female reproductive system chapter 17. 2 female reproductive system overview purpose of female...

Female Reproductive System

CHAPTER 17

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Female Reproductive System Overview• Purpose of female reproductive system

– Reproduction– Secretes hormones that support secondary

sex characteristic changes– Secretes hormones that sustain pregnancy

should fertilization occur

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External Genitalia

• Mons pubis– Fatty tissue that covers and cushions

symphysis pubis• Labia majora

– Two folds of skin containing fatty tissue and covered with hair• Located on either side of the vaginal opening,

extending from the mons pubis to the perineum

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External Genitalia• Labia minora

– Two thin folds of tissue located within the folds of the labia majora• Extends from the clitoris downward toward the

perineum

• Bartholin’s glands– Located on either side of the vaginal orifice

• Secrete a mucous substance that lubricates the vagina

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External Genitalia• Clitoris

– Short, elongated organ composed of erectile tissue

– Located just behind the upper junction of the labia minora

– Homologous to the penis • Urinary orifice

– Not true part of female reproductive system, but part of the vulva

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External Genitalia• Vaginal orifice

– Located in lower portion of the vestibule, below the urinary meatus

– Also known as the vaginal introitus• Perineum

– Area between vaginal orifice and anus– Consists of muscular and fibrous tissue and

serves as support for pelvic structures

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Internal Genitalia• Vagina

– Muscular tube that connects the uterus with the vulva• Rests between bladder (anteriorly) and rectum

(posteriorly)

– Stretchable folds of inner lining known as rugae• Capable of expanding during childbirth to

permit passage of baby’s head without tearing lining

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Internal Genitalia• Uterus

– Pear-shaped, hollow, muscular organ that houses the fertilized implanted ovum as it develops throughout pregnancy• Source of monthly menstrual flow if pregnancy

does not occur

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Internal Genitalia• Uterus

– Three identifiable portions• Fundus

– Small dome-shaped upper portion

• Body– Central portion

• Cervix– Narrower, necklike portion at lower end

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Internal Genitalia

• Wall of uterus contains three layers– Perimetrium

• Outermost serous membrane layer

– Myometrium• Middle, muscular layer

– Endometrium• Innermost layer, highly vascular

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Internal Genitalia

• Fallopian tubes– Also known as uterine tubes or oviducts– Serve as passageway for the ova as they exit

the ovary enroute to the uterus– Free end of each tube ends in fingerlike

projections called fimbriae• Fimbriated ends draw ovum into tube through

wavelike motions when ovum is released from ovary

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• Ovaries– Female sex cells = female gonads– Almond-shaped pair of ovaries, held in place

by ligaments– Responsible for:

• Producing mature ova and releasing them at monthly intervals

• Producing hormones necessary for normal growth and development of female

• Producing hormones necessary for maintaining pregnancy should it occur

Internal Genitalia

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Mammary Glands (Breasts)

• Mammary glands– Known as the breasts– Responsible for production of milk (lactation)– Consist of glandular tissue with supporting

adipose tissue and fibrous connective tissue, covered with skin

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• Structures of the breasts– Nipple

• Located at center of each breast• Consists of sensitive erectile tissue

– Areola• Darker pigmented area surrounding the nipple• Montgomery’s tubercles

– Small sebaceous glands present in areola

MammaryGlands (Breasts)

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• Tissues of the breasts– Adipose – Connective – Glandular

• Lactiferous ducts– Narrow tubular structures of the breast that

transport milk to the nipple for breastfeeding

Mammary Glands (Breasts)

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Female Pelvis• Landmarks of the pelvis

– True pelvis boundaries– Sacrum, coccyx, pubic bone, ischial spines– Serve as reference points for measuring

across pelvic outlet from varying angles– Measurement determines size of pelvic

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Puberty and the Menstrual Cycle

• Puberty– Period of life at which the ability to reproduce

begins– Female reproductive organs are fully

developed– Secondary sex characteristic changes occur

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• Menstrual cycle– Menstrual Phase

• Days 1 – 5• Menstrual flow occurs on day one and last for 3 to

5 days– Postmenstrual Phase

• Days 6 – 12• Interval between menses and ovulation


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• Menstrual cycle – Ovulatory Phase

• Days 13 – 14• Graafian follicle ruptures, releasing mature

ovum into pelvic cavity = ovulation– Premenstrual Phase

• Days 15 – 28• Phase between ovulatory phase and onset of

menstrual flow


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• Amenorrhea– Absence of menstrual flow

• Dysmenorrhea– Painful menstrual flow

• Menorrhagia– Abnormally long or very heavy menstrual

periods

Common Signs and Symptoms

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• Metrorrhagia– Uterine bleeding at times other than the

menstrual period• Oligomenorrhea

– Abnormally light or infrequent menstruation

Common Signs and Symptoms

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Forms of Contraception

• Abstinence– Abstaining from having vaginal intercourse– Advantage:

• 100 percent effective

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Forms of Contraception • Oral contraceptives

– Birth control pills– Contain synthetic forms of the hormones,

estrogen and progesterone• Advantages• Disadvantage

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• Depro-Provera injection– Form of contraception administered

intramuscularly, approximately once every 12 weeks• Advantages• Disadvantages


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• Intrauterine device– Small plastic T-shaped device inserted into

the uterus to prevent implantation of an ovum into the uterus• Advantages• Disadvantages


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• Birth control patch– Thin, flexible square skin patch that

continuously delivers hormones into the bloodstream for a full seven days to prevent pregnancy• Advantages• Disadvantages

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• Barrier methods– Methods of birth control that place physical

barriers between the cervix and the sperm– Sperm cannot pass the cervix and enter the

uterus, and thus the fallopian tubes– Examples:

• Spermicidal jellies and creams• Condoms• Diaphragms


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• Permanent methods of birth control– Tubal ligation– Surgically cutting and tying the fallopian tubes

to prevent passage of ova or sperm through the tubes• Prevents pregnancy• Known as female sterilization


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Tubal Ligation


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• Permanent methods of birth control• Micro-insert system

• Alternate to tubal ligation• Provides bilateral occlusion of fallopian tubes by

inserting a soft, flexible micro-insert into each fallopian tube

• Requires no incisions and can be performed without general anesthesia

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• Permanent methods of birth control – Vasectomy– Male sterilization– Surgically cutting and tying the vas deferens

to prevent passage of sperm• Prevents pregnancy


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Permanent Methods of Birth Control

Vasectomy

PATHOLOGICAL CONDITIONS

Female

Reproductive System

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Carcinoma of the Breast

• Pronounced– (car-sin-OH-mah of the breast)

• Defined– Malignant tumor of the breast tissue– Most common type (ductal carcinoma)

originates in the mammary ducts• Has ability to invade surrounding tissue if not

detected early enough

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Cervical Carcinoma• Pronounced

– (SER-vih-kal car-sin-OH-mah)• Defined

– Malignant tumor of the cervix• Symptoms include bleeding between menstrual

periods, after sexual intercourse, after menopause, and an abnormal Pap smear

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Cervicitis• Pronounced

– (ser-vih-SIGH-tis)• Defined

– Acute or chronic inflammation of the uterine cervix

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Cystocele• Pronounced

– (SIS-toh-seel)• Defined

– Herniation or downward protrusion of the urinary bladder through the wall of the vagina

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Endometrial Carcinoma

• Pronounced– (en-doh-MEE-tree-al car-sin-OH-mah)

• Defined– Malignant tumor of the inner lining of the

uterus– Also known as adenocarcinoma of the uterus

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Endometriosis• Pronounced

– (en-doh-mee-tree-OH-sis)• Defined

– Presence and growth of endometrial tissue in areas outside the endometrium • Lining of the uterus

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Fibrocystic Breast Disease

• Pronounced– (figh-broh-SIS-tik breast dih-ZEEZ)

• Defined– Presence of single or multiple fluid-filled cysts

that are palpable in the breasts• Cysts are benign and fluctuate in size with the

menstrual period

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Fibroid Tumor

• Pronounced– (FIGH-broyd tumor)

• Defined– A benign, fribous tumor of the uterus

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Leiomyoma

• Pronounced– (ligh-oh-my-OH-mah)

• Defined– Benign, smooth muscle tumor of the uterus

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• Pronounced– (oh-VAY-ree-an car-sin-OH-mah)

• Defined– Malignant tumor of the ovaries, most

commonly occurring in women in their 50s• Rarely detected in early stage

Ovarian Carcinoma

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Ovarian Cysts

• Pronounced– (oh-VAY-ree-an SISTS)

• Defined– Benign, globular sacs (cysts) that form on or

near the ovaries• May be fluid filled or may contain semisolid

materials

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Pelvic Inflammatory Disease (PID)

• Pronounced– (PELL-vik in-FLAM-mah-toh-ree dih-ZEEZ)

• Defined– Infection of the fallopian tubes– Salpingitis

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Stress Incontinence, Urinary

• Pronounced– STRESS in-CON-tin-ens YOO-rih-nair-ee)

• Defined– Inability to hold urine when the bladder is

stressed by sneezing, coughing, laughing, or lifting

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Vaginitis• Pronounced

– (vaj-in-EYE-tis)• Defined

– Inflammation of the vagina and the vulva

DIAGNOSTIC TECHNIQUES, TREATMENTS

AND PROCEDURES

Female

Reproductive System

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Diagnostic Techniques, Treatments, and Procedures

• Aspiration biopsy– Invasive procedure in which a needle is

inserted into an area of the body, such as the breast

– Withdraws tissue or fluid sample for microscopic examination and diagnosis

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• Breast self-examination– Procedure in which the woman examines her

breasts and surrounding tissue for evidence of any changes that could indicate the possibility of malignancy


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• Colposcopy– Visual examination of the vagina and cervix

with a colposcope• Lighted binocular microscope used for direct

examination of the surfaces of the vagina and cervix


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• Cone biopsy– Surgical removal of a cone-shaped segment of

the cervix for diagnosis or treatment• Also known as conization

• Cryosurgery– Destruction of tissue by rapid freezing with

substances such as liquid nitrogen


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• Culdocentesis– Surgical puncture through the posterior wall

of the vagina into the cul-de-sac to withdraw intraperitoneal fluid for examination• Checking for evidence of inflammation, purulent

drainage, bleeding, ovarian cysts, ectopic pregnancy, or ovarian malignancy


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• Dilation and Curettage–Dilatation or widening of the cervical

canal with a dilator, followed by scraping of the uterine lining with a curet

–Also termed D & C

Diagnostic Techniques,Treatments, and Procedures

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• Endometrial biopsy– Invasive test for obtaining a sample of

endometrial tissue with a small curet, for examination

• Hysterosalpingography– X-ray of the uterus and the fallopian tubes, by

injecting a contrast material into these structures


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• Laparosopy– Process of viewing the abdominal cavity with

a laparoscope


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• Loop Electrosurgical Excision Procedure (LEEP)– Procedure used to remove abnormal cells

from the surface of the cervix using a thin wire loop that acts like a scalpel• Painless electrical current passes through the loop

as it cuts away a thin layer of surface cells from the cervix


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• Mammography– Process of examining with x-ray the soft

tissue of the breast to detect various benign and/or malignant growths before they can be felt

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• Papanicolaou smear – Microscopic examination of cells scraped from

within the cervix, from around the cervix, and from the posterior part of the vagina to test for cervical cancer

– Pap Smear


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• Liquid-based pap (LBP)– Process of collecting a tissue sample from the

endocervix and the exocervix with a sampling device that is placed directly into a liquid fixative instead of being spread onto a glass slide• Process provides immediate fixation and improves

specimen adequacy

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• Pelvic ultrasound– Noninvasive procedure that used high-

frequency sound waves to examine the abdomen and pelvis

• Pelvimetry– Process of measuring the female pelvis,

manually or by x-ray, to determine its adequacy for childbearing


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