FEMALE REPRODUCTIVE SYSTEM Flashcards
the external female genital organs consisting of other external structure
vulva
is a pad of fat lying over the symphysis pubis, covered with pubic hair from the time of puberty
mons pubis
- are two folds of fat and areolar tissue, covered with skin and pubic hair on the outer surface
- protects the labia minora, urinary meatus and vagina
labia majora
are two folds of the skin between the labia majora, pinkish, moist and highly vascular
labia minora
erectile organ; extremely sensitive and highly vascular and plays a part in the orgasm of sexual intercourse
clitoris
- oval shaped area formed between labia minora, clitoris and fourchette
- Contains external urethral meatus, vaginal introitus and Bartholin’s glands
vestibules
also known as the introitus of the vagina and occupies the posterior two-thirds of the vestibule
vaginal orifice
the vaginal orifice is partially closed by the ___ a thin membrane that tears during sexual intercourse or during birth of the first child
hymen
are two small glands which open on either side of the vaginal orifice and lie on the posterior part of the labia majora; secrete mucus which lubricates the vaginal opening
bartholin’s glands
- most posterior part of external female reproductive organ
- composed of fibrous and muscular tissues that support pelvic structures
perineum
the perineum extends from the ___ anteriorly to the ____ posteriorly
fourchette, anus
- Birth canal; elastic elastic fibro-muscular tube; 8-10 cm long
- Slightly acidic (pH 4.5) that protects against infection
vagina
allow the vaginal walls to stretch during intercourse and delivery lying between the ___ anteriorly and ___ posteriorly
bladder, rectum
- a passage that allows the escape of the menstrual flow
- receives the penis and the ejected sperm during sexual intercourse
- provides an exit for the fetus during delivery
vagina
- Known as womb; Core of reproduction
- hollow, pear-shaped muscular organ
uterus
Lies in the center of the pelvic cavity between the base of the bladder, and the rectum and above the vagina
uterus
Normal position of the uterus is ___ (rotated forward and slightly antiflexed (flexed forward)
anteverted
what are the layers of the uterus
perimetrium, myometrium, endometrium
uterus layer:
Outer layer of serous membrane that covers most of the uterus
perimetrium
uterus layer:
- Middle layer of thick muscle
- bulk of the uterus
- Has 3 layers of muscle that contract under influence of oxytocin during labor
myometrium
layer of the myometrium designed to expel (push) the fetus efficiently toward the pelvic outlet during birth
longitudinal fiber (outer layer)
layer of the myometrium that contracts after birth to compress the blood vessels that pass between them to limit blood loss
middle layer
layer of the myometrium that prevents the reflux of menstrual blood and tissue into fallopian tube
inner layer circular fiber
uterus layer:
- inner layer of the uterus
- Responsive to the cyclic variations of estrogen and progesterone during the female reproductive cycle every month
endometrium
what happens to the uterus during mestruation
sloughs of the endometrium
what happens to the uterus during pregnancy
provides support and allows fetus to grow
what happens to the uterus during labor and birth
uterine muscles contract and cervix dilates
- narrow neck of the uterus
- elastic, can stretch
cervix
the ___ os of the cervix open into the body of the uterine cavity
internal
the ___ is located between the internal os and external os
cervical canal
the ___ os opens into the vagina
external
function of the cervical mucus:
- ___ vaginal canal
- act as a ___ agent
- provide an ___ environment to shelter deposited sperm from the acidic vagina
- lubricate
- bacteriostatic
- alkaline
- also known as uterine tube; oviducts
- transport of fertilized and unfertilized ovum to the uterus and provide a site for fertilization
fallopian tubes
- It supplies the fertilized ovum with the nutrition during its continued journey to the uterus
- two tubes; each tube is 10 cm long
fallopian tubes
where fertilization takes place
ampulla
site for tubal ligation
isthmus
- two almond shaped
- oval solid structure, each weighs 4-8 g
- located on each side of the uterus, below and behind the uterine tubes
- production of eggs
ovaries
the ovaries secrete ___ and ____
estrogen and progesterone
support and stabilize the various reproductive organs
uterine ligaments
- bony structure that supports & protects the lower abdominal and internal reproductive organs
- allow movement of the body especially walking and running
permits the body to sit and kneel
pelvis
bony canal through which the fetus must pass during birth. It has a brim, a cavity and an outlet
true pelvis
these are also known as the hip bones, composed of the ilium, ischium, and pubis
innominate bones
the hips bones fuse to form a circular cavity called the ___
acetabulum
broad upper prominence of the hip
ilium
arise near the junction of the ilium and ischium and project into the pelvic cavity
ischial spines
serve as reference point during labor to evaluate the descent of the fetal head into the birth canal
ischial spines
the margin of the ilium
iliac crest
the anterior terminal point of the iliac crest
anterior superior iliac spine
the anterior lower point in the iliac crest
anterior inferior iliac spine
the posterior terminal point of the iliac crest
posterior superior iliac crest
the concave anterior portion
iliac fossa
an imaginary line or ridge which divides the false from the true pelvis
ileopectinal line / linea terminalis
the strongest bone, under the ilim and below the actebulum
ischium
where the weight of the seated body rests
ischial tuberosity
serve as reference points during labor (shortest diameter of the pelvic cavity)
ischial spines
forms the slightly bowed front portion of the innominate bone
pubis
point of union of the 2 pubic bones at the anterior midline
symphysis pubis
the triangular shape below the junction of the symphysis pubis
pubic arch
If the angle formed is ___ , it is very possible that the ischial spines are too close to one another resulting in a narrow pelvic cavity
acute
a wedge-shaped bone formed by the fusion of five vertebrae.
sacrum
a projection into the pelvic cavity on the anterior upper portion
sacral promontory
small triangular bone last on the vertebral column is the ___
coccyx
point of coccygeal and sacral articulation
sacrococcygeal joint
the points of union between the sacrum and the ilum
right and left sacroiliac joints
during pregnancy, what hormones influence the softening and stretching of ligaments at the joints
relaxin
the junction of the two pubic bones which are united by a pad of cartilage
symphysis pubis
the strongest in the whole body; connects the sacrum to the iliac bones on each side
sacroiliac ligaments
between the sacrum and the ischial tuberosities; one on each side
sacrotuberous ligaments
between the sacrum and the ischial spines one on each side
sacrospinous ligaments
strengthens the symphysis pubis
interpubic ligaments
between the 5th sacral vertebrae and the coccyx
sacrococcygeal ligaments
provide structural support and connection of various tissues in and around the pelvis
pelvic ligaments
- designed to overcome the force of gravity exerted on the pelvic organs.
- acts as a buttress or support to the irregularly shaped pelvic outlet, thereby providing stability and support for surrounding structures
pelvic floor
deep fascia, the levator ani, and coccygeal muscles form the part of the pelvic floor known as the ___
pelvic diaphragm
Above the pelvic diaphragm is the ___; below and behind it is the ___.
pelvic cavity, perineum
The ___ muscle makes up the major portions of the pelvic diaphragm and consists of four muscles
levator ani
4 muscles of the levator ani
- iliococcygeus
- pubococcygeus
- puborectalis
- pubovaginalis
a thin muscular sheet underlying the sacrospinous ligament, helps the levator ani support the pelvic organs
iliococcygeal muscle
- portion above the pelvic brim
- supports the weight of the enlarged pregnant uterus
- directs the presenting fetal part into the true pelvis
false pelvis
where the the false pelvis bounded on?
either side of the ilium
- portion below the pelvic brim
- made up of the sacrum, coccyx, and innominate bones and represents the bony limits of the birth canal
true pelvis
the true pelvis consists of 3 parts:
- pelvic inlet
- pelvic cavity
- pelvic outlet
upper border of the true pelvis and is typically rounded
pelvic inlet
extends from the subpubic angle to the middle of the sacral promontory
diagonal conjugate
considered the shortest anteroposterior diameter through which the head must pass descending to the pelvic inlet
obstetric conjugate
extends from the middle of the sacral promontory to an area approximately 1cm below the crest
obstetric conjugate
how to get the length of the obstetric conjugate
subtract 1.5cm from the length of the diagonal conjugate
the size of this diameter determines whether the fetus can move down into the birth canal in order for engagement to occur
obstetric conjugate
extends from the middle of the sacral promontory to the middle of the pubic crest (superior surface of the symphysis)
true conjugate / conjugate vera
- represents the greatest distance between the linea terminalis on either side
- largest diameter of the inlet and is measured by using the linea terminalis as the point of reference
transverse diameter
typical size of the diagonal conjugate
12.5 cm
typical size of the obstetric conjugate
10.5-11 cm
typical size of the true conjugate
11 cm
typical size of the transverse diameter
13.5 cm
measured from the sacroiliac joints to the ileopectineal eminence of the left and right hand sides of the pelvis
oblique diameters
the right and left oblique diameters typically measure ___
12.5 cm
a curved canal with a longer posterior than anterior wall
pelvic cavity
A change in the ___ can increase the tilt of the pelvis and can influence the progress of labor
lumbar curve
- situated at the lower border of the true pelvis
- size can be determined through the assessment of the transverse diameter
pelvic outlet
interspinous diameter typically measures
10.5 cm
what do you call the phenomenon where the pubic arch narrows and the baby’s head is pushed backward toward the coccyx
outlet dystocia
- most common and normal female pelvis
- inlet is rounded, with the AP diameter a little shorter than the transverse diameter
- wide and round pubic arch
gynecoid pelvis
- has non prominent ischial spines, straight and parallel side walls, and a wide, deep, sacral curve
- sacrum is short and slopes backward
gynecoid pelvis
- resembles a male pelvis
- inlet is heart shaped
- not favorable for labor and birth
android pelvis
- the posterior sagittal diameters are too short, and the anterior sagittal diameter is long
- sacral promontory is indented, anterior segment is narrow, the forepelvis is sharply angled
android pelvis
- inlet is oval
- long AP diameter, short T diameter
- adequate outlet narrow pubic arch
anthropoid pelvis
- posteriori and anterior sagittal diameters are extremely long
- variable ischial spines, straight side walls, and a narrow and long sacrum
outlet has a normal or moderately narrow pubic arch
anthropoid pelvis
- flat female pelvis
- inlet is a distinctly transverse oval
- wide T diameter, short AP diameter
platypelloid pelvis
- outlet has an extremely wide pubic arch
- short posterior and anterior sagittal diameters
- has variable ischial spines, parallel side walls, a wide sacrum with a deep curve inward
platypelloid pelvis
- contributes to femaleness
- controls the development of the female secondary sex characteristics
estrogen
what are the 3 classical estrogens
- estrone
- b-estradiol
- estriol
- assist in the maturation of the ovarian follicles and cause endometrial proliferation
- amount is greatest in the proliferative phase
estrogen
- inhibit FSH and stimulate LH production
- myometrial contractility increases in both uterus and fallopian tubes increases
- uterine sensitivity to oxytocin increases
estrogen
- secreted by the corpus luteum
- found greatest during the secretory phase
- decreases uterine motility and contractility caused by estrogens
progesterone
- causes the endometrium to further increase its supply of nutrients
- hormone of pregnancy
- prepares the breast for lactation
progesterone
- Oxygenated fatty acids that are produced by the cells of the endometrium
- Critical to the rupture of the graafian follicle, thereby releasing the mature egg cell
prostaglandins
prostaglandin type:
relaxes smooth muscles & potent vasodilator
PGE
potent vasoconstrictor; increases muscular and arterial contractility
PGF
cycle where ovulation occurs
ovarian cycle
cycle where menstruation occurs
uterine cycle
2 phases of the ovarian cycle
- follicular
- luteal
ovarian cycle:
- day 1-14
- primordial follicle matures under influence of FSH and LH up to the time of ovulation
follicular
ovarian cycle:
- day 15-28
- ovum leaves follicle
- corpus luteum develops under LH influence and produces high levels of progesterone and low levels of estrogen
luteal
ovarian cycle:
- immature follicle matures as a result of FSH
- mature graafian follicle appears on the 14th day
follicular
just before ovulation the mature oocyte completes its first meiotic division yielding a polar body and a secondary oocyte
zona pellucida
ovarian cycle:
- graafian follicle matures and enlarges
- ovum is discharged near the fibria of the fallopian tube
- temp increases about 0.3-0.6 24-48 hours after ovulation
follicular phase
ovarian cycle:
- begins when the ovum leaves its follicle
- corpus luteum develops from the ruptured follicle
- if the ovum is fertilized and implants, the egg begins to secrete hCG
luteal phase
ovarian cycle:
- if fertilization does not occur within a week, the corpus luteum begins to degenerate into corpus albicans
luteal phase
- hormone produced primarily by the syncytiotrophoblastic cells of the placenta during pregnancy
- stimulates the corpus luteum to produce progesterone to maintain the pregnancy
hCG - human chorionic gonadotropin
ovarian cycle:
The ___ secretes gonadotropin-releasing hormone (GnRH) to the ___ in response to signals received from the central nervous system
hypothalamus,
pituitary gland
what are the hormones release by the pituitary gland
LH and FSH
FSH or LH:
- primarily responsible for the maturation of the ovarian follicle
- as the follicle matures, it secretes estrogen which enhance the development of the follicle
FSH
FSH or LH:
- stimulates the release of prostaglandin
- they are involves in the processes of oocyte maturation
- ovulation takes place following the very rapid growth of the follicle
LH
during ovulation the FSH ___ and the LH ___
decreases,
increases
the corpus luteum secretes significant amounts of ___ that regulates the implantation
inhibin A
after the corpus luteum degenerates and the production of progesterone and estrogen is diminished, what happens?
FSH and LH is produced
a cyclic uterine bleeding in response to cyclic hormonal changes
menstruation
composed of blood mixed with fluid, cervical and vaginal secretion, bacteria, mucus, leukocytes, and other cellular debris
menses
average length of the menstrual cycle
28 days (+5 / -5)
average length of menses
4-6 days
age of onset of menstruation
11-13 days
average blood loss during menses
30-50 ml
average loss of iron during menses
0.5-1 mg daily
characteristics of menstrual discharge
- dark reddish color
- musty odor
- mixture of secretions of vulva sebaceous gland
menstrual cycle:
- day 1-7
- estrogen levels are low, cervical mucus is scant, viscous and opaque
menstrual phase
menstrual cycle:
- day 8-14
- estrogen peaks just prior to ovulation, cervical mucus at ovulation is clear, thin, watery, alkaline, and more favorable to sperm
- shows ferning pattern; and has spinnbarkeit greater than 5cm
- Just before ovulation, body temperature may drop slightly, then at ovulation body temperature rises sharply and remains elevated under influence of progesterone
proliferative phase
menstrual cycle:
- day 15-26
- estrogen drops sharply, and progesterone dominates
- endometrium becomes corkscrew or twisted in appearance
- lining takes on the appearance of rich, spongy velvet
secretory phase
menstrual cycle:
- day 27-28
- both estrogen and progesterone levels drop
- no fertilization = corpus luteum begins to regress
- endometrium degenerates
ischemic phase
before ovulation the basal temp is often less than ___
37 C
after ovulation, BBT ___
increases
during ovulation, cervical mucus is thin and clear known as ___
spinnbarkeit
some women feel localized abd pain during ovulation called ___
mittelschmerz
during first half of the cycle:
- cervical mucus:
- sperm survival:
- thick and scant
- poor
at the time of ovulation:
- cervical mucus:
- sperm survival:
- thin and copious
- excellent
during second half of the cycle:
- cervical mucus:
- sperm survival:
- thick and scant
- poor
- a test where cervical mucus may or may not form fern-like patterns depending on the dominating hormone
- estrogen - presence of fern-pattern
- progesterone - no fern-pattern
fern test
- testing the stretchability of cervical mucus
- estrogen - thin and watery
- progesterone - thick and viscous
spinnbarkeit test
