female reproductive Flashcards
gonads and accessory structures
ovaries
- make ova
- secrete estrogen (estradiol, estrone, estriol) and progesterone
Accessory
- eterine tubes
- uterus
- vagina
internal
in pelvic cavity Ovaries Uterine tubes Uterus Vagina
sacs of peritoneum around uterus
Vesicouterine pouch between bladder and uterus
Rectouterine pouch between rectum and uterus
Ligaments
Ovarian ligament - anchors ovary medially to uterus
Suspensory ligament - anchors ovary laterally to pelvic wall
Mesovarium - suspends ovary
Suspensory ligament and mesovarium part of broad ligament – supports uterine tubes, uterus, and vagina
ovary blood supply and layers
ovarian arteries and ovarian branch of the uterine arteries
surrounded by fibrous tunica albuginea
germinal epithelium = outer layer
two poorly defined regions:
- outer cortex which houses forming gametes
- inner medulla which houses blood vessels and nerves
Ovarian follicles
immature egg (oocyte) surrounded by
- follicle cells (one layer thick)
- granulosa cells (over one layer)
Several stages of development
- primordial follicle = single layer of follicle cells and oocyte
- more mature follicles = several layers of granulosa cells
- vesicular (antral or tertiary) follicle = fully mature with fluid-filled antrum –> follicle bulges from ovary surface
ovulation and corpus luteum
ovulation = ejection of oocyte from ripening follicle
corpus luteum develops from ruptured follicle after ovulation
duct system contact with ovary
no contact
oocytes are cast into peritoneal canvity where some are lost
uterine tubes
anatomy
function
receive ovulated oocyte - usual site of fertilization
Isthmus = constricted region where tube joins uterus
ampulla
Distal expansion with infundibulum near ovary - ciliated fimbriae of infundibulum create current
- oocytes carried along by peristalsis and ciliary action
- nonciliated cells (peg cells) nourish oocyte and sperm
- covered externally by peritoneum
- mesosalpinx = mesentery that supports uterine tubes
Uterus: cervix, cervical canal, and cervical glands
cervix = narrow nexk, or outlet projecting into vagina
cervical canal communicates with vagina via external os and uterine body via internal os
cervical glands secrete mucus that blocks sperm entry except during midcycle
the rest of the uterus
hollow, thick walled, muscular organ
receives, retains, and nourishes fertilized ovum
Anteverted - inclined forward; retroverted - inclined backward
body = major portion fundus = rounded superior region isthmus = narrow inferior region
uterus histology
perimetrium = serous layer (visceral peritoneum) myometrium = interlacing layers of smooth muscle endometrium = mucosal lining
endometrial layers
Stratum functionalis
- changes in response to ovarian hormone cycles
- sheds during menstruation
stratum basalis
- forms new functionalis after menstruation
- unresponsive to ovarian hormones
uterine vascular supply
Uterine arteries arise from internal iliacs; branch into
Arcuate arteries in myometrium; branch into
Radial arteries in endometrium; branch into
- Straight arteries –> stratum basalis
- Spiral arteries –> stratum functionalis (Degenerate and regenerate; spasms –> shedding of functionalis layer during menstruation)
Cervical cancer
- 450,000 women each year - kills half. In US those who dies are those who didn’t get regular screening and those with immune deficiencies
- most common bt 30-50
Risks: basically all cases related to HPV
Papanicolau (pap) smear for detection
-every 2-3 years. every 5 years if negative HPV test. May discontinue at age 65 if normal screenings prior
HPV vaccine
-3 dose vaccine
Recommended for 11- and 12-year-old girls and boys as well as catch up immunization for those under 26. Those between the age of 26-45 can consider it if they are considered at risk. Does not prevent the need for screening. Does not cover all strains of HPV that cause cervical cancer.
vagina: gross anatomy
- Thin-walled tube 8-10 cm in length
- -Birth canal and organ of copulation
- Extends between bladder and rectum from cervix to exterior
- Urethra parallels course anteriorly; embedded in anterior wall
- Vaginal fornix = upper end of vagina surrounding cervix
vagina microscopic anatomy
layers
HIV access
hymen
Layers of wall
- fibroelastic adventitia
- smooth muscle muscularis
- stratified squamous mucosa with rugae
dendritic cells in mucosa may provide route for HIV transmission
Mucosa near vaginal orifice forms incomplete partition called hymen - ruptures with intercourse
External genitaila: mons pubis, labia majora/minora
Mons pubis - fatty area overlying pubic symphysis
Labia majora - hair-covered, fatty skin folds
-Counterpart of male scrotum
Labia minora - skin folds lying within labia majora
- Join at posterior end of vestibule fourchette
- Vestibule - recess within labia minora
external genitalia: greater vestibular glands, clitoris, and perineum
Greater vestibular glands
- Flank vaginal opening
- Homologous to bulbo-urethral glands
- Release mucus into vestibule for lubrication
Clitoris - anterior to vestibule
- glans of the clitoris = exposed portion
- prepuce of clitoris = hoods glans
- counterpart of glans penis
Perineum
- diamond shaped region bt pubic arch and coccyx
- bordered by ischial tuberosities laterally
Mammary glands
Modified sweat glands consisting of 15–25 lobes
Function in milk production
Areola - pigmented skin surrounding nipple
Suspensory ligaments (Cooper’s ligaments) – attach breast to underlying muscle
Lobules within lobes contain glandular alveoli that produce milk
breast cancer: stats and contraceptives
Invasive breast cancer most common malignancy, second most common cause of cancer death in U.S. women
13% will develop condition
Use of hormonal contraceptives quadruple risk of most aggressive breast cancer (triple negative breast cancer) in women under the age of 40
Breast cancer: cause and risk factors
Usually arises from epithelial cells of smallest ducts; eventually metastasize
Risk factors include
- Early onset of menstruation and late menopause
- No pregnancies or first pregnancy late in life
- No or short periods of breast feeding
- Family history of breast cancer
- Hormonal contraceptive use
10% due to hereditary defects, including mutations to genes BRCA1 and BRCA2
50 – 80% develop breast cancer
Greater risk of ovarian cancer as well
70% of women with breast cancer have no known risk factors
Breast cancer diagnosis
Early detection via self-examination and mammography
-X-ray examination
-American Cancer Society recommends screening every year for women 40 and over. This is controversial because it has not shown to increase survival. Increased risk from unnecessary invasive diagnostic tests such as biopsies,
-U.S. Prevention Services Task Force on Breast Cancer Screening recommends screening every two years in ages 50 and over
These recommendations are for asymptomatic women with no significant risk factors.
-Women who have symptoms or have significant risk factors will have mammography recommendations based on their individual case, not on the general population screening recommendations