Chapter 28 The Female Reproductive System

1. Chapter 28The Female Reproductive System Sex Differentiation Female Anatomy Female Physiology

2. MALE Testes Sperm Scrotum Penis FEMALE Ovaries Egg Labia Majora Clitoris Sex DifferentiationMale & female are indistinguishable forthe first 10 weeks of development. Females develops due to absence of testosterone hormone causing degeneration of the male anatomical structures

3. Ovaries- egg makers, resemble unshelled almonds • Histology: (Superficial to deep) • 1. Germinal epithelium- skin of the ovary • 2. Tunica albugunea- just inside of the above • 3. Ovarian cortex- contains ovarian follicles (Where the action is!) • 4. Ovarian medulla- middle of ovary, blood vessels are found • Remember: Gerry to AL: “Court me!”

4. Uterine or FallopianTubes (Oviducts) • 3 Major portions of the fallopian tube • near uterus forms a narrow isthmus • middle portion is body (ampulla) • flared distally into infundibulum

5. Plumbing • The ovaries hang close to the fallopian tubes, but do not connect directly, this area of the tube is called the infundibulum • These tubes are 4 inches long, their purpose in life is to transport eggs to the uterus • The ampulla, the lateral part of the tube is where fertilization usually occurs. • Fertilization must occur within 24 hours of ovulation. • In seven days the fertilized egg called a Zygote arrives in the uterus

6. Inverted pear, top= fundus middle= body bottom= cervix which has an open called the os that leads from the vagina to the uterus Uterus or womb has many purposes: Pathway for sperm to reach fallopian tubes Site of menstruation (inner uterine layer is the endometrium) Site of implantation of fertilized ovum Development of the fetus (0ven) The Uterus

7. Feminine Ligaments • A series of ligaments hold the ovaries in place: • Broad ligament (watch who you callin’…) of the uterus- part of the parietal peritoneum, attaches to the ovaries • Ovarian ligament- anchors the ovaries to the uterus • Suspensory ligament- binds the ovaries to the pelvic wall

8. Vagina or Birth Canal • The Vagina has many purposes: • Passageway for menstrual flow • Passageway for child birth • Passageway for semen • The vagina is inferior to the uterus, it attaches at the fornix, rugae line the vagina • Acidic- to retard bacterial growth but harmful to sperm (but semen neutralizes this) • Hymen- a border around the orifice of the vagina, partially closing it

9. Female External Genitalia • Vulva- (pudendum)- refers to the external genitals of the female: • Mons Pubis- (mons= mountains)- area of pubic hair • Labia majoria- (labia= lips, majus= large)- outer lips of genitals • Labia minora- inner lips of genitals • Clitoris- anterior mass of erectile tissue between labia majus and minus

10. Two Triangle, One Diamond • The perineum is a diamond-shaped area between the pubic symphysis and the coccyx, composed of muscles • A line drawn between the ischial bones divides the diamond into two triangles • The anterior triangle is the urogenital triangle, containing the external genitalia • The posterior triangle is the anal triangle • What exercise strengthen the perineum?

11. The Breasts • Two mammary glands are modified sudoriferous glands • instead of sweat they produce sweet milk • Anterior to the pectoralis major muscles • Axillary tail in armpit contains many lymphatic vessels, common site of breast cancer • Smooth muscle can contract causing wrinkling of the skin & erecting the nipple in response to cold, touch or arousal

12. Anatomy of Breast • Suspensory ligaments of the breast are called Cooper’s ligaments, bras counter- Coop’s Droop • Around the nipple is a circular colored area called the areola (not made of _____ tissue), this is modified sebaceous (oil) glands, darken during pregnancy

13. Anatomy of Lactating Breast • Milk emerges through the nipple from the lactiferous ducts of the breast of the lactating women

14. Path of Milk • Through the process of lactation (milk production) the mammary glands create, secrete and eject milk • Milk forms in the lobules, then flows to the secondary tubules, mammary ducts, lactiferous sinus, lactiferous ducts then out the nipple (LoST MD to LS,D) • Lactation is hormonally controlled. Prolactin is the major hormone involved, as the name implies. Oxytocin is responsible for the ejection of milk from the nipple in response to infant’s suckling

15. Cow’s milk is not a good substitute for human milk decreased fat and increased protein, human milk is increased fat, decreased protein. Why? harder to digest & more nitrogenous waste (diaper rash) 10% of women become pregnant again while nursing Lactation- secretion and ejection of milk Oxytocin- hormone that causes the release of milk Colostrum- antibody rich pre-milk appears the first four days, one of the important reasons mothers should, at least, attempt breastfeeding Advantages for the kid: decreased heart disease, allergies, cancer, GI problems and infections Advantages for mom: decreased breast CA and osteoporosis, weight loss Breast Milk

16. Oogensis and the Sexual Cycle • Oogenesis- Formation of eggs in the ovaries • Primary oocytes (first eggs)- develop at infancy. • About 400 primary oocytes will ovulate during a woman’s reproductive life. • Sexual cycle - events recurring every month when pregnancy does not occur • ovarian cycle = events in the ovaries • menstrual cycle = parallel changes in the uterus

17. Ovary EventsF (sun burst) L A (Follicle, ovulation, corpus Luteum, corpus Albicans)

18. 3 Parts of Female Reproduction • This starts in the female at menarche (men- arc) and stops at menopause (menses pause) • Lasts about a month (avg.), the phases are: • 1. Follicular phase • Menstrual phase • Preovulatory phase • 2. Ovulation • 3. Postovulation phase

19. Ovarian Cycle -- Follicular Phase • From beginning of menstruation (day 1) to ovulation(14) • Seldom possible to predict date of ovulation

20. Ovarian Cycle -- Menstrual Phase (Part of Follicular Phase) • During discharge of menstrual fluid (days 1-5)

21. Ovarian Cycle -- Preovulatory Phase (Part of Follicular phase) • From days 6 to 14, one follicle advances to graafian stage & protrudes from surface of ovary • atresia of other follicles occurs with  FSH • Egg stopped at metaphase II stage of meiosis

22. Ovarian Cycle -- Ovulation • Results from a spike of LH(caused by  estrogen from follicle) •  blood flow causes follicle to swell rapidly; collagenase weakens ovarian wall; fluid oozes out with oocyte and is swept up into uterine tube by fimbriae

23. Ovarian Cycle -- Postovulatory Phase • Luteal phase - corpus luteum forms from ruptured follicle under direction of Luteinizing Hormone   progesterone stimulates secretory phase of menstrual cycle (in uterus) • Premenstrual phase – if no pregnancy, corpus luteum  corpus albicans   progesterone  menstruation

24. Female Hormone Imbalance • Low progesterone: Can cause dysmenorrhea. • In the absence of adequate progesterone, the pelvic ligaments do not relax (as they should in preparation for pregnancy) • Pain is caused by the pressure on the tight uterian ligamnts during menstration • Excessive progesterone: Late menses of long duration (32-35 days or longer) • usually scanty flow • Normal menses should be 3-5 days no more or no less

25. Female Hormone Imbalance • Excessive Estrogen: Heavy menstral flow, lasting 7 days or longer, short cycle (21-22 days not uncommon) • Retaining water, breast soreness • Low Estrogen: Very short flow (1-2 days), late peroids

26. Female Sexual Response

27. Female Sexual Response

28. Female Sexual Response

29. Adjustments to Pregnancy • Gestation (pregnancy) lasts an average of 266 days from conception to childbirth • Gestational calendar is measured from first day of the woman’s last menstrual period (LMP) • Birth is predicted to occur 280 days from LMP • 3 three month intervals called trimesters

31. After Birth • Mother’s anatomy & physiology return to normal in the first 6 weeks after delivery • shrinkage of the uterus is called involution • breastfeeding promotes involution

32. Baby Planning • Abstain • Sterilization • Oral contraception • IUD • Spermatocides • Barriers- condoms, diaphragm • Sympto-thermal method- family planning • body temp, cervical mucus, (problem- fertile 2 days before ovulation)

33. Clinical • Inguinal Hernias- turn your head and cough • Hysterectomy- removing the uterus • Amenorrhea, Dysmenorrhea • Breast CA in males and females • STDs • Cervical CA- if you have sex, Uterian CA- nuns, less risk if you have kids • Prevention= have kids but don’t have sex

34. Signs of Ovulation • 4 signs of egg release • 1. Cervical mucus change* • Egg white • 2. Basal temperature increases* • Increases ½ a degree, first AM temperature • 3. LH surges • This is one day after ovulation • 4. Pain • Mittelschmerz- German for pain in the middle • *Best time for pregnancy is within 24 hours of these