1. Chapter 28 Lecture Outline
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2. Female Reproductive System
Reproductive Anatomy
*Puberty and Menopause
*Oogenesis and the Sexual Cycle
Female Sexual Response
Pregnancy and Childbirth
Lactation

3. Female Reproductive System
Produce and deliver gametes
Provide nutrition and room for fetal development
Give birth
Nourish infant

4. *Ovary Produces eggs and hormones
almond-shaped, 3 cm x 1.5 cm x 1 cm
tunica albuginea capsule like on testes
cortex produces gametes; medulla holds vessels
Each egg develops in its own fluid-filled follicle and is released by ovulation
Ligaments
attached to uterus by ovarian ligament
attached to pelvic wall by suspensory ligament
contains ovarian artery, vein and nerves
anchored to broad ligament by mesovarium

5. *Anatomy of Ovary

6. Uterine (Fallopian) Tubes
10 cm long, muscular tube lined with ciliated cells
Major portions
narrow isthmus near uterus
body (ampulla): middle portion
flares distally into infundibulum with fimbriae
Enclosed in superior margin of broad ligament (mesosalpinx)

7. Uterus
Thick-walled, pear-shaped muscular chamber that opens into vagina and tilts forward over urinary bladder
internal and external os of cervical canal
openings into uterine tubes in two upper corners
Domed fundus above body of organ

8. Histology of Uterine Wall
Perimetrium - external serosa layer
Myometrium - middle muscular layer
1.25 cm thick in nonpregnant uterus
smooth muscle
produces labor contractions, expels fetus
Endometrium
simple columnar epithelium with thick layer compound tubular glands
stratum functionalis – superficial, shed each period
stratum basalis - deep layer, regenerates a new stratum functionalis with each menstrual cycle

9. Normal/Abnormal PAP Smears

10. Breast Cancer 1 out of 8 American women
Tumors begin with cells from mammary ducts
may metastasize by lymphatics
Symptoms may include palpable lump, skin puckering, skin texture and drainage from nipple
Most breast cancer is nonhereditary
some stimulated by estrogen
Risk factors include
aging, ionizing radiation, carcinogenic chemicals, alcohol, smoking and fat intake
70% lack risk factors

11. *Puberty Begins at age 9-10 (US) Triggered by rising levels of GnRH
stimulates anterior lobe of pituitary to produce
follicle-stimulating hormone (FSH)
luteinizing hormone (LH)
Follicles develop and begin to secrete estrogen and progesterone

12. *Puberty Thelarche - development of breasts
Pubarche - growth of pubic and axillary hair; apocrine and sebaceous glands
Menarche - first menstrual period
requires at least 17% body fat in teenager, 22% in adult
leptin stimulates gonadotropin secretion
improved nutrition ( body fat) has lowered avg. age of onset to 12
Female hormones secreted cyclically and in sequence

13. Climacteric Midlife change in hormone secretion Results
due to age related depletion of follicles
occurs with menopause (cessation of menstruation); average age of 52
Results
atrophy of uterus, vagina and breasts
skin becomes thinner, bone mass declines, and risks of cardiovascular disease increase
hot flashes (sudden dilation of cutaneous arteries) occur several times a day
HRT = hormone replacement therapy

14. *Oogensis and Sexual Cycle
Reproductive cycle - events occurring between fertilization and birth
Sexual cycle - events recurring every month when pregnancy does not occur
ovarian cycle = events in ovaries
menstrual cycle = parallel changes in uterus

15. *Oogenesis Monthly event produces haploid egg by meiosis
Embryonic development of ovary
female germ cells arise from yolk sac
differentiate into oogonia, multiply
transform into primary oocytes - early meiosis I
most degenerate (atresia) by childhood
by puberty 400,000 oocytes remain
FSH stimulates completion of meiosis I, produces secondary oocyte and 1st polar body
proceeds to meiosis II and ceases until fertilization
after fertilization , releases 2nd polar body

16. *Oogenesis and Follicle Development

17. *Sexual Cycle Averages 28 days, ranges from 20 to 45
Hormone cycle: hierarchy of control
hypothalamus pituitary  ovaries  uterus
Follicular phase (2 weeks)
menstruation occurs during first 3 to 5 days of cycle
uterus replaces lost endometrium and follicles grow
Luteal phase (2 weeks)
corpus luteum stimulates endometrial thickening
endometrium lost without pregnancy

18. *Ovarian Cycle - Follicular Phase
Menstruation (day 1) to ovulation(14) (variable)
Difficult to predict date of ovulation
Contains menstrual and preovulatory phases

19. *Ovarian Cycle - Preantral Phase
Discharge of menstrual fluid (days 1-5)
Before follicle develops antrum
primordial and primary follicles

20. *Ovarian Cycle - Antral Phase
Day 6 to 14, one dominant follicle advances to mature (graafian) follicle; secretes estrogen

21. *Ovarian Cycle - Ovulation
Mature follicle ruptures, releases oocyte influenced by LH

22. Histology of Ovarian Follicles

23. *Pituitary-Ovarian Axis

24. *Ovarian Cycle - Luteal Phase
Corpus luteum - forms from ruptured follicle, under influence of LH; secretes progesterone

25. *Menstrual Cycle - Proliferative Phase
Day 6-14 rebuild endometrial tissue
mitosis occurs in stratum basalis
result of estrogen from developing follicles

26. *Menstrual Cycle - Secretory Phase
Further thickening of endometrium due to secretion and fluid accumulation -- not mitosis
Due to progesterone stimulation of glands

27. *Menstrual Cycle Premenstrual Phase
Involution of corpus luteum, progesterone falls
spiral arteries constrict causes endometrial ischemia
stratum functionalis sloughs

28. *Menstrual Cycle - Menstrual Phase
Blood, serous fluid and endometrial tissue are discharged

29. Pregnancy and Childbirth
Gestation (pregnancy)
lasts an average of 266 days from conception to childbirth
gestational calendar measured from first day of the woman’s last menstrual period (LMP)
Birth predicted 280 days from LMP
3 three month intervals called trimesters

30. Prenatal Development Age based terminology
blastocyst is less than 2 weeks old
embryo is from 2 to 8 weeks old
fetus is 9 weeks to birth
neonate - newborn to 6 weeks

31. *Hormones of Pregnancy
HCG (human chorionic gonadotropin)
secreted by trophoblast within 9 days of conception
prevents involution of corpus luteum
Estrogens
increases to 30 times normal before birth
corpus luteum is source for first 12 weeks until placenta takes over
causes uterine, mammary duct and breast enlargement

32. *Hormones of Pregnancy
Progesterone
secreted by placenta and corpus luteum
suppresses secretion of FSH and LH preventing follicular development
prevents menstruation, thickens endometrium
stimulates development of acini in breast
HCS (human chorionic somatomammotropin)
secreted from placenta in direct proportion to its size
 mother’s glucose usage and  release of fatty acids

33. *Hormones of Pregnancy
Aldosterone secretion rises
fluid retention  mother’s blood volume
Endocrine organs
thyroid gland increases 50% in size
 BMR of mother
parathyroid glands enlarge
stimulate osteoclasts to release additional calcium from mother’s bones

34. *Hormone Levels and Pregnancy

35. *Labor Contractions Self-amplifying cycle of stretch and contraction
positive feedback cycles increase contractions
cervical stretching  oxytocin secretion  uterine contraction  repeat
reflex arc from uterus  spinal cord  abdominal skeletal muscles

36. *Mammary Gland Development
Lactation
synthesis and ejection of milk from mammary glands in breast
Ducts grow and branch
due to high estrogen levels in pregnancy
Followed by budding and development of acini at the ends of the ducts
due to progesterone

37. *Colostrum and Milk Synthesis
Colostrum forms in late pregnancy
similar to breast milk; contains 1/3 less fat, thinner
first 1 to 3 days after birth
contains IgA protection from gastroenteritis
Synthesis is promoted by prolactin (from pituitary)
synthesis of hormone begins 5 weeks into pregnancy, by full term it is 20x normal level
steroid hormones from placenta oppose it until birth

38. *Colostrum and Milk Synthesis
At birth, prolactin secretion drops, but  20 times after nursing
without nursing, milk production stops in 1 week
5-10% of women become pregnant while nursing
inhibition of GnRH and reduced ovarian cycling

39. *Milk Ejection Controlled by a neuroendocrine reflex
infant’s suckling stimulates sensory receptors in nipple, signaling hypothalamus and posterior pituitary to release oxytocin
oxytocin stimulates myoepithelial cells
Myoepithelial cells surround secretory cells in acinus
contract to squeeze milk into duct
milk flow within seconds after suckling begins

40. Contraceptive Devices