Female Reproductive System CHAPTER 17 Female Reproductive System

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

External Genitalia Mons pubis Labia majora 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

External Genitalia Labia minora Bartholin’s glands 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

External Genitalia Clitoris Urinary orifice 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

External Genitalia Vaginal orifice Perineum 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

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

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

Internal Genitalia Uterus Three identifiable portions Fundus Body Small dome-shaped upper portion Body Central portion Cervix Narrower, necklike portion at lower end

Internal Genitalia Wall of uterus contains three layers Perimetrium Outermost serous membrane layer Myometrium Middle, muscular layer Endometrium Innermost layer, highly vascular

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

Internal Genitalia 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

Mammary Glands (Breasts) 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

Mammary Glands (Breasts) 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

Mammary Glands (Breasts) Tissues of the breasts Adipose Connective Glandular Lactiferous ducts Narrow tubular structures of the breast that transport milk to the nipple for breastfeeding

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

Puberty and the Menstrual Cycle Period of life at which the ability to reproduce begins Female reproductive organs are fully developed Secondary sex characteristic changes occur

Puberty and the 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

Puberty and the 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

Common Signs and Symptoms Amenorrhea Absence of menstrual flow Dysmenorrhea Painful menstrual flow Menorrhagia Abnormally long or very heavy menstrual periods

Common Signs and Symptoms Metrorrhagia Uterine bleeding at times other than the menstrual period Oligomenorrhea Abnormally light or infrequent menstruation

Forms of Contraception Abstinence Abstaining from having vaginal intercourse Advantage: 100 percent effective

Forms of Contraception Oral contraceptives Birth control pills Contain synthetic forms of the hormones, estrogen and progesterone Advantages Disadvantage

Forms of Contraception Depro-Provera injection Form of contraception administered intramuscularly, approximately once every 12 weeks Advantages Disadvantages

Forms of Contraception Intrauterine device Small plastic T-shaped device inserted into the uterus to prevent implantation of an ovum into the uterus Advantages Disadvantages

Forms of Contraception 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

Forms of Contraception 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

Forms of Contraception 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

Forms of Contraception Tubal Ligation

Forms of Contraception 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

Forms of Contraception Permanent methods of birth control Vasectomy Male sterilization Surgically cutting and tying the vas deferens to prevent passage of sperm Prevents pregnancy

Permanent Methods of Birth Control Vasectomy

PATHOLOGICAL CONDITIONS Female Reproductive System

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

Cervical Carcinoma Pronounced Defined (SER-vih-kal car-sin-OH-mah) Malignant tumor of the cervix Symptoms include bleeding between menstrual periods, after sexual intercourse, after menopause, and an abnormal Pap smear

Cervicitis Pronounced Defined (ser-vih-SIGH-tis) Acute or chronic inflammation of the uterine cervix

Cystocele Pronounced Defined (SIS-toh-seel) Herniation or downward protrusion of the urinary bladder through the wall of the vagina

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

Endometriosis Pronounced Defined (en-doh-mee-tree-OH-sis) Presence and growth of endometrial tissue in areas outside the endometrium Lining of the uterus

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

Fibroid Tumor Pronounced Defined (FIGH-broyd tumor) A benign, fribous tumor of the uterus

Leiomyoma Pronounced Defined (ligh-oh-my-OH-mah) Benign, smooth muscle tumor of the uterus

Ovarian Carcinoma Pronounced Defined (oh-VAY-ree-an car-sin-OH-mah) Malignant tumor of the ovaries, most commonly occurring in women in their 50s Rarely detected in early stage

Ovarian Cysts Pronounced Defined (oh-VAY-ree-an SISTS) Benign, globular sacs (cysts) that form on or near the ovaries May be fluid filled or may contain semisolid materials

Pelvic Inflammatory Disease (PID) Pronounced (PELL-vik in-FLAM-mah-toh-ree dih-ZEEZ) Defined Infection of the fallopian tubes Salpingitis

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

Vaginitis Pronounced Defined (vaj-in-EYE-tis) Inflammation of the vagina and the vulva

DIAGNOSTIC TECHNIQUES, TREATMENTS AND PROCEDURES Female Reproductive System

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

Diagnostic Techniques, Treatments, and Procedures 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

Diagnostic Techniques, Treatments, and Procedures 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

Diagnostic Techniques, Treatments, and Procedures 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

Diagnostic Techniques, Treatments, and Procedures 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

Diagnostic Techniques, Treatments, and Procedures 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 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

Diagnostic Techniques, Treatments, and Procedures Laparosopy Process of viewing the abdominal cavity with a laparoscope

Diagnostic Techniques, Treatments, and Procedures 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

Diagnostic Techniques, Treatments, and Procedures 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

Diagnostic Techniques, Treatments, and Procedures 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

Diagnostic Techniques, Treatments, and Procedures 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

Diagnostic Techniques, Treatments, and Procedures 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