Female Reproductive System

Front 1

the female reproductive organs include what?

Back 1

- ovaries

- uterine tubes

- uterus

- vagina

- vulva (external organs)

-mammary glands

Front 2

where are the ovaries located?

Back 2

- pelvic cavity

- lateral to the uterus

- kept in position by several ligaments

Front 3

functions of the ovaries?

Back 3

1. produce oestrogen and progesterone

2. produce the secondary oocyte to expel it into pelvic cavity (ovulation)

Front 4

describe the structure of ovaries:

Back 4

- ovarian cortex - contains ovarian follicles/oocytes

- ovarian medulla - contains blood vessels, lymphatic vessels and nerves

Front 5

how long are the fallopian tubes (uterine tubes)?

Back 5

~ 10cm

Front 6

what are fimbriae?

Back 6

funnel shaped portion near the ovary ends in finger-like processes

Front 7

what happens to the fallopian tubes and fimbriae at the time of ovulation?

Back 7

- the uterine tube bends to drape over the ovary

- fimbriae stiffen and sweep the ovarian surface

- fimbriae have cilia which create currents in the peritoneal fluid to carry the oocyte into the tube

Front 8

what is the ampulla?

Back 8

the lateral 2/3 of the uterine tube where fertilisation takes place, usually within 24 hours of ovulation

Front 9

what is the isthmus?

Back 9

narrow short portion of uterine tube which joins to the uterus

Front 10

what is the function of the isthmus?

Back 10

to transport the fertilised ovum (zygote) from the peritoneal cavity to the uterus

Front 11

how does it do this?

Back 11

- cilia

- peristalsis (created by smooth muscle in walls of uterine tubes)

Front 12

how long does it take zygote to reach uterus?

Back 12

reaches uterus about 4-5 days after ovulation

Front 13

clinical implications/connection to uterine tubes?

Back 13

infection in the uterine tubes due to pelvic inflammatory disease like Chlamydia may lead to scar tissue in the uterine tube

Front 14

what are the possible implications of this?

Back 14

- may narrow or block uterine tubes causing sterility

or

- may narrow the tubes allowing the tiny sperm to reach and fertilise the ovum but not allowing the much larger zygote to reach the uterus on the return journey.

Front 15

what can result from the second implication?

Back 15

zygote starts to develop in the narrow tube and an unsustainable ectopic pregnancy results

Front 16

how else can an ectopic pregnancy occur?

Back 16

may result from cigarette smoking which reduces activity of cilia

Front 17

why?

Back 17

because this slows transport of the fertilized ovum to the uterus so it starts to implant in the uterine tube

Front 18

describe the structure of the uterus?

Back 18

- a hollow, thick-walled muscular organ

- the size and shape of an inverted pear

Front 19

name the anatomical subdivisions of the uterus and briefly describe each:

Back 19

- fundus: rounded region superior to entrance of the uterine tubes

- body: major portion

- isthmus: narrow region

- cervix: narrow neck of uterus

- uterine cavity

Front 20

what is the cervix?

Back 20

the narrow neck of the uterus

Front 21

what is the cervical canal?

Back 21

the cavity of the cervix

Front 22

what do glands in the mucosa of the cervical canal produce?

Back 22

cervical mucus

Front 23

what happens when it is thick?

Back 23

when thick it forms a cervical plug thatphysically impedes sperm penetration

Front 24

what happens when the cervical mucus becomes thin and when does it become thin?

Back 24

it becomes thin under the influence of oestrogen in mid-cycle allowing sperm to pass through the cervix

Front 25

what else does cervical mucus block?

Back 25

–blocks the entry of microorganismsfrom the vagina

Front 26

what does the mucus contain?

Back 26

–contains proteins, lipids, enzymes

Front 27

what does this mucus supplement?

Back 27

–mucus supplements the energy needs of the sperm

Front 28

what are the roles of the cervix in pregnancy?

Back 28

-Firmly closed for most of pregnancy (holds fetus in uterus)

-Softens, thins, and becomes stretchy at end of pregnancy to allow delivery ofbaby

Front 29

clinical connection to the cervix?

Back 29

cervical cancer

Front 30

where does cervical cancer start?

Back 30

in the epithelial cells covering the tip of the cervix

Front 31

what have these cells often been previously damaged by?

Back 31

Often these cells have been previously damaged by the human papilloma virus (HPV),or other STI’s.

Front 32

what does HPV cause?

Back 32

genital warts

Front 33

what is gardasil and what does it do?

Back 33

Gardasil, a three-dose vaccine, protects against HPV-induced cancer.

Front 34

how does a cervical smear work?

Back 34

The cervical smear test scrapes some ofthese cells & examines them for abnormalities.

Front 35

name the 3 layers of the uterus:

Back 35

- endometrium

- myometrium

- perimetrium

Front 36

describe the endometrium:

Back 36

•Innermost functional layer is shed during menstruation

•basal layer replaces functional layer each month

Front 37

describe the myometrium:

Back 37

3 layers of smooth muscle which expel the fetus during labour

Front 38

describe the perimetrium:

Back 38

visceral peritoneum

Front 39

what structures support the uterus in position?

Back 39

•pelvic floor muscles

•uterine ligaments

Front 40

what are the functions of the uterus?

Back 40

•route for transport of sperm

•receives, retains & nourishes the fertilized ovum.

•muscular wall contracts during labour to expel the fetus

Front 41

describe blood supply to the uterus:

Back 41

-The uterine arterioles branch from the internal iliac arterioles.

- Spiral arterioles supply the functional layer of the endometrium

Front 42

what happens to the spiral arterioles each month just before menstruation?

Back 42

Each month just before menstruation they spasm, restricting bloodflow to the functional layer which dies & is discarded

Front 43

what happens after menstruation?

Back 43

They regenerate after menstruation when a new functional layer isformed.

Front 44

describe the structure of the vagina:

Back 44

•10 cm long fibro-muscular canal thatextends from the cervix to the exterior of the body

•vaginal orifice (opening) – initiallycovered by a thin membrane called the hymen

•lies between urinary bladder and rectum

Front 45

functions of the vagina?

Back 45

•receptacle for penis

•outlet for menstrual flow

•passageway for childbirth

Front 46

name the layers of the vagina?

Back 46

- mucosal layer (inner layer)

- muscularis layer (middle layer)

Front 47

what is the muscosal layer continuous with?

Back 47

that of the uterus

Front 48

how does the mucosal layer lie?

Back 48

liesin a series of transverse folds = rugae which stimulate the penis during sex& allow for expansion during childbirth

Front 49

does the mucosal layer have glands?

Back 49

nope

Front 50

then how is the vagina lubricated?

Back 50

has no glands but is lubricated by cervical secretions & secretions from epithelial cells in the vaginal wall

Front 51

what do epithelial cells secrete large amounts of?

Back 51

glycogen

Front 52

what do resident bacteria do to this glycogen and what is the result?

Back 52

Resident bacteria ferment this to form lactic acid. The acidic environment protects from pathogens but is hostile for sperm.

Front 53

who is the vagina more alkaline in and what can result?

Back 53

the vagina is more alkaline in adolescents predisposing sexually active teenagers to sexually transmitted infections.

Front 54

what neutralises the acidity of the vagina?

Back 54

alkaline components of semen

Front 55

describe the muscularis layer (middle layer?)

Back 55

is smooth muscle- allows condiderable stretch

Front 56

what does the vulva consist of?

Back 56

- mons pubis

- labia majora

- clitoris

- labia minora

- vestibule

Front 57

what is the mons pubis?

Back 57

fat pad that cushions the symphysis pubis

Front 58

what are the labia majora?

Back 58

outer folds of the vulva

Front 59

what is the clitoris?

Back 59

small mass of erectile tissue which has a role in sexual excitement

Front 60

what is the labia minora?

Back 60

innerfolds encircle the vestibule

Front 61

what is the vestibule?

Back 61

area between the labia minora

Front 62

what does the vestibule contain?

Back 62

-vaginal orifice (opening) with an incomplete partition called a hymen

–urethral orifice

–ducts of mucus-secreting glands emerge from either side of the urethra

–ducts of mucus-secreting glands emerge from either side of the vaginal opening

Front 63

what happens to the hymen?

Back 63

thisruptures causing bleeding either during first intercourse, or from previoustampon insertion or sports activities or pelvic examinations

Front 64

what is the perineum and what does it contain?

Back 64

diamond-shaped area between the thighs& buttocks of both males and females

–containsexternal genitals & anus

Front 65

describe mammary glands:

Back 65

Modified sweat glands which are part of the skin

Front 66

what is the function of mammary glands?

Back 66

synthesis, secretion and ejection of milk (lactation)

Front 67

structure of breasts:

Back 67

- size of breast determined by the amount of adipose tissue

- milk secreting alveoli are clustered into lobes and even smaller lobules within the breasts

Front 68

what does connective tissue form between lobes of breast mammary glands?

Back 68

Between the lobes connective tissue formssuspensory ligaments which attach the breast to the underlying muscle, forminga natural support like a ‘built-in bra’

Front 69

how does milk flow from glands?

Back 69

Milk flows from the milk-secreting alveoli to lactiferous ducts which open to the outside at the nipple

Front 70

what happens prior to milk reaching nipple?

Back 70

Priorto reaching the nipple the ducts enlarge to form lactiferous sinuses

Front 71

when would baby's sucking be ineffective?

Back 71

The baby's sucking will be ineffective if the mouth only sucks the nipple. The jaws must reach further back to squeeze behind the sinuses to obtain milk effectively

Front 72

what is the areola?

Back 72

darkened, pigmented area around the nipple

Front 73

clinical connection to breasts?

Back 73

breast cancer

Front 74

what is one of the most common cancers in females?

Back 74

breast cancer

Front 75

where does it originate?

Back 75

the epithelial cells of the smaller ducts

Front 76

risk factors for breast cancer?

Back 76

include early menses & late menopause, no pregnancies, short or no periods of breast feeding, family history of breast cancer (especially sister/mother).

Front 77

diagnosis of breast cancer?

Back 77

changein skin texture, skin puckering or leakage from the nipple. Mammogram detects small lumps

Front 78

what does the female reproductive cycle encompass?

Back 78

–ovarian cycle which includes development of the oocytes &surrounding follicles

–menstrual (uterine) cycle

–hormonal changes that regulate the above cycles

–cyclical changes in the breasts

Front 79

what does the menstrual (uterine) cycle include?

Back 79

•preparation for the endometrium to receive & nurture a fertilized oocyte. If implantation does not occur, the functional layer is shed during menstruation.

•changes to the cervix

Front 80

describe hormonal regulation of the reproductive cycle?

Back 80

•Gonadotropinreleasing hormone (GnRH) secreted by the hypothalamus controls the female reproductive cycle

• GnRH stimulates the anterior pituitary gland to release follicle stimulating hormone FSH & luteinizing hormone LH

Front 81

what does follicle stimulating hormone do?

Back 81

initiates growth of follicles

Front 82

what does this include?

Back 82

1.nurtureof the developing oocyte

2. secrete oestrogen fromthe cells lining the follicle

Front 83

what does luteinizing hormone do?

Back 83

luteinizing hormone stimulates ovulation & promotes formation of the corpus luteum

-the corpus luteum then secretes progesterone & oestrogen

Front 84

what kind of feedback mechanism controls female reproductive hormones?

Back 84

negative feedback

Front 85

what are the phases of the female reproductive cycle?

Back 85

1.themenstrual phase (menstruation)

2.pre-ovulatoryphase

3.ovulation

4.post-ovulatoryphase

Front 86

1. what days are considered the menstrual phase?

Back 86

days 1-5

Front 87

2. what days are considered the preovulatory phase?

Back 87

days 16-13

Front 88

3. what day is ovulation?

Back 88

day 14

Front 89

4. post-ovulatory phase?

Back 89

days 15-28

Front 90

1. what is the first day of bleeding considered to be?

Back 90

the beginning of the 28 day cycle

Front 91

1. what occurs in the uterus to the spiral arterioles during the menstrual phase when there are low progesterone levels?

Back 91

Low levels of progesterone causes thespiral arterioles to constrict & the functional layer of the endometriumdies

Front 92

1. what happens to the dead functional layer?

Back 92

the dead functional layer detaches fromthe uterine wall causing 3 – 5 days of bleeding

Front 93

1. what is shed during this phase?

Back 93

50 to150 ml of blood, tissue fluid, mucus & epithelial cells is shed from theendometrium

Front 94

2. what occurs in the ovary?

Back 94

a dominant follicle develops into a mature follicle

Front 95

2. what has happened to this mature follicle by day 14?

Back 95

by day 14 the maturefollicle hasenlarged & bulges at the surface of the ovary

Front 96

2. what do the folicular cells surrounding the oocyte do?

Back 96

secrete oestrogen and secrete oestrogen and release it into the blood

Front 97

2. what sub-phase is occurring in the uterus?

Back 97

proliferative phase

Front 98

2. when does the proliferative phase occur?

Back 98

between menstruation and ovulation

Front 99

what makes this phase different?

Back 99

–ismore variable in length that the other phases

Front 100

what occurs during this phase?

Back 100

–oestrogenproduced by the growing follicle causes a new functional layer 4-10 mm thick todevelop in the endometrium

–Asthis layer proliferates & thickens endometrial glands develop & spiralarterioles grow into it. >

Front 101

3. what causes ovulation?

Back 101

a surge in the level of LH

Front 102

3. what is ovulation?

Back 102

is therupture of the mature (Graafian) follicle& release of the secondary oocyte into the peritoneal cavity

Front 103

3. name 4 signs of ovulation:

Back 103

•increase in basal body temperature

•cervical mucus thins & forms channels to allow sperm to pass through it (caused by rising oestrogen levels).

•cervix softens

•discomfort/pain

Front 104

3. what occurs following ovulation?

Back 104

•the ovarian follicle collapses

•the follicular cells slowly begin to:

–enlarge& change character

–form the corpus luteum (under the influence of LH)

•the corpus luteum then secretes progesterone & oestrogen.

Front 105

4. when does the post-ovulatory phase occur?

Back 105

occurs between ovulation and onset of the next menstrual period

- this is the most constant timeline that lasts 14 days

Front 106

4. in the ovary, what does the corpus luteum secrete?

Back 106

large quantities of:

•progesterone

•& some oestrogen

Front 107

4. what happens if the secondary oocyte is not fertilised?

Back 107

the corpus luteum becomes a non-functional corpus albicans

Front 108

4. what does the progesterone and oestrogen promote in the uterus?

Back 108

thicking to 12-18mm of endometrium

Front 109

4. what does the thickened functional layer increasingly?

Back 109

•vascular– ready for development of the placenta

•glandular– secretes glycogen (energy source for embryo)

Front 110

4. what happens if no fertilisation occurs?

Back 110

menstrual phase will begin

Front 111

describe oestrogen?

Back 111

dominant hormone of pre-ovulatory stage, secreted by ovarian follicles

Front 112

effects of oestrogen?

Back 112

•endometrial thickening & developmentof endometrial glands•Increases vascularisation of the myometrium and the endometrium

•development of ducts in breasts andbreast enlargement

•Maintains female secondary sexualcharacteristics.

•Increases protein anabolism, includingbuilding strong bones.

•lowers total blood cholesterol level.

Front 113

describe progesterone:

Back 113

dominant hormone of post-ovulatory phase, secreted by cells of the corpus luteum

Front 114

what does progesterone stimulate?

Back 114

•development of secretory tissue in the thickened endometrium (secretory stage)

•vascularisation of the myometrium and the endometrium

•development of glandular tissue in the breast and breast enlargement

Front 115

clinical application: menstrual disorders?

Back 115

- primary dysmenorrhea

- amenorrhea

Front 116

what is primary dysmenorrhea?

Back 116

pain/discomfort associated with menstruation that is not associated with physical abnormality or pathological process.

Front 117

what can primary dysmenorrhea reflect?

Back 117

- high levels of prostaglandins

Front 118

what is the treatment of choice?

Back 118

meds that inhibit prostaglandin production

Front 119

what is amenorrhea?

Back 119

absence of menstruation usually caused by pregnancy or the menopause. Also may occur in female athletes with low levels of fat.

Front 120

what happens with amenorrhea?

Back 120

- the reproductive cycle ceases

- loss of bone mass as the levels of oestrogens fall if prolonged

Front 121

what is the combined oral contraceptive pill?

Back 121

progesterone and oestrogen combination pill

Front 122

the pill, mechanism of action?

Back 122

negative feedback on the anterior pituitary& hypothalamus to prevent secretion of FSH & LH.

–prevents development of the ovarian follicle

–prevents ovulation

Front 123

benefits of the pill?

Back 123

combats irregular, painful or heavyperiods.

Front 124

complications of the pill?

Back 124

thromboembolism is the main complication.The risk is increased with age, cigarette use, obesity.

–The combined oral contraceptive increases clotting factors, platelet aggregation& blood lipids.

Front 125

what is the progestogen implant and how does it work?

Back 125

Jadelle alow-dose, slow-release progestogen which:

–inhibits maturation of the oocyte & ovulation

–changes the consistency of cervical mucus making it more difficult for sperm to reach the egg

–is inserted under the skin in the medial aspect of the upper arm.

Front 126

age-related changes to female reproductive system?

Back 126

•The reproductive cycle usually occursevery 28 days from the first period (menarche ).

•Peak of reproductive abilities in late20’s.

•After this ovaries become less responsiveto hormonal stimulation & ovarian function gradually declines.

Front 127

cont...

Back 127

•Ovulation & menstruation ceasecompletely age 46 – 64 yrs (menopause). The ovaries continue to produce oestrogen for a while after menopausebut then stophormone production.

•Without sufficient oestrogen thereproductive organs & breasts atrophy, the vagina becomes dry, weight gain,lossof bone mass, rising total blood cholesterol but decreased HDL levels, hot flushes& sweating, some women experience irritability & depression.

•Sexual desire (libido) is usuallymaintained by adrenal sex steroids).