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Saladin Chapter 27

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Title: Chapter 27 Author: Judy Megaw Last modified by: CHB109 Created Date: 4/9/2006 5:39:28 PM Document presentation format: On-screen Show (4:3) Company – PowerPoint PPT presentation

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Title: Saladin Chapter 27


1
Saladin Chapter 27
  • Female Reproductive System

2
FUNCTION
  • Provide offspring for survival of the species.

3
FEMALE REPRODUCTIVE SYSTEM
  • FUNCTIONS
  • Produce gametes.
  • Site for fertilization.
  • Provide nourishment protection for offspring.

4
FEMALE REPRODUCTIVE SYSTEM
5
FEMALE 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.

6
FEMALE 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.

7
FEMALE 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.

8
FEMALE REPRODUCTIVE SYSTEM Ovaries
  • Corpus luteum remnants of follicle after
    ovulation.
  • Secretes progesterone, estrogens, relaxin
    inhibin.
  • Degenerates into corpus albicans.

9
FEMALE REPRODUCTIVE SYSTEM Ovaries
10
FEMALE REPRODUCTIVE SYSTEM Ovaries
11
FEMALE 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.

12
FEMALE 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.

13
FEMALE REPRODUCTIVE SYSTEM UTERINE FALLOPIAN
TUBES
14
FEMALE REPRODUCTIVE SYSTEM Uterus
  • Pathway for sperm.
  • Site of menstruation.
  • Site of implantation.
  • Site of fetal development.

15
FEMALE REPRODUCTIVE SYSTEM Uterus
  • Parts
  • Fundus
  • Body uterine cavity
  • Isthmus
  • Cervix cervical canal
  • External os

16
FEMALE 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.

17
FEMALE REPRODUCTIVE SYSTEM UTERUS
18
FEMALE 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.

19
FEMALE 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.

20
FEMALE REPRODUCTIVE SYSTEM Uterus
21
FEMALE REPRODUCTIVE SYSTEM Vagina
  • Functions
  • Passage for menstrual flow.
  • Passage for sperm.
  • Passage for childbirth.
  • Tubular fibromuscular organ with mucus membrane
    of stratified squamous epithelium.

22
FEMALE 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.

23
FEMALE 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.

24
FEMALE 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.

25
FEMALE REPRODUCTIVE SYSTEM Vulva
  • Greater vestibular glands equiv. To Cowpers
    produce mucus for lubrication.

26
FEMALE 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.

27
FEMALE 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.

28
Mammary Glands
29
Breast 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.

30
Breast Cancer
  • Most is non-hereditary
  • Treatment - lumpectomy, simple or radical
    mastectomy, radiation and chemo

31
Breast Cancer
32
Breast Cancer
33
Breast Cancer
34
PUBERTY MENOPAUSE
  • PUBERTY
  • USA - 9 - 10 onset
  • GnRH --gt FSH LH
  • FSH --gt follicles --gt estrogens, progesterone
    inhibin
  • Estrogens "feminize" body

35
PUBERTY 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.

36
PUBERTY MENOPAUSE
  • Progesterone - prepares uterus for possible
    pregnancy
  • Inhibin suppresses FSH

37
PUBERTY 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.

38
Oogenesis
  • 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.

39
Oogenesis
  • 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.

40
Sexual Cycle
  • 28 days on average
  • Control hypothalamus --gt pituitary --gt ovaries
    --gt uterus
  • Ovarian cycle 2 phases - follicular luteal

41
Sexual 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

42
Sexual 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.

43
Sexual Cycle
  • The time BEFORE ovulation is the pre-ovulatory
    period
  • Ovulation - rupture of follicle - omit
    mechanism

44
Sexual 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.

45
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46
FEMALE 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

47
FEMALE 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

48
FEMALE 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

49
FEMALE 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

50
FEMALE 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

51
http//www.schneiderchildrenshospital.org/peds_htm
l_fixed/peds/adolescent/cycle.htm
52
Gestation
  • 39 weeks see Ch. 29 for stages
  • Embryonic phase zygote - through week 8.
  • Fetal phase 9-39 weeks.
  • Neonate first 6 wks after birth

53
Hormones 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.

54
Hormones 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

55
Childbirth
  • 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

56
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57
Childbirth
  • 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

58
Childbirth
  • Stretching of smooth muscles also promotes onset
    of contractions fetal dancing

59
LABOR
  • 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.

60
LABOR
61
LABOR 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.

62
LABOR 3 stages
63
LABOR 3 stages
64
LABOR 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.

65
Lactation
  • 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

66
Lactation
  • 2. milk prolactin stimulates synthesis
    antagonized by steroids hence no
    production DURING pregnancy hormone
    surge with each feeding stimulates
    production for next feeding

67
Lactation
  • 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.
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