Female Reproductive

Lec 23

What are the 3 primary functions of

the female reproductive system?

1. Produces gametes (ova)

2. Prepares to support a developing embryo

3. Undergoes changes according to the

menstrual cycle

What are the main 7 parts of the

female reproductive system?

1. Ovaries

2. Fallopian tubes (AKA uterine tubes)

3. Uterus

4. Vagina

5. External genitalia

6. Muscles in the pelvic floor

7. Perineum

3. What do the ovaries look like?

4. Where are they located?

5. What are they covered by?

6. What 3 ligaments hold the ovaries in

place?

7. What 2 ligament holds the fallopian

tube in place?

1. Small, almond-shaped organs, each 3 ½ cm long,

2cm wide (1 ½” x 1”).

2. Within the peritoneal cavity on the posterior body

wall

3. Covered by a superficial epithelium called the

visceral peritoneum.

Ovaries are held in place by 3 ligaments:

Broad ligament:

Ovarian ligament

Suspensory ligament

Broad ligament and suspensory ligaments hold up

fallopian tubes

Ovaries receive blood supply from

what artery?

Ovarian artery

Internal structure of the ovary

The ovary is covered with what

tissue?

Visceral peritoneum

What layer of thin dense connective

tissue is found deep to the visceral

peritoneum?

Tunica albuginea.

Internal to the tunica albuginea is

the___ and what can be found here?

Internal to that is the ovarian cortex, which is where

the developing eggs (oocytes) are found.

What layer is deep to the ovarian

cortex, and what structures does it

contain?

Internal to that is the ovarian medulla, which is loose

connective tissue with veins, arteries, nerves, and

lymphatics.

14. What is occurring during the ovarian

cycle?

15. What is the medical term for an egg

cell?

This is the process of egg development on a monthly

basis.

Oocyte

16. How many chromosomes dows the

typical (diploid) cell of the developing

blastocyte (baby) have?

17. How many come from each of the

gamete cells? (the oocyte and the sperm

cell)

The typical (diploid) cells of the blastocyte (baby)

have 46 chromosomes.

The gametes (oocyte and sperm cells) each

contribute typically 23 chromosomes.

18. The oocyte is surrounded by what

type of cells?

19. What is the whole structure called?

What hormone influences the

development of female secondary sex

characteristics?

Estrogen

What happens to the oocytes during

puberty?

At puberty there is a change in hormones which

causes maturing of some of these primary oocytes

which will lead to ovulation and then menstruation.

22. When does ovulation occur and what

happens during ovulation?

23. What is the luteal phase and what

happens during this phase?

24. What does the corpus luteum secrete,

and what is the function of that

secretion?

Ovulation occurs about approx 14 days through each

menstruation (28 day) cycle. An oocyte exits from

one ovary and enters the peritoneal cavity. It is then

swept into the Fallopian tube (uterine tube) waiting

to be fertilized by a sperm cell.

The luteal phase occurs after ovulation and the

remaining follicle becomes a corpus luteum.

The corpus luteum secretes progesterone, which

causes the uterus lining to thicken to prepare for

implantation of an embryo

The ovary during the ovarian (sex)

cycle

26. The average ovarian cycle is how

many days?

27. When does the ovarian cycle begin

and what occurs?

28. What happens to the oocytes during

days 1-7?

29. What hormone is secreted during

days 1-7?

The average ovarian cycle is 28 days.

Day 1

The ovarian cycle begins on the first day of

menstruation. The primary follicle begins to

develop.

Days 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

Diagram of ovaries on day 1 and day

7 of ovarian cycle

The primary follicle develops into a

___________

Secondary follicle

What hormone is secreted by the

secondary follicle?

Estrogen

Can more than one follicle develop at

once?

Sometimes more than one follicle matures causing a

double ovulation (one egg from each ovary) which

can lead to a multiple birth.

34. When does the primary follicle begin

to develop?

35. When does the female sex cycle

begin?

Day 1 of menstruation.

Day 1 of menstruation.

What is it called when a follicle is

fully mature, and on what day does this

occur?

Day 14: a fully mature follicle is called a graafian

follicle.

What is the ring that surrounds the

oocyte?

The oocyte is surrounded by a ring called the corona

radiata

What is the function of the corona

radiatia?

Provides nutrients for the ovum as it travels down

the fallopian tube.

What is the name of the space in the

graafian follicle that contains a clear

fluid?

antrum

What is the antrum surrounded by?

The antrum is surrounded by the follicular cells

By day 14 what starts to form on the

outside of the ovary?

42. On the day of ovulation, the

adenohypophysis secretes what

hormone?

43. What effect does that hormone have?

44. What is this process called?

LH (luteinizing hormone).

LH causes fluid to rapidly flow into the antrum,

which then expands and pops the blister on the

ovary. The egg and corona radiata are released into

the peritoneum.

This process is called ovulation; there might be

some noticeable discomfort from this.

45. What is the corpus luteum?

46. After a pregnancy the corpus luteum

will turn into dead tissue; a white scar

called what? Does it secrete hormones?

The corpus luteum is the leftover follicle cells that

remain in the ovary after the oocyte leaves.

After a pregnancy the corpus luteum disintegrates

into a white scar called the corpus albicans. The

corpus albicans does not secrete hormones.

In autopsy, you can see how many of these scars are

present to determine how many pregnancies she had.

What hormone is secreted by the

corpus luteum?

Progesterone

Ovary diagram

What is occurring days 14-21 during

the ovarian cycle?

The egg takes a few days to make its ways down to

the uterus. The follicular cells continue to grow and

make estrogen, which continues to build the uterus

lining so it’s ready for the egg by the time it gets

there.

What happens to the egg on day 23 if

there is no fertilization? What is

happening to the estrogen levels on day

23?

If no fertilization, the egg starts to break down.

The estrogen levels are still elevated until day 27.

What happens around day 27 during

the ovarian cycle?

Estrogen levels have dropped significantly

What happens on day 28 during the

ovarian cycle?

Menstruation starts and the uterine lining breaks

down this is the start of a new ovarian cycle. (day 1)

Can women get pregnant while they

are having a period?

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, even

during menstruation (sperm can live up to ten days

in the female

What is one of the most common

causes of infertility in women?

One of the most common causes of infertility in

women is STD (sexually transmitted disease).

What nutrient is needed for women to

have a menstrual cycle?

Fat is needed to have the menstrual cycle. Skinny

and athletic women may not menstruate

56. Which hormone pills can a woman

take to increase her follicle stimulation?

57. How do these pills work?

Women who have trouble conceiving can increase

their chances by taking fertility pills with fsh

hormone.

Fsh causes 100 follicles to develop, 4-5 of which

may mature  multiple births

58. How do birth control pills prevent

pregnancy?

59. How are they taken?

60. How does norplant prevent

pregnancy?

61. How effective are condoms at

preventing pregnancy?

Birth control pills are made of estrogen, so they

inhibit the development of the follicles, but the

uterine lining still grows.

You take them for 3 weeks, then take one week 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.

Implantable birth control = norplant, etc, releases

tiny amount of estrogen continuously. Women that

have irregular cycles can take bcp to regulate them.

Condoms are also 99% effective if used correctly; if

not, only 85% effective. Solution = put the woman

in charge of the condom, and the failure rate drops

dramatically

How does the morning-after pill work

to possibly prevent a pregnancy?

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. It greatly reduces the chance of

pregnancy by preventing implantation of any

fertilized egg.

How does estrogen affect a woman’s

body?

The estrogen allows for deposition of subcutaneous

fat, which is what gives women their curves.

In pregnancy, it causes the breasts get larger, the

mammary glands get bigger

64. How long before planning conception

should a women stop taking BCP?

65. There is a ____% chance of getting

pregnant if you had unprotected sex

twice a week for a Year.

66. BCP/condoms are __% effective.

6-12 months before planning conception.

90% chance of pregnancy. (if not, may have fertility

Problem)

BCP are 99% effective.

Condoms up to 99% effective if used correctly

In breast cancer, the cancer cells

usually originate from where?

Cancer cells usually originate from the milk ducts.

What is a symptom of breast cancer?

The skin of the breasts will dimple because the

suspensory ligaments of the breast are involved.

Fallopian (uterine) tubes

The fallopian tube has fimbriae (“fingers”) that

surround the ovary. When the egg is released, it

goes into the peritoneal cavity

What structure in the fallopian tube

drags the egg in?

Cilia that line the fallopian tube create a current that

drags the egg in.

What are the 3 parts of the fallopian

tube made of?

It is made of the infundibulum (funnel), the ampulla

(most of the tube), and the isthmus (the part of the

tube closest to the uterus).

What part of the fallopian tube is

usually the area where fertilization

occurs?

The ampulla is where fertilization usually occurs.

73. On cross section, lumen of the

fallopian tube is lined by what?

74. Deep to the epithelium is what layer?

75. What is the function of this layer?

Ciliated simple columnar epithelium.

Deep to the epithelium are two layers of muscle; the

inner circular layer and the outer longitudinal layer,

for peristalsis.

What occurs when there is an ectopic

pregnancy?

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.

Where is the most common area for

an ectopic pregnancy to occur?

The most common location for an ectopic pregnancy

is the fallopian tubes.

What is a tubal pregnancy?

A tubal pregnancy is a type of ectopic pregnancy

where the egg implants in the lining of the fallopian

tube.

What are the dangers of ectopic

pregnancies

A woman who goes into the er with abdominal pain

will always get a pregnancy test and they will do

surgery to remove the embryo. The egg can also

implant into the wall of the peritoneal cavity; also

fatal. If left undiagnosed the fallopian tube will burst

and can be fatal to the women.

Where do sperm go once they reach

the end of the fallopian tube?

Sperm swim out of the opening of the fallopian tube

and into the peritoneal cavity.

What is pelvic inflammatory disease

(PID) caused by?

Any STD (sexually transmitted disease)

What organs are not affected by PID?

It could then continue to all organs in the pelvis

except those organs which are retroperitoneal

(kidney, ureter, and urethra).

What is salpingitis?

Inflammation of the Fallopian (uterine) tube

Why is the pelvic cavity at risk for

disease and how does it protect itself?

A woman’s peritoneal cavity is open to the external

world; that’s why the lumen of the fallopian tube has

to be so narrow, and the cervix also has mucous for

protection

What is the most common cause of

pelvic inflammatory disease (pid)?

Sexually transmitted disease (std), usually

chlamydia or gonorrhea.

What are four characteristics of

pelvic inflammatory disease?

1) it can lead to sterility.

2) it is usually caused by chlamydia or gonorrhea.

3) it includes salpingitis (inflamed fallopian tube).

4) it does not inhibit ovulation.

What happens during a tubal

ligation?

A permanent way to prevent pregnancy by

surgically removing a piece of the fallopian tube so

the sperm cannot reach the egg. Only 1 in a million

does not work.

What is the least effective method of

birth control?

Withdrawing the penis before ejaculation. Statistics

say that there is a 30% chance of pregnancy with

this method.

89. What are the 5 parts of the uterus?

90. The largest gross region of the uterus

is where?

Fundus, body, cervix, cervical canal, and vagina.

The largest gross region of the uterus is its body

Uterus diagram

Most support of the uterus is

provided by what two structures?

It is held in place by the round ligament and by

mesentery; the broad ligament.

When a woman is standing, what

organ does the uterus sit on top of?

When a woman stands upright, the uterus sits on top

of the urinary bladder

94. What are the 2 layers of the

endometrium?

95. Which of these two layers can divide

and replace itself?

96. What layer goes through changes

during menses?

Endometrium (two layers)

1. Stratum functionale

2. Stratum basale

The stratum basale is the inner layer, and can divide

and grow to replace itself.

On top of it is the stratum functionale, which

undergoes the changes during menses.

97. What is the stratum functionale lined

by?

98. What is the function of the lamina

propria?

It is lined by simple columnar epithelium, under

which is the lamina propria with lots of uterine

glands which has lots of blood vessels.

The lamina propria secretes nutrients and coats and

protects the uterine lining.

99. What does the stratum functionale

maintain?

100. What is left over after the stratum

functionale breaks down?

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.

101. Deep to the endometrium is the what?

102. When are these smooth muscles

used?

Deep to the endometrium is the myometrium, made

of smooth muscles which contract during birth.

What is another name for the

perimetrium (besides epimetrium)?

Visceral perineum. This is a general term that

applies to any organ, whereas perimetrium or

Epimetrium is specific for the uterus.

104. What is endometriosis and how does

it occur?

105. Where can pieces of tissue from

endometriosis be found?

106. How is endometriosis diagnosed?

107. How is endometriosis treated?

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, in

the lung pleura. These cells still respond to hormone

changes, grow, and break down and die, causing

pain during menstruation or other parts of the body.

It’s difficult to diagnose because the pain goes away

before the doctor appointment. The symptoms vary,

depending on the location. One lady had it on her

lung pleura and got a collapsed lung every month.

Treatment is to give hormones to prevent menses.

Surgery to remove it, if possible.

108. What are fibroids and where are they

found?

109. When are fibroids most painful?

110. What is the most common reason

women get a hysterectomy?

These are benign tumors like scar tissue in the

myometrium.

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)

What happens during a

hysterectomy?

The surgery involves going through the abdominal

wall, cut the broad ligament and fallopian tubes, and

removing the uterus by pulling it out through the

vagina.

112. What is the function of the vagina?

113. How long is the vagina?

The function is to receive the penis and sperm.

It’s about 9 cm long.

114. Lined by what and for what reason?

115. How is the vagina able to stretch

during the birthing process?

116. What is rugae and what is its

function?

117. What attaches the vagina to

surrounding structures?

It is lined by mucosa made of non-keratinized

stratified squamous epithelium, therefore its function

is to protect against abrasions.

Below it 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. 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.

Where is the hymen found?

It is found at the vaginal opening the mucosa

extends into the vaginal orifice or hymen.

If the hymen covers the whole thing, can’t 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.

What are the external genitalia called?

The vulva

What area is the pad of adipose tissue

above the pubic symphysis?

Mons pubis, covered with pubic hair.

The outer labias of the vulva are

called?

The labia majora is an extension on either side of the

vestibule, also with pubic hair

The inner labias of the vulva are

called?

labia minora, which are thin folds of mucosal tissue

The area of the vulva which has

erectile tissues like a penis?

clitoris

What tissue is inside a clitoris?

Corpora cavernosa.

What tissue covers the clitoris?

Prepuce

What is the female homologue

(equivalent) of the male’s scrotum?

Labia majora

127. Where is the vestibule?

128. Within it you can find what anatomy?

Vestibule is the area bounded by the labia minora.

Within it are the urethral orifice, vaginal orifice, and

vestibular glands (in the posterior region) which

secrete mucus during sexual arousal for lubrication.

What happens to the vagina during

childbirth?

During childbirth the vaginal orifice enlarges, so it

will either stretch or tear at the posterior portion.

What happens if the outside of the

vagina tears?

If it tears, the vagina and the anus can be connected

by the tear = bad infection. The surgeon can do an

angled cut away from the anus, through the muscle

What is the purpose of an

episiotomy?

A purpose of an episiotomy during childbirth is to

minimize tearing of the central tendon and muscles

of the pelvic floor.

What issues might occur after a

vaginal delivery?

Tearing or 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.

What happens when there is a

prolapsed uterus?

A weak muscle can decrease the support of the

uterus, which can then prolapse and fall out through

the vagina

134. Where are the mammary glands

found?

135. What are the mammary glands

functions?

They are found in the breasts and are modified

sweat glands with glandular structure (undeveloped

in non-pregnant women)

Their main function is milk production and starts

after giving birth

What are the 4 main types of

reproductive system cancers found in

females?

1. Ovarian cancer arises from cells in the germinal

epithelium

2. Endometrial cancer arises from the

endometrium of the uterus

3. Cervical cancer slow-growing, arises from

epithelium at the tip of the cervix

4. Breast cancer is the second most common cause

of cancer deaths in women

5. 97% occurs in women over 50

What cells does breast cancer usually

arise from?

Cells in the milk ducts.

What causes the dimpling when the

skin is dimpled from breast cancer?

The suspensory ligaments of the breast

How is breast cancer treated?

 Surgical removal of the mass (lumpectomy),

whole breast (mastectomy)

 Radiation therapy

 Administration of selected hormones

 Chemotherapy

140. The onset of puberty occurs in

females about what age?

141. What happens to the reproductive

organs during puberty?

Period of life between ages 10-15

Reproductive organs grow to their adult size

142. Do the same events happen in the

same sequence in all females?

143. What is the first menstruation called?

Events of puberty occur in the same sequence in all

individuals. Age at which events of puberty occur

varies widely

Menarche – the first menstruation