NOTE 1

REPRO NOTES 1

FEMALE REPRODUCTIVE SYSTEM 

I. External Structure. 

Mons Veneris.  It is a pad of adipose tissue located over the symphysis pubis. It is covered by a triangle of coarse, curly hairs. Its purpose –is to protect the junction of the pubic bone from trauma. 

Labia Minora. Posterior to the mons veneris spread two hairless folds of connective tissue.  Before menarche these fold are fairly small; by childbearing age they are firm and full; after menopause, they atrophy and again become much smaller. 

Labia Majora. These are two folds of adipose tissue cover by a loose connective tissue and epithelium; they are positioned lateral to the labia minora. 

  Other external organ are: Clitoris, Skenes glands or the paraurtethral gland, Bartholin’s gland, fourchette, and the hymen 

II. INTERNAL STRUCTURE 

Ovaries. Produce, mature and discharge ova. In the process, the ovaries produce estrogen and progesterone and initiate and regulate menstrual cycles. Ovaries are formed with three principal division:

1. a protective layer of surface epithelium 

2. the cortex filled with the ovarian and the graafian follicle 

3. the central medulla containing the nerves, blood vessels, lymphatic tissue and some smooth muscle tissue. 

Fallopian tubes. Fallopian tubes arise from each upper corner of the uterine body and extend outward and backward until each opens at the distal end next to the ovary. Fallopian tubes are approximately 10 cm in length in a mature woman. Their function is to convey the ova from the ovaries to the uterus and to provide a place for fertilization of the ova by sperm. It is one the smooth hollow tunnel, it is anatomically divided into four separate parts. The most proximal division, the interstitial portion, isthmus is the next distal portion. It is, like the interstitial tube, extremely narrow. The ampulla is the third and also the longest portion of the tube. It is this ampullar portion that fertilization of an ovum usually occurs. The infundibular portion is approximately 2 cm long and is funnel shaped. 

Uterus. The uterus is a hallow, muscular, pear shaped organ located in the lower pelvis, posterior to the bladder and the anterior to the rectum. It consist of three division:

1. Fundus

2. body/corpus

3. cervix 

Uterus lies in the center of the pelvic cavity between the base of the bladder and the rectum and above the vagina. It is level or slightly below the brim of the pelvis, with an external opening of the cervix about the level of the ischial spines. The mature organ weighs about 50 to 70 g and approximately 7.5 cm long and 5 cm wide, and 1 to 2.5 cm thick. 

Uterine and Cervical Coats.  Uterine walls of three separate coats or layers of tissue. 

1. inner one of mucous membrane (endometrium) 

2. middle one of muscle fibers (myometrium)

3. outer one of connective tissue (perimetrium) 

VAGINA.  The vagina is a hallow musculo membranous canal located posterior to the bladder and anterior to the rectum. It extends from the cervix of the uterus to the external vulva. It functions is to act as the organ of intercourse and to convey sperm to the cervix so sperm can meet with the ovum in the fallopian tube. With childbirth it expands to serve as the birth canal. 

During a woman’s reproductive life an acidic vaginal environment is normal (pH 4.0 to 5.0). Secretion from the vaginal epithelium provides a moist environment. Acidic environment is maintained by a symbiotic relationship between lactic acid-producing bacilli and the vaginal epithelial cells. The amount of glycogen regulated by the ovarian hormones. Any interruption of this process can destroy the normal self-cleansing action of the vagina. A relative neural pH of 7.5 is normal from infancy until puberty and after menopause. 

MENSTRUATION. A menstrual cycle also called as a female reproductive system defined as a periodic uterine bleeding in response to cyclic hormonal changes. It is the process that allows for conception and implantation of a new life. Its purpose is to bring an ovum to maturity and renew a uterine tissue bed that will be responsive to its growth and should it be fertilized. Menarche, the first menstruation period in girls, may occur as early as 9 or as late as 17 and still be within normal limits. The length of the menstrual cycles differs from woman, but the expected average length is 28 days (from the beginning of one menstrual flow to the beginning of the next). Emotional and physical factors can alter the cycle interval.    Frequently ovulation does not occur in early cycles this is known as anovulatory cycle. 

HUMAN SEXUALITY. Sexuality is a multidimensional phenomenon that includes feelings, attitudes, and actions. It has both biologic and cultural components. It encompasses and gives direction to person physical, emotional, social, and intellectual responses throughout life.

Human Sexuality is the expression of sexual feelings due to genetic predisposition or one’s own personal experimentation. Sexuality can be influenced by hormonal changes in the development of the fetus during pregnancy. Sexuality influences social behavior. Human sexuality can also be understood as part of the social life of human, governed by implied rules of behavior status. Sexual identity can be molded by the social environment to which one is exposed, e.g. an authority figure giving a little boy a toy truck to play with, and a girl a doll. Human physiology makes sexuality possible, but it does not predict sexual behavior in any way. Sexuality molds the environments in which we live, influencing print, audio and video. Human sexual choices are usually made using cultural social filters. Some may choose to abstain from sex before marriage because their religious creed goes against such actions. 

HUMAN SEXUAL RESPONSE

Excitement. Excitement occurs with physical and physiologic (sight, sound, emotion, or thought) stimulation that causes parasympathetic nerve stimulation. This lead to arterial dilation and venous constriction in the genital area. The blood supply to this area increases, with resulting vasocongestion and increasing muscular tension. In women, vasocongestion causes the clitoris to increase in size and mucoid fluid to appear on vaginal walls as lubrication. The vagina widens in diameter and increases in length. The breast nipples become erect. In men, erection occurs: there is scrotal thickening and elevation of the testes. In both sexes, there is an increase in heart and respiratory rates and blood pressure. 

Plateau. Plateau stage is reached just before orgasm. In the woman, the clitoris is drawn forward and retracts under the clitoris prepuce: the lower part of the vagina becomes extremely congested (formation of the orgasmic platform), and there is increased nipple engorgement. In men, the vasocongestion leads to full distention of the penis. Heart rate increases to 100 to 175 beats per minute and respiratory  rate to approximately 40 respiration per rate 

Orgasm. Orgasm occurs when stimulation proceeds through the plateau stage to a point at which the body suddenly discharges accumulated sexual tension. A vigorous contraction of the muscles in the pelvic area expels or dissipates blood and fluid from the area of congestion. The average number of contractions from the woman is from 8-15 contractions intervals of one every 0.8 sec. in men, muscle contraction surrounding the seminal vessels and prostrate projects semen into the proximal urethra. These contractions are followed immediately by three to seven propulsive ejaculatory contractions, occurring at the same time interval in woman, which force semen from the penis. 

Resolution. Resolution is the period during which the external and internal genitalia organs return to an un-aroused state. For the male, a refractory period during which the further orgasm is impossible occurs first. Women do not go through this refractory period, so it is impossible for women who are interested and properly stimulated to have additional orgasm immediately after the first. It generally takes 30 minutes for both men and women.