ANATHOMY & PHYSIOLOGY

Female Reproductive System

Figure 1.1. Parts of a female reproductive system

The female reproductive system consists of external structures and internal organs
system serves various purposes. It is responsible for the production of gametes, fertilization,
production of reproductive hormones, and the development and reproduction of new
individuals. The egg cells, known as ova or oocytes, are produced by the ovaries. The oocytes
are subsequently transferred to the fallopian tube, where they may be fertilized by a sperm. The
fertilized egg is subsequently transferred to the uterus, where the uterine lining has thickened in
response to the usual reproductive hormones. Once within the uterus, the fertilized egg can
implant into the thicker uterine lining and develop further. Sexual maturation is the process this
system undergoes to carry out its role in the process of pregnancy and birth. If implantation
fails, the uterine lining is lost as menstrual flow.
EXTERNAL STRUCTURES

Figure 1.2 External Parts of a female reproductive system

The Mons Veneris also called “Mons Pubis” is a pad of adipose tissues located over the
symphysis pubis. Covered by the pubic hair. Its function is to protect the junction of the
pubic bone and the surrounding delicate tissue from trauma.
The Labia Majora consists of two tissue folds that are linked anteriorly but separated
posteriorly, and are placed lateral to the labia, and are covered with epithelium and loose
connective tissue. It is protected by a component known as pubic hair, which acts as an
extra layer of defense against hazardous microorganisms entering the structure. It serves to
protect the external genitalia and shield the outlets of the distal urethra and vagina from
trauma.
The Labia Minora is two hairless folds of connective tissue which normally pink in color.
The internal surface is covered with mucous membrane and the external surface is covered
with the skin. There are abundant sebaceous glands all over the area.

The Vestibule is the flattened and smooth surface found inside the labia where the opening
to the urethra and the vagina arises.
The Clitoris is a small, rounded organ of erectile tissue at the front of the labia minora that
is covered by a fold of skin called the prepuce. It is the center for sexual arousal and
pleasure for females as it is highly sensitive to touch and temperature.
The Paraurethral glands which are also known as the “Two Skene Glands” are located
lateral to the urethral meatus and have ducts that open into the urethra.
The Bartholin glands are also known as vulvovaginal glands are located somewhat lateral
and posterior to the vaginal entrance.
 It composes of ducts that secrete a fluid that helps to lubricate the external
genitalia during coitus. These secretions are alkaline to help sperm survive in the
vagina.
The Fourchette is the ridge of tissue formed by the posterior joining of the labia minora and
Majora and this is the part being cut during child delivery to enlarge the vaginal opening.
The Perineal Muscle which is often called as “Perineal Body” is located posterior to the
fourchette. A muscular area that also stretches during childbirth allows the vagina and the
passage of the fetal head to enlarge. Kegel’s exercise, squatting, and tailor sitting are the
common suggested exercise during pregnancy which aims to make the perineal muscle
flexible to allow easier expansion during childbirth and avoid tearing the tissue.
The Hymen is a thin membrane that covers the opening of the vagina during childhood, it is
tough but elastic, semicircle tissue that is often torn during the first sexual intercourse. Its
function is to shield the embryonic vagina from "external sources of infection" such as
bacteria and dirt.

INTERNAL STRUCTURES

Figure 1.3. Internal parts of a female reproductive system

The Ovaries are two shaped almond organ that is grayish white in color, approximately 4 cm
by 2 cm long and a thickness of 1.5 cm. They are located on both sides of the uterus, on
opposite ends of the pelvic wall. Each of the ovaries is connected to the fimbria which is the
tissue that connects the ovaries to the fallopian tube. This organ is responsible in the
generation and maturation of discharge ova or the egg cells and also secrets the two main
hormones which are the estrogen and progesterone and initiate and regulate the menstrual
cycle.

The Fallopian tube are smooth and narrow tubes that measures approximately 10 cm long. It
serves as a pathway for the egg cell in traveling to the uterus. The ova (egg cells) migrate
from the ovaries to the uterus via these tiny tubes, which are linked to the upper section of the
uterus. In most cases, the fallopian tubes are where an egg is fertilized by a sperm. The
fertilized egg then travels to the uterus and inserts itself in the uterine lining. The fallopian
tubes consist of four main parts, from medial to lateral:

• Interstitial Portion- It measures 1 cm long and 1mm in diameter. It lies within

the uterine wall.
• Isthmus- It is a lateral continuation of the interstitial portion that measures about
2 cm long which is responsible in tubal ligation procedure.
• Ampulla- It measures 5 cm long which is the longest portion of the fallopian tube
and this where fertilization of the ovum usually takes place.
• Infundibular – A funnel shaped portion of the fallopian tube that measures about
2 cm long wherein the fimbria is attached which helps in guiding the ovum into
the fallopian tube.

Figure 1.4. Parts of the Fallopian Tube

UTERUS- A hollow, muscular, pear-shaped organ located posteriorly to the bladder and
anteriorly to the rectum in the lower pelvis. It measures approximately 5 to 7 cm long and 5cm
wide weighing 50 to 60 grams. In the widest part of the uterus which is the upper part it
measures 2.5 cm deep. Uterus is responsible in receiving the ovum in the fallopian tube. It
serves as a place of implantation, nourishment and provides protection to the growth and
maturity of the fetus. During pregnancy, the size of the uterus increases to accommodate the
growing fetus. Increase in length, Depth, Width, and Weight also occurs length by 6.5 cm to
32 cm, Depth increases from 2.5 cm to 22cm, Width expands 4 cm to 24 cm and Weight also
increases from 50 g to 1,000g. It has 3 divisions including:

• Corpus- A wider region superior to the cervix.

 • Fundus- it is the uppermost part of the uterus that expands to accommodate the
growing fetus. It is palpated to determine amount of uterine growth, and uterine
contraction during pregnancy and labor.
• Cervix- The lowest portion in the uterus. It measures approximately 2 to 5 cm
long.

3 LAYERS OF UTERINE WALLS

 Endometrium- It is the innermost lining closest to the uterine. The stratum functional
grows and vascularizes during the menstrual cycle and is then sloughed off during
menstruation, whereas the stratum basalis remains essentially constant and this
where the fertilized egg is attached for implantation process.
 Myometrium- A layer of smooth muscle. It prevents the back flow of menstrual blood
into the tubes. It also prevents pre-term as it holds the internal cervix.
 Perimetrium- The outermost layer that strengthens, covers, and supports the organ.
It also secrets lubricating fluid to reduce friction.

Figure 1.5. Parts of the Uterus

VAGINA a hollow, musculo membranous canal located posterior to the bladder and anterior to
the rectum, an organ for copulation and serves as a passageway of menstruation and serves
as the birth canal.
Mentrual Cycle

Figure 1.6: The Menstrual Cycle

Menstrual cycle is made up of various stages or phases that the female body must go
through each month to prepare for the potential of becoming pregnant. Hormone fluctuations
are responsible for the body's shift from one phase to the next. It is divided into four phases.
The average cycle is 28 days long; however, cycles can last anywhere from 21 to 35 days. The
duration of each phase varies from person to person and the length of each phase might also
vary with time and age.
The menstrual cycle begins when the hypothalamus detects low levels of estrogen and
progesterone in the bloodstream, which encourages the hypothalamus to produce
Gonadotropin- releasing hormone (GnRH). The GnRH then stimulates the pituitary gland to
release gonadotropic hormones such as follicle stimulating hormone (FSH) and luteinizing
hormone (LH), which cause the ovaries to generate estrogen. The ovarian cycle is concerned
with the formation of ovarian follicles and the occurrence of ovulation.
Its first phase begins with the follicular phase, which begins on the first day of
menstruation. Increasing levels of FSH generated by the pituitary gland drive follicle growth in
the ovaries and also boost estrogen output during this period. As the follicle develops further, it
matures into Graafian follicles, and estrogen levels rise before to ovulation. The pituitary glands
LH level peaks on the 14th day of the menstrual cycle, whereas estrogen levels rapidly decline.
After that, the prostaglandin is produced, causing the Graafian follicle to burst and the egg to
be expelled. As a result, ovulation commences.
Following ovulation, the Luteal phase begins, during which the FSH falls and the LH
continues to rise. It then guides the remaining follicle cells in the ovary to produce a
progesterone-rich corpus luteum. If fertilization does not take place, the corpus luteum
degenerates and eventually becomes corpus albicans.
In contrast, the uterine cycle focuses on how the functional endometrium builds and
sheds in response to ovarian activity. The first phase of the menstrual cycle, also known as the
Proliferative phase, begins immediately after a menstrual flow or 5 days after the ovarian cycle
produces an ovum. The endometrium is quite thin immediately after menstruation, but it
continues to proliferate and grow when the ovary generates estrogen. The Secretory phase of
the menstrual cycle begins after ovulation. Increased progesterone secretion causes the
functional layer to transform into a secretory mucosa, which is more receptive to the
implantation of the fertilized ovum. The elevated progesterone in the corpus luteum causes the
uterine endometrial glands to appear corkscrew or twisted and dilated with glycogen and
mucus. If implantation or fertilization does not occur, the corpus luteum in the ovary begins to
deteriorate after 8 to 10 days, resulting in a decrease in progesterone production during the
Ischemic phase. When progesterone is removed from the body, the endometrium of the uterus
begins to degrade on days 24 and 25 of the cycle. Menstruation begins to flow during the fourth
phase of the menstrual cycle, signaling the start of a new menstrual cycle. The menstrual flow
is made up of shed endometrial fragments, blood, mucus, and unfertilized eggs.

Fertilization Process

Figure 1. 7: The Fertilization Process

There are two types of sex cells, or gametes, involved in the human reproductive
process which are the egg cell and the sperm cell. The fertilization process occurs when the
male gamete, or sperm, and the female gamete, the egg or ovum, meet in the female
reproductive system. When sperm and egg combine, the result is a fertilized egg known as a
zygote. The zygote develops into an embryo, which then develops into a fetus.

Usually, a matured ovum is released every month from the graafian follicle, and this
process is called ovulation. It happens about two weeks after the start of their last menstrual
period. Once the mature ovum is released fertilization must fairly occur since it is only capable
for fertilization for 24 hours and the most 48 hours. When an egg is released from the ovary,
it goes into the fallopian tube wherein it will remain there until fertilized by a single sperm.
Furthermore, a man's sperm count can reach 400 million, with the sperm moving upstream
through its flagella and toward the fallopian tubes on its journey to fertilize an egg. During
ovulation, the viscosity of the cervical mucus lowers, making it easier for spermatozoa to
penetrate. Some sperm can reach the egg in less than a half-hour, while others can take up to
days. Sperms have a lifespan of 48 to 72 hours and only a few hundred will ever get close to
the egg and begin capacitation. The spermatozoa then secrete hyaluronidase, which binds
the ring of mucopolysaccharide fluid, the zona pellucida and corona radiata that serves as
protective barrier of the ovum. The surface of the egg then changes as sperm penetrates and
only one spermatozoa is capable in penetrating the cell membrane. Once penetrated it then
changes its composition to become impervious, making it impossible for any other sperm to
enter and it is when fertilization takes place. Once the sperm and egg cell binds, the genetic
makeup, including whether it is a boy or a girl is completed, and develops into a zygote.

After the binding, the fertilized ovum then begins to multiply quickly, dividing into many
cells. It then travels the fallopian tube 3 to 4 days after fertilization and enter the uterus for the
implantation process. When the fertilized egg reaches the uterus, it will consist of 16-50 cells
and at this stage the fertilized egg will appear to be bumpy which is called the morula. The
morula then will continue to multiply as for another 3 to 4 days as it floats in the uterine cavity.
Then it will attach to the endometrium, which is the uterus' lining. This process is known as
implantation, and as a result, cells continue to divide. Blastocyst will be formed that will be
later on develop as embryo and the trophoblast which covers blastocyst will later become the
placenta and membranes. the Once the egg connects to the uterus, some cells from the
placenta create the trophoblast, while others form the embryo, the blastocyst. Once implanted
the zygote will be become an embryo and as the pregnancy goes on the embryo will become
fetus. The heart begins to beat at week 5. The brain, spinal cord, heart, and other organs are
still in the early stages of development. At the eighth week, the developing baby, now known
as a fetus, is almost a half-inch long and keeps growing until the full term of pregnancy
wherein the baby will then be delivered.

Overall, fertilization occurs when a sperm cell successfully combines with an egg cell in
the fallopian tube. When fertilization occurs, the newly fertilized cell is referred to as a zygote.
The zygote will then proceed down the fallopian tube and into the uterus for implantation. A
blastocyst then is formed when a zygote implants. The blastocyst, which eventually develops
into a fetus, is "fed" by the uterine lining. On the other hand, in an ectopic pregnancy which is
also called as extrauterine pregnancy the fertilized ovum implants somewhere other than the
uterus resulting for a pregnancy to happen outside the uterus. Ectopic pregnancy is common in
the fallopian tube and on rare cases it can   arise the ovary, cervix, or in the abdominal cavity.
Organs other than the uterus are not designed to hold a growing embryo and cannot expand,
resulting in bleeding in the mother, making an ectopic pregnancy a life-threatening condition
requiring an emergency treatment.
Figure 1.8: Normal Pregnancy vs. Ectopic Pregnancy