FEMALE REPRODUCTIVE SYSTEM DR NOOR AINI HARUN PAKAR OBSTETRIK DAN GINEKOLOGI HOSPITAL TUANKU FAUZIAH, KANGAR, PERLIS FEMALE REPRODUCTIVE SYSTEM Female Reproductive Organs consists of Ovaries Uterine Tubes/ Fallopian Tubes Uterus Vagina External Genitalia Mammary Glands Internal Reproductive Organ Located within the pelvis between urinary bladder and the rectum. Uterus and vagina are in the midline, ovary in each sides of the uterus Internal organ are held in place within the pelvis by a group of ligaments ANATOMY Ovaries 2 ovaries, almond shape organ, measuring 4x 2 cm (1.5x0.75 inches) Suspended in the pelvic cavity by ligament Ovarian ligaments attaches the ovary to the superior margin of the uterus Ovaries are attached to the posterior surface 0f the broad ligament by fold of peritoneum called the mesovarium Outer part of the ovary- dense connective tissue, contains follicles. Each follicle contains an oocyte. Inner part of the ovary- loose connective, where blood vessel, nerve and lymphatic vessels are located Uterine Tubes / Fallopian tubes Extends from the uterus to the ovary. 4 inches long (10 cm) They opened directly into the peritoneal cavity near each ovary and receive the oocyte. The opening of each uterine tube is surrounded by long, thin processes called fimbriae. The fimbriae nearly surround the surface of the ovary. As soon as the oocyte is ovulated, it come into contact with the surface of the fimbriae. Cilia on the fimbriae surface sweep the oocvte into the uterine tube Fertilisation occurs in the ampulla region of the tube. Uterus Pear shape organ with thick muscular wall. In young nulliparous adult, it measures 3 inches long (8 cm), 2 inches wide (5 cm), I inch (2.5 cm) thick. Divided into body, fundus, cervix. Fundus- part of the uterus that lies above the entrance of the uterine tubes. Body- Part of the uterus that lies below the entrance of the uterine tubes. It narrow below where it becomes continous with the cervix. The cervix pierces the anterior wall of the vagina and divided into supravaginal part and vaginal part of the cervix. Uterus Cavity- triangular shape in coronal section. Cavity of the cervix- cervical canal Cervical canal communicate with the uterine cavity through the internal os and communicate with the vagina through the external os. Uterine wall is composed of 3 layers- serous layer (perimetrium), muscular layer (myometrium), inner layer (endometrium). Endometrium consist of simple columnar epithelial cell with an underlying connective tissue layer. Endometrial glands are formed by fold of endometrium. Superficial part of the endometrium is sloughed off during menstruation. Uterus Supported by broad ligament and round ligament (minor support). Much support is provided inferiorly by skeletal muscle of the pelvic floor (levator ani muscles) and condensations of the pelvic fascia which forms 3 important ligaments transverse cervical ligaments, pubocervical ligaments and sacrocervical ligaments. If ligaments or muscles that support the uterus are weakened, the uterus can extend inferiorly or descend into the vagina, a condition called prolapsed uterus. Vagina Female organ of copulation. Functions to receive penis during intercourse. Functions to receive penis during intercourse. Measures 3 inches long (8 cm) Upper half of the vagina lies above the pelvic floor and the lower half within the perineum. The area of vaginal lumen which surrounds the cervix is divided into 4 region- anterior fornix, posterior fornix, right lateral and left lateral. Hymen- thin mucosal fold surrounds the entrance into the vaginal orifice. After child birth the hymen consist of hymen tags. Also allow menstrual flow and child birth. External Genitalia (Vulva) Consists of vestibule and its surroundig structures. The vestibule is the space into which the vagina and the urethra open. Urethra opens just anterior to the vagina. The vestibule is bordered by a pair of thin, longitudinal skin fold called labia minora. A small erectile structure called the clitoris is located in the anterior margin of the vestibule. 2 labia minora unite over the clitoris to form a fold of skin called the prepuce. On each side of the vestibule, between the vaginal opening and the labia minora, are opening of the greater vestibular gland-produce lubricating fluid that helps maintain the moistness of the vestibule External Genitalia (Vulva) Labia majora- lateral to labia minora 2 labia majora unite anteriorly called the mon pubis. Medial surface of the labia majora are covered with numerous sebaceous and sweat glands. The space between the labia majora called the pudendal cleft. Region between the vagina and the anus is the clinical perineum. Oocyte Development Primordial Follicle- primary oocyte surrounded by a single layer of flat cells (granula cells). Primordial follicles – Primary follicle – secondary follicle – mature follicle – ovulation – corpus luteum– corpus albican Ovarian Cycle Hormon involved GnRH from hypothalamus FSH, LH from Pituitary anterior Estrogen from ovary Progesteron from ovary Menstrual Cycle Physiology Menstrual cycle- Series of changes that occur in sexually mature, non pregnant female. Menses- bleeding that occur during which part of the endometrium sloughed and expelled from the uterus. Typically menstrual cycle every 28 days. Menstrual cycle can be as short as 18 days or as long as 40 days. Menstrual cycle results from the cyclical changes that occur in the endometrium of the uterus (controlled by the secretions of FSH, LH from the anterior pituatary gland) Menstrual Flow usually 4-6 days. Ovulation occurs at day 14 of menstrual cycle Menstrual Cycle Proliferative phase Time between ending of menstruation and ovulation. Maturing follicles in ovary mature. Follicles produce estrogen and act on endometrial gland start to form. Time between ovulation and the next menses is called the secretory phase (luteal phase) Series of Cyclical hormon changes occur during menstrual cycle. Menstrual Cycle If fertilization occurs, the zygote undergoes several cell divisions to produce a collection of cells called the blastocyst. Blastocysts arrives the uterus by 7-8 days after ovulation. The endometrium is prepared to receive the blastocyst. If secondary oocyte is not fertilize , the endometrium is sloughs away as a result of declining progestero. Unless the secondary oocyte is fertilized, the CL begin to produce less progesterone by day 24-25 of the MC. By day 28, declining progesterone causes endometrium to slough away to begin menses and the next menstrual cycle. .Menopause 40-50 yrs Declining ovarian function Symptoms THANK YOU