Procreative Health o almond-shape space between the labia

PROCREATION minora, clitoris and fourchette

o contains structures:
 process that permits two living beings to
produce a third one that is different from A. Urethral meatus
each of them.  Skene’s glands
REPRODUCTION (paraurethral glands )
is the biological process by which new individual B. Vaginal introitus
organisms are produced.  Bartholin’s glands
(vulvovaginal glands )
The known methods of reproduction are broadly
C. Hymen – crescent-shaped
grouped into two main
membrane
types: sexual and asexual.
6. Fourchette
Asexual reproduction
o thin fold of tissue formed where labia
 an individual can reproduce without minora meet
involvement with another individual of that o Episiotomy  site
species.
Internal Genitalia
Sexual reproduction
1. Vagina
 requires the involvement of two
o organ of copulation / “birth canal”
individuals, typically one of each sex.
o hollow, musculomembranous canal
 During production in humans, each
parent transmits to the child one of the two o (8-12 cm) 4cm diameter
copies of his or her genetic material, located o Fornix
on the parent’s 23 pairs of chromosomes .
o anterior, posterior and lateral
 The transfer is made by the
parent’s gametes , reproductive cells that o space surrounding the cervix
contain only 23 chromosomes as a result of a o Doderlein’s bacilli- keep vagina acidic
special kind of cell division : meiosis. o Functions of the Vagina:
Reproductive System
o Organ of copulation
Female Reproductive System
o Passage in delivery & menstrual
External Genitalia blood
 Collectively called Vulva (Pudenda) o Secretory duct during
 Refers to the externally visible structure menstruation
of the female reproductive system extending 2. Uterus
from  symphysis pubis to the perineum
o “the womb”
o pear-shaped, hollow muscular  organ
1.Mons Pubis (mons veneris) - fatty pad
over the symphysis pubis; cushions & o anteverted, directed forward 7-8 cm long
protects pubic bone o Functions of the uterus:
2. Labia Majora (labium majus) 1. menstruation
 longitudinal folds of pigmented skin 2. environment for pregnancy
extending from mons pubis to the perineum; 3. labor & delivery
covered with thick, curly hair
o Layers:
 Escutcheon
1. perimetrium/parametrium
3. Labia Minora (smaller lips) 
o outermost
o hairless folds of tissue within the labia
majora, extending from clitoris to the 2. myometrium
fourchette o middle layer
4. Clitoris o layers of smooth muscle
o small ( approx 1-2 cm ) rounded organ of fibers that interlaces
erectile tissue at the upper end of labia o contraction
minora o “living ligature”
o Prepuce - Skin covering
3. Endometrium
o Smegma - epidermal secretion with o innermost
strong odor
o rich in gland and blood vessels
5. Vestibule
o sloughs off as menstruation
Parts of Uterus:
1. Corpus (body)  formed by:
o main contractile portion  the innominate bones
o forms bulk of muscles o ilium (crest of ilium)
o uppermost part (FUNDUS) o ischium (ischial tuberosity)
o Important role of fundus in OB: o pubis
 sacrum - wedge shaped, forms the
2. Isthmus back part of the pelvis
o joins the corpus to the cervix  coccyx

o contains uterine canal  Pelvic sections:

 false pelvis
3. Cervix
o larger, shallow
o forms the main opening of the uterus 
o lies above the inlet
o 2-4 cm long 
o aids in supporting
o operculum 
abdominal viscera
o internal os - opens into uterine cavity
 true pelvis
o external os - opens into vagina
o low, deep
Uterine ligaments:
o pelvic inlet - entrance to the
 Broad - 2 wing-like structures that true pelvis
extends from the lateral margin to the uterus
o midpelvis - mid portion of
to the pelvic walls
pelvis; contains ischial spine
 Round - 2 fibrous cords from the uterine
walls that helps hold the uterus in its o pelvic outlet - exit of the
forward position true pelvis
 Uterosacral - 2 cord-like folds of the * Linea Terminalis- separates true and false
peritoneum from the lower cervix to the pelvis.
sacrum. Measurements:
*Transverse – Mackenrodt’s Ligaments (or
Cardinal Ligaments)(lateral ligaments)
4. Fallopian tubes “salphinges”
o erves as a passageway for the expelled
ovum
o 10-12 cm long
o Parts: 
A. interstitial - part of tube that lies
in the uterine wall
B. isthmus - part that is cut or sealed
during tubal ligation; attach tube to  Diagonal conjugate
uterus o anterior sacral promontory to
C. ampulla- site of fertilization the INFERIOR margin of symphysis pubis
D. infundibulum o 12.5 – 13 cm
o most distal portion  True conjugate
o its funnel-shaped opening o Conjugate Vera
encircled with o from anterior sacral promontory
FIMBRIAE - finger-like projections which anchor to the SUPERIOR margin of symphysis
the ovary to the fallopian tube  pubis
5. Ovaries o 11 – 11.5 cm
o female gonads  Obstetric Conjugate
o the sex glands sized and shaped like o Sacral promontory to INNER
almonds SURFACE of symphysis pubis
o Functions: o 10.5 - 11 cm
1. Ovulation  Biischial diameter
2. Secretion of hormones o distance between ischial spines
o Estrogen o 10 cm
o Progesterone  Tuberischial diameter
Pelvis – passageway of fetus o transverse diameter of outlet
 o 8 cm
Breast - Mammary Glands
Parts:
1. Acini cells -- milk-producing cells
2. Collecting duct/ Lactiferous duct
3. Lactiferous sinus – storage
4. Nipples
5. Areola - * Montgomery’s Tubercles
Hormones:
 Prolactin - hormone for milk production
  Oxytocin - hormone for milk expression
Male Reproductive System
A. External Genitalia
1. Mons pubis - area over symphysis pubis
2. Penis - organ of urination & copulation
 Shaft
o corpus spongiosum
o corpus cavernosa
 Glans penis - distal end of organ
 Prepuce - protects glans at birth
3. Scrotum
 wrinkled pouch of thin skin,
covering a tight muscle
 protects the testes from trauma
and changes in temperature
 Cremasteric reflex
 protect testes and maintain the
temperature of the testes 2 degrees lower
than body temperature.
B. Internal Genitalia
1. Testes
o male sex glands or gonads
o 2-3 cm wide that lie in the scrotum
o Parts:
 semineferous tubules
o site of spermatogenesis
 Leydig’s / interstitial cells
o secretes testosterone
 Sertoli cells
o provide nourishment to
the  sperm
2. Epididymis
o storage site for maturing sperm
o approx 20 ft. long
o it absorbs about 90% of the fluid
secreted by the testis
o sperm remain stored here for 40-60
days and are absorbed if not ejaculated
prior to that time.
3. Vas deferens/ Ductus deferens
o passage way for sperm from
epididymis to  seminal vesicles
o Vasectomy
4. Ejaculatory duct
o allows the sperm to enter the urethra
and then exit the body
o passes the prostate gland
5. Accessory structures
o Seminal vesicles
 located along the lower Prostaglandins
posterior surface of the bladder
 30% semen produced  produced by the prostate and seminal
o Prostate gland  vesicles
 surrounds the prostatic  stimulate peristaltic contractions of the
urethra female reproductive tract that may help draw
 60% semen produced semen into the uterus.
o Bulbourethral gland
 Cowper’s gland
 located below the prostate
 5% semen production
6. Urethra
o passageway for urine and semen
o 18-20 cm hollow tube

Semen (seminal fluid)

 thick, whitish fluid ejaculated by the man

during orgasm 
 alkaline Spermine
 mixture of secretion from epididymis,
seminal vesicle, prostate, and bulbourethral  is a base that reduces acidity of the female
gland. vagina, increasing the survival rate of sperm.

Secondary sex characteristics

 Features not essential for reproduction

but attract the sexes to each other.

Major constituents of semen:

 Sperm
 Fructose
 Clotting and anticoagulant factors
 Prostaglandins
 Spermine
 Sperm cells from epididymis are present Male Sexual Response
at a count of 50-120 million sperm/ml
 < 20-25 million/ml = infertility (sterility)  erection of the penis, allowing it to
penetrate the female vagina
 ejaculation, expelling semen into the
vagina

Ejaculation
 Initiated by sympathetic nerve impulses
 The ducts and accessory glands contract,
emptying their contents into the urethra.
 The urethral sphincters constrict.
 The bulbospongiosus muscles of the penis
contract rapidly and rhythmically, propelling
semen from the urethra
Fate of sperm cells
capacitated :
 viable for 2 days (egg: 12-24 hr)
 only ~ 100 reach the destination.
 only one sperm fertilizes the egg
Refractory Period
 a period following ejaculation and lasting
anywhere from 10 minutes to a few hours
 impossible to attain another erection and
orgasm
Physiology of Menstruation
Menstruation – periodic shedding of blood,
mucus & epithelial cells from uterus
Menstrual Cycle
 Time between the beginning of one
period & beginning of next period.
 Menstrual cycles begin at menarche and
end with menopause.
 An episodic uterine bleeding in response
to cyclic hormonal changes
 Purpose: bring ovum to maturity & renew
uterine tissue  bed responsible for its
growth.  
 Four Structures Involve:
1. Hypothalamus: Releases the GnRH
2. Pituitary Gland: Anterior Pituitary
gland
o Adenohypophysis
o Produces Two hormones:
FSH & LH
3. Ovary:  Premordial follicles is
activated by  FSH until it matures  termed
as Graafian follicle. With  the increase of
LH from the PG – “Ovulation” takes place
(on the 14 day).
o Corpus luteum - yellow  
body  produces  lutein  which is rich  
with Progesterone
o if with fertilization, corpus
luteum remains for 16 to 20 weeks of
gestation
o if fertilization does not
occur , the unfertilized ovum
atrophies after 4-5 days and the
corpus luteum regresses  after 8-10
days of ovulation and gradually
turned into “corpus albicans” (white
body).
4. Uterus: (Undergo uterine changes)
o The Changes has Four
Phases:
A. First phase
(Proliferative)
 immediately
after menstrual flow, first 4-5 
days of the cycle
 also called
Estrogenic, Follicular, or 
Postmenstrual.
B. Second Phase
(Secretory)
 6-14  days
 also termed
as Progestational, Luteal,
Premenstrual.
 the lining of
the endometrium is rich with
capillaries and     thick,
vascular, spongy layers
C. Third phase
(Ischemic)
 15-28 days
 at 8- 10 days,
the corpus luteum begins to
regress
 the
endometrium of the uterus
begins to degenerate (app.  at
day 24 or 25  of the cycle)
 Capillaries
rupture
D. Fourth phase
(Menses)
 actual
menstrual flow - which is the
end of a defined menstrual
cycle 
the  only
external marker of the  cycle, 
Components of Menstrual Flow:
 Blood
 Mucin
 Fragments of endometrial tissue
 Atrophied and unfertilized ovum
Characteristics of Menstrual Cycle:
 Average length – 28 days
Average flow – 2-7 days
Normal color – dark red
 Average flow – 30-80 ml.
 Menarche – first menstrual period
 Menopause – marks end of reproductive
life as a result of estrogen depletion
 Climacteric – transitional period during
which ovarian function & hormonal
production decline (35y/o)
 o that leads to arterial
dilation and venous constriction in
the genital area; 
o with resulting
vasocongestion and increasing
muscular tension

 vaginal
lubrication
WOMEN  vaginal barrel
lengthens and
distends
 cervix and
fundus are pulled
Ovarian Cycle upward
 clitoris increase
OVULATION
in size
 expulsion of an ovum from the ovary on
 erection
spontaneous rupture of a mature follicle as a
 scrotal skin
result of cyclic ovarian and pituitary
MEN becomes congested
endocrine function.
and thick
 It usually occurs on the fourteenth day
after the first day of the last menstrual period
BOTH there is an increase HR,
and often causes brief, sharp lower
RR and BP
abdominal pain on the side of the ovulating
ovary
WOMAN
 rupture of graafian follicle & formation of
the ovum
 occurs 14 days before the onset of
menstruation
o 28 day cycle
o 20 day cycle
o 45 day cycle

MAN

2.  PLATEAU – 2nd stage;  the entry & coitus

phase

 clitoris retracts
under the hood
 vagina becomes
Sexual Response Pattern greatly engorged
WOMEN
along with labia
1. EXCITEMENT - 1st phase
minora
 Physical & Psychological
stimulation causes parasympathetic
 pre-orgasmic
nerve stimulation
emission
  testes
continues to
elevate until they
MEN are situated close
to the body to
facilitate
ejaculatory
pressure

WOMAN

4. RESOLUTION - 4th stage - phase of

relaxation

 the reproductive organs return to

their unstimulated state

WOMEN  female  has no

refractory period

MEN  REFRACTORY
MAN PERIOD: ( 30 min )

WOMAN

MAN

3. ORGASM - 3rd stage- climax

 strong vaginal
contractions
WOMEN  (8-15
contractions at
interval of 0.8’’)

 occurrence of
ejaculation (3-7
propulsive
ejaculatory
MEN contractions at
same interval with
women)
 shortest stage of
sexual response
cycle

MAN