The Female Reproductive System Health Science 1

What is the purpose? The female reproductive system enables a woman to: produce eggs (ova) the women’s sex cells protect and nourish the fertilized egg until it is fully developed Reproduce and give birth

Outside Structures Vulva: The external part of the female reproductive organs The labia (lips) are two pairs of skin flaps surround the vaginal opening. The labia minora The labia majora are two outer flaps of tissue that sorround the labia minora and the opening of the vagina. Clitoris: an organ of sensitive erectile tissue located anterior to the urinary meatus. Urethra (the canal that carries urine from the bladder to the outside of the body) is located between the labia as well as the opening to the vagina. Perineum: region between the vaginal opening and the anus Bartholin glands: 2 small glands on either side of vaginal orifice Perineum: area where an episiotomy is performed Hymen: mucous membrane partially covering the entrance to the vagina. Some girls who are still virgins have no hymen at all. Girls who do have a hymen can "break (or pop) their cherry" in a number of differerent ways, sometimes without even knowing it. Some of the non-sexual ways in which a hymen will tear are: 1. Through an accident or injury 2. Horseback riding, bicycling, high jumping, or gymnastics 3. Insertion of finger or instrument by doctor during pelvic exam 4. Tampon insertion 5. Overzealous douching Sex and the Hymen Sexual methods of "deflowering" a girl (another euphemism for rupturing the hymen) include: 1. Inserting a finger deeply or roughly into the vagina 2. Masturbation with a phallic-shaped vibrator or other such tool 3. Sexual intercourse While the presence of a hymen indicates virginity, the absence of a hymen is does not prove a girl is not a virgin.

Frontal Outside View

The Vagina, Cervix and Uterus Vagina: a fibro muscular tube that connects from the cervix to the outside of the vulva. Cervix: the lower portion of the uterus that opens into the vagina. Uterus: a hollow, pear shaped organ with a muscular wall and a lining. 3 layers; endometrium, myometrium and uterine serosa Upper portion:fundus Endometrium: implantation takes place (inner most layer) Myometrium: muscle Serosa: outermost layer Bent-forward position. 3 inches long in a non pregnant woman Cul-de –sac: space between the uterus and the rectum, in the abdominal cavity. MD looks for cancer here, also check for blood to determine an ectopic pregnancy

The Fallopian Tubes and The Ovaries Fallopian Tubes: funnel shaped passages to the ovaries about 10 cm long. Fimbriae: finger like structures at the end near the ovaries Ovaries: main reproductive organs of women about the shape/size of an almond. produce hormones; estrogens and progesterone contains graafian follicles, which contain an ovum. Ovum released during ovulation Corpus luteum (yellow body)

Side View

Breasts Accessory organ of reproduction Mammary glands Glandular tissue (contain milk glands) Fibrous and fatty tissue Lactiferous ducts (milk ducts) Mammary papilla (nipple) Areola- dark pigmented area

Phases of the Menstrual Cycle Menstral Phase: Day 1-5 Bloody discharge Post-menstral Phase: Day 6-12 endometrial repair (increase in estrogen) Ovulatory Phase: Day 13-14 ovulation (graafian follicle ruptures) egg released into fallopian tube Premenstral Phase: Day 15-28 empty graafian follicle fills with corpus luteum, secretes progesterone and estrogen to build lining of endometrium for implantation; no fertilization, hormone levels change to cause breakdown of the endometrium - menses Day 6-12 endometrial repair (increase in estrogen) ovum grows in graafian follicle during this period Day 13-14 ovulation (graafian follicle ruptures) egg now in fallopian tube middleschmerz – pain sometimes felt midcycle Day 15-28 empty graafian follicle fills with corpus luteum, secretes progesterone and estrogen to build lining of endometrium for implantation NO conception: corpus luteum stops producing progesterone and estrogen, PMS (moodiness, irritability, breast tenderness) 5 days and then menses The sloughing of this bloody tissue, or menses, lasts from 3 to 7 days Menarche 9 to 16 years old The menstrual cycle continues until 45 to 50 years of age

Disorders of the Reproductive System Cancer of the female reproductive system Breast, endometrial, cervical, ovarian Cervicitis: bacterial infection Chlamydia Caused by the bacteria Chlamydia trachomatis, is the most common sexually transmitted Endometriosis Growth of endometrial tissue in an area other than the uterus Cancer: Breast- Most common type is invasive ductal carcinoma Usually metastasize to lymph nodes first, skin, chest and then other organs Dx mammogram and biopsy Tx: lumpectomy, SNB sentinel node biopsy to check for lymph node involvement modified radical mastectomy Medication choice depends on presence of estrogen receptors (ER) Endometriosis: most common symptom is postmenopausal bleeding Risk group: exposure to estrogen, nulliparous women, obesity DX: D&C TX: Hysterectomy and Radiatin therapy Cervical: Risk group: early intercourse, multiple partners, STD and HPV PAP shows dysplasia Graded carcinoma in situ (CIS) localized Graded I-III TX biopsy, conization, hysterectomy, radiation Ovarian found in advanced stages often leading to death, metastisizes before pt. aware of symptoms, Tx oophorectomy, salpingectomy and chemo Cervicitis: bacterial infection, (Chlamydia and gonorrhea) raw red patched on cervix and leukorrhea Tx cryocauterization if no malignancy Chlamydia STD, symptoms sometimes not present, discharge, painful urination, etc. Tx antibiotics, without treatment infertility as scarring will occur Endometriosis: S?S dysmenorrhea, pelvic pain, infertility, tissue causes scarring, TX symptoms/ hysterectomy

Disorders Fibroid tumors Benign growths found in the uterus (leiomyomas) Ovarian Cysts: collection of fliud in a sac in the ovary PID: inflammation in pelvic region Fibrocystic disease: nodular consistency of the breast Genital warts Caused by one type of human papillomavirus Gonorrhea Bacterial infection and one of the most prevalent sexually transmitted diseases Herpes simplex virus One of the most common sexually transmitted diseases Fibroids (leiomyomata) if too large cause metrorrhagia, pelvic pain or menorrhagia. TX: hysterectomy/myomectomy CYSTS: Some normal (unruptured graafian follicles or ruptured that have sealed quickly) Some have tumor cells (cystadenocarcinomas) MD destinguish between the 2 and remove if needed. Dermoid cyst lined with human material such as skin, hair teeth and cartilage, Surgical removal PID; Leading cause STD’s, lead to adhesions and scarring in fallopian tubes. Vaginal discharge and pain. Tx with antibiotics FIBROCYSTIC DISEASE:often associated with PMS, mammogram and biopsy rule out carcinoma

Disorders Syphilis Trichomonas vaginalis Vaginitis Yeast infection Caused by a spirochete bacteria, Treponema pallidum Trichomonas vaginalis A parasitic protozoon Vaginitis A nonspecific infection Yeast infection An overgrowth of yeast in the vagina Other STDs described on pg 300

Clinical tests Pap smear: microscopic analysis of cervical cells Pregnancy Tests: Detect HCG in blood Hysterosalpingography: xray image of the uterus and fallopian tubes using contrast Mammography: xray image of the breast Ultrasound: sound waves produce an image Aspiration: withdraw fluid from a cavity

Procedures Cauterization: burning Colposcopy:view vagina and cervix Conization: remove cone shaped section of cervix Cryosurgery: freezing tissue Culdocentesis: remove fluid from cul de sac D&C: scrape endometrium Exenteration: remove internal organs Laparoscopy: view abdominal cavity Tubal ligation: sterilization procedure