ANATOMY AND PATHOPHYSIOLOGY

The Anatomy and Physiology of Female Reproductive

Organ

Vagina
The vagina is a muscular, hollow tube that extends from the vaginal opening to the cervix of
the uterus. It is situated between the urinary bladder and the rectum. It is about three to
five inches long in a grown woman. The muscular wall allows the vagina to expand and
contract. The muscular walls are lined with mucous membranes, which keep it protected
and moist. A thin sheet of tissue with one or more holes in it, called the hymen, partially
covers the opening of the vagina. The vagina receives sperm during sexual intercourse from
the penis. The sperm that survive the acidic condition of the vagina continue on through to
the fallopian tubes where fertilization may occur. The vagina is made up of three layers, an
inner mucosal layer, a middle muscularis layer, and an outer fibrous layer. The inner layer is
made of vaginal rugae that stretch and allow penetration to occur. These also help with
stimulation of the penis. The middle layer has glands that secrete an acidic mucus (pH of
around 4.0.) that keeps bacterial growth down. The outer muscular layer is especially
important with delivery of a fetus and placenta.

Uterus
The uterus is shaped like an upside-down pear, with a thick lining and muscular walls.
Located near the floor of the pelvic cavity, it is hollow to allow a blastocyte, or fertilized egg,
to implant and grow. The wall of uterus is composed of three layers. The innermost layer is
endometrium, which is the mucosal lining of uterine cavity. It is highly vascular and contain
glands. The middle layer is the muscular layer, myometrium. Interlacing smooth muscle
fibers comprise this layer. The outermost layer is perimetrium. It is a thin serous layer.
Fallopian tube
The uterine tube (fallopian tube) carries an egg from the ovary to the uterus. Unless a
biological abnormality, surgery, or ectopic pregnancy caused the loss of one tube, women
should have two uterine tubes in their bodies.

Ovaries
The ovaries form part of the female reproductive system. Each woman has two ovaries.
They are oval in shape, about 4cm long and lie on either side of the womb (uterus) against
the wall of the pelvis in a region known as the ovarian fossa. The ovaries produce and
release eggs (oocytes) into the female reproductive tract at the mid-point of each menstrual
cycle. They also produce the female hormones estrogen and progesterone.
Hormones:
 
 

 Estrogen
Estrogens are a group of hormones that play an important role in the normal sexual and
reproductive development in women. They are also sex hormones. The woman's ovaries
make most estrogen hormones, although the adrenal glands and fat cells also make small
amounts of the hormones.
In addition to regulating the menstrual cycle, estrogen affects the reproductive tract, the
urinary tract, the heart and blood vessels, bones, breasts, skin, hair, mucous membranes,
pelvic muscles, and the brain. Secondary sexual characteristics, such as pubic and armpit
hair, also start to grow when estrogen levels rise.

 Progesterone
Progesterone prepares the endometrium for the potential of pregnancy after ovulation. It
triggers the lining to thicken to accept a fertilized egg. It also prohibits the muscle
contractions in the uterus that would cause the body to reject an egg. While the body is
producing high levels of progesterone, the body will not ovulate.
If the woman does not become pregnant, the corpus luteum breaks down, lowering the
progesterone levels in the body. This change sparks menstruation. If the body does
conceive, progesterone continues to stimulate the body to provide the blood vessels in the
endometrium that will feed the growing fetus. The hormone also prepares the limit of the
uterus further so it can accept the fertilized egg.

Phases of Menstrual cycle:

Menstrual phase (day 1-5)

Menstrual phase begins on the first day of menstruation and lasts till the 5th day of the
menstrual cycle.

Follicular phase (day 1-13)

This phase also begins on the first day of menstruation, but it lasts till the 13th day of the
menstrual cycle.

Ovulation phase (day 14)

On the 14th day of the cycle, the pituitary gland secretes a hormone that causes the ovary
to release the matured egg cell. The released egg cell is swept into the fallopian tube by the
cilia of the fimbriae. Fimbriae are finger like projections located at the end of the fallopian
tube close to the ovaries and cilia are slender hair like projections on each Fimbria.
Luteal phase (day 15-28)
This phase begins on the 15th day and lasts till the end of the cycle.

Gestational hypertension

Gestational hypertension is a form of high blood pressure in pregnancy. It occurs in

about 6 percent of all pregnancies. Another type of high blood pressure is chronic
hypertension--high blood pressure that is present before pregnancy begins. Gestational
hypertension can develop into preeclampsia. This condition occurs often in young women
with a first pregnancy. It is more common in twin pregnancies, in women over the age of 35,
in women with chronic hypertension or who had hypertension in a previous pregnancy, in
African-American women, and in women with diabetes. Gestational hypertension is
diagnosed when blood pressure readings are higher than 140/90 mm Hg in a woman who
had normal blood pressure prior to 20 weeks and has no proteinuria (excess protein in the
urine). Preeclampsia is diagnosed when a woman with gestational hypertension also has
increased protein in her urine. Eclampsia is a severe form of preeclampsia. Women with
eclampsia have seizures resulting from the condition. Eclampsia occurs in about one in
1,600 pregnancies and develops near the end of pregnancy, in most cases.

Causes
The cause of gestational hypertension is unknown. Some conditions may increase the risk of
developing the condition, including the following:

Pre-existing hypertension (high blood pressure)

Kidney disease
Diabetes
Hypertension with a previous pregnancy
Mother's age younger than 20 or older than 40
Multiple fetuses (twins, triplets)
African-American race