1. Female Reproductive System
CHAPTER 17
Female Reproductive System

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

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

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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

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

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

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

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

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

25. 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

26. 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

27. 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

28. 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

29. Forms of Contraception
Tubal Ligation

30. 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

31. 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

32. Permanent Methods of Birth Control
Vasectomy

33. PATHOLOGICAL CONDITIONS
Female
Reproductive System

34. 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

35. 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

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

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

38. 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

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

40. 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

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

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

43. 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

44. 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

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

46. 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

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

48. DIAGNOSTIC TECHNIQUES, TREATMENTS AND PROCEDURES
Female
Reproductive System

49. 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

50. 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

51. 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

52. 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

53. 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

54. 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

55. 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

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

57. 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

58. 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

59. 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

60. 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

61. 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