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Introduction. The female gamete is the ovum (egg)The ovum is produced in the female gonadOvariesOvum leaves the ovary, travels down the fallopian tube to the uterusIf sperm are present in the fallopian tube fertilization may occurThe embryo then has a 40 week gestation periodThe embryo is term
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1. Chapter 8 Female Reproductive System
2. Introduction The female gamete is the ovum (egg)
The ovum is produced in the female gonad
Ovaries
Ovum leaves the ovary, travels down the fallopian tube to the uterus
If sperm are present in the fallopian tube fertilization may occur
The embryo then has a 40 week gestation period
The embryo is termed fetus after the 2nd month of pregnancy
3. Introduction Ova mature and are released from the ovaries
This begins at the onset of puberty and continues until menopause
Puberty
secondary sex characteristics begin to develop
Menopause
Cessation of fertility
Diminishing hormone production
4. Introduction Women are born with all of the eggs (ova) they will possibly release
Puberty signifies that the eggs are mature and they begin to leave the ovary
If an egg becomes fertilized it may grow and develop in the uterus
5. Introduction If fertilization occurs various hormones are released from the ovary and placenta
If there is no fertilization the resulting hormone changes cause the menstruation to occur
Bleeding and shedding of the uterine wall
6. Introduction Estrogen and progesterone are the hormones important for pregnancy and menstruation
The pituitary gland releases the hormones needed for the function of the ovaries, breasts, and uterus
This is located at the base of the brain
7. Introduction Gynecology
Study of the female reproductive system
Obstetrics
Specialty concerned with pregnancy and delivery of the fetus
Neonatology
Study and treatment of the newborn child
8. Anatomy Ovaries
The female gonads
Almond shaped organs in the lower abdomen
Produce ova (eggs) and hormones
Fallopian tubes
Leads from each ovary to the uterus
9. Anatomy Uterus
aka: the womb
Muscular organ located between the urinary bladder and rectum
This is where the embryo develops
10. Anatomy Uterus
Divided into three parts
Fundus
The upper portion
Corpus
The middle portion
Cervix
The lower neck portion
11. Anatomy Cul-de-sac
Midway between the uterus and rectum
Often examined for the presence of cancerous growth
Vagina
Tube extending from the uterus to the exterior of the body
12. Anatomy Bartholin glands
Two small round glands on either side of the vaginal orifice
Helps to lubricate the vagina
Clitoris
Similar to the penis in males
Composed of erectile tissue
Anterior to vaginal orifice and urethral meatus
13. Anatomy Perineum
Region between the vaginal orifice and rectum
Can be torn during childbirth and cause injury
Episiotomy is often performed before delivery and sewn together afterwards
14. Anatomylateral view
15. Anatomyvulva Vulva
The external genitalia
Consists of
Labia majora
The outer lips of the vagina
Labia minora
The smaller inner lips
Hymen
Mucous membrane that partially covers the entrance to the vagina
Clitoris
Bartholin Glands
16. Anatomyvulva
17. Anatomyovaries Utero-ovarian ligament
Located on either side of the uterus
Holds the ovaries in place
Graafian follicles
Thousands contained in each ovary
Each follicle contains an ovum
Ruptures to release ovum when mature
18. Anatomyovaries Once ovum is released the graafian follicle fills with blood and yellow, fat like material
Then called corpus luteum
Ovulation
Release of ovum from ovary
19. Anatomyfallopian tubes Fallopian tube
~5 ˝ in. long duct
Runs from ovary to uterus
End has finger like structures called fimbriae
These “catch” the ovum and pull it into the tube
This is where fertilization will occur
20. Anatomyfallopian tubes Takes ~5 days for the ovum to pass through the fallopian tube
It is during this time that fertilization is most likely to occur
If the egg remains unfertilized it disintegrates in a day or two
21. Anatomyuterus Uterus
Pear shaped organ
Muscular walls
Mucous membrane lining filled with blood vessels
Divided into three parts
Fundus
Corpus
Cervix
22. Anatomyuterus Uterus (cont.)
Endometium
Specialized epithelial mucosa
Myometrium
Muscular layer
Uterine serosa
Outer membranous tissue
Serosa is outer most layer of any organ in the abdomen or thorax
23. Anatomyvagina Cervical opening leads to the vagina
~ 3 in. long
Leads to the outside of the body
24. Anatomyanterior view
25. Anatomybreast Breasts are accessory organs to reproduction
They are located on the upper anterior region of the thorax
Breasts are mammary glands composed of
Glandular tissue
Contains milk glands
Develop in response to hormones from ovaries during puberty
26. Anatomybreast Composed of (cont)
Fibrous and fatty tissue
Lactiferous ducts
Carry milk from glandular tissue
Sinuses
Carry milk to nipple
27. Anatomybreast Composed of (cont.)
Nipple
Called mammary papilla
Small opening for the milk to pass through
Areola
Dark pigmented area around the nipple
During pregnancy breasts reach their full development
Hormones from the pituitary gland stimulate lactation after parturition
28. Anatomybreast
29. Anatomybreast
30. Menstruation Menstruation begins during puberty
This is called menarche
Menstration is happens in cycles
Each cycle is divided into 28 days
These days are grouped into 4 time periods
31. Menstrual Cycle Days 1-5
Menstrual period
Period when fluid discharge is present
Composed of endometrial cells, glandular secretions, and blood
32. Menstrual Cycle Days 6-12
Endometrium begins to repair itself
Estrogen is released by maturing graafian follicles
Maturing ovum finishes growth during this period
33. Menstrual Cycle Days 13-14
Graafian follicle ruptures
Ovum leaves the ovary and travels slowly down the fallopian tube
Rupturing process is known as ovulation
34. Menstrual Cycle Days 15-28
Empty follicle fills with yellow material and becomes corpus luteum
Corpus luteum functions as endocrine organ
Secretes estrogen and progesterone
These stimulate building the lining of the uterus for pregnancy
35. Menstrual Cycle Days 15-28 (cont.)
If fertilization does not occur production of hormones ceases
This can cause premenstrual symptoms
Depression
Breast tenderness
Irritability
Known as premenstrual syndrome (PMS)
About 5 days after hormone cessation, endometrium breaks down and menstrual cycle begins again
36. Menstrual Cycle
37. Pregnancy When fertilization occurs the ovum implants in the endometrium
The corpus luteum continues to produce progesterone and estrogen
This supports the vascular and muscular development of the uterine lining
Placenta forms within the uterine wall
38. Pregnancy Placenta derived from maternal endometrium and the chorion
Outermost membrane surrounding the embryo
Amnion is the innermost embryonic membrane
Holds fetus suspended in the amniotic cavity
39. Pregnancy
40. Pregnancy The amnion and amniotic fluid normally rupture during labor
This is when a woman’s “water breaks”
Maternal and fetal blood never mix during pregnancy
The placenta acts as a filter for nutrients, oxygen and waste
41. Pregnancy Placenta produces its own hormone
Human chorionic gonadotropin (HCG)
This is what is tested for with home pregnancy tests
After the baby is delivered the placenta is expelled
This is known as the afterbirth
42. Pregnancy
43. Pregnancy
44. PathologyCervix Carcinoma of the cervix
Cervical cancer
More common in women who
Have coitus at early age
Have multiple sex partners
History of STDs
Evidence of HPV
Detection via Pap smear
Treatments include conization, hysterectomy, or radiation therapy
45. PathologyCervix Endometriosis
Endometrial tissue found in abnormal locations
Can cause
Dysmenorrhea
Pelvic pain
Infertility
Dyspanreunia
Treatment ranges from symptomatic relief of pain to hysterectomy
46. PathologyOvaries Ovarian Carcinoma
Ovarian cancer
Accounts for more deaths than those of the cervix and uterus combined
Usually discovered in advanced stages
Treatment includes surgery, radiotherapy and chemotherapy
47. PathologyOvaries Ovarian Cysts
Typically benign
Occasionally cysts need to be removed to distinguish between benign and malignant tumors
48. PathologyFallopian Tubes Pelvic Inflammatory Disease (PID)
Leading causes are gonorrhea and chlamydial infection
Can be repetitive which can lead to adhesions and scarring within the fallopian tubes
Increases risk of ectopic pregnancy and difficulty getting pregnant
49. PathologyFallopian Tubes PID (cont.)
S&S
Vaginal discharge
Pain in the abdomen (LLQ & RLQ)
Fever
Tenderness on palpation of the cervix
Antibiotics are used as treatment
50. PathologyBreast Carcinoma of the breast
Tumor will typically spread to lymph nodes in axilla first
Once introduced to lymph nodes cancer may spread to other body organs
Tumor is usually removed as primary treatment
Early detection important
51. PathologyBreast Carcinoma of the breast (cont.)
Should perform self examination every month starting about age 20
About 211,000 new cases expected in the US each year
About 1,600 men expected to develop breast cancer
52. PathologyPregnancy Ectopic Pregnancy
Implantation of fertilized egg anywhere besides normal uterine location
Occurs in about 1% of pregnancies
About 90% of those occur in the oviducts
Other sites include oviducts and abdominal cavity
All are surgical emergencies
53. Clinical Tests Pap Smear
Physician uses a vaginal speculum, wooden spatula and cotton swab to take secretions from cervix and vagina
Microscopic analysis is then performed on the sample
Recommended for every woman over 18 years of age, or under if sexually active
54. Clinical Tests Pregnancy test
Can be blood or urine
Detects presence of HCG
Mammography
X-rays of the breast to screen for cancer
Recommended around age 50 for a baseline and every 1 – 2 years after
55. Clinical Procedures Tubal Ligation
A sterilization process
Fallopian tubes are burned or cut, and then tied off
A small incision is made in the abdomen and a laparoscope is inserted through which instrumentation can be inserted
56. Clinical Procedures Cesarean Section
“C” section
Removal of fetus by abdominal incision
Indications
Cephalopelvic disproportion
Hemorrhage
Fetal distress
Breech or shoulder presentation