Female Reproductive System Flashcards
Where do the reproductive organs lie?
Within the pelvic cavity and the perineum.
What lies within the pelvic cavity?
Ovaries
Uterine tubes
Uterus
Superior Vagina
What lies within the perineum?
Perineal Muscles Bartholins glands Clitoris Inferior Vagina Labia
What forms the roof over the pelvic organs?
Inferior peritoneum
What pouches are formed by the peritoneum lying over the pelvic organs?
vesico-uterine
Recto-uterine
A double layer of peritoneum forms what?
The broad ligaments of the uterus
Broad ligaments of the uterus.
Extends between uterus and the floor and lateral wall of the pelvis.
Maintains uterus position
What can be found within the broad ligaments of the uterus?
Uterine tubes
Proximal round ligament
What is the round ligament?
An embryological remnant
Where is the round ligament found?
Attaches to lateral aspect of uterus
Passes through deep inguinal wall and attaches to superficial tissue of perineum.
What holds the uterus in place?
Broad ligament
Strong ligaments e.g uterosacral
Endopelvic fascia
Muscles of pelvic floor
What is endopelvic fascia?
Basically packing around the uterus to limit movement
Where does the uterus lay?
Anteverted and Anteflexed
Cervix tipped anteriorly relative to vagina
Uterus is tipped anteriorly relative to cervix
How can the cervix lie?
Retroverted and Retroflexed
Everything is tipped posteriorly
Where is the egg usually fertilised?
Within the ampulla of the uterine tubes.
Why is the fact that the fimbricated end of the uterine tubes is open important?
Allows delivery of oocyte into tubes
A communication between genital tract and peritoneum, so infection can pass through
Where are the ovaries found?
Laterally in pelvic wall in ovarian fossa
Where do ovaries develop?
On posterior body wall
What do ovaries do?
Secrete hormones in repose to FSH and LH
Secrete oocyte
How many fornices does the vagina have?
4
Anterior
Posterior
2 x lateral
How can the perineum be divided up?
Urogenital triangle
Anal triangle
What makes up the urogenital triangle?
2 ischial spines and pubis symphisis
What makes up the anal triangle?
2 x ischial spines
Coccyx
Levator Ani
Skeletal muscle making up most of pelvic diaphragm
Under tonic contraction
What is the nerve supply for the Levator ani?
S3 S4 S5 sacral plexus - Nerve to Levator Ani
Dual supply so Pudendal nerve aswell
Under what circumstances does the levator ani contract further?
In response to increased intrabdominal pressure e.g. coughing sneezing
Which nerve supplies the perineal muscles?
Pudendal
What is the perineal body?
Bundle of collagenous and elastic tissue to which the perineal muscles attach.
Key for pelvic floor strength
What are bartholins glands also know as?
Greater Vestibular glands
What do bartholins glands do?
Secrete lubricating fluid
Where are bartholins glands found?
Posterior aspect of the vagina
Where are females breast located?
Ribs 2 -6
Lateral border of sternum to mid axially line
What do the breast sit on?
Lies of deep fascia covering pec major and serratut anterior
What is the retromammary space?
Space between deep fascia and breast
What is the function of the retromammary space?
Allows movement of the breast independent of the chest wall.
How is breast tissue attached to the skin?
Via suspensory ligaments
How is the breast divided up?
Into quadrants
Upper Outer and Inner
Lower Outer and Inner
Where does most of the lymph within the breast drain?
75% to ipsilateral axially nodes
Ultimately drain into superclavicular
Lymph within the internal quadrants may drain to which nodes?
Parasternal
Lymph within the Lower quadrants may drain to which nodes?
Abdominal
Level 1 Axillary nodes
Inferior and lateral to Pectoralis Minor
Level 2 Axillary Nodes
Deep to Pectoralis Minor
Level 3 Axillary Node
Superior and medial to Pectoralis Minor
What is the blood supply and drainage to the breast?
Axillary and Internal Thoracic arteries and Veins
What does the pelvic floor do?
Separates the pelvic cavity from the perineum
What makes up the pelvic floor?
Pelvic Diaphragm
Muscles of perineal pouches
Perineal membrane
What muscles form the pelvic diaphragm ?
Levator Ani
Coccygeus
What is the anterior gap between the medial borders of the pelvic diaphragm called?
Urogenital hiatus
What muscles make up the Levator Ani?
Iliococcygeus
Pubococcygeus
Puborectalis
What are some of the pelvic ligaments?
Uterosacral
Transverse cervical
Lateral ligament of the bladder
Rectal ligaments
Where does the deep perineal pouch sit?
Below fascia of inferior aspect of pelvic diaphragm and superior to perineal membrane.
What is found within the deep perineal pouch?
Urethra
Vagina
Bulbourethral gland (Men)
Neuromuscular bundles for Clitoris and Penis
Where is the perineal membrane found?
Superficial to perineal deep pouch
What is the perineal membrane?
Thin sheet of depression fasciae
Last passive support for pelvic organs
Closes urogenital triangle
What openings does the perineal membrane have?
Urethra and Vagina
What does the female Superficial Perineal Pouch contain?
Contains female erectile tissue and associated muscle
Clitoris and Crura
Bulbs of vestibule
Muscles
What muscles are found in both genders superficial Perineal Pouch?
Bulbospongiosus
Ischiocaverosus
What erectile tissue is found in the clitoris and the crura?
Corpus Cavernosum
What is found in the Male Superficial perineal pouch?
Root of the penis
Associated muscles - bulbo…. ischio….
Proximal spongy urethra
What erectile tissue makes up the Bulb of the penis?
Corpus Spongiosum
What erectile tissue makes up the crura of the penis?
Corpus Cavernosum
What is the function of the ovaries?
Produce gametes
Secrete Oestrogen and progesterone
What makes up the ovarian Medulla?
Loose connective tissue
Contorted arteries veins and lymphatics
What makes up the cortex of the ovaries?
Scattered ovarian follicles in a storm of connective tissue
What is the outer layer of the cortex?
Tunic Albuginea - dense layer
What covers the cortex?
Thin outer layer of cuboidal cells - germinal epithelium
What arteries supply the ovaries?
Helicine arteries
Where does the bloody supply of the ovaries come from?
Within the Broad ligament
What takes place at week 6?
Germ cells from yolk sack invade ovaries and proliferate to form oogonia.
To form Oogonia what must happen to the germ cells?
Undergo mitosis
How do Oogonia become Oocytes?
Develop and divide by meiosis
What is Oogenesis?
Development of oocytes from oogonia
What is Folliculogenesis?
Growth of the follicle - oocyte and any asoicated support cell.
What is Atrexia?
Loss of oocyte or oogonia via apoptosis
Before birth at what stage are follicles halted at?
Meiosis - Prophase 1
How can follicular development be divided?
Pre Antra
Antral
What are Pre Antra follicles?
Primordial
Primary
Late Primary
What are Antral Follicles ?
Secondary follicles
Mature Graafian Follicles
What defines the Primary Follicles
Presence of Cuboidal Cells
Zona Granulosa
When does the Zona Pellucida form?
Starts to appear between the oocyte and the granuloma during the primary follicle stage.
What if its present classifies a Primary Follicle?
The cuboidal cell, as Pregranulosa cells have squamous
What defines a late Primary Follicle?
Granulosa cell proliferation
What layers from in Late Primary Follicles?
Theca Interna
Theca Externa
Theca Interna
Inner layer
Secretes Oestrogen and precursors
Theca Externa
Outer layer
Formed of Fibroblasts
What defines a Secondary Follicle?
Formation of the Antrum
What happens in a Secondary Follicle?
Antrum fills with follicular fluid forms second follicle
Granuloma and Thecal layers continue to grow
What is Graafian follicle ?
Stage before release of the oocyte
Stratum Granulosum - layer of granular cells around central follicle
1 day prior to ovulation what happens to the follicle?
Udergoes Meiosis 1 to produce two cells
What are produced when the Oocyte undergoes Meiosis 1?
Forms Secondary Oocyte
A tiny polar body carrying second nucleus is degenerated.
What happens to the secondary Oocyte?
Undergoes Meiosis 2
What stage of Meiosis 2 does the secondary oocyte reach?
Metaphase II
At what point does the oocyte complete Meiosis?
Only if fertilised
What signs seen on the ovary indicate it will rupture to release the oocyte?
Follicular Stigma
Tunica Albuginea
What happens to the follicle post ovulation?
Transforms into the Corpus Luteum
What does the Corpus Luteum do?
Secretes oestrogen and progesterone to prepare uterus for implantation
If implantation occurs what happens?
HCG is released preventing the breakdown of the Corpus Luteum maintaining the progesterone levels and in turn the pregnancy
If no implantation occurs what happens to the Corpus Luteum?
Becomes the Corpus Albicans
White coloured connective tissue.
How does the oocyte move down the uterine tubes?
Gentle peristalsis
Current from ciliated cells
What is the function of the secretory cells in the uterine tubes?
Release nutrients
Describe the Ampulla.
Highly folded mucosa lined by ciliated columnar epithelium and secretory cells.
Surrounded by smooth muscle.
Describe the smooth muscle found in the uterine tubes?
Inner circular layer
Outer longitudina layer
Describe the isthmus.
Much simpler lining than the ampulla
Mostly secretory cells less ciliated
More Smooth muscle
What are the three layers of the Uterus?
Endometrium
Myometrium
Peritoneum
Describe the endometrium.
Inner secretory containing tubular secretory glands embedded in connective tissue stroma.
Describe the Myometrium.
3 layers of smooth muscle collagen and elastic tissue
Describe the Perimentrium
Outer visceral covering of loose connective tissue covered by mesothelium
What are the two layers found in the Endometrium?
Stratum Functionalis
Stratum Basilis
Describe the Stratum Functionalis
Undergoes monthly growth degeneration and loss
Describe the Stratum Basilis
Reserve tissue that regenerates the Functionalis
What happens to the Endometrium in the Proliferative phase?
Glands are relatively straight and lined by columnar epithelium
Oestrogen drives proliferation and thickening
How long does the proliferative phase last?
Up to 1 day post ovulation
What happens to the endometrium in the Secretory or Luteal Phase?
Glands become coiled and secrete glycogen
What happens to the endometrium in the menstrual phase?
Arterioles in functionalis undergoes reconstruction
Depriving tissue of blood , breakdown leakage and tissue sloughing.
What is the cervix?
Short cylinder of connective tissue with a narrowed lumen projecting into the upper vagina.
What covers the cervix?
Mostly stratified squamous epithelium but transitions into secretory columnar
Why is the transition between stratified and secretory on the cervix important?
Higher risk of dysplasia so cervical cancer risk
What glands are found on the cervix?
Endocervical glands
What do endocervical glands secrete during the proliferative phase?
Thin watery mucous to allow sperm to pass
What do endocervical glands secrete during ovulation?
Thick viscous mucous to prevent sperm passage swell as microorganisms
What lines the vagina?
Non keratinised stratified squamous epithelium
Why is the squamous epithelium in the vagina of a woman in her reproductive years thicker?
Glycogen accumulation
What are the four layers of the vagina?
Non keratinised stratified squamous epithelium
Lamina Propria - connective tissue thin walled blood vessels
Fibromuscular layer - inner and outer smooth muscles
Adventitia
How do commensal bacteria protect the vagina?
They metabolise the glycogen into lactic acid to prevent pathogenic bacteria growth
What makes up the mons pubis?
Highly oblique hair follicles
Substantial subcutaneous fat pad lying over the pubic symphysis
Labia Majora
Similar to Mons Pubis
Rich in apocrine and sebaceous glands
Small bundles of smooth muscle
Labia Minora
Lacks subcutaneous fat pad and hair follicles
Rich in vasculature and sebaceous glands
Where does keratinised epithelium found external extend to?
Level of the hymen
Clitoris
Two tubes of erectile tissue
Covered in fibrocollagenous sheath rich in innervation
