ANATOMY AND PHYSIOLOGY OF THE REPRODUCTIVE SYSTEM

I. Male Reproductive System

A. MALE EXTERNAL STRUCTURES

PENIS
 male organ of copulation and urination
 composed of longitudinal erectile tissues:
o 2 corposa cavernosa
o 1 corposa spongiosum
 PNS → causes vasodilation → blood congestion → penile erection
 SNS → inhibits penile erection
Parts:
1. Shaft or Body.
2. Glans Penis – most sensitive
3. Prepuce or foreskin – covers the glans
→ removed during circumcision
 Phimosis – When prepuce cannot be retracted over the glans
4. Urethral meatus – passageway of semen and urine

SCROTUM
 Saclike structure containing the testes
 Rugated, skin – covered, muscular pouch suspended from the perineum
Functions:
1. Support the testes
2. Help regulate temperature of sperm
a. Contracts when cold
b. Relaxes when hot

TESTES
 2 ovoid glands, 2-3 cm wide, lie in the scrotum
Surrounding Tissues:
1. Tunica Vaginalis – sac of serous membrane; allows free movement of testes within scrotum
 Inflammation causes accumulation of fluid →Hydrocele
2. Tunica Albuginea – fibrous covering; divides the testes into 200 – 300 lobules
 Each lobule contains:
o Seminiferous Tubules -→ produce spermatozoa
o Leydig Cells or Interstitial Cells → a connective tissue which sorrounds seminiferous tubules; produce
testosterone
3. Tunica Vasculosa – inner layer of connective tissue; contains blood vessels
Functions:
1. Hormone production – Testosterone
→ stimulates spermatogenesis
→ development of secondary sex characteristics
2. Spermatogenesis
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Hypothalamus
↓
GnRH
↓
Anterior Pituitary

LH FSH
↓ ↓
Leydig Cells Spermatogonia
↓ ↓
Production of testosterone Sperm Cells

Parts of the Testes:

1. Seminiferous Tubules
→ where spermatogenesis takes place
→ about 176 sperm cells a day
2. Leydig Cells
→ produce testosterone
3. Sertoli Cells or Supporting Celss
→ plays a role in sperm transport

B. MALE INTERNAL STRUCTURES

Epididymis
 Long coiled tube approximately 20 feet long
 Sperm travels for 12 – 20 days
 Takes 64 days for sperm to mature
 Therapy for:
o Aspermia – absence of sperm
o Oligospermia - ↓ 20 M sperm/ml
Becomes effective only after 2 months

Vas Deferens (Ductus Deferens)

 Passageway of sperm cells from epididymis to the urethra
 Surrounded by arteries and veins
 Protected by a thick fibrous coating
 Cut during vasectomy

Ejaculatory Duct
 Passageway of semen
 Connect seminal vesicles to the urethra

Seminal Vesicles
 Behind the bladder; in front of rectum
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 2 convoluted pouches, 4 cm long each

 Secretes the viscous portion of semen which has ↑ sugar, protein & prostaglandin; alkaline

Prostate Gland
 Walnut-shaped body below the bladder; surrounding urethra & 2 ejaculatory ducts
 Secretes thin milky alkaline fluid; help neutralize acidic nature of male urethra

Cowper’s/Bulbourethral Glands
 lie beside the prostate gland
 secretes alkaline fluid; counteracts acid ecretion of the urethra

Urethra
 hollow tube approximately 8 inches (18-20 cm)
 passageway for urine and semen

Semen/Seminal Fluid
 composition: Seminal Vesicles → 60%
Prostate Gland → 30%
Testes → 5%
Bulbourethral Gland → 5%
 Normal Volume:
o 2 – 5 ml; about 100 M sperm/ml

II. Female Reproductive System

A. FEMALE EXTERNAL STRUCTURES

(Vulva or Pudenda)

Mons Pubis or Mons Veneris

 pad of adipose tissue above the symphysis pubis
 protects symphysis pubis from trauma

Labia Majora
 2 thick folds of adipose tissue originating from mons, terminates in the perineum
 Provide covering and protection to external organs located under it

Labia Minora
 2 thin folds of connective tissue
 Joins anteriorly – forms prepuce
 Joins posteriorly – forms fourchette
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 Lower border of upper portion – frenulum

 Richly supplied with sebaceous glands

Clitoris
 Highly sensitive and erectile tissue situated under prepuce of labia minora
 “Seat of a woman’s sexual pleasure and orgasm”
 Composed of 2 erectile tissues called corposa cavernosa
 Produces cheese – like secretions called smegma
 A useful guide in female catheterization

Fossa Navicularis
 Space between the fourchette and vaginal introitus

Vestibule
 Triangular space between labia minora
 It is where vaginal introitus, urethral meatus, Bartholin’s gland and Skene’s gland are located

Bartholin’s/Vulvovaginal Glands
 Also known as paravaginal or major vetibular glands
 Located at each inner side of the vagina
 Secretes alkaline mucus that keeps vaginal introitus lubricated

Skene’s Glands (Paraurethral/Minor Vestibular glands)

 Situated at each inner side of the urethral meatus

 Secretions of Skene’s and Bartholin’s glands increases with sexual stimulation

o Provide lubrication to the vagina
o Facilitate coitus

Vaginal Orifice
 External opening of the vagina
 Located just below the urethral meatus

Hymen
 A thin, circular membrane made of elastic tissue situated at the vaginal opening

Urethral Meatus
 Located just below the clitoris
 Passageway of urine

 Vulvar Blood Supply

 Pudendal Artery
 Inferior Rectus Artery
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 Vulvar Nerve Supply

 Anterior – ilioinguinal & genito – femoral nerves (L1 level)
 Posterior – pudendal nerve (S3 level)
 Lymph Drainage
 Superficial inguinal nodes

B. FEMALE INTERNAL ORGANS

Vagina
 A hollow, membranous and muscular canal about 8-12 cm long
 Located behind the bladder, in front of the rectum
 Separated from rectum by cul-de-sac of Douglas
Functions:
1. Organ of copulation
2. Discharges menstrual flow
3. Birth Canal
 Rugae – transverse folds of skin in the vaginal wall
→ allows vaginal canal to stretch and enlarge considerably during delivery
 Vaginal Column
→ longitudinal folds of skin in the vaginal canal
→ allows vaginal canal to enlarge during delivery
 Fornix/Fornices
→ cervix projects into vagina forming 4 recesses or depression around the vagina’s upper portion
 Anterior – 1
 Posterior – 1
 Lateral – 2
 Vaginal ph
 Before puberty – 6.8-7.2 (alkaline)
 After puberty – 4-5 (acidic)
 Doderlein’s Bacilli (Noemal Flora of the Vagina)
→ Converts glycogen content of cervical mucus to lactic acid
 Blood Supply of Vagina
o Upper portion – cervico-vaginal branch of uterine artery
o Middle Portion – inferior vesical arteries
o Lower Portion – rectal and pudendal arteries

UTERUS
 Hollow muscular canal resembling an inverted pear with thick muscular walls
 2.3 – 3 inches (8 cm) long; 1 inch (2.5 cm) thick; 2 inches (5 cm); weighs 50 – 70 grams
Functions:
1. Organ of reproduction
2. Organ of menstruation
3. Expulsion of fetus through uterine contractions
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Parts:
1. Fundus – uppermost convex portion
→ ideal site for implantation of zygote
2. Cornua – point of attachment of the fallopian tubes
3. Isthmus – upper third of the cervix (between body & cervix)
4. Corpus – 2/3 of the uterus
→ Houses fetus during pregnancy
5. Cervix – considered “neck of the uterus”
→ 2.5 cm long; 2.5 cm wide
Parts:
1. Internal Os
2. Cervical canal
3. External Os
Layers:
1. Perimetrium – outermost serosal layer
2. Myometrium – middle muscular layer
3. Endometrium – innermost ciliated mucosal
 Glandular layer (Zona Functionalis) – peel during menstruation
 Basal Layer (Zona Basalis)
Positions of the Uterus:
Normally/Majority of Women
 Anteverted – bend forward on the long axis of vagina
 Anteflexed – bend forward at the level of the internal os on the long axis of the cervix
On some women
 Retroverted – bend backward on the vagina
 Retroflexed – bend backward on cevix
Uterine ligaments:
1. Transverse – cervical/Cardinal/Mackenrodt’s Ligaments
→ From cervix and upper part of vagina to lateral pelvic wall
→ Main support; damage→ uterine prolapsed
2. Broad/Peritoneal Ligaments
→ Sides of corpus to lateral pelvic walls
→ Assists in anteversion of uterus
 Mesometrium – supports corpus
 Mesosalphinx – supports the fallopian tube
 Mesovarium – supports the ovaries
3. Round Ligaments – connects uterus to labia majora
→ Give stability during pregnancy
4. Uterosacral/Sacrocervical
→ Connect cervical portion of uterus to sacral vertebra
→ Maintains traction on cervix – helps keep normal position of uterus
5. Anterior Ligament
→ Anterior portion of supravaginal cervix to posterior surface of bladder
→ Overstretching → cystocele
6. Posterior Ligament
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→ Posterior portion of uterus to rectum

→ Form Cul-de-sac of Douglas
→ Damage → rectocele
Blood Supply:
 Arteries – Uterine artery
→ Ovarian artery
 Veins – uterine, ovarian and vaginal veins
Internal iliac vein
 Lymphatic drainage
→ Fundus → Lumbar
→ Corpus → External Iliac
→ Cervix → Internal Iliac
Nerve Supply/Innervation:
1. Uterine contractions: Efferent Symphatetic Nerves from T5 to T10
2. Uterine relaxation: Parasymphatetic fibers
S3 – S4
3. Painful contractions: Afferent pain fibers
T11 – T12
Fallopian Tubes/Oviducts/Uterine Tubes
 Pair of tube-like structures from cornua, ends near the ovaries
 10 – 14 cm (4 cm) long; ¼ in diameter
Functions:
1. Transport ovum from ovary to the uterus
2. Site of fertilization
3. Provide nourishment to ovum
Parts:
1. Interstitial/Intramural – 1 cm long
→ penetrates myometrial wall into the uterine cavity

2. Isthmus – 1 cm long
→ Narrowest portion
→ Site of tubal ligation
3. Ampulla – middle portion; widest
→ Usual site of fertilization
4. Infundibilum – most distal portion; catches ovum
→ Has fingerlike projections → Fimbria
→ Longest fimbria is attached to ovary → Fimbria Ovarica
Layers:
1. Mucosal Layer
2. Muscular Layer
3. Peritoneal Layer

Ovaries
 Oval, almond – shaped & sized, grayish white sex glands on either side of uterus
 4 cm long by 2 cm diameter; weighs 16-19 g; 1.5 cm thick
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 Female gonads
Functions:
1. Oogenesis → development and maturation of ovum
2. Ovulation → release of ovum from ovary
3. Hormone Production → Estrogen & Progesterone in non-pregnant women
→ Regulate menstruation
Layers:
1. Tunica albuginea → outermost protective layer
2. Cortex → Functional layer
3. Medulla → contains blood vessels, lymphatics, nerves & muscle fibers
Number of follicles in each ovary:
2 months intrauterine → 600, 000 oogonia
5 months intrauterine → 6, 800, 000 oogonia
At birth → 2 Million oocytes
Prepubertal/Childhood → 300, 000 – 400, 000
36 years old → 30, 000 – 40, 000
Menopause → Absent

Mammary Glands/Breasts
 Accessory organ; provide nourishment to infant
External Structures:
1. Nipple or Mammary Papillae
→ Center of each breast, has 15 – 20 openings connected to lactiferous ducts
2. Areola
→ Pigmented skin; surrounds nipple
3. Montgomery Tubercles
→ Glands in the areola; secrete an oily substance → keep areola & nipple lubricated
Internal Structures:
1. Lobes → contains 15 – 20 lobes each breast
→ divided into several lobules
2. Lobules → composed of clusters of acini cells
3. Acini Cells → milk secreting cells stimulated by prolactin
4. Lactiferous ducts → Passageway of milk
5. Lactiferous sinus → reservoir of milk; behind nipples
6. Adipose tissue → protects from injury
Hormones that Influence Mammary Glands:
1. Estrogen – development of the ductile tissues
2. Progesterone – development of acinar structures
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3. Human Placental Lactogen – breast development during pregnancy

4. Oxytocin – Let-down reflex
→ Inhibited by Progesterone
5. Prolactin – stimulate milk production
→ Inhibited by Estrogen

↓ Estrogen & Progesterone → APG produce prolactin

↓
Stored ← Foremilk production in glandular tissues
↓
Infant sucks/use breast pump → PPG produce Oxytocin
↓
Hindmilk produced ← Let-down reflex

Pelvic Floor and Its Muscles

Perineal Body
 Muscles and fibrous tissue between vagina and rectum
Urogenital Diaphragm
 Transverse perineal muscle
 Support → anal canal during defecation
→ vaginal during delivery
→ urinary meatus during urination
Perineal Diaphragm → composed of:
1. Superficial perineal muscles
a. Bulbocavernous muscles
b. Ischiocavernous muscles
c. External anal sphincter
d. Sphincter of the urethra
2. Levator ani muscles
a. Pubococcygeus muscles
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b. Iliococcygeus muscles
c. Ischiococcygeus muscles

Pelvis
Types:
1. Gynecoid – circular (ideal for childbirth) 50%
2. Android – Heart shaped 30%
3. Anthropoid – oval shaped 20%
4. Plattypeloid – flat shaped 3%

Pelvic Bones
1. 2 innominate bones
a. Ilium
b. Ischium
c. Pubis
2. Sacrum
3. Coccyx
Functions
 Allow movement
 Protect Pelvic Organs
 Bridge to femur
 Adapted for childbearing
Division of Pelvis
1. False Pelvis → lies above linea terminalis (pelvic brim)
→ no obstetrical significance
2. True Pelvis → lies below linea terminalis
→ bounded above by promontory, alae of sacrum, linea terminalis
Division of True Pelvis
1. Pelvic Inlet – entrance to true pelvis
Boundaries
a. Anterior – rami of pubic bone, symphysis pubis
b. Posterior – sacral promontory
c. Lateral – linea terminalis
Principal diameters
a. Anteroposterior diameter/Obstetrical conjugate
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→ shortest distance between the promontory and symphysis pubis (10 cm)
Transverse diameter → 13.5 cm
→ greatest distance between line terminalis
b. Right and Left Oblique diameter → 12.5 cm
→ sacroiliac iliac synchondroses to iliopectineal eminence
2. Pelvic cavity – at the level of ischial spines
→ interspinous diameter (10 cm)
3. Pelvic outlet → inferior portion bounded in back by coccyx
Boundaries:
a. Anterior – area under the pubic arch
b. Posterior – tip of the sacrum
c. Lateral – ischial tuberosities; sacrosciatic ligaments
Diameters:
a. Anteroposterior – 9.5 – 11.5
→ from the lower margins of the symphysis to the tip of the sacrum
b. Transverse – 11 cm
→ between inner edges of the ischial tuberosities
c. Posterior sagittal - >7.5 cm
→ tip of the sacrum to line between ischial tuberosities

Analogous Structures
Male Female
Spermatozoa Ovum
Glans Penis Glans Clitoris
Scrotum Labia Majora
Penis Vagina
Testes Ovaries
Vas Deferens Fallopian Tubes
Prostate Glands Skene’s Glands
Cowper’s Glands Bartholin’s Glands
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Sequence of Pubertal Changes

Male
1. Increase in weight
2. Growth of testes
3. Growth of face, axillary and pubic hair
4. Voice changes
5. Penile Growth
6. Increase in height
7. Spermatogenesis (production of sperm)

Female
1. Growth spurt
2. Increase in the transverse diameter of pelvis
3. Breast development
4. Growth of pubic hair
5. Onset of menstruation
6. Growth of axillary hair
7. Vaginal secretions