1. The Female
Reproductive
System
Health Science 1

2. 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

3. 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.

4. Frontal Outside View

5. 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

6. 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)

7. Side View

8. 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

10. 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 ovulation (graafian follicle ruptures) egg released into fallopian tube
Premenstral Phase: Day 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 ovulation (graafian follicle ruptures) egg now in fallopian tube
middleschmerz – pain sometimes felt midcycle
Day 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

12. 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

13. 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

14. 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

15. 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

17. 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