Lecture 3- The female reproductive tract Flashcards
overview of the female repro system- do a purpose games
- Bladder anterior
- Rectum posterior
Microstructure of the ovary
Directly homologous to the testes and descend similarly to testes (stops descending before the testes do)
hilum of the ovary is where
blood vessels enter and exit the ovarian tissue.
the ovaries are lined by
- a germinal epithelium- where the gametes (eggs) are formed (similar epithelium of the seminal vesicle tubercles)
Capsule around the ovary made from
peritoneum
Why do I sometimes get a sharp pain at ovulation?
Mature follicle rupturing through ovarian capsule (during ovulation on day 14)
Why do nuns tend to get ovarian cancer?
- Every time a follicle ruptures the capsule of the ovary it damages it
- This leaves to mitosis increases chance of mutations in the ovarian capsule
- Therefore the more ovulations you have the more likely you are to get cancer
- Therefore being a nun you don’t have children or go on the pill so you get maximum number of ovulations
ovarian cysts
- Generally small
- Women usually don’t know they have a cyst
- Presentation of ovarian cyst:
- Pain and bloating
- If it ruptures
- Could twist and occlude a blood supply
- Discomfort during intercourse
The uterine tubes fuse with the
uterus
- At the end of the uterine tubes we have the opening where the egg has to go to get into the female tract
- Surrounded by the fimbriae
gross anatomy of cervic
Fundus- top of the uterus
Body- majority
Cervix- bottom leading to the vagina
Uterus sits
*
- behind and above the bladder and anterior to the rectum.
- Covered by peritoneal layers
- Rectouterine pouch
- Vesicouterine pouch
the cervix : what isthe hole facing the vagina called
the external oss of the cervix
outside of the cervix is covered in
squamous epithelium (external oss)
inside of cervix (cervical canal) lined with
strat columnar epithelium
in the cervix when the cervix goes from columnar to squamous…
transformation zone= where malignant changes can come – neoplasia can occur (where HPV virus has effect)
normal cervix
can see where the columnar epithelium has come into the canal- compelltely normal- cervical ectrophia- appearance of cervix of someone ovulating, on the combined pill or if pregnant
- External oss can be slit like (has had a child) or like a dot (has not had a child)
abnormal cervix
cervical cancer
How does the uterus expand as the fetus grows?
*
This is a term uterus (40 weeks gestation)
- Goes from pelvic structure to abdominal structure
- Fundus is right up to the transverse colon
- May get gastroesophageal reflux
- Compresses the rectum posteriorly
- May get constipation
- Squashes the bladder
- May cause urinary frequency
- The round ligament of the uterus and the uterosacral ligament get stretched
- Can cause pain
outline the structures of the uterine tubes
- Fimbria hold the ovary
- Fimbria connected to the tube by the infundibulum- acts as a funnel to guid the egg
- Infundibulum opens into the ampulla (where fertilisation occurs)
- Then the tube narrows to become the isthmus where it enters the uterine cavity
lining of uterine tube
Lining
- Lined by ciliated cells- waft ovum towards uterus
- Very convoluted
- Peg cells (secretory)- release substances that support the egg and sperm
- Sperms swims all the way up the tube and can go into the peritoneum
If the descent of the zygote is impaired it may implant in the tube-
ectopic pregnancy
The uterine tubes open into the
peritoneum
The tubes open into the peritoneum cavity- for a split second the egg is released into the peritoneal cavity before it is picked up by the fimbriae
- Can insert a canula into the uterus and see a spill of contrast into the peritoneal cavity
- Very rarely you can have ectopic that try and plant in the peritoneal cavity
another risk of the urterine tubes being open into the peritoneum
Also risk of air entering the peritoneal cavity
e. g. if you sit on top of the bubbles in a jacuzzi
e. g. penis pushing air causing a pneumoperitoneum (air in the peritoneum).
e. g. Also risk of infection in the peritoneum- peritonitis.
peritoneal ligaments of the uterus and ovary
- broad ligament
- round ligament
- ligament of the ovary
- suspensary ligament of the ovary
- Broad ligament
- peritoneal fold
- Attaching the uterus to the pelvic side walls
- Round ligament and ligament of the ovary are
- remnants of the gubernaculum
- Suspensory ligament of the ovary
- neurovascular pathway bulging into the peritoneum
The uterus and its relationship to the peritoneum
- Beige covered peritoneum (not sure if its parietal or visceral)
- As if you’ve thrown a sheet over the pelvic organs and its landed on top of it and goes down between the uterus and the rectum (Rectouterine pouch) and the uterus and the bladder (vesicouterine pouch)
arterial supply of the reproductive
- Arterial supply from the internal iliac arteries
organs
- Arterial supply from the internal iliac arteries
uterus supplies by the
uterine artery through the double fold of the broad ligament
vagina supplies by the
vaginal artery
- Anastomosis between the uterine and vaginal artery- can bleed a lot in surgery e.g. hysterectomy
Microanatomy of the vagina
Very thick stratified squamous epithelium lining it
features of the statified squamous epithelium of the vagina
- Large granules containing glycogen- metabolised by various bacteria (lactobacilli) which they convert into lactic acid which helps to maintain an acidic pH
- If you disrupt the bacteria (e.g. with a douchebag) you can increase the pH of the bacteria and cause thrush
Describing the position of the uterus and vagina
Uterus is a mobile structure- tethered at the round ligaments helping to pull the uterus in anteverted/anteflexed position
- If the axis of the vagina is less than 180 degrees the uterus is anteflexed
- If its greater than 180 – pointing back- retroflexed
- Angle of the cervix is less than 180- cervix is anteverted
- If more than 180- retroverted
the vulva
The vulva is the outer part of the female reproductive system. It’s also called the external genitalia.
types of FGM
