ANTR 350 Chapter 28 Female Reproductive System

Broad ligament (main parts)

3 Parts: -Mesometrium --The mesentery of the uterine body = Largest part -Mesosalpinx --The mesentery of the uterine tubes -Mesovarium --The mesentery of the ovary Functions/Structure: -Double layer of peritoneum -Extends from: --= lateral body walls and floor of the pelvis to cover the uterus and cervix. -On uterus, ovary, u-tubes

Define mammography and explain how mammograms help to detect breast cancer

An x-ray of the breast that can detect small areas of increased tissue density It can identify many small malignancies that are not yet palpable in a self-examination Most physicians agree that women between 40 and 49 should have a mammogram done every 1 to 2 years. Women over 50 should undergo clinical screenings every year Women with a family history of breast cancer should consider regular mammography before the age of 40

Describe the location of the following spaces using anatomical directional terminology: vesicouterine pouch, rectouterine pouch

Anterior Vesicouterine pouch -Forms the space between the uterus and the urinary bladder -Formed by the reflection of peritoneum from the superior surface of the bladder onto the anterior surface of uterus Posterior rectouterine pouch -Forms the space between the uterus and the rectum -Formed by the reflection of peritoneum from the posterior surface of the uterus onto the anterior surface of rectum

Describe the blood supply and venous drainage of the ovaries

Aorta-> Gonadal Primary blood supply and drainage -Ovarian vasculature Ovarian arteries -Supply ovaries and uterine tubes -branches of the abdominal aorta -travel in suspensory ligament of ovary

Breast cancer (Independent Reading- Clinical View: Breast Cancer in Chapter 28)

Breast cancers arise from the duct epithelium, not the actual milk-producing cells Review lymph drainage from the breast Lymph drainage from the breast goes predominately to the axilla, the axillary lymph nodes on the side with the cancer must be examined to see if the malignancy has spread -Treatment depends upon the stage of the malignancy, but usually includes surgery and/or chemotherapy -Patients often take drugs that block the effect of the estrogen receptor

Describe the location of the clitoris including the crura and glans. Specify the type of tissue the clitoris is composed of. Describe the relationship of the clitoris to the pubic bones

Clitoris: -Organ of sexual arousal (densely innervated) -A small, cylindrical, erectile body --Usually less than 2 centimeters in length -Located at the anterior regions of the labia minora -Tissue: Corpus Cavernosum --Paired, cylindrical masses of vascular erectile tissue --Body: ---Two small erectile bodies (corpora cavernosa) form the body of the clitoris ---The shaft portion of clitoris ---covered laterally and anteriorly by the prepuce ---Attached to pubic symphysis by suspensory ligaments --Glans: ---The free distal end of the body ---Usually covered by the prepuce ---Most highly innervated part of the clitoris ---Capping the body of the clitoris is the glans --Cruz (Crura): ---un-fused portion of the corpora cavernosa ---attached laterally to the inferior pubic rami ---Extending from each of these bodies posteriorly are elongated masses ---Attaches to the pubic arch.

Explain how the breast changes over the course of a female's life time

During pregnancy, the amount of prolactin produced increases, which caused the mammary gland to grow and form more expanded and numerous alveoli

Describe what happens in Endometriosis (See Clinical View: Endometriosis in Chapter 28)

Endometrial tissue exists outside of the uterus At the end of the monthly cycle, this displaced endometrium cannot slough and be expelled The ensuing hemorrhage and breakdown of the displaced endometrium cause considerable pain and eventually scarring that often leads to deformities of the uterine tubes

Location of Uterine Tubes

Extend laterally from both sides of the uterus toward the ovaries

Function of Uterine Tubes

Fertilization of the oocyte occurs in the lateral part of these tubes, and the pre-embryo begins to develop as it travels toward the uterus Uterine tubes are paired passageways that capture the ovulated secondary oocyte, provide the site for fertilization, and transport the oocyte to the uterus

Describe the function of the breast.

Gland's complex secretory product (called breast milk) contains proteins, fats, and a sugar to provide nutrition to infants -lobules (milk producing glands) -ducts (milk passages that connect the -lobules and the nipple) -stroma (fatty tissue and ligaments surrounding the ducts and lobules, blood vessels, and lymphatic vessels)

Describe the blood supply and venous drainage of the uterus

Internal Iliac -> uterine artery (travels through transverse cervical ligament) -Primary blood supply and drainage --Uterine and Vaginal vasculature -Uterine and Vaginal arteries (Veins of same name) --Branches of internal iliac arteries --Travel in the transverse cervical ligament Veins of the same names as arteries

Describe the function and location of the ovaries within the pelvis

Location: -Pelvic Cavity (at the brim) -Attached by suspensory ligaments, to lateral pelvic wall -Small, almond-shaped organs Function: -Produces and releases both female gametes (secondary oocytes) and sex hormones

Round Ligaments of the Uterus

Ovarian Ligament U-tube (Isthmus Function: -Extend from the uterotubal junctions -Pass through the inguinal canals -Attach to labia majora -Keep uterus in anteverted position

Parts of the Uterine Tubes

Paired passageways Small in diameter and reach maximum length of 10 to 12 cm (after puberty) Tubes are coverd and suspended by the mesoalpinx Each uterine tube is composed of contiguous segments that are distinguishable in both gross examination and histologic sections: -The infundibulum is the free, funnel-shaped, lateral margin of the uterine tube. Its numerous individual fingerlike folds are called fimbriae. The fimbriae of the infundibulum are not attached to the ovary but enclose it at the time of ovulation. --Funnel-shaped --opens into peritoneal cavity --Fimbriae: Finger-like projections -> rush the ovary surface -> pickup oocytes -> transport into lumen of ampula -The ampulla is the expanded region medial to the infundibulum. Fertilization of a secondary oocyte typically occurs there. --Longest portion of the u-tube --Usual site of fertilization --Common site for Tubal (ectopic) pregnancy -The isthmus extends medially from the ampulla toward the lateral wall of the uterus. It forms about one-third of the length of the uterine tube. --Narrow, short --Adjacent to the uterine wall -The uterine part (intramural part or interstitial segment) extends medially from the isthmus and is continuous with the wall of the uterus. --(intramural part) --Embedded in the wall of the uterus

Describe the somatic and visceral innervation of the vagina

Parasympathetic -Parasympathetic motor drive to vaginal exocrine glands --Increases secretions for lubrication during sexual arousal phase of copulation --Signals supplied via pelvic splanchnic nerves (via S2 -S4 spinal nerves) Sympathetic -Sympathetic motor drive to vaginal smooth muscle --Rhythmic contractions during orgasm --Signals via sacral splanchnic nerves Visceral afferents -Sense pain and stretch from upper (3/4) portion of vagina Somatic afferents -Carried in the pudendal nerve (origin = S2-S4 ) -Innervates lower ¼ of vagina -Sense touch, hot/cold, pressure

Structure of Uterus

Pear-shaped, thick-walled muscular organ within the pelvic cavity The uterus is partitioned into the following regions: -The fundus is the broad, curved superior region extending between the lateral attachments of the uterine tubes. -The major part of the uterus is its middle region, called the body, which is composed of a thick wall of smooth muscle. -A narrow, constricted inferior region of the body that is superior to the cervix is called the isthmus. -The cervix is the narrow inferior portion of the uterus that projects into the vagina.

Location of Uterus

Pelvic cavity (True pelvis) Uterus is angled anterosuperiorly across the superior surface of the urinary bladder, a position referred to as anteverted If the uterus is positioned posterosuperiorly, this position is called retroverted

Describe the location of the perineum and list the contents of the perineum in females (Figure 28.1 Perineum)

Perineum: diamond-shaped region between the thighs. Distinguished into two triangles: Anterior triangle = Urogenital triangle -Urogenital triangle -Contents: external genitalia, associated musculature, vasculature and nerves Posterior triangle = Anal triangle -Anal triangle -Contents: anal canal and orifice, associated musculature, vasculature, and nerves Boundaries -Superior = pelvic diaphragm -Inferior = skin -Anterior = pubic symphysis -Posterior = tip of coccyx -Lateral = ischial tuberosities -Anterolateral = ischiopubic rami -Posterolateral = pelvic ligaments

Describe the relationship of the reproductive organs to the urinary and digestive organs located in the pelvis using anatomical directional terminology

Peritoneum folds around the various pelvic organs, it produces two major dead-end recesses, or pouches Anterior Vesicouterine pouch forms the space between the uterus and the urinary bladder, and the posterior rectouterine pouch forms the space between the uterus and the rectum

Explain why is it possible for the endometrial tissue to migrant to locations outside of the uterus

Pieces of endometrium displaced onto the external surfaces of organs within the abdominopelvic cavity (Example:- surfaces of ovaries, uterine tubes, urinary bladder, and intestines) -> Endometrial tissues implant on surfaces -> Endometrial tissues respond to hormones in facsmile to endometrium inside uterus -> "blood + tissue slaugh off into pelvic cavity ==> painful condition

Describe the general functions of the female reproductive systems

Produce haploid (n) gametes Produce hormones for sexual function, & development of sex characteristics: (e.g. estrogens => regional hair, fat distribution, breast developmt) Implantation of embryo Maintenance of pregnancy Provides a passageway for birth

Describe the location of the Uterus within the pelvis in relations to other major structures using anatomical directional terms (example: bladder is anterior to uterus)

Relationship to bladder Normal = superior and posterior to bladder

List the structures that help to support the uterus and prevent prolapse

Round Ligaments, Broad Ligaments, Transverse Cervical Ligaments, and Uterosacral Ligaments Muscles of the Pelvic Floor (Pelvic and urogenital diaphragm)

Uterosacral ligaments

Spans from the uterine cervix to the sacrum

Function of Uterus

Sperm pathway Implantation of embryo Maintenance of fetus Lumen (internal space) that connects to the uterine tubes superolaterally and to the vagina inferiorly Pre-embryo makes contact with the uterine lining and implants in the inner uterine wall. Uterus then supports, protects, and nourishes the developing embryo/fetus by forming a vascular connection that later develops into the placenta. Uterus ejects the fetus at birth after maternal oxytocin levels increase to initiate the uterine contractions of labor -If a secondary oocyte is not fertilized, the muscular wall of the uterus contracts and sheds its inner lining as menses

Describe the location of the following spaces: fornixes

Superior portions of the vagina, extending into the recesses created by the vaginal portion of cervix posterior fornix is the larger recess, behind the cervix. It is close to the recto-uterine pouch. There are three smaller recesses in front and at the sides: -The anterior fornix is close to the vesico-uterine pouch. -The two lateral fornices.

Define Ectopic Pregnancy (See Clinical View: Tubal Pregnancy in Chapter 28)

The fertilized ovum (oocyte) is implanted in any tissue other than the uterine wall About half of ectopic pregnancies will resolve without treatment. -Surgery required, if Fallopian tube ruptures or is in danger of doing so. Specify the most common location of ectopic pregnancy -In the cervix, ovaries, abdomen, --Most occur in the Fallopian tube

Describe the reproductive tract's relationship to the peritoneal cavity in females

The rectouterine pouch double folded extension of peritoneum between the rectum and posterior wall of uterus The vesicouterine pouch double fold of peritoneum between the anterior surface of the uterus and the bladder Not completely closed Abdominal ostia of the uterine tubes open into the peritoneal cavity -Potential pathway between the female genital tract and abdominal cavity

Describe the location of the vagina and its relationship to other organs

Thick-walled, fibromuscular tube that forms the inferiormost region of the female reproductive tract and measures about 10 centimeters in length in an adult female Heavily invested with both blood vessels and lymphatic vessels. Arterial supply comes from the vaginal arteries, and venous drainage is via vaginal veins. The lumen of the vagina is flattened anteroposteriorly Musculomembranous canal Projects anteroinferiorly Pierces the pelvic diaphragm Forms Vaginal fornix (with cervix) Location: -Posterior to urethra and bladder -Anterior to rectum -Organ of copulation -Birth canal Relationship: -Vagina connects the uterus with the outside of the body anteroventrally --Birth Canal -Copulatory organ of the female, as it receives the penis during intercourse, and it serves as the passageway for menstruation

Transverse cervical ligaments (cardinal ligaments) containing the uterine vasculature

Transverse cervical ligament Extends to the pelvic wall

Describe the parts of the uterus (body and cervix)

Uterine Body -Upper 2/3 -Triangular shape Uterine Cervix -Lower 1/3 of uterus -Cylindrical shape -Projects into vagina -Internal os -External os -Least mobile part of the uterus

Specify the type of tissue the uterus is composed of

Uterine wall: -3 Layers: --Perimetrium ---Outermost layer ---Serous covering = peritoneum and connective tissue --Myometrium ---Middle layer ---Thick wall of smooth muscle ---Undergoes massive hypertrophy and some hyperplasia with pregnancy --Endometrium ---Innermost lining of uterine wall ---Highly vascularized ---Undergoes changes during the menstrual cycle (growth and shed cycles) ---Two layers ----Basal Layer/ Stratum Basalis -----Deepest layer ----Functional layer/stratum functionalis -----Superficial layer

Specify the type of tissue the vagina is composed of

Vagina's relatively thin, distensible wall consists of three tunics: an inner mucosa, a middle muscularis, and an outer adventitia Mucosa -Mucosa consists of a nonkeratinized stratified squamous epithelium and a highly vascularized lamina propria Muscularis -muscularis of the vagina has both outer and inner layers of smooth muscle. The outer layer is composed of bundles of longitudinal smooth muscle cells that are continuous with corresponding muscle cells in the myometrium. The smooth muscle cells of the inner circular layer are interwoven with the outer longitudinal muscle fibers at the point where the two muscle layers meet Outer Adventitia -inner elastic fibers and an outer layer of areolar connective tissue