2. FEMALE REPRODUCTIVE SYSTEM
INTRODUCTION
The female reproductive system is made up of the internal
and external sex organs that function in reproduction of
new offspring. In humans, the female reproductive system is
immature at birth and develops to maturity at puberty to be
able to produce gametes, and to carry a foetus to full term.
The reproductive tract in women is contained mainly in the
pelvic cavity.
3. DIVISION
The female reproductive system is divided to;
EXTERNALGENITALIA
Mons pubis
Labia majora
Labia minora
Clitoris
Urethral opening
Vaginal opening
Perineum
INTERNAL GENITALIA
Vagina
Cervix
Uterus
Fallopian tubes
Ovaries
6. Mons Pubis:
The mons pubis is the rounded eminence, made by fatty tissue
beneath the skin, lying in front of the pubic symphysis.
It is the triangular mound of fatty tissue that covers the pubic
bone.
It protects the pubic symphysis.
A few fine hairs may be present in childhood; later, at puberty,
they become coarser and more numerous. The upper limit of the
hairy region is horizontal across the lower abdomen.
7. Labia Majora:
The vulva is bounded on each side by the elevation of skin and
subcutaneous tissue which form the labia majora.
These are the outer lip like structure and have a darker
pigmentation.
CHARACTERISTICS:
i. It protects the introitus and the urethral opening.
ii. These are covered with hair and sebaceous glands.
iii. They become flaccid with age and after child birth.
8. Labia Minora:
They are two thin folds of skin, devoid of fat, on either side just
within the labia majora. Except in the parous women, they are
exposed only when the labia majora are separated.
The folds contain connective tissues, numerous sebaceous glands,
erectile muscle fibers and numerous vessels and nerve endings.
They are more sensitive and responsive to touch than labia
majora.
9. Clitoris:
It is a small cylindrical erectile body, measuring about 1.5–2
cm situated in the most anterior part of the vulva.
Highly sensitive organ composed of nerves, blood vessels and
erectile tissue.
It is made up of a shaft and a glans.
Becomes engorged with blood during sexual stimulation.
Urethral opening is located directly below the clitoris.
10. Urethral Opening:
The opening is situated in the midline just in
front of the vaginal orifice about 1–1.5 cm
below the pubic arch.
The paraurethral ducts open either on the
posterior wall of the urethral orifice or directly
into the vestibule.
11. Vaginal Opening/ Introitus:
The vaginal orifice lies in the posterior end of the vestibule and is of
varying size and shape.
In virgins and nulliparae, the opening is closed by the labia minora, but
in parous, it may be exposed.
It is incompletely closed by a septum of mucous membrane, called
hymen. The membrane varies in shape but is usually circular or
crescentic in virgins.
Posterior to the vaginal opening are the two Bartholin’s glands.
Skene’s glands are the largest paraurethral glands. The two Skene’s
ducts may open in the vestibule on either side of the external urethral
meatus.
12. Perineum:
It is the muscle and tissue located between the
vaginal opening and anal canal.
It supports and surrounds the lower parts of the
urinary and digestive tracts.
The perineum contains an abundance of nerve
endings that make it sensitive to touch.
15. Vagina
It is a distensible fibromuscular tube that extends from the perineum through
the pelvic floor and into the pelvic cavity.
It measures approximately 8-12cm in length.
It extends from the vestibule to the uterus, and is situated behind the bladder
and infront of the rectum.
It is directed upward and backward.
Its axis forming with that of the uterus an angle of over 90 degree, opening
forward.
The vaginal pH, from puberty to menopause, is acidic. The pH varies with
the estrogenic activity and ranges between 4 and 5.
16. BLOOD SUPPLY:
The blood supply to the vagina is from the vaginal
(branch of the internal iliac artery) and the vaginal
of the uterine artery.
LYMPHATIC DRAINAGE:
Lymph from the upper vagina drains into the internal
and external iliac nodes.
Lymph from the lower vagina drains to the superficial
inguinal nodes.
17. Cervix
The cervix is composed mainly of fibrous connective tissues.
The smooth muscle fibers average 10–15%. Only the posterior
surface has got peritoneal coat.
Mucous coat lining the endocervix is simple columnar with basal
nuclei and that lining the gland is non-ciliated secretory columnar
cells.
The vaginal part of the cervix is lined by stratified squamous
epithelium.
The squamocolumnar junction is situated at the external os.
19. Characteristics
The uterus is a hollow pyriform muscular organ situated in the pelvis
between the bladder in front and the rectum behind.
POSITION:
Its normal position is one of the anteversion and anteflexion. The uterus
usually inclines to the right (dextrorotation) so that the cervix is directed to
the left (levorotation) and comes in close relation with the left ureter.
MEASUREMENTS AND PARTS:
o The uterus measures about 8 cm long, 5 cm wide at the fundus and its walls
are about 1.25 cm thick. Its weight varies from 50 gm to 80 gm.
20. It has got the following parts:
Body or corpus
Isthmus
Cervix
Body or corpus: The body is further divided into fundus—the part which lies above the
openings of the uterine tubes. The body proper is triangular and lies between the openings of
the tubes and the isthmus.
Isthmus is a constricted part measuring about 0.5 cm, situated between the body and the
cervix.
Cervix is cylindrical in shape and measures about 2.5 cm. It extends from the isthmus and
ends at the external os which opens into the vagina after perforating its anterior wall.
Parts of uterus
21. The wall consists of three layers from outside inwards –
• Parametrium
• Myometrium
• Endometrium
BLOOD SUPPLY:
Arterial supply — The blood supply is from the uterine arteries one on each side.
Veins: The venous channels correspond to the arterial course and drain into internal iliac veins.
22. Fallopian Tubes ( uterine tubes/oviducts)
The uterine tubes are paired structures, measuring about 10 cm and are
situated in the medial three-fourth of the upper free margin of the broad
ligament.
PARTS:
There are four parts. From medial to lateral are—(1) intramural or interstitial
lying in the uterine wall and measures 1.25 cm in length and 1 mm in diameter,
(2) isthmus—almost straight and measures about 3–4 cm in length and 2 mm in
diameter, (3) ampulla—tortuous part and measures about 5 cm in length which
ends in, (4) wide infundibulum measuring about 1.25 cm long with a maximum
diameter of 6 mm.
23. FUNCTIONS:
The important functions of the tubes are—
(1) Transport of the gametes,
.(2) To facilitate fertilization and survival of zygote through its secretion.
BLOOD SUPPLY:
Arterial supply is from the uterine and ovarian. Venous drainage is through
the pampiniform plexus into the ovarian veins.
LYMPHATICS:
The lymphatics run along the ovarian vessels to para-aortic nodes.
24. Ovaries:
The ovaries are paired sex glands or gonads in female which are concerned for
(i) germ cell maturation, storage and its release and
(ii) steroidogenesis.
Each gland is oval in shape and pinkish gray in color and the surface is scarred
during reproductive period.
It measures about 3 cm in length, 2 cm in breadth and 1 cm in thickness. Each
ovary presents two ends—tubal and uterine, two borders—mesovarium and
free posterior and two surfaces—medial and lateral.
25. BLOOD SUPPLY: Arterial supply is from the ovarian artery, a branch of the
abdominal aorta. Venous drainage is through pampiniform plexus, to form
the ovarian veins which drain into inferior vena cava on the right side and
left renal vein on the left side. Part of the venous blood from the placental
site drains into the ovarian veins and thus may become the site of
thrombophlebitis in puerperium.
LYMPHATICS: Through the ovarian vessels drain to the para-aortic lymph
nodes.
NERVE SUPPLY: Sympathetic supply comes down along the ovarian
artery from T10 segment. Ovaries are sensitive to manual squeezing.