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Female Reproductive System Female Pelvis (sagittal section) ureter common iliac artery & vein uterine tube uterine fundus uterine cavity recto-uterine pouch (cul de sac/Douglas’ sac) vesico-uterine pouch urinary bladder urethra mons pubis clitoris labium minus labium majus posterior fornix cervix rectum vagina anus introitus vaginalis https://www.youtube.com/watch?v=qCLmR9YY7o Oogenesis • Mitosis of oogonia during fetal life produces a diploid primary oocyte • Meiosis I begins before birth, it won’t be completed until the girl reaches puberty. • Meiosis I is completed after puberty, it produces a secondary oocyte and a first polar body, both are haploid cells. • Secondary oocyte is ovulated in metaphase of meiosis II, process will be completed if fertilization occurs; at completion of meiosis II the mature gamete (a haploid cell) is ready to fuse with the male gamete (also a haploid cell); a second polar body is produced. Fertilization will produce a diploid cell, the Conceptus or Zygote. Oogenesis, Ovulation Ovulation • Each almond-sized ovary hosts 100.000 to 200.000 primordial follicles • During each ovarian cycle several of these primary follicles develop into secondary follicles • Eventually one secondary follicle develops into a tertiary follicle a.k.a. “Graafian follicle” “containing an oocyte. • The follicular sac ruptures releasing the oocyte (ovum), this event called “Ovulation” • After ovulation the empty follicle becomes a gland called Corpus Luteum that secretes progesterone and also moderate amounts of estrogen. Progesterone plays an important role in the preparation of the uterus for pregnancy • If the oocyte is not fertilized, the corpus luteum becomes an atretic structure named Corpus Albicans; the internal lining of the uterus (endometrium) sheds and is eliminated as part of the menses. Uterus, Oviducts, Ovaries Oviducts • The two uterine tubes called oviducts or Fallopian tubes have at their lateral ends fingerlike projections called fimbriae • These fimbriae sweep over the surface of the ovary and trap the ovum during ovulation bringing it toward the slightly expanded portion of the oviduct, called infundibulum • Once inside the oviducts, the ovum is moved toward the uterus by the tube peristalsis and the action of the cilia in the tubal lumen. • The oviducts widen along their length in the ampulla and then narrow at the isthmus, at their point of entrance to the uterus • Fertilization of the ovum usually occurs at the distal third of the tubes, the conceptus is then pushed toward the uterus. Uterus • A pear-shaped muscular sac, located between the urinary bladder and the rectum. • It is around 7.5 cm long and a maximum diameter of 5 cm and weights around 30-40 g • It consists of three major regions : • The fundus, the superior portion, located right over the level of entrance of the oviducts • The body, the most extense portion and the elongated cervix, its portion that shows at the vagina • In its normal position the uterus tilts anteriorly maintaining its cavity mostly aligned with the cervical canal and covering most of the superior and posterior portions of the urinary bladder. This usual bending uterine attitude is called anteversion and it is considered the normal position of the uterus. A) B) C) D) E) F) G) H) I) J) K) L) Uterine (Fallopian) tube Broad ligament Uterine fundus Uterine cavity Uterine body Uterine isthmus (segment) Uterine cervix Vaginal lateral fornices Introitus vaginalis External Os of cervix Cervical canal Internal Os of cervix C A Female Genitalia Anterior view B D A E B F L K G J V a g i n a H I Uterine Positions Anteverted (usual, “normal”) Retroverted: Abnormal, prone to prolapse Uterus • The tubular cervix projects into the vagina, the vaginal folds around the cervix are called each one a vaginal fornix. • The external cervical orifice, called external os communicates with the cervical canal which opens into the cavity of the uterus via an internal os. • The uterine body is the broadest part of the uterine cavity, the usual site for the implantation of the placenta during pregnancy and the area where the developing fetus resides. Uterus: Suspensory Ligaments • A double layered fold of peritoneum called the mesovarium holds the ovaries to the broad ligament of the uterus • The suspensory ligaments hold the ovaries to the pelvic wall • The ovarian ligaments hold the ovaries to the uterus • The round ligaments extend laterally from the ovaries and provide posterior support. The Uterine Wall • The uterine wall consists of three main tissue layers: • The perimetrium, the outer layer, is an extension of the visceral peritoneum and hence called a serosa. • The myometrium is the thick middle layer, composed of three layers of smooth muscle, responsible for the powerful contractions during labor • The endometrium is a double epithelial layer, its inner basilar zone produces a new functional zone each month. The outer functional zone is a very active glandular tissue able to support an implanted embryo. It sheds on every cycle and is discarded as part of the menses Vagina • An elastic, distensible muscular tube, around 7.5 -9 cm long extending from the cervix to the vestibule, a space bounded by the female external genitalia. • The shallow recess surrounding the protruding cervix is called the vaginal fornix • The vagina lies parallel to the rectum which is posterior to her. Anteriorly, the urethra extends along the superior end of the vagina to open in the area of the vestibule • The vagina has three major functions: • Serves as a passageway for the menses • Is the female copulatory organ • Forms the inferior portion of the birth canal The Vulva Female External Genitalia • The vulva includes the following structures: • Mons Pubis, a pad of adipose tissue over the pubic symphysis, usually covered by pubic hair • The labia majora, (singular: labium majus), two longitudinal folds of skin, extending from the pubis to the posterior angle of the vulva • The labia minora, (singular: labium minus), two small folds of skin covered internally by a mucosa, they extend longitudinally and guard the vestibule, the place where the vagina opens. • The clitoris, is a small cylindrical mass of erectile tissue, the analogous of the penis; it also has a prepuce covering its distal tip called the glans • The entrance to the vagina, the introitus vaginalis is often covered by an elastic epithelial fold called the hymen • The female urethral opening, located at the vulvar vestibule, close to the anterior wall of the vagina, midway between the clitoris and the introitus vaginalis. Para-urethral exocrine glands (Skene’s glands) surround the female urethra. Female Mammary Gland • The female mammary glands are modified sweat glands. They complete their anatomical development at puberty, under the stimulus of estrogens. • Fat deposition is the main contributor to the size of the breast, and its size is not related with the capacity of the organ to produce milk for lactation of the offspring. • Each gland consists of 15 to 20 lobes of glandular tissue separated by fat and connective tissue. Each lobe contains smaller lobules formed of milk-secreting cells called alveoli. • Lactiferous ducts drain milk from the lobules toward the lactiferous sinuses. These sinuses empty the milk to a raised portion of the breast called the nipple. • A circular pigmented area of skin called the areola surrounds the nipple. Breast Breast Quadrants Frequency of breast cancer by quadrant: Upper outer : 50% Upper inner: 15% Lower outer: 11% Lower inner: 6% Areolar area: 18%