because, when its secretion decreases, the endometrial lining will slough off and pregnancy will be lost. hCG suppresses the maternal immunologic response so that placenta is not rejected. Human Placental Lactogen ( hPL [Human Chorionic Somatomammotropin ] ): This hormone is lactogenic and growth-promoting properties. It promotes mammary gland growth in preparation for lactation in the mother. It also regulates maternal glucose, protein, and fat levels so that this is always available to the fetus. Estrogen  is referred to as the "hormone of women" because it stimulates the development of secondary female sex characteristics. It contributes to the woman's mammary gland development in preparation for lactation and stimulates uterine growth to accommodate growing fetus. Progesterone  is necessary to maintain endometrial lining of the uterus during pregnancy. This hormone prevents preterm labor by reducing myometrial contraction. Levels of progesterone are high during pregnancy.

44. Placental expulsion  begins as a physiological separation from the wall of the uterus. The period from just after the fetus is expelled until just after the placenta is expelled is called the  third stage of labor . The placenta is usually expelled within 15–30 minutes of the baby's being born. Placental expulsion can be managed actively, for example by giving  oxytocin  via intramuscular injection followed by cord traction to assist in delivering the placenta. As an alternative, it can be managed expectantly, allowing the placenta to be expelled without medical assistance.

45. AMNIOTIC FLUID Amniotic fluid  or  liquor amnii  is the nourishing and protecting liquid contained by the  amniotic sac  of a pregnant woman. From the very beginning of the formation of the extracoelomal cavity, amniotic fluid [AF] can be detected. This firstly water-like fluid originates from the maternal plasma, and passes through the fetal membranes by osmotic and hydrostatic forces. As the placental and fetal vessels develop, the fluid passes through the fetal tissue, as the exsudatum of the skin.

46. At first it is mainly water with  electrolytes , but by about the 12-14 th week the liquid also contains  proteins ,  carbohydrates ,  lipids   and phospholipids , and  urea , all of which aid in the growth of the fetus. The volume of amniotic fluid is positively correlated with the growth of fetus. From the 10th to the 20th week it increases from 25ml to 400ml approximately. From the 8th week, when the fetal kidneys begin to function, fetal urine is also present in the AF. Approximately in the 10th week the breathing and swallowing of the fetus slightly decrease the amount of AF, but neither urination nor swallowing contributes significantly to AF quantity changes, until the 25 week, when keratinization of skin is complete. Then the relationship between AF and fetal growth stops. It reaches the plateau of 800ml at the 28 week ( gestational age ). The amount of fluid declines to roughly 400 ml at 42 weeks ga . Till term it measures about 600-800 ml.

47. The forewaters are released when the amnion  ruptures . This is commonly known as the time when a woman's "water breaks". When this occurs during  labour  at  term , it is known as "spontaneous rupture of membranes" ( SROM ). If the rupture precedes labour at term, however, it is referred to as " premature rupture of membranes " ( PROM ). The majority of the hindwaters remain inside the womb until the baby is born. Artificial rupture of membrane (ARM), a manual rupture of the amniotic sac, can also be performed to release the fluid if the amnion has not spontaneously ruptured. [2]

48. Functions of amniotic fluid Amniotic fluid is "inhaled" and "exhaled" by the fetus. It is essential that fluid be breathed into the lungs in order for them to develop normally. Swallowed amniotic fluid also creates urine and contributes to the formation of  meconium . As well, amniotic fluid protects the developing baby by cushioning against blows to the mother's abdomen, allows for easier fetal movement, promotes muscular/skeletal development. Analysis of amniotic fluid, drawn out of the mother's abdomen in an  amniocentesis  procedure, can reveal many aspects of the baby's genetic health. This is because the fluid also contains fetal cells, which can be examined for genetic defects.