ANATOMY AND PHYSIOLOGY OF FEMALE

REPRODUCTIVE SYSTEM

BY:
LAMNUNNEM HAOKIP
SENIOR TUTOR/ LECTURER
OBG NURSING
SSNSR
 INTRODUCTION

• The reproductive organs in females are those which are concerned with
copulation, fertilization growth and development of fetus and its subsequent exit
to the outer world.

• The organs are broadly divided into:

External
Genitalia

FRO

Internal Accessory
Genitalia reproductive organ
• The female reproductive system consists of the primary as well as accessory sex
organs. The primary sex organs in females are a pair of ovaries, which produce
ova or egg and they also secrete female sex hormones like progesterone and
estrogen. The other accessory sex organs include the uterus, fallopian tubes,
cervix and vagina. The external genitalia comprises the labia minora, labia
majora and clitoris. The mammary glands are not considered genital organs but
are important glands in the female reproductive system.
EXTERNAL GENITALIA
VULVA / PUDENDUM
• The external female genitalia are a part of the female reproductive system, and
include the: mons pubis, labia majora, labia minora, clitoris, vestibule,
hymen, vestibular bulb and vestibular glands.

• The components of the external female genitalia occupy a large part of the female
perineum and collectively form what's known as the vulva.

• The functions of the external female genitalia are many, such as reproduction and
sexual pleasure, parturition and the protection of the internal genital organs.
 ORGANS ANATOMY PHYSIOLOGY

MONS PUBIS The mons pubis consists of a mass of Protects the genital area from
subcutaneous adipose tissue anterior to the infections.
pubic symphysis, and bears most of the
pubic hair.

LABIA The two large folds which forms the Protect the urethra and vaginal
MAJORA boundary of the vulva and composed of skin opening.
fibrous tissue and fat and contain large nos. Stimulates and expand during
of sebaceous glands. coitus.

LABIA Thin delicate folds of fat free, hairless skin Helps to keep the germs out and
MINORA located between labia majora. They have becomes engorged with blood
many nerve endings. during sexual stimulation.
 ORGANS ANATOMY PHYSIOLOGY

CLITORIS It is 1.5 - 2 cm long, homologous with the Centre of sexual sensation in

penis which act as an erectile organ and women.
located posterior to the anterior labial Facilitates sperm entry to the body.
commissure.

VAGINAL A small opening that is in a position both Important for intercourse,

ORIFICE rear and posterior to the urethral opening. menstrual discharge and
reproduction.

VESTIBULE A part of the vulva between the labia Keeping the vulva moist and
minora which leads to the urinary meatus facilitates coitus and parturition.
and vaginal opening and contains vestibule
glands. Skene’s glands.
 ORGANS ANATOMY PHYSIOLOGY

HYMEN A thin layer of mucus membrane which Embryologically, it tends to keep

partially occludes the opening of the vagina. germs and dirt out of vagina.
Normally incomplete to allow the passage
of menstrual flow.

VESTIBULE Aka Bartholin’s Gland situated on each side Secret mucus that keeps the vulva
GLANDS near the vaginal opening. moist.
Approximately the size of pea and have Act as a lubricant.
ducts, opening into the vestibule
immediately lateral to the attachment of the
hymen.
PERINEUM Is the most posterior part of the external And is composed of fibrous and
female reproductive organs. muscular tissues that support
It extends from fourchette anteriorly to the pelvic structures.
INTERNAL GENITALIA
 • The vagina is an elastic, muscular canal with a
VAGINA soft, flexible lining that provides lubrication
and sensation. The vagina connects the uterus to
the outside world. The vulva and labia form the
entrance, and the cervix of the uterus protrudes
into the vagina, forming the interior end.

• The vagina receives the penis during sexual

intercourse and also serves as a conduit for
menstrual flow from the uterus. During
childbirth, the baby passes through the vagina
(birth canal)
UTERUS • The Uterus, also called womb, an inverted pear-
shaped muscular organ of the female
reproductive system, located between the
bladder and the rectum.

• The uterus has four major regions: the fundus,

the body, the isthmus and the cervix.

• The uterus is 6 to 8 cm (2.4 to 3.1 inches) long;

its wall thickness is approximately 2 to 3 cm (0.8
to 1.2 inches). The width of the organ varies; it is
generally about 6 cm wide at the fundus and
only half this distance at the isthmus.
 Layers of the Uterus
• PERIMETRIUM: The perimetrium is the outer serous layer of the uterus. The serous
layer secretes a lubricating fluid that helps to reduce friction. The perimetrium is also
part of the peritoneum that covers some of the organs of the pelvis.

• MYOMETRIUM: The myometrium is the middle layer that stretches (the smooth
muscle cells expand in both size and number ) during pregnancy to allow for the uterus
to become several times its non-gravid size, and contracts in a coordinated fashion, via a
positive feedback effect on the "Ferguson reflex", during the process of labor. After
delivery, the myometrium contracts to expel the placenta, and crisscrossing fibres of
middle layer compress the blood vessels to minimize blood loss.
• ENDOMETRIUM: The endometrium (also known as the mucosal layer or membrane) is the
innermost layer of the uterus. It is composed of the epithelial layer and cell-rich connective tissue
layer (lamina propria). Functionally, the epithelial layer of the endometrium can be divided into
two layers:

• The basal layer - is composed mainly of stem cells that serve to regenerate the functional layer.

• The functional layer - is adjacent to the uterine cavity and is lined by a single layer of columnar
epithelium. The thickness of this layer changes during the menstrual cycle (under the influence of
estrogen and progesterone) in order to prepare the endometrium to host an embryo. If this doesn't
happen, the functional layer sheds during menstruation. However, if pregnancy occurs, the
endometrium becomes a thick blood vessel-rich, glandular tissue layer.
FALLOPIAN TUBE • The bilateral muscular fallopian (uterine) tubes connect
the uterine stalks to the superior regions of the ovaries.
Ovum fertilization often takes place in the fallopian
tubes. They also carry the resulting zygote for
implantation into the uterus. Length 8 to 14 cm average
10 cm. Its divided into 4 parts.

• The fallopian tube serves as the specific location for

sperm and egg fertilization. Small hair-like projections,
known as the cilia, line the fallopian tubes. The
muscles and cilia in the tube wall push an egg down
along all the uterus’ tubes. The fertilized egg travels to
the uterus after fertilization and implants there
OVARIES • Ovaries are the female gonads — the primary
female reproductive organs. These glands have
three important functions: they secrete hormones,
they protect the eggs a female is born with and
they release eggs for possible fertilization.

• Before puberty, ovaries are just long bundles of

tissue. As the female matures, so do her ovaries.

• Oval solid structure, 1.5 cm in thickness, 2.5 cm

in width and 3.5 cm in length respectively. Each
weights about 4–8 gm.
 Support Structures

• The bony pelvis support and protects the lower abdominal and internal
reproductive organs.

• Muscle, Joints and ligaments – levator ani, broad ligaments provide and added
support for internal organs of the pelvis against the downward force of gravity and
the increases in intra-abdominal pressure.
FEMALE PELVIS
• The pelvis is a basin like structure which connects the spine to lower limbs. It is
located between the abdomen and the legs. This area provides support for the
intestines and also contains the bladder and reproductive organs.

• It is a skeletal ring formed by:

Two Innominate Bones

Sacrum

Coccyx
 Two Innominate Bone
Each hip bone is composed of three bones:

Ilium: It is the flared out part. The greater part of its inner
aspect is smooth and concave, forming the iliac fossa. The
upper border of the ilium is called iliac crest.

Ischium: It is the thick lower part. It has a large

prominence known as the ischial tuberosity on which the
body rests while sitting. Behind and little above the
tuberosity is an inward projection the ischial spine.

Pubis: The pubic bone (pubis) is located at the base of the

pelvic girdle and join the 2 hip bones together.
 Sacrum

• Is a wedge shaped bone consisting of five fused bones.

The anterior surface of the sacrum is concave. The upper
border of the first sacral vertebra known as the sacral
promontory.

Coccyx
• It is a vestigial tail consists of four fused vertebrae
forming a small triangular bone.
Pelvic Joints

There are four pelvic joints:

Two sacroiliac joint
One pubic joint
One sacrococcygeal joint
 The four different pelvis shapes are:
• Gynecoid: This is the most common type of pelvis in females and is generally
considered to be the typical female pelvis. Its overall shape is round, shallow, and
open.

• Android: This type of pelvis bears more resemblance to the male pelvis. It’s
narrower than the gynecoid pelvis and is shaped more like a heart or a wedge.

• Anthropoid: An anthropoid pelvis is narrow and deep. Its shape is similar to an

upright egg or oval.

• Platypelloid: The platypelloid pelvis is also called a flat pelvis. This is the least
common type. It’s wide but shallow, and it resembles an egg or oval lying on its side.
 Giving Birth Based on Types of Pelvis

• Gynecoid: The gynecoid pelvis is thought to be the most favorable pelvis type for
a vaginal birth. This is because the wide, open shape give the baby plenty of room
during delivery.

• Android: The narrower shape of the android pelvis can make

labor difficult because the baby might move more slowly through the birth canal.
Some pregnant women with an android pelvis may require a C-section.
• Anthropoid. The elongated shape of the anthropoid pelvis makes it roomier from
front to back than the android pelvis. But it’s still narrower than the gynecoid
pelvis. Some pregnant women with this pelvis type may be able to have a vaginal
birth, but their labor might last longer.

• Platypelloid. The shape of the platypelloid pelvis can make a vaginal birth
difficult because the baby may have trouble passing through the pelvic inlet.
Many pregnant women with a platypelloid pelvis need to have a C-section.
 PARTS OF TRUE PELVIS
• BRIM: Formed by the sacrum posteriorly, the iliac bones laterally and the pubic bone
anterior. It is almost rounded with the APD the shortest. The diameters of the Brim are:

 APD – 11cms

 TVD – 13.5cms

 OD – 12cms

• CAVITY: Extends from the brim above and outlet below. 12 cms

• OUTLET: Anatomical and Obstetrical Outlet.

LANDMARKS OF PELVIS
 CONTRACTED PELVIS

• Anatomical Definition: It is a pelvis in which one or more of its diameters is

reduced below the normal by one or two centimetres.

• Obstetric Definition: It is a pelvis in which one or more of its diameters is

reduced so that it interferes with the normal mechanism of labour. Factors
influencing the size and shape of the pelvis.
 Aetiology of CP
Nutritional defects
Rachitic
Osteomalacic
Diseases or Injuries affecting the bones o the pelvis
Fracture
Tumour
Poliomyelitis
Hip joint disease.
Developmental defects
Naegele’s pelvis
Robert’s pelvis
Kyphotic pelvis
 DIAGNOSIS/ INVESTIGATIONS
• Family history
• Personal history
• Medical / surgical history
• Obstetric history
• Contracted pelvis should be suspected in the following cases:
Small stature
Pendulous abdomen
Exaggerated spinal curvature
Deformities of the limb.
Abdominal examination
Posterior position – common
Pendulous abdomen
Badly flexed head
Vaginal examination
Clinical pelvimetry
 Management
It depends mainly on the degree of proportion.
Minor disproportion – VD
Moderate disproportion – TOL
Severe disproportion – CS
Trial of labour
Caesarean section
Severely contracted pelvis
Elderly primi gravida
Breech
Prev. LSCS
Failed TOL
If disproportion due to fetal causes
Craniotomy
Symphysiotomy
Manipulative correction
 Complications of CP
MATERNAL
During pregnancy:
a) Incarcerated retroverted gravid uterus
b) Malpresentations
c) Pendulous abdomen
d) Nonengagement
e) Pyelonephritis especially in high assimilation pelvis
During labour
a) Uterine Inertia, slow cervical dilatation and prolonged labour
b) PROM
c) Obstructed labour and rupture uterus
d) PPH
FETAL
a) ICH
b) Asphyxia
c) Fracture skull
d) Nerve injuries
e) Intra amniotic infections.