Female reproductive system

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The Female The Female reproductive reproductive

systemsystem

The ovaryThe ovary

Follicullar growth and Follicullar growth and developmentdevelopment

• Each ovarian follicle consists of an immature ovum, Each ovarian follicle consists of an immature ovum, PRIMARY OOCYTE, surrounded by spheroidal cells, with PRIMARY OOCYTE, surrounded by spheroidal cells, with large vesicular nucleus and a prominent nucleolus.large vesicular nucleus and a prominent nucleolus.

• Infants has 400,000 follicles, with progressive reduction in Infants has 400,000 follicles, with progressive reduction in number as the female matures and menstruate until number as the female matures and menstruate until virtually none is left after menopause.virtually none is left after menopause.

• AS it grows the flattened follicular cells becomes cuboidal AS it grows the flattened follicular cells becomes cuboidal then columnar in shape, divide actively to produce a then columnar in shape, divide actively to produce a stratified layer around the ovum.stratified layer around the ovum.

• It soon increase in size, becomes a cavity ( ANTRUM) filled It soon increase in size, becomes a cavity ( ANTRUM) filled with clear fluid ( Liquor folliculi) rich in hyaluronic acid, with clear fluid ( Liquor folliculi) rich in hyaluronic acid,

• Cumulus oophorus, is formed by a projection into the Cumulus oophorus, is formed by a projection into the antrum.antrum.

• Membrana granulosa, is formed as a continuous stratified Membrana granulosa, is formed as a continuous stratified follicular cells around the antrum cavity.follicular cells around the antrum cavity.

Follicullar growth and Follicullar growth and developmentdevelopment

• Theca folliculi is then formed as the follicle increase in size Theca folliculi is then formed as the follicle increase in size and is organized into capsules. It is separated from the and is organized into capsules. It is separated from the membrana granulosa by basal lamina – Glassy membrane.membrana granulosa by basal lamina – Glassy membrane.

• It then differentiates into 2 layers; It then differentiates into 2 layers;

a. inner vascular, Theca interna, with enlarged epitheloid a. inner vascular, Theca interna, with enlarged epitheloid stromal cells with numerous capillaries inbetween.stromal cells with numerous capillaries inbetween.

b. outer fibrous layer, Theca externa, composed of closely b. outer fibrous layer, Theca externa, composed of closely packed collagenous fibers and fusiform cells merge packed collagenous fibers and fusiform cells merge peripherally into the surrounding ovarian stroma.peripherally into the surrounding ovarian stroma.

. .

The follicle with the Theca Interna and the The follicle with the Theca Interna and the Theca ExternaTheca Externa

Mature Graafian folliclesMature Graafian follicles• Requires 10 to 14 days to Requires 10 to 14 days to

reach maturity.reach maturity.• 10 mm in dm. and occupies 10 mm in dm. and occupies

the whole breadth of the the whole breadth of the cortex and indents the cortex and indents the medulla.medulla.

• It bulges on the free surface It bulges on the free surface of the ovary – Stigma.of the ovary – Stigma.

• The enlarged antrum is The enlarged antrum is filled with fluid and is bound filled with fluid and is bound by the membrana granulosa, by the membrana granulosa, is surrounded by a thick is surrounded by a thick Zona pellucida.Zona pellucida.

• On maturity the cell spaces On maturity the cell spaces are filled with fluid are filled with fluid weakening the connection weakening the connection between the ovum and the between the ovum and the membrana granulosa.membrana granulosa.

The cortex of the The cortex of the ovary contains numerous follicles contains numerous follicles embedded in a thick stroma.  Most of the follicles are embedded in a thick stroma.  Most of the follicles are resting primordial follicles.  Follicles which have been resting primordial follicles.  Follicles which have been stimulated to develop progress through primary and stimulated to develop progress through primary and secondary stages to become mature tertiary orsecondary stages to become mature tertiary or Graafian follicles Graafian follicles

• Maturation of the Maturation of the Ovum: OOgenesisOvum: OOgenesis

• The large cell within each The large cell within each follicle is anfollicle is an oocyte.  The oocyte.  The cells which surround cells which surround each follicle are each follicle are granulosa cells. granulosa cells.  Flattened granulosa  Flattened granulosa cells indicate resting cells indicate resting primordial follicles. primordial follicles.  Cuboidal granulosa cells  Cuboidal granulosa cells indicate primary follicles, indicate primary follicles, which have begun the which have begun the process of maturation process of maturation toward ovulation.  Atretic toward ovulation.  Atretic follicles have begun to follicles have begun to degenerate.degenerate.

The cortex of the ovary contains numerous follicles embedded in a thick The cortex of the ovary contains numerous follicles embedded in a thick stroma.  Most of the follicles are resting primordial follicles. Follicles which stroma.  Most of the follicles are resting primordial follicles. Follicles which have been stimulated to develop progress through primary and secondary have been stimulated to develop progress through primary and secondary stages to become mature tertiary or Graafian follicles, in which a large fluid-stages to become mature tertiary or Graafian follicles, in which a large fluid-filled cavity, the antrum, is surrounded by many layers of granulosa cells. filled cavity, the antrum, is surrounded by many layers of granulosa cells.  Stromal cells around the follicle form the theca interna, which  Stromal cells around the follicle form the theca interna, which secretes estrogen.secretes estrogen.

At the end of the monthly cycle, or at the end of At the end of the monthly cycle, or at the end of pregnancy, the corpus luteum degenerates into a pregnancy, the corpus luteum degenerates into a fibrous scar called a fibrous scar called a corpus albicans.corpus albicans.The corpus luteum forms by reoganization of granulosa and The corpus luteum forms by reoganization of granulosa and theca cells following ovulation.theca cells following ovulation.

• Ovulation = the follicle reaches maturity, Ovulation = the follicle reaches maturity, filled with watery liqour secretions & filled with watery liqour secretions & expands, called PreOvulatory swelling.expands, called PreOvulatory swelling.

• Maturation of the Ovum: OOgenesisMaturation of the Ovum: OOgenesis• The ovum that is released at ovulation is a The ovum that is released at ovulation is a

secondary oocyte ( immature). secondary oocyte ( immature). • Oogonia = primitive ova with diploid Oogonia = primitive ova with diploid

chromosomes divide by mitosis to produce chromosomes divide by mitosis to produce the primary Oocytes in the fetal ovary.the primary Oocytes in the fetal ovary.

• On ovulation, the nucleus of the 2ndary On ovulation, the nucleus of the 2ndary oocyte starts the 2oocyte starts the 2ndnd maturation division maturation division which stops in the metaphase and remains which stops in the metaphase and remains in this condition until fertilization. The in this condition until fertilization. The penetration of the spermatozoa triggers the penetration of the spermatozoa triggers the completion of the 2completion of the 2ndnd maturation division. maturation division.

The Corpus LuteumThe Corpus Luteum• The folded collapse The folded collapse

folliclefollicle• Granulosal cell Granulosal cell

differentiate into large differentiate into large vesicular nuclei called vesicular nuclei called the “Granulosa Lutein the “Granulosa Lutein cells”cells”

• Theca interna becomes Theca interna becomes the “Theca Lutein Cells”the “Theca Lutein Cells”

• Corpus luteum of Corpus luteum of menstruation = menstruation = unfertilized, discharges unfertilized, discharges ovumovum

• 400 follicles reach 400 follicles reach maturity at 30 years and maturity at 30 years and only 1 ovum is only 1 ovum is discharged every month.discharged every month.

• Atresia = involution of a Atresia = involution of a follicle.follicle.

• Interstitial cells = large Spheroidal Interstitial cells = large Spheroidal cell filled with small lipid cell filled with small lipid droplets,found in the ovarian stroma.droplets,found in the ovarian stroma.

• Hormones of the Ovary = produce sex Hormones of the Ovary = produce sex hormones estrogen ( from the follicle ) hormones estrogen ( from the follicle ) and progesterone ( Uterine glands).and progesterone ( Uterine glands).

• Blood vessels and lymphatics = Blood vessels and lymphatics = branches from the ovarian and uterine branches from the ovarian and uterine arteries, form a spiral vessel called arteries, form a spiral vessel called helicine vessel. helicine vessel.

The Fallopian The Fallopian tubestubes

The regions of the fallopian The regions of the fallopian tubestubes

• Infundibulum – funnel shaped opening into Infundibulum – funnel shaped opening into the peritoneal cavity with margins drawn out the peritoneal cavity with margins drawn out into numerous folds called fimbriae.into numerous folds called fimbriae.

• Ampulla – the expanded intermediate Ampulla – the expanded intermediate segment, 2/3rds of the total length.segment, 2/3rds of the total length.

• Isthmus – slender, narrow tube connects the Isthmus – slender, narrow tube connects the fimbriae to the uterus.fimbriae to the uterus.

• Intramural(interstitial) portion, the Intramural(interstitial) portion, the continuation of the canal thru the uterine continuation of the canal thru the uterine wall.wall.

• The walls of the tube thickens progressively The walls of the tube thickens progressively towards the uterus, the lumen diminishes in towards the uterus, the lumen diminishes in size.size.

Layers of the fallopian Layers of the fallopian tube wallstube walls

• Mucosa = lining are in longitudinal folds, Mucosa = lining are in longitudinal folds, simple columnar cells both ciliated (occur in simple columnar cells both ciliated (occur in small groups) and non ciliated (narrow and small groups) and non ciliated (narrow and peg-shaped, secretory in nature).peg-shaped, secretory in nature).

• Muscularis – broad inner circular layer and Muscularis – broad inner circular layer and thin outer layer with scattered bundles of thin outer layer with scattered bundles of fibers oriented longitudinally. Peristaltic fibers oriented longitudinally. Peristaltic contractiosn aid the ovum trip to the uterine contractiosn aid the ovum trip to the uterine cavity.cavity.

• Serosa – invested with a fold of reflected Serosa – invested with a fold of reflected peritoneum, with loose connective tissue peritoneum, with loose connective tissue surfaced with mesothelium. Deeper layer surfaced with mesothelium. Deeper layer contains the longitudinal bundles of the contains the longitudinal bundles of the muscularis.muscularis.

Blood vessels , Lymphatics Blood vessels , Lymphatics and nervesand nerves

• Blood vessels and lymphatics are Blood vessels and lymphatics are numerous and found in the lamina numerous and found in the lamina propria and the serosa.propria and the serosa.

• Nerves form rich plexus and supply Nerves form rich plexus and supply muscle fibers and the mucosa.muscle fibers and the mucosa.

The wall of the The wall of the fallopian tubefallopian tube includes an elaborately folded includes an elaborately folded mucosamucosa surrounded by a surrounded by a muscularismuscularis.  In the ampulla, shown .  In the ampulla, shown here, the mucosa is quite elaborate and the muscularis is here, the mucosa is quite elaborate and the muscularis is relatively thin.   Mucosal folds occupy most of the potential relatively thin.   Mucosal folds occupy most of the potential lumenal space, so that cilia on the epithelial surface can lumenal space, so that cilia on the epithelial surface can effectively move the egg toward the uterus.   The simple effectively move the egg toward the uterus.   The simple columnar epithelium of the mucosa contains both columnar epithelium of the mucosa contains both secretory secretory cellscells and and ciliated cellciliated cell

The wall of the The wall of the fallopian tubefallopian tube includes an includes an elaborately folded elaborately folded mucosamucosa surrounded by a surrounded by a muscularismuscularis.  The thickness of both layers varies .  The thickness of both layers varies along the length of the tubealong the length of the tube

In the isthmus, shown here, the mucosa is relatively In the isthmus, shown here, the mucosa is relatively simple and the muscularis is quite thick.  The ampulla, simple and the muscularis is quite thick.  The ampulla, where elaborate mucosal folds occupy most of the where elaborate mucosal folds occupy most of the potential lumenal space and the muscularis is relatively potential lumenal space and the muscularis is relatively thin.thin.

The uterusThe uterus

Layers of the Uterine WallLayers of the Uterine Wall

• Outer layer = the Serosa or Outer layer = the Serosa or perimetriumperimetrium

• Middle layer = the muscularis ore Middle layer = the muscularis ore myometrium.myometrium.

• The Inner layer = the mucosa of the The Inner layer = the mucosa of the endometrium.endometrium.

• Perimetrium = typical serosa with single Perimetrium = typical serosa with single layer of mesothelial cells supported by a layer of mesothelial cells supported by a thin layer of connective tissue.thin layer of connective tissue.

• Myometrium = massive coat of smooth Myometrium = massive coat of smooth muscle about 12 to 15 mm thick. Muscles muscle about 12 to 15 mm thick. Muscles are arranged in a bundle separated by are arranged in a bundle separated by connective tissue.connective tissue.

• 3 layers of muscles:3 layers of muscles:a. stratum subvasculare = inner muscle a. stratum subvasculare = inner muscle layer with longitudinal fibers.layer with longitudinal fibers.b. stratum vasculare = thick mid layer with b. stratum vasculare = thick mid layer with blood vessels.blood vessels.c. stratum supravasculare = outer c. stratum supravasculare = outer longitudinal layer beneath the perimetrium.longitudinal layer beneath the perimetrium.

The The uterusuterus has an extremely thick muscular wall, the has an extremely thick muscular wall, the myometrium, and a thick mucosa, the endometrium with myometrium, and a thick mucosa, the endometrium with tubular glands lined by simple columnar epithelium.  The tubular glands lined by simple columnar epithelium.  The endometrium undergoes extensive changes during the endometrium undergoes extensive changes during the menstrual cycle. menstrual cycle.

The The myometriummyometrium consists of smooth muscle.  The consists of smooth muscle.  The endometriumendometrium consists of a thick stroma containing consists of a thick stroma containing numerous irregularly-shaped tubular glands lined by numerous irregularly-shaped tubular glands lined by columnar epithelium.  This image shows the columnar epithelium.  This image shows the endometrium in proliferative phase.endometrium in proliferative phase.

Cyclic changes in the Cyclic changes in the EndometriumEndometrium

• The menstrual stage with external The menstrual stage with external menstrual discharge.menstrual discharge.

• Proliferative ( follicular) stage = Proliferative ( follicular) stage = concurrent with follicular growth and concurrent with follicular growth and estrogen secretion.estrogen secretion.

• Progestational ( luteal ) stage = Progestational ( luteal ) stage = associated with active corpus luteum.associated with active corpus luteum.

• Ischemic ( premenstrual ) stage = when Ischemic ( premenstrual ) stage = when there is interruption of blood flow in the there is interruption of blood flow in the coiled arteries.coiled arteries.

During the During the proliferative phaseproliferative phase, when the stratum , when the stratum functionalis is growing, the endometrial glands have a functionalis is growing, the endometrial glands have a relatively smooth contour and mitotic figures are relatively smooth contour and mitotic figures are common.common.

Endometrium, Proliferative stage. A helical (corkscrew) shape Endometrium, Proliferative stage. A helical (corkscrew) shape permits the permits the spiral arteryspiral artery to extend into the thickening stroma to extend into the thickening stroma of the proliferative of the proliferative endometriumendometrium and also, later, to retract back and also, later, to retract back into the stratum basalis when the stratum functionalis is into the stratum basalis when the stratum functionalis is eventually sloughed off.  Because of its corkscrew shape, each eventually sloughed off.  Because of its corkscrew shape, each spiral arteryspiral artery typically appears as an aligned cluster of profiles typically appears as an aligned cluster of profiles (asterisks)(asterisks) deep in the endometrium. deep in the endometrium.

The endometrial glands have matured in the The endometrial glands have matured in the secretory phasesecretory phase, their , their contour is more tortuous and the epithelium consists of mature contour is more tortuous and the epithelium consists of mature secretory cells. The endometrium is highly vascular, and the blood secretory cells. The endometrium is highly vascular, and the blood vessels also participate in the menstrual cycle.  Distal vessels are vessels also participate in the menstrual cycle.  Distal vessels are sloughed off, while the sloughed off, while the spiral arteriesspiral arteries (named for their helical shape) (named for their helical shape) retract into the stratum basalis and constrict to limit blood loss retract into the stratum basalis and constrict to limit blood loss during menstruation.  The spiral arteries then extend again (like during menstruation.  The spiral arteries then extend again (like springs) as the stratum functionalis regeneratessprings) as the stratum functionalis regenerates

Functions of the PlacentaFunctions of the Placenta• Transfers blood and nutrition from the mother to the Transfers blood and nutrition from the mother to the

fetus.fetus.• Transfer waste product from the fetal metabolism to the Transfer waste product from the fetal metabolism to the

maternal circulation for disposal.maternal circulation for disposal.• Maternal circulation is separated from the materanal Maternal circulation is separated from the materanal

circulation:circulation:a. Syncitial trophoblast.a. Syncitial trophoblast.b. Cytotrophoblast from the 1b. Cytotrophoblast from the 1stst trimester of pregnancy. trimester of pregnancy.c. Basal lamina of the trophoblast.c. Basal lamina of the trophoblast.d. Fetal connective tissue.d. Fetal connective tissue.e. Basal lamina of the fetal capillaries.e. Basal lamina of the fetal capillaries.f. Fetal endothelium.f. Fetal endothelium.

* Hormones produce = estrogen, progesterone, relaxin, * Hormones produce = estrogen, progesterone, relaxin, renin, chorionic gonadotropinsrenin, chorionic gonadotropins

Many chorionic villi are seen in the vicinity of the Many chorionic villi are seen in the vicinity of the uterine wall.  Both large and small chorionic villi have uterine wall.  Both large and small chorionic villi have the same basic structure, a surface of the same basic structure, a surface of syncytiotrophoblast surrounding a core of mesenchyme syncytiotrophoblast surrounding a core of mesenchyme containing fetal blood vessels.  Fetal blood vessels are containing fetal blood vessels.  Fetal blood vessels are visible here only in the largest villi.  The small villi visible here only in the largest villi.  The small villi vastly increase the surface area available for material vastly increase the surface area available for material interchange with maternal blood.  Decidual cells are interchange with maternal blood.  Decidual cells are large cuboidal cells derived from endometrial stroma.large cuboidal cells derived from endometrial stroma.

The External The External Female genitaliaFemale genitalia

The The cervixcervix and vagina represent the distal portion of the and vagina represent the distal portion of the reproductive tract, lined by stratified squamous reproductive tract, lined by stratified squamous epithelium. epithelium. Surface samples of cervical epithelium (Surface samples of cervical epithelium (Pap smearsPap smears) are ) are used to screen for cervical cancer.used to screen for cervical cancer.

Coats of the Vaginal wallCoats of the Vaginal wall

• Mucosa = with transverse folds or rugae.Mucosa = with transverse folds or rugae.Lined with thick stratified squamous non- Lined with thick stratified squamous non- keratinized cells, lacks glands, is lubricated keratinized cells, lacks glands, is lubricated by mucus from the cervix.by mucus from the cervix.

• Muscularis = smooth muscle fibers arranged Muscularis = smooth muscle fibers arranged in interlacing bundles. Inner bundle is in interlacing bundles. Inner bundle is circular and thin. The outer bundle is thicker, circular and thin. The outer bundle is thicker, longitudinally arranged, continuous with the longitudinally arranged, continuous with the myometrium.myometrium.

• Adventitia = the thin layer of dense Adventitia = the thin layer of dense connective tissue, blends with other connective tissue, blends with other surrounding organs.surrounding organs.

• The Clitoris = incomplete counterpart of the Penis.The Clitoris = incomplete counterpart of the Penis.

Consists of 2 cavernous erectile bodies which ends in Consists of 2 cavernous erectile bodies which ends in a small glans clitoridi. Covered by a thin stratified a small glans clitoridi. Covered by a thin stratified squamous cells.squamous cells.

• Labia Majora = folds of mucous membrane forming Labia Majora = folds of mucous membrane forming the lateral wall of the vestibule.the lateral wall of the vestibule.

• Labia majora = folds of skin that covers the labia Labia majora = folds of skin that covers the labia minora externally.. Outer layer is covered by a minora externally.. Outer layer is covered by a cornified epidermis w/c contains hairs, sweat glands, cornified epidermis w/c contains hairs, sweat glands, sebaceous glands.sebaceous glands.

• Vestibule = where the vagina and urethra opens. Vestibule = where the vagina and urethra opens. Lined by stratified squamous epithelium. With Lined by stratified squamous epithelium. With numerous small vestibular glands around the opening numerous small vestibular glands around the opening and near clitoris.( glands of Littre)and near clitoris.( glands of Littre)

• Bartholins glands( major vestibular gland). = Bartholins glands( major vestibular gland). = analogous to the bulbourethral glands of males. analogous to the bulbourethral glands of males. Produce lubricating mucous.Produce lubricating mucous.

• The Mammary gland = specialized The Mammary gland = specialized cutaneous glands locate within the cutaneous glands locate within the subcutaneous tissue. Develops at puberty. subcutaneous tissue. Develops at puberty. Has 15 to 20 lobes each.Has 15 to 20 lobes each.

• Nipple and areola = traversed by Nipple and areola = traversed by lactiferous ducts, opens by a pore on the lactiferous ducts, opens by a pore on the skin surface.skin surface.

• Glands of Montgomery = special dark Glands of Montgomery = special dark areolar glands.areolar glands.

• Pregnancy = colostrum is produced at Pregnancy = colostrum is produced at the end of pregnancy.the end of pregnancy.

• Lactation = Production of milk at the end Lactation = Production of milk at the end of pregnancy by the granular endoplasmic of pregnancy by the granular endoplasmic reticulum and the golgi complex vacoules.reticulum and the golgi complex vacoules.

• Hormonal control = Estrogen and Hormonal control = Estrogen and progesterone influenced the growth of the progesterone influenced the growth of the duct system at puberty. Lactation is duct system at puberty. Lactation is induced by the presence of prolactin from induced by the presence of prolactin from the pars distalis of Hypophysis.the pars distalis of Hypophysis.

• Oxytocin from the posterior pituitary Oxytocin from the posterior pituitary initiates contraction of the glands to initiates contraction of the glands to ejection of milk from the alveoli and the ejection of milk from the alveoli and the ducts.ducts.

• Oxytocin is produced by the nerve Oxytocin is produced by the nerve impulses reaching the hypothalamus after impulses reaching the hypothalamus after stimulation of tactile receptors in the stimulation of tactile receptors in the nipple area.nipple area.

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