NCM 109 - LESSON 1

• Organs of the female reproductive system and their structure:

  • Mons Veneris: rounded, soft fatty tissue over the symphysis pubis, covered by dark and curly pubic hair, protects the pubic bone joint from trauma
  • Labia Minora: hairless folds of connective tissue, pink in color, covered with mucous membrane internally and skin externally, abundant with sebaceous glands, protects labia majora, urinary meatus, and vaginal mucosa
  • Labia Majora: folds of adipose tissue covered by loose connective tissue and epithelium, positioned lateral to labia minora
• • Clitoris: small rounded organ of erectile tissue at the forward junction of labia minora, sensitive to touch and temperature, center of sexual arousal and orgasm
  • Skene's Gland (Paraurethral Glands): located lateral to the urinary meatus, ducts open into the urethra
  • Bartholin's Glands (vulvovaginal glands): located lateral to the vaginal opening, lubricates the external vulva during coitus
  • Fourchette: ridge of tissue formed by the posterior joining of the two labia majora
  • Hymen: tough but elastic semicircle of tissue covering the opening of the vagina in childhood
• Vagina:

  • Hollow membranous canal located posterior to the bladder and anterior to the rectum
  • Acts as an organ of copulation, conveys sperm to the cervix, expands as a birth canal
  • Contains folds or rugae for stretching without tearing
  • Upper portion separated from the rectum by the cul-de-sac of Douglas
  • Passageway for menstrual blood flow, fetus, and penis for intercourse
  • Fornices serve as a place for pooling of semen following coitus
  • Bulbocavernosus acts as a voluntary sphincter at the external opening to the vagina
• Uterus:

  • Muscular pear-shaped organ located in the pelvis, cavity for fetal development and menstruation
  • Functions include receiving ova, providing a place for implantation and nourishment, furnishing protection to a growing fetus, and expelling the fetus
  • Divisions: Corpus/Body, Fundus, Isthmus, Cervix
  • Layers of uterine wall: Endometrium, Myometrium, Perimetrium
  • Uterine ligaments: Cardinal ligament, Broad ligament, Round ligament, Uterosacral ligament, Anterior ligament, Posterior ligament
• Fallopian Tube:

  • Two trumpet-shaped tubes for fertilization of ova by sperm
  • Parts include Interstitial portion, Isthmus, Ampulla, Infundibulum
  • Fimbriae help guide fertilized ova into the tube
• Ovaries:

  • Almond-shaped organs producing, maturing, and discharging ova
  • Initiate and regulate the menstrual cycle, produce estrogen and progesterone
  • Layers of the ovary: Tunica Albuginea, Cortex, Medulla
• Pelvis:

  • Contains generative organs and the birth canal
  • Made up of 4 united bones: Innominate bones (Ilium, Ischium, Pubis), Sacrum, Coccyx
  • Division of the pelvis into False Pelvis and True Pelvis
  • Linea Terminalis separates the False and True Pelvis
  • True Pelvis has 3 parts: Pubis in front, Ilium and Ischia on the sides, Sacrum and Coccyx behind
• True pelvis is formed by the pubis in front, the ilia and the ischia on the sides, and the sacrum and coccyx behind
• Parts of the true pelvis:

  • Pelvic Inlet/Brim: entrance to the true pelvis, wider transversely
  • Pelvic Cavity: space between the inlet and the outlet, level of the ischial spine marks the midpoint or midplane of the pelvis
  • Pelvic Outlet: inferior portion of the true pelvis, anteroposterior diameter is greater than the transverse
• Types of pelvis:

  • Gynecoid: "normal female pelvis", well rounded forward and back, most ideal for childbirth
  • Anthropoid: "Ape like pelvis", narrow transverse diameter, larger AP diameter of the inlet than normal
  • Platypelloid: "Flattened pelvis", oval inlet with shallow AP diameter, fetal head cannot rotate to match the curve of the pelvic cavity
  • Android: "Male pelvis", pubic arc forms an acute angle, lowest dimensions extremely narrow, fetus has difficulty exiting from the pelvis
• Pelvic measurements and pelvimetry:

  • Performed with radiography and/or internal examination
  • Indication: to determine if the pelvis is large enough for the fetus to pass through
  • External pelvic measurements:
  • Intercristal: distance between iliac crests (28 cms)
  • Interspinous: distance between anterosuperior iliac spine (25 cms)
  • Intertrochanteric: distance between trochanters of the femur (31 cms)
  • External conjugate/Baudelocque’s: distance between symphysis pubis and depression below L5 (18-20 cms)
  • Internal pelvic measurements:
• • Diagonal Conjugate: distance between sacral prominence and inferior margin of symphysis pubis, average margin 12.5-13 cm
  • True Conjugate (Conjugate vera): estimated from diagonal conjugate, average margin 10.5-11 cm
  • Ischial Tuberosity Diameter: distance between ischial tuberosities or transverse diameter of the outlet, average margin 11 cms
• Male reproductive system:

  • External structures include the penis, scrotum, and testis
  • Spermatozoa are produced in the testis
  • Semen is derived from the prostate gland, seminal vesicles, epididymis, and bulbo-urethral glands
  • Penis composed of erectile tissue, penile erection stimulated by parasympathetic nerve innervation
  • Scrotum supports testes and regulates sperm temperature
  • Testes are ovoid glands in the scrotum, produce spermatozoa and testosterone
  • Internal structures:
  • Epididymis: conducts sperm from testis to vas deferens
• • Vas Deferens: carries sperm to ejaculatory ducts
  • Seminal Vesicles: pouches that empty into the urethra
  • Ejaculatory Ducts: pass through prostate gland and join seminal vesicles with urethra
  • Prostate Gland: secretes thin alkaline fluid
  • Urethra: hollow tube leading from bladder to outside through penis