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Female Reproductive System

FEMALE REPRODUCTIVE SYSTEM

CHAPTER OBJECTIVES
When you have completed this chapter you should be able to:
  • Name and describe the female reproductive organs.
  • Describe the role hormones play in ovulation and menstruation.
  • Describe the anatomy and function of the breast.

Ovaries

The ovaries are the primary sex organs of the female and produce the female sex cells (ovum). They are paired almond-shaped glands, about 3 cm long and 1.5 cm wide and lie close to the lateral pelvic walls.

Each ovary is suspended int he peritoneal cavity by several ligaments. A suspensory ligament holds the upper pole of the ovary to the pelvic wall and an ovarian ligament holds the lower pole to the uterus. The frontal border of the ovary is attached to the back of the broad ligament by a fold of peritoneum called the mesovarium. Its medial surface is covered by the uterine tube, which arches over the ovary to end in finger-like fimbriae and cover its lateral surface.

Ovulation

At birth each ovary contains a large number of primary oocytes. Each primary oocyte is enclosed in a primordial follicle and after puberty, just before the beginning of each menstrual cycle some of the primordial follicles develop into graafian follicles. One of these graafian follicles will continue to mature and rupture, allowing an ovum (oocyte) to leave the ovary. The ovum then travels down the uterine tube where it may be fertilized by a male sperm.

After the ovum has been released into the uterine tube the remains of the graafian follicle in the ovary develops into a corpus luteum.  The corpus luteum releases progesterone and oestrogen, which triggers the endometrial lining of the uterus to thicken, ready to receive the egg. If the ovum is fertilized, the corpus luteum will remain until after the pregnancy, otherwise it will degenerate within two weeks. If the ovum is not fertilized and the hormones are no longer released, the endometrium is shed in a process called menstruation.

The function of the ovary is controlled by the follicle stimulating hormone (FSH) and luteinizing hormone, released from the anterior pituitary gland. The hormones are also responsible for the development of secondary sexual characteristics, which include growth of the breasts and pubic hair.

At the age of about 45, the ovaries stop producing ova in a process called the menopause.

THE OVARY

SELF-TEST
Complete the following questions before you go onto the next section:
  • Describe the position of the ovaries.
  • How are the ovaries suspended?
  • Describe the process of ovulation.

Uterine tubes

The paired uterine tubes receive the oocyte from the ovary and provide a site for fertilization. After fertilization the resulting zygote is conveyed along the rest of the tube to the uterus by the movement of cilia lining the tube.

Each uterine tube is around 10 cm in length and can be divided into 4 parts;

Name Description
Infundibulum The wide, funnel-shaped, distal end of the uterine tube that is closely associated with the ovary. It has finger-like processes or fimbriae, that loosely enclose the ovary.
Ampulla The middle and longest part of the uterine tube. It is within the lumen of the ampulla that fertilization generally occurs.
Isthmus The medial third of the uterine tube, it is the narrowest part of the tube and opens into the upper end of the uterus.
Intrauterine part The part of the tube which passes through the wall of the uterus to open into the uterine cavity through the small uterine os.
SELF-TEST
Complete the following questions before you go onto the next section:
  • Name the 4 parts of the uterine tube.
  • In which part of the uterine tube does fertilization usually occur?

Uterus

The uterus is a hollow organ with thick muscular walls approximately 8 cm long, 6 cm wide, and 3 cm thick. It is roughly pear-shaped and usually lies at right angles to the vagina in between the rectum and the bladder.

It can be described in three parts;

Name Description
Cervix The narrow neck of the uterus that protrudes into the vagina inferiorly. It has a narrow canal running through it, connecting the cavity of the uterus to that of the vagina. The upper opening is called the internal os, and the lower opening the external os.
Fundus The dome-shaped portion that lies superior to the entry point of the uterine tubes.
Body The main, pear-shaped part of uterus.

THE UTERUS

The walls of the uterus are composed of three layers;

Name Description
Perimetrium The outer layer of connective tissue, derived from peritoneum.
Myometrium The middle layer of smooth muscle, which contracts rhythmically during childbirth to expel the baby.
Endometrium The internal mucosal layer that thickens during the menstrual cycle and partially disintegrates prior to menstruation.

The uterus is held in position by a series of ligaments;

Name Description
Broad ligament A sheet of peritoneum that suspends the uterus from the lateral pelvic walls.
Round ligament Lies within the broad ligament and travels out of the pelvic cavity through the inguinal canal to the labia majora. They are homologous with the ductus deferens in the male.
Transverse cervical ligament Runs in the broad ligament to hold the cervix to the lateral cervical wall.
Uterosacral ligament Connects the cervix to the sacrum.

THE BROAD LIGAMENT

Pregnancy

If an oocyte is successfully fertilized in the uterine tube, it travels to the cavity of the uterus and becomes embedded within the endometrium of the uterine wall. Here the developing foetus grows until it fills the uterus, from which point the uterus will expand with it. Where the egg implants will determine the site of the placenta, an organ that supplies the foetus with maternal blood.

PREGNANCY

Menstruation

Menstruation is the shedding of the endometrial lining of the uterus. This occurs every month in women from puberty to the menopause. The following table describes how hormones control this process;

Action Effect
1 The anterior lobe of the pituitary releases the follicle-stimulating hormone (FSH). FSH stimulates the ovary to develop a graafian follicle.
2 The ovum within the follicle develops and the follicle produces oestrogen. Oestrogen triggers the endometrium of the uterus to thicken.
3 The anterior lobe of the pituitary will stop producing FSH due to the high levels of oestrogen, and will start producing a luteinizing hormone (LH). After the ovulation, LH converts the remains of the follicle into a corpus luteum.
4 The corpus luteum releases progesterone. Progesterone signals to the endometrial lining of the uterus to continue thickening.
5 If the ovum is fertilized, the corpus luteum will remain until after the pregnancy, continuing to produce progesterone, otherwise it will degenerate within two weeks and so the levels of progesterone will decrease. The continued production of progesterone during pregnacy maintains the endometrial linning and prepares the breasts for lactation.  The decrease in progesterone if preganacy does not occur causes the endometrium to be shed and is called menstruation. It also triggers the pituitary to release FSH to begin the cycle again.

Clinical considerations

Cervical cancer A common but treatable form of cancer in females. It can be detected by taking cell samples from the cervix and checking for any abnormalities. Samples are usually obtained by a Papanicolaou (Pap) smear.
SELF-TEST
Complete the following questions before you go onto the next section:
  • Describe how ligaments support the uterus.
  • Which layer of the uterus is lost during menstruation?
  • What is the role of FSH in menstruation?

Vagina

The vagina is a fibromuscular tube that runs between the cervix and the vaginal orifice. It lies anterior to the anal canal and rectum, and posterior to the bladder and urethra, which is embedded within its anterior aspect. The vaginal walls consist of an outer connective tissue layer, a middle muscular layer and an inner mucosa.  The muscular layers of the vaginal walls are composed of smooth muscle arranged in an external longitudinal and an internal circular layer.   The vagina is lubricated by mucous glands found on the cervix as well as the secretions of the greater vestibular glands.. 

Function

It serves as the outlet for menstrual flow, receives the erect penis during intercourse, and forms the inferior portion of the birth canal in parturition.

SELF-TEST
Complete the following questions before you go onto the next section:
  • Describe the anatomical position of the vagina.
  • What is the function of the vagina?

External genitalia

The external genitalia of the female are collectively known as the vulva, and are described as the following structures;

Name Description
Mons pubis A pad of fat that lies over the pubic symphysis, covered with course pubic hair.
Labia majora The labia majora are a pair of longitudinal cutaneous folds extending backwards from the mons pubis to the perineum. The lateral surface of the labia is covered by pubic hair, while the medial surface is smooth. They provide protection for the vaginal and urethral orifices.
Labia minora The labia minora are paired, hairless cutaneous folds lying medial to the labia majora. They extend backwards from the clitoris to form the frenulum, where they merge with the surrounding skin. Anteriorly, the labia minora have two layers: the superior joins anterior to the clitoris to form the prepuce.
Clitoris The clitoris is an erectile organ that is highly sensitive to tactile stimulation and will enlarge during female sexual arousal. It consists of a glans attached to a body, which at the level of the pubic bone separates into a V shape forming the crura, which are made up of corpora cavernosa tissue.
Vestibule This is the area in between the labia minora. The urethra and vagina open into this space.
Urethral orifice The urethra opens into the vestibule, in front of the vaginal orifice about 2 cm posterior to the clitoris.
Vaginal orifice The vagina orifice is the external opening of the vagina which opens into the vestibule behind the urethral orifice. In a virgin an incomplete mucous membrane fold, the hymen may cover it.
Greater vestibular glands The greater vestibular glands are located superior to the labia majora, behind the vaginal orifice. They are homologous to the bulbo-urethral glands in the male and secrete mucous into the vestibule of the vagina during sexual arousal. They also contain some endocrine tissue.
SELF-TEST
Complete the following questions before you go onto the next section:
  • Describe the differences between the labia minora and majora.
  • What are the different parts of the clitoris?
  • Which structure in the male are the greater vestibular glands homologous to?

Breasts

The breasts are accessory organs to the female reproductive system. They are mounds of a variable size and shape that lie on the front of the thorax superficial to pectoralis major. The breasts develop during puberty and then again during pregnancy. In the centre of each breast is the nipple, which turns from pink to brown after a woman has her first child.

Each breast contains mammary glands that form 15 to 20 lobes and are arranged like the petals of a flower. Each lobe has many smaller lobules, which end in dozens of tiny bulbs that can produce milk. Ducts drain the milk from these lobes into the centre of the nipple, the areola. The breasts will secrete an antibody-rich substance called colostrum for about three days after childbirth, after this they produce milk.

THE BREAST

SELF-TEST
Complete the following questions before you go onto the next section:
  • Describe the position of the breasts.
  • How many lobules does each breast contain?
Test your understanding of this chapter with the Interactive QUIZZES and MCQs