ANATOMY AND PHYSIOLOGY

Female reproductive system

Photograph of the vulva: A pictorial of the human female reproductive system. A pictorial of a non-lactating and lactating breast.

1. Pubic hair (shaved) 4. Labia majora

2. Clitoral hood 5. Labia minora

3. Clitoris 6. Perineum
FEMALE EXTERNAL REPRODUCTIVE ORGANS

Mons Pubis

The mons pubis is a softly rounded mound of subcutaneous fatty tissue beginning at the lowest

portion of the anterior abdominal wall. Also known as the mons veneris, this structure covers the

front portion of the symphisis pubis after puberty. The mons pubis is covered with pubic hair,

typically with the hairline forming at transverse line across the lower abdomen. The hair is short

in all women. The mons pubis protects the pelvic bones, especially during coitus.

Labia Majora

The labia majora are longitudinal, raised folds of pigmented skin, one on either side of the vulvar

cleft. As the pair descends, they narrow and merge to form the posterior junction of the perineal

skin. Their chief function is to protect the structures lying between them.

Labia Minora

The labia minora are soft of skin within the labia majora that converge near the anus, forming the

fourchette. Each labium minus has the appearance of shiny mucous membrane, moist and devoid

of hair follicles. The labia minora are rich in sebaceous glands, which lubricate and waterproof

the vulvar skin and provide bactericidal secretioins.

The clitoris, located between the labia minora, is about 5-6 mm long and 6-8 mm across. Each

tissue is essentially erectile. The glands of the clitoris is partly covered by the fold of skin called

prepuce, or clitoral hood.

Urethral meatus and Paraurethral glands

The urethral meatus is located 1-2.5 cm beneath the clitoris in the midline of the vestibule: it

often appears as a puckered, slitlike opening. At times the meatus is difficult to visualize because

of the presence of blind dimples or small mucosal folds. The paraurethral glands or Skene’s

glands, open into the posterior wall of the urethra close to its opening. Their secretions lubricate

the vaginal opening, facilitating sexual intercourse.

Vaginal vestibule

The vaginal vestibule is a boat-shape depression and closed by the labia majora and visible when

they are separated. The vestibule contains the vaginal opening, or introitus, which is the border

between the external and inter genitals

The hymen is a thin, elastic collar or semi-collar of tissue that surrounds the vaginal opening.

The hymen essentially opening.

However, modern studies of female genital anatomy have revealed that the hymen surrounds

rather than entirely covers the vaginal opening, and can be torn not only through sexual

intercourse but also through physical activity, masturbation, menstruation, or the use of tampons,

thus dispelling old beliefs.

opening of the ducts of the vulvovaginal (Bartholin’s) gland. They lie under the constrictor

muscle of the vagina. This glands secrete a clear, thick, alkaline mucus that enhances the

viability and motility of the sperm deposited at the vaginal vestibule.

Perineal body

The perineal body is a wedge-shaped mass of fibromuscular tissue found between the lower part

of the vagina and the anus.The superficial area between the anus and the vagina is referred to as

perineum. The muscles that meet at the perineal body are the external spinchter ani, both levator

ani (the superficial and the deep transverse perineal), and the bulvocarvernosus. These muscles

mingle with elastic fibers and connective tissue in an arrangement that allows a remarkable

amount of stretching.

FEMALE INTERNAL REPRODUCTIVE ORGANS

The female internal reproductive organs are: the vagina, uterus, fallopian tube, and ovaries.

These are trget organs for estrogenic hormones, and they play a unique part in the reproductive

cycle

Vagina

The vagina is a muscular and membranous tube that connects the external genital with the uterus.

It extends from the vulva to the uterus to a position nearly parallel to the pain of the pelvic brim.

The vagina is often called the birth canal because it forms the lower part of the pelvis through

which the fetus must pass during birth.

around the cervix called the vaginal fornix. The upper 4th of the vagina is separated from the

rectum by the pouch of douglas. This deep pouch or recess is posterior to the cervix. The walls of

the vagina are covered with ridges, or rugae crisscrossing each other. These rugae allow the

vaginal tissue to stretch enough for the fetus to pass through during child birth. The vagina has 3

functions; 1st serve as the passage for sperm and for the fetus during birth; 2nd provide passage for

the menstrual products from the uterine endometrium to the outside of the body; and lastly, it

protect against trauma from sexual intercourse and infection from pathogenic organisms.

Uterus

The uterus is a hallow, muscular, thick-walled organ shaped like an upside-down pear. It lies in

the center of the pelvic cavity between the base of the bladder and the rectum and above the

vagina.

The uterus is divided into two major parts, an upper triangular portion called the corpus or

uterine body and a lower cylindric portion called the cervix. The upper 2/3 of the uterus (the

corpus or uterine body) composed of mainly of smooth muscle layer (myometrium). The lower

third is cervix or neck. The rounded upper most (dome shaped top) portion of the corpus that

extends above the points of attachment of fallopian tubes is called the fundus. The elongated

portion of the uterus where the fallopian tubes enter is called the cornua. The isthmus is the

portion of the uterus between the internal cervical OS and the endometrial cavity.

The isthmus takes on importance in pregnancy because it becomes lower uterine segment.
The function of the uterus is to provide safe environment for fetal development. The uterine

lining is cyclically prepared by steroid hormones for implantation of the embryo, a process

known as nidation.

Uterine Corpus

The uterine corpus is made up of 3 layers. The outer most layers is the serosal layer or

perimetrium which is composed of peritoneum. The middle layer is the muscular uterine layer or

myometrium this muscle uterine layer is continuous with the muscle layer of the fallopian tubes

and the vagina. This continuity helps this organs present a unified reaction to various stimuli-

ovulation, or orgasm or the deposit of sperm to the vagina. The myometrium has 3 distinct layers

of uterine involuntary muscles. The outer layer, found mainly over the fundus is made up of

longitudinal muscles that cause cervical effacement and expel the fetus during birth. The thick

middle layer is made up of interlacing muscle fibers in figure-8 pattern. The inner muscle layer is

composing of circular fibers that form sphincter at the fallopian tube attachment sites and at the

internal OS. The internal OS sphincter inhibits the expulsion of the uterine contents during

pregnancy but stretches in labor as cervical dilation occurs. The sphincters at the fallopian tube

prevent menstrual blood from flowing backward into the fallopian tube from the uterus. The

uterine contractions of labor are responsible from the dilatation\of the cervix and provide the

major force for the passage of the fetus through pelvis and vaginal canal at birth. The mucosal

layer or the endometrium of the uterine corpus is the inner most layer. This single layer is

composed of columnar epithelium, glands, and stroma. The glands of the endometrium produce a

thin, watery alkaline secretion that keeps the uterine cavity moist. This endometrial milk not only

help sperm travel to the fallopian tubes but also nourishes the developing embryo before it

implants in the endometrium.

The narrow neck of the uterus is the cervix it meets the body of the uterus at the internal OS and

descends about 2.5 cm. to connect with the vagina at the external OS. Thus it provides a

protective entrance for the body of the uterus. Vaginal cervix appears pink and ends at the

external OS. The cervical canal appears rosy red and is lined with columnar ciliated epithelium,

which contains mucus secreting glands. The cervical mucus has three functions, first is to

lubricate vaginal canal; second is to act as a bacteriostatic agent; to provide an alkaline

environment to shelter deposited sperm from the acidic vagina.

At ovulation cervical mucus is clearer, thinner more profuse and more alkaline than at other

times.

Fallopian Tubes

The two fallopian tubes, also known as the oviducts or uterine tubes, arise from each side of the

uterus and reach almost to the sides of the pelvis, where they turn toward the ovaries each tube is

approximately 8 to13.5 cm long. A short section of each fallopian tube is inside the uterus; its

opening into the uterus is only 1mm in diameter, this linkage increase a woman’s biologic

vulnerability to disease processes.

Each fallopian tube may be divided into three parts: the isthmus, the ampulla, and the

infundibulum, or fimbria. The isthmus is straight and narrow, with a thick muscular wall and an

opening (lumen) 2 to 3mm in diameter. It is the site of tubal ligation, surgical pregnancy. Curve

ampulla comprises the oute r 2/3 of the tube the ampulla ends. The ampulla ends at the fimbria
which is a funnel shaped enlargement with many projection, called fimbriae reaching out to the

ovary. The longest of these, the fimbria ovarica, is attached to the ovary to increase the chances

of intercepting the ovum as it is released.

The wall of the fallopian tube is made up of 4 layers: peritoneal (serous), sub serous (adventitial),

muscular and mucous tissues. The peritoneum covers the tube. The sub serous contains the blood

and nerve supply and the muscular layer is responsible for the peristaltic movement of the tube.

The mucosal layer, immediately next to muscular layer is composed of ciliated and non ciliated

cell. The fallopian tube has 3 functions to provide transport for the ovary the uterus (transport

time through the fallopian tube varies from 3-4 days): to provide a site for fertilization: to serve

as a warm, moist, nourishing environment for the ovum or zygote (fertilized egg).

Ovaries

The ovaries are two almond shaped structures just below the pelvic brim. One ovary is located

on each side of the pelvic cavity. The ovaries are composed of three layers: the tunica albuginea,

the cortex and the medulla. The tunica albuginea is dense and dull white and serves as a

productive protective layer. The cortex is the main functional part because it contains ova,

graafian follicle, corpora lutea, the generated corpora lutea (corpora albicantia) and degenerated

follicles. The medulla is completely surrounded by the cortex can contain the nerves and the

blood and the lymphatic vessels. Ovaries are the primary sources of the two important hormones:

the estrogen and the progesterone.