M2

• Female reproductive system

  Has both external and internal components
• Gynecology


  The study of the female reproductive organs
• Female external genitalia

  • Mons veneris
  • Labia minora
  • Labia majora
  • Vestibule
  • Clitoris
  • Skene glands
  • Bartholin glands
  • Fourchette
  • Perineal muscle
  • Hymen
• Mons veneris


  • Pad of adipose tissue located over the symphysis pubis
  • Covered by a triangle of coarse, curly hairs
  • Protects the junction of the pubic bone from trauma
• • Hairless folds of connective tissue
  • Pink in color
  • Internal surface covered with mucous membrane
  • External surface covered with skin
  • Abundant with sebaceous glandsLabia minora
• Labia majora


  • Two folds of tissue, fused anteriorly but separated posteriorly
  • Positioned lateral to the labia minora
  • Composed of loose connective tissue covered by epithelium and pubic hair
  • Serve as protection for the external genitalia
• Vestibule

  Flattened, smooth surface inside the labia<|>Openings to the bladder (urethra) and uterus (vagina) arise from this space
• Clitoris


  Small, rounded organ of erectile tissue<|>Covered by a fold of skin (prepuce)<|>Sensitive to touch and temperature<|>Center of sexual arousal and orgasm in a woman
• Female circumcision can lead to contractions and scarring of the vulva that make vaginal childbirth difficult
• Skene glands

  Paraurethral glands located on each side of the urinary meatus<|>Their ducts open into the urethra
• Bartholin glands


  Vulvovaginal glands located on each side of the vaginal opening<|>Their ducts open into the proximal vagina near the labia minora and hymen
• Fourchette


  Ridge of tissue formed by the posterior joining of the labia minora and the labia majora
• Perineal muscle


  Stretches during childbirth to allow enlargement of the vagina and passage of the fetal head
• Hymen


  Tough but elastic semicircle of tissue that covers the opening to the vagina during childhood<|>Often torn during first sexual intercourse
• Imperforate hymen does not allow for the passage of menstrual blood from the vagina or for sexual relations until it is surgically incised
• Vulvar blood supply

  Mainly from the pudendal artery and a portion from the inferior rectus artery<|>Venous return is through the pudendal vein
• Vulvar nerve supply

  Anterior portion derives from the ilioinguinal and genitofemoral nerves<|>Posterior portions supplied by the pudendal nerve
• Female internal reproductive organs

  • Ovaries
  • Fallopian tubes
  • Uterus
• Ovaries


  • Approximately 3 cm long, 2 cm in diameter, and 1.5 cm thick
  • Grayish-white and appear pitted
  • Located close to and on both sides of the uterus in the lower abdomen
• Function of ovaries


  Produce, mature, and discharge ova<|>Produce estrogen and progesterone<|>Initiate and regulate menstrual cycles
• If ovaries are removed before puberty, absence of estrogen prevents maturation and maintenance of secondary sex characteristics
• Ovaries are unique


  Not covered by a layer of peritoneum, allowing ova to readily escape and enter the uterus
• Reproductive cells (gametes)

  Contain half the usual number of chromosomes (22 autosomes and 1 sex chromosome)
• Maturation of oocytes

  1. 5-7 million ova form in utero

  2. Most never develop beyond a primitive state and atrophy

  3. By birth, only about 2 million are still present

  4. By age 7, only about 500,000 are present in each ovary

  5. By 22 years of age, the count is down to 300,000

  6. By menopause, none are left
• Parts of the fallopian tube

  • Interstitial portion
  • Isthmus
  • Ampulla
  • Infundibular portion
• Fallopian tubes


  • Arise from each upper corner of the uterine body
  • Extend outward and backward until each opens at its distal end, next to an ovary
  • Approximately 10 cm long in a mature woman
  • Function is to convey the ovum from the ovaries to the uterus and provide a place for fertilization
• Uterus

  Hollow, muscular, pear-shaped organ located in the lower pelvis<|>Receives the ovum from the fallopian tube, provides a place for implantation and nourishment, furnishes protection to a growing fetus, and expels the fetus at maturity
• Anatomical divisions of the uterus


  • Body or corpus
  • Isthmus
  • Cervix
• Uterine wall

  • Endometrium (inner layer of mucous membrane)
  • Myometrium (middle layer of muscle fibers)
  • Perimetrium (outer layer of connective tissue)
• Endometrium


  Consists of two layers of cells: basal layer (stable) and glandular layer (influenced by hormones)
• Endocervix


  Mucous membrane that lines the cervix, also affected by hormones
• Internal cervical os

  The distal opening to the vagina
• External cervical os


  The level of the external os is at the level of the ischial spines
• Uterine wall layers

  • Endometrium (inner layer of mucous membrane)
  • Myometrium (middle layer of muscle fibers)
  • Perimetrium (outer layer of connective tissue)
• Endometrium


  Consists of two layers of cells, the basal layer remains stable and the glandular layer is influenced by hormones
• Endocervix


  The mucous membrane that lines the cervix, affected by hormones and secretes mucus
• Cervix lining


  Lower outer surface and internal cervical canal are lined with stratified squamous epithelium, similar to vagina
• Myometrium


  Composed of three interwoven layers of smooth muscle, offers strength to the uterus, constricts fallopian tubes and cervix
• Perimetrium


  Outermost layer of the uterus, adds further strength and support
• Uterine blood supply

  1. Descending abdominal aorta divides to form iliac arteries, then hypogastric and uterine arteries

  2. Ovarian artery joins uterine artery to add more blood

  3. Vessels "unwind" and stretch as uterus enlarges in pregnancy