Title: Saladin Chapter 27
1Saladin Chapter 27
- Female Reproductive System
2FUNCTION
- Provide offspring for survival of the species.
3FEMALE REPRODUCTIVE SYSTEM
- FUNCTIONS
- Produce gametes.
- Site for fertilization.
- Provide nourishment protection for offspring.
4FEMALE REPRODUCTIVE SYSTEM
5FEMALE REPRODUCTIVE SYSTEM Ovaries
- OVARIES from endodermal tissue.
- Produce secondary oocytes during oogenesis.
- Held by 3 ligaments broad part of parietal
peritoneum, ovarian to uterus suspensory to
pelvic wall.
6FEMALE REPRODUCTIVE SYSTEM Ovaries
- HISTOLOGY
- Germinal epithelium of simple squamous to
cuboidal epithelium on outer surface. - Tunica albuginea deep to germinal layer.
- Cortex contains ovarian follicles dense CT.
- Medulla loose CT, vessels, nerves.
7FEMALE REPRODUCTIVE SYSTEM Ovaries
- Ovarian follicle oocyte surrounding follicle
cells - In cortex. - Epithelial layers progressively become more
numerous, fluid is secreted into space with
oocyte. - Graafian follicle large, fluid filled
contains secondary oocyte ready for ovulation.
Secretes estrogens.
8FEMALE REPRODUCTIVE SYSTEM Ovaries
- Corpus luteum remnants of follicle after
ovulation. - Secretes progesterone, estrogens, relaxin
inhibin. - Degenerates into corpus albicans.
9FEMALE REPRODUCTIVE SYSTEM Ovaries
10FEMALE REPRODUCTIVE SYSTEM Ovaries
11FEMALE REPRODUCTIVE SYSTEM UTERINE FALLOPIAN
TUBES
- Transport channels for ova.
- Usually site of fertilization ? zygote reaches
uterus in about 7 days. - Layers mucosa, smooth muscles serosa.
- Mucosa continuous with vagina uterine.
12FEMALE REPRODUCTIVE SYSTEM UTERINE FALLOPIAN
TUBES
- Path for infectious agents to enter peritoneal
cavity ex. PID. - Infundibulum portion closest to ovary.
- Fimbriae finger-like projections from
infundibulum - Sweep- push ova into tube.
13FEMALE REPRODUCTIVE SYSTEM UTERINE FALLOPIAN
TUBES
14FEMALE REPRODUCTIVE SYSTEM Uterus
- Pathway for sperm.
- Site of menstruation.
- Site of implantation.
- Site of fetal development.
-
15FEMALE REPRODUCTIVE SYSTEM Uterus
- Parts
- Fundus
- Body uterine cavity
- Isthmus
- Cervix cervical canal
- External os
16FEMALE REPRODUCTIVE SYSTEM Uterus
- Secretory cells of the cervical mucosa lining
produce cervical mucus. - Held in place by 4 ligaments broad, uterosacral,
cardinal, round. - 3 layers Uterine Wall
- Perimetrium part of visceral peritoneum.
- Myometrium 3 layers of smooth muscles
stimulated by oxytocin during labor.
17FEMALE REPRODUCTIVE SYSTEM UTERUS
18FEMALE REPRODUCTIVE SYSTEM Uterus
- Endometrium highly vascularized.
- Simple ciliated columnar epithelium secretory
cells. - 2 layers
- Stratum functionalis closest to uterine cavity
shed during menstruation. - Stratum basalis permanent layer which
repeatedly gives rise to stratum functionalis.
19FEMALE REPRODUCTIVE SYSTEM Uterus
- Blood supply uterine arteries ? arcuate
arteries ? radial arteries ? straight arterioles
or spiral arterioles. - Straight arterioles terminate in s. basalis
supply materials needed to regenerate s.
functionalis. - Spiral arterioles penetrate into s. functionalis
change markedly during menstrual cycle.
20FEMALE REPRODUCTIVE SYSTEM Uterus
21FEMALE REPRODUCTIVE SYSTEM Vagina
- Functions
- Passage for menstrual flow.
- Passage for sperm.
- Passage for childbirth.
- Tubular fibromuscular organ with mucus membrane
of stratified squamous epithelium.
22FEMALE REPRODUCTIVE SYSTEM Vagina
- Mucus has large amounts of glycogen which
decomposes to produce acids. The low pH retards
microbial growth, but is harmful to sperm. -
- Muscularis smooth muscle, rugae, highly
stretchable.
23FEMALE REPRODUCTIVE SYSTEM Vulva
- External female genitalia.
- Mons pubis skin adipose cushion of pubic
symphysis. - Labia majora 2 folds of skin with sebaceous
sudoriferous glands. - Labia minora 2 folds medial to majora contain
mostly sebaceous gland.
24FEMALE REPRODUCTIVE SYSTEM Vulva
- Clitoris small mass of erectile tissue nerves
with prepuce a glans analogous to penis. - Vestibule cleft between labia minora contains
hymen, vaginal orifice, urethral orifice duct
openings. - Paraurethral glands equiv. To prostate secrete
mucus.
25FEMALE REPRODUCTIVE SYSTEM Vulva
- Greater vestibular glands equiv. To Cowpers
produce mucus for lubrication.
26FEMALE REPRODUCTIVE SYSTEM Mammary Glands
- Modified sudoriferous glands which produce milk.
- Areola pigmented area around nipple contains
modified oil glands. - Function lactation control prolactin
synthesis oxytocin ejection.
27FEMALE REPRODUCTIVE SYSTEM Mammary Glands
- 15-20 lobes separated by adipose tissue.
- Subdivided into lobules with clusters of alveoli
milk secreting glands. - Produce milk passes to lactiferous sinuses
storage to lactiferous ducts to nipple.
28Mammary Glands
29Breast Cancer
- 12 or more of population
- Begin in mammary ducts - metastasize via axillary
nodes - 2 genes that cause it have been identified - BRCA
1 and 2.
30Breast Cancer
- Most is non-hereditary
- Treatment - lumpectomy, simple or radical
mastectomy, radiation and chemo
31Breast Cancer
32Breast Cancer
33Breast Cancer
34PUBERTY MENOPAUSE
- PUBERTY
- USA - 9 - 10 onset
- GnRH --gt FSH LH
- FSH --gt follicles --gt estrogens, progesterone
inhibin - Estrogens "feminize" body
35PUBERTY MENOPAUSE
- Phases
- thelarche - breast development
- pubarche - hair, etc.
- menarche - beginning of menstruation - related to
nutrition and body fat status - ovulation doesn't usually start until a year
later.
36PUBERTY MENOPAUSE
- Progesterone - prepares uterus for possible
pregnancy - Inhibin suppresses FSH
37PUBERTY MENOPAUSE
- MENOPAUSE - when cycling ceases
- begins when egg count drops below 1000
- organs atrophy
- hot flashes - sudden dilation of cutaneous
vessels - Hormone replacement therapy - progesterone and/or
low dose estrogen - have risks.
38Oogenesis
- Primordial germ cell from yolk sac migrates to
ovary during development. - Mitosis ? a primary oocyte 2N Primary oocyte
enters meiosis I, stops primary follicle. - At puberty LH levels rise, oocyte completes
meiosis I Secondary oocyte polar body.
39Oogenesis
- In monthly cycles, one or more secondary oocytes
enter meiosis II, stop at metaphase II. - If fertilization occurs ? completes meiosis II
ovum. - Ovum nucleus fuses with sperm ? zygote if no
fertilization, ovum degenerates.
40Sexual Cycle
- 28 days on average
- Control hypothalamus --gt pituitary --gt ovaries
--gt uterus - Ovarian cycle 2 phases - follicular luteal
41Sexual Cycle
- Follicular Phase preantral - before birth,
antral phases - Primordial follicle - develops 12-16 wks
gestation - oocyte in early meiosis single
layer of follicular cells - Primary follicle - pre-birth - follicular cells
thicken and ad layers -- gt zona pellucida
glycoprotein gel
42Sexual Cycle
- Secondary antral follicle - develops from
primary to Graafian several develop each
month. - Dominant follicle - The one that wins the race to
develop first undergoes ovulation expulsion
from Graafian follicle into body cavity.
43Sexual Cycle
- The time BEFORE ovulation is the pre-ovulatory
period - Ovulation - rupture of follicle - omit
mechanism
44Sexual Cycle
- The Luteal phase then begins - the corpus luteum
develops from the remnants of the Graafian
follicle secretes Es P increases 10X - If no pregnancy --gt stops secretion and becomes
corpus albicans.
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46FEMALE REPRODUCTIVE CYCLE
- MENSTRUAL CYCLE build up, breakdown and
disposal of endometrium monthly. - 1. General 4 phases involve hormonal changes
brain, pituitary, ovaries, uterus, cyclic
changes in breast and cervical tissue - Average
cycle 28 days 24-35 range
47FEMALE REPRODUCTIVE CYCLE
- 2. Proliferative phase - days 6-14
- Estrogen stimulates replacement of stratum
functionalis via mitosis in stratum basalis ?
increases endometrium thickness - Estrogen also stimulates formation of
progesterone receptors
48FEMALE REPRODUCTIVE CYCLE
- 3. Secretory phase days 15-28
- Progesterone stimulates increased proliferation
of endometrial glands and stimulates release of
glycogen from them. - Progesterone also stimulates vascularization and
thickening of the stratum functionalis and an
increase in tissue fluid
49FEMALE REPRODUCTIVE CYCLE
- 4. Premenstrual phase
- If fertilization does not occur,m corpus luteum
degenerates to Corpus albicans and get low
Progesterone and Estrogen levels ?constriction of
spiral arterioles ? ischemic phase ? necrosis,
degeneration
50FEMALE REPRODUCTIVE CYCLE
- 5. Menstrual phase first 1-5 days
- Cells supplied by spiral arterioles slough off
results in total loss of stratum functionalis
50-150 mL blood, tissue and fluid
51http//www.schneiderchildrenshospital.org/peds_htm
l_fixed/peds/adolescent/cycle.htm
52Gestation
- 39 weeks see Ch. 29 for stages
- Embryonic phase zygote - through week 8.
- Fetal phase 9-39 weeks.
- Neonate first 6 wks after birth
53Hormones of Pregnancy
- 1. HCG from blastocyst placenta stimulates
growth of corpus luteum to continue progesterone
estrogen production - 2. Estrogens - most effects from estrodiol.
Increases 30X during pregnancy 1st 12 wks from
CL, then placenta stimulates fetal maternal
tissue growth, breast growth, etc.
54Hormones of Pregnancy
- 3. Progesterone CL, then placenta. With
Estrogen suppresses pituitary no additional
follicle development,, suppresses
contractions, keeps endometrium intact - See Table 28.2 for other hormones of pregnancy
- OMIT Adjustments to Pregnancy
55Childbirth
- 1. Vertex position most common move into
at 7th mo. - 2. Uterine contractility Braxton Hicks
contractions twitches of uterus - 3. Labor contractions onset of birth
parturition
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57Childbirth
- Increases in ES overrides P, to allow
contractions of the uterine muscles - Oxytocin stimulates contractions in concert
with prostaglandins produced by fetal membranes,
- Relaxin increases the flexibility of the pubic
symphysis
58Childbirth
- Stretching of smooth muscles also promotes onset
of contractions fetal dancing
59LABOR
- Birth parturition.
- Increases in ES overrides P, to allow
contractions of the uterine muscles. - Oxytocin stimulates contractions, relaxin
increases the flexibility of the pubic symphysis.
60LABOR
61LABOR 3 stages
- Stage of Dilation - onset of contractions,
rupture of amniotic sac, dilation of cervix. - Stage of Expulsion - from point of maximal
cervical dilation until baby's body exits through
the vagina. - Placental stage - time required after expulsion
of the infant until placenta is expelled.
62LABOR 3 stages
63LABOR 3 stages
64LABOR 3 stages
- Puerperium post delivery 6 wks body is
returning to normal - 1. uterine involution
- 2. lactation nursing for median age 2.8
years world wide.
65Lactation
- Mammaries develop under stimulation of estrogen
and other hormones. Many ducts. - Colostrum milk
- 1. colostrums low fat milk 1-3 days, has
antibodies that get into circulation -
66Lactation
- 2. milk prolactin stimulates synthesis
antagonized by steroids hence no
production DURING pregnancy hormone
surge with each feeding stimulates
production for next feeding -
67Lactation
- 3. few women become pregnant while
nursing, but SOME do inhibits GnRH - 4. postpartum cycles are usually anovulatory
for several months - Milk ejection oxytocin stimulus is suckling
- CONTRACEPTION review methods pages 1096 1098.