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Female reproductive system

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Female reproductive system

  1. 1. It is consists of • two ovaries, • two uterine tube, • the uterus, • the vagina and • the external genitalia. • Mammary glands are not part of the reproductive system but connected to the functional state of the reproductive system
  2. 2. • Shape: almond • Size : vertical: ant-pos: transverse= 3*1.5*1
  3. 3. •It is covered by Simple cuboidal epithelium
  4. 4. Positions of ovaries In nulliparous adult Below the pelvic brim, in the ovarian fossa The newborn Above the pelvic brim Multiparous female May prolapsed in the recto-uterine pouch Ectopic ovary In the inguinal canal or in the labium majus
  5. 5. Presenting parts of ovaries Parts Name of parts Relations Two ends Tubal ends Directed upwards and related with uterine tube and suspensory ligament uterine ends Directed below and related with the uterus and ligament of ovary Two borders Mesovarian border It is attached with the posterior layer of broad ligament posterior free border Related with ureter and internal iliac vessels Two surfaces Medial surface Related with the terminal parts of uterine tube lateral surface Rest on ovarian fossa
  6. 6. What is ovarian fossa? • It is a peritoneal depression of the lateral pelvic wall where lateral surface of ovaries are rest.
  7. 7. Boundaries of ovarian fossa • Above : external iliac vein • Behind : ureter and internal iliac vessels • Floor : obturator nerve and vessels • Above and in front : obliterated umbilical artery
  8. 8. Blood supply of the ovary Arterial supply Ovary Ovarian artery Uterine A
  9. 9. Venous drainage of ovaries Rt Lt IVC Left renal vein Pampiniform plexus
  10. 10. Lymphatic drainage of ovary Pre –aortic and para – aortic lymph node
  11. 11. Nerve supply of ovary • Mainly sympathetic system from T10 to T11 segment of spinal cord
  12. 12. Histology of ovaries Ovary is covered by simple cuboidal epithelium Cortex of ovary contains different stages of ovarian follicles Medulla of ovary is formed by loose connective tissue and blood and lymphatic vessels
  13. 13. • It is covered by germinal epithelim - simple cuboidal epithelium • Tunica albuginea: is a dense connective tissue under the germinal epithelium • Cortical region : contain ovarian follicles • Medullary region : contain a rich vascular bed within a loose connective tissue
  14. 14. Ovary of a woman of reproductive age showing its main components: germinal epithelium, tunica albuginea, cortical region, and medullary region.
  15. 15. Ovulation Release of secondary oocyte from graafian follicle .
  16. 16. When and why ovulation is occurred? • Takes place about 14th of menstral cycle in humans. • 2. Occurs in response to a peak in production of leutinizing hormone by cells called gonadotrophs that are located in the anterior lobe (pars distalis) of the pituitary gland.
  17. 17. During ovulation, oocyte and corona radiata released from graafian follicles Remaining portion of graafian follicle is formed corpus luteum
  18. 18. What is corpus luteum ? • It is a temporary endocrine glands • After ovulation remaining granulosa and theca cells of Graafian follicle increase in size and form corpus luteum . • Corpus luteum secrete progesterone and estrogens
  19. 19. What is corpus luteum of menstruation ? It fertilization and implantation don’t occur c.luteum remain active for only 14 days. 14days after ovulation c.luteum degenerates and form a white scar which is known as corpus albicans.
  20. 20. What is corpus luteum of pregnancy? • If fertilization and implantation occur the corpus luteum increases in size to form corpus luteum of pregnancy • Its degeneration prevent by human chorionic gonadotropin hormone which secreted from placenta. • C .luteum of pregnancy : it functions decline after 8 wk of pregnancy.
  21. 21. What is the function of ovary?
  22. 22. Uterine tube : The oviducts (also called uterine tubes or fallopian tubes)These tubes are about 10 cm long and extend to the ovaries. They are highly mobile due to a layer of smooth muscle in wall. The oviducts can be divided into 4 segments
  23. 23. Parts of uterine tube Length intermural portion (pars interstitialis) - portion of the oviduct that lies within the uterine wall, opens into the uterus at distal end. 1cm isthmus - portion of tube adjacent to uterus 3cm Narrowest part of u. tube ampulla - more dialated portion that extends to infundibulum 5cm Most dilated part of u. tube. Fertilization take place infundibulum - funnel shaped, next to ovary, has finger like processes called fimbria. 1cm Collect ovum
  24. 24. Lymphatic drainage • Intra-mural part drain into the superficial inguinal lymph notes • Rest of the parts drain into the pre-aortic and para-aortic LN
  25. 25. Nerve supply of uterine tube • Sympathetic: T10- L2 segments of spinal cord • Parasympathetic : lateral part: from vagus Medial part from pelvic splanchnic nerve
  26. 26. The wall of the oviduct has 3 layers A mucosa adjacent to the oviduct lumen. • a. Consists of long, longitudinal folds that are most numerous in the ampulla. • b. The mucosal epithelium is simple columnar and contains two types of cells. • * Columnar ciliated cells • * Secretory cells - peg cells. • 2. A muscularis - muscular layers • a. Inner circular and outer logitudinal layer of smooth muscle. • b. Only the inner circular layer is well developed. • 3. An outer serosa
  27. 27. Mammary gland • They are modified apocrine sweat glands • There are 15-20 lobes in each mammary glands • Types of gland: branched tubuloalveolar glands
  28. 28. Different parts of mammary glands • Nipple : an elevation where lactiferous ducts are opened • Areola : a dark stain area which surround the nipple. It contain sebaceous glands, sweat glands and glands of Montgomery. Beneath the areola lactiferous sinuses are present
  29. 29. Composition of mammary glands It has two parts • Parenchyma: Glandular part(tubuloalveolar type) and duct • Stroma: Dense collagenous connective tissue and Fat
  30. 30. Mammary glands Topic Inactive Pregnancy Lactating Duct Numerous Proliferation of duct Numerous duct Gland Buds of alveoli Development of alveoli Alveoli enlarge and filled with secretion Connective tissue More Less Less Fat More Less Less
  31. 31. Changes during pregnancy • Nipple Change: nipple became larger and darker. Montgomery's tubercules: they are small, pimple like white areas on areola. • Larger Breasts
  32. 32. Stroma more developed Gland and duct system more developed
  33. 33. Part of the uterus • Fundus: is the part of the body that lies above an imaginary horizontal line passing through the entrance of uterine tubes. • Body : part of the uterus from fundus to the isthmus • Cervix: part of the uterus lies below the isthmus. It is divided by vaginal wall into two part : the supravaginal part and the vaginal parts • Two lateral border: is non peritoneal, attached to the broad ligament and related with the uterine artery • It has two angles or cornua: they are situated it the junction of the fundus and body. It is related with the three structures • i) anterior inferiorly – round ligament of uterus ( other end of this end into the labia majora of the female external genitalia • ii) uterine tube • iii) posterior inferiorly ligament of the ovary (its other end is related with the uterine end of the ovary)
  34. 34. Cervical Canal • terminal portion of uterine cavity • has impermeable plug of mucus, – helps prevent entrance of pathogens – that becomes permeable during ovulation – – does allow sperm to penetrate • Epith of cervix isn’t shed in menstruation like the epith of rest of uterus = simple columnar, and cervical glands remain intact in this area – they secret the mucus to make mucus plug
  35. 35. • Uterus contain a T shaped uterine cavity which is continuous with the cavities of the uterine tube and by internal os to the cervical canal
  36. 36. Uterus Anteflexon: • it is the forward angle between the body of the uterus and cervix. Measuring about 125°
  37. 37. • Anteversion : forward angle between the axis of the cervix and that of the vagina. It is measuring about 90° Anteversion
  38. 38. Peritoneal covering of the uterus • In front, the peritoneum covers the superior surface o f the urinary bladder and goes to isthmus of the uterus. Then it cover anterior surface of the uterus, fundus, posterior surface of the uterus upto the posterior fornix of the vagina then it goes to the middle third of the rectum
  39. 39. Relation of the uterus • Anterior surface is rest on the superior surface of the urinary bladder separated by vesicouterine pouch • Posterior surface is related with the sigmoid colon and small intestine • Laterally it is related with uterine artery and ureter near the cervix
  40. 40. Histology of the uterus • Endometrium {mucous membrane of the uterus)= i)lining epithelium : simple columnar epithelium ii)Lamina propria contain uterine glands • Myometrium contain smooth muscle cells which are randomly oriented • Perimetrium is the visceral peritoneum
  41. 41. Endometrium of uterus • Stratum functionale • Stratum basale
  42. 42. The menstruation phase (1rst to the 4th day) • distinguishes the beginning of each menstruation cycle. When an implantation does not occur, the back-formation of the yellow body (corpus luteum) lowers the amounts of circulating estradiol and progesterone hormones, which leads to the expulsion of the functional layer of the endometrium.
  43. 43. Vascular mechanisms basic to menstruation • the reduction in the estrogen and progesterone level • Causes • constriction of spiral arteries • Result • necrosis of the tissue. Only the functional layer affected but the basal layer remains intact. • The radial and basal arterioles do not react to the hormonal variations, but the spiral arteries functional layer are hormone sensitive and constrict when the progesterone concentration decreases. • So interruption of the blood supply (ischemia), which results in the dying out of the functional layer of the endometrium. Together with blood, which does not coagulate due to a local fibrinolytic factor, the necrotic tissue is eliminated
  44. 44. During the proliferative or follicular phase (4th to 14th day) • the secretion of estrogen through the growing ovarian follicle is responsible for the proliferation of the endometrium • The uterus epithelium covers the surface again. • The glands grow longer and • the spiral arteries begin to grow • At the end of the proliferative phase the estradiol peak (released by the growing follicles) triggers a positive feedback mechanism at the level of the pituitary and the ovulation commences 35 to 44 hours after the initial LH increase (cyclic hormonal changes).
  45. 45. The secretory phase (14th to 28th day) • During the secretory phase the endometrium differentiated due to the influence of progesterone (from the corpus luteum) and attains its full maturity. • Gland enlarge and corkscrew shaped.gland epithelium rich in glycogen. Spiral artery become more coiled
  46. 46. Support of uterus • Structural support • Ligaments: Mackenrodt’s ligaments. It is the cardinal ligament of uterus prevent downward displacement of the uterus through vagina • Muscles : levator ani .(pelvic diaphram) • Perineal body • Functional support
  47. 47. Vagina • Within outward 1. Mucosa : lining epithelium : non keratinized stratified squamous epithe Lamina propria contain numerous blood vessels but no gland 1. Muscular layer: smooth muscles arranged in inner circular and outer longitudinal layer 2. Adventitia
  48. 48. Vagina • Anterior wall : short 7.5 cm and non peritoneal • Posterior wall long 9cm and peritoneal • Upper ¼ part of posterior surface is covered by peritoneum Lateral wall is related to the following from above downwards 1) Ureter and uterine artery 2) Mackenrodt’s ligament 3) Levator ani 4) Muscles of urogenital diaphragm 5) Bulb of vestible
  49. 49. Fornices of vagina • Upper part of vagina is surrounded the cervix of uterus and the area between the cervix and vagina • Four fornix • Ant, pos and two lateral • Pos fornix is 2cm deeper than ant fornix
  50. 50. Blood supply of vagina • Arterial supply • Vaginal a bra of inter iliac a • Vaginal bra of uterine a • Inter pudendal a • Middle rectal a • Inf vesicle a • Vein : vaginal vein drain into inter iliac vein
  51. 51. Lymphatic drainage • Lower 1/3 drain into superficial inguinal lymph node • Upper 2/3 internal and exter iliac ln
  52. 52. Nerve supply • Upper 2/3 is pain insensative • Sym L1,2 parasympathetic : S2,3 • Lower 1/3 is extremely sensitive and supplied by inf rectal and pos labial bra of pudendal nerve
  53. 53. Hymen • It is an incomplete mucous fold which is situated close to the external orifice of vagina • Shape • annular • Crescentic • Cribriform • Sometime it may imperforated
  54. 54. Blood supply of vulva • Superficial and deep External pudendal artery branch of femoral artery • Posterior labial artery branch of internal pudendal artery
  55. 55. NS of vulva • Anterior third of the scrotum is supplied by ilio-inguinal and genitofemoral nerves • Posterior 2/3 is supplied by scrotal branches of pudendal nerve and perineal branches of pos femoral cutanteous nerve
  56. 56. 196. Describe the relation of the ovary to the uterine tube! The upper or tubal end of the ovary is closely related to the uterine tube. The infundibulum has irregular fringes called fimbriae that project from the margin of the infundibulum to the ovary. 197. Define the term “broad ligament of the uterus” and list those structures that are located within its substance! A double layered peritoneal ligament extending from the sides of the uterus to the lateral walls and the floor of the pelvis. Structures: uterine tube, round lig. of uterus, ovarian lig., epoophoron, paroophoron, uterine vessels, uterovaginal venous plexus, nerves. 198. Define the term “parametrium”! The loose connective tissue found between the two diverging layers of the broad ligament of uterus, which connects the lateral part of the cervix with the pelvic wall. 199. Define the position of the uterus under normal conditions? In the axis of the true pelvic, in anteflexion (bends forward) and anterversion (inclines forward) 200. Define the term anteflexion and anteversion of the uterus! Anteversion: the cervix is inclined anteriorly at an acute angle (appr. 60°-70°) to the vagina. Anteflexion: the body of the uterus is bent anteriorly at an acute angle (appr. 60’-70’) to the cervix. 201. Describe visceral relations of the uterus! anterior : posterior wall of bladder,
  57. 57. • posterior : anterior surface of rectum, small intestines, above : small intestines, lateral : ureter, before its opening into the urinary bladder. • 202. What is the epithelium of the a.) cervical canal and b.) vaginal portion of the uterus? simple columnar mucous producing epithelium, with scatterd ciliated cells, stratified squamous non keratinizing epithelium. • 203. Describe the peritoneal relations of the uterus! The body and the posterior aspect of the supravaginal portion of the cervix is enclosed between the two layers of the broad ligament. The peritoneum reflects from the uterus posteriorly to the rectum and anteriorly to the urinary bladder forming the rectouterine and vesicouterine pouches, respectively. • 204. Define the term “Douglas pouch”? Rectouterine pouch. Reflection of the peritoneum from the rectum to the uterus. The deepest point of the peritoneal cavity. • 205. List those structures that help to fix the uterus in its original position! Vagina, pelvic and urogenital diaphragms, round lig., ovarian lig., vesicouterine fold, rectouterine fold, thickenings of the visceral pelvic fascia, broad lig., parametrium. • 206. Which lymph nodes receive lymph from the a.) fundus, b.) body and c.) cervix of the uterus? aortc, external iliac, superficial inguinal lymph nodes, external iliac lymph nodes, internal iliac and sacral lymph nodes.
  • MarufaMelancholy

    Oct. 13, 2020

brief and easy discussion on FRS

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