ANATOMY AND PHYSIOLOGY OF THE FEMALE REPRODUCTIVE SYSTEM

The organs of the reproductive systems are concerned with the general process of reproduction, and each is adapted for specialized tasks. These organs are unique in that their functions are not necessary for the survival of each individual. Instead, their functions are vital to the continuation of the human species. The female reproductive system consists of internal organs and external organs. The internal organs are located in the pelvic cavity and are supported by the pelvic floor. The external organs are located from the lower margin of the pubis to the perineum. The appearance of the external genitals varies greatly from woman to woman, since age, heredity, race, and the number of children a woman has borne determines the size, shape, and color. 1. Internal Organs a) Uterus The uterus is a hollow organ about the size and shape of a pear. It serves two important functions: it is the organ of menstruation and during pregnancy it receives the fertilized ovum, retains and nourishes it until it expels the fetus during labor. The uterus is located between the urinary bladder and the rectum. It is suspended in the pelvis by broad ligaments. Divisions of the uterus. The uterus consists of the body or corpus, fundus, cervix, and the isthmus. The major portion of the uterus is called the body or corpus. The fundus is the superior, rounded region above the entrance of the fallopian tubes. The cervix is the narrow, inferior outlet that protrudes into the vagina. The isthmus is the slightly constricted portion that joins the corpus to the cervix. Walls of the uterus. The walls are thick and are composed of three layers: the endometrium, the myometrium, and the perimetrium. The endometrium is the inner layer or mucosa. A fertilized egg burrows into the endometrium (implantation) and resides there for the rest of its development. When the female is not pregnant, the endometrial lining sloughs off about every 28 days in response to changes in levels of hormones in the blood. This process is called menses. The myometrium is the smooth muscle component of the wall. These smooth muscle fibers are arranged. In longitudinal, circular, and spiral patterns, and are interlaced with connective tissues. During the monthly female cycles and during pregnancy, these layers

undergo extensive changes. The perimetrium is a strong, serous membrane that coats the entire uterine corpus except the lower one fourth and anterior surface where the bladder is attached. b) Vagina The vagina is the thin in walled muscular tube about 6 inches long leading from the uterus to the external genitalia. It is located between the bladder and the rectum. The vagina provides the passageway for childbirth and menstrual flow; it receives the penis and semen during sexual intercourse. c) Fallopian Tubes (Two) Each tube is about 4 inches long and extends medially from each ovary to empty into the superior region of the uterus. The fallopian tubes transport ovum from the ovaries to the uterus. There is no contact of fallopian tubes with the ovaries. The distal end of each fallopian tube is expanded and has finger-like projections called fimbriae, which partially surround each ovary. When an oocyte is expelled from the ovary, fimbriae create fluid currents that act to carry the oocyte into the fallopian tube. Oocyte is carried toward the uterus by combination of tube peristalsis and cilia, which propel the oocyte forward. The most desirable place for fertilization is the fallopian tube. d) Ovaries The ovaries are for oogenesis-the production of eggs (female sex cells) and for hormone production (estrogen and progesterone). The ovaries are about the size and shape of almonds. They lie against the lateral walls of the pelvis, one on each side. They are enclosed and held in place by the broad ligament. There are compact like tissues on the ovaries, which are called ovarian follicles. The follicles are tiny sac-like structures that consist of an immature egg surrounded by one or more layers of follicle cells. As the developing egg begins to ripen or mature, follicle enlarges and develops a fluid filled central region. When the egg is matured, it is called a graafian follicle, and is ready to be ejected from the ovary. Process of egg production oogenesis The total supply of eggs that a female can release has been determined by the time she is born. The eggs are referred to as oogonia in the developing fetus. At the time the female is born, oogonia have divided into primary oocytes, which contain 46 chromosomes and are surrounded by a layer of follicle cells. Primary oocytes remain in the state of suspended animation through childhood until the female reaches puberty (ages 10 to 14 years). At puberty, the anterior pituitary gland secretes follicle-stimulating hormone (FSH), which stimulates a small number of primary follicles to mature each month. As a primary oocyte begins dividing, two different cells are produced, each containing 23 unpaired chromosomes. One of the cells is called a secondary oocyte and the other is called the first polar body. The secondary oocyte is the larger cell and is capable of being fertilized. The first polar body is very small, is nonfunctional, and incapable of being fertilized. By the time follicles have matured to the graafian follicle stage, they contain secondary oocytes and can be seen bulging from the surface of the ovary. Follicle development to this stage takes about 14 days. Ovulation (ejection of the mature egg from the ovary) occurs at this 14-day point in response to the luteinizing hormone (LH), which is released by the anterior pituitary gland. The follicle at the proper stage of maturity when the LH is secreted will rupture and release its oocyte into the peritoneal cavity. The motion of the fimbriae draws the oocyte into the fallopian tube. The luteinizing hormone also causes the ruptured follicle to change into a granular structure called corpus luteum, which secretes estrogen and progesterone. If the secondary oocyte is penetrated by a sperm, a secondary division occurs that produces another polar body and an ovum, which combines its 23 chromosomes with those of the sperm to form the fertilized egg, which contains 46 chromosomes. Process of hormone production by the ovaries

Estrogen is produced by the follicle cells, which are responsible secondary sex characteristics and for the maintenance of these traits. These secondary sex characteristics include the enlargement of fallopian tubes, uterus, vagina, and external genitals; breast development; increased deposits of fat in hips and breasts; widening of the pelvis; and onset of menses ormenstrual cycle. Progesterone is produced by the corpus luteum in presence of in the blood. It works with estrogen to produce a normal menstrual cycle. Progesterone is important during pregnancy and in preparing the breasts for milk production. 2. External Female Organs The external organs of the female reproductive system include the mons pubis, labia majora, labia minora, vestibule, perineum, and the Bartholin s glands. As a group, these structures that surround the openings of the urethra and vagina compose the vulva, from the Latin word meaning covering. a) Mons Pubis This is the fatty rounded area overlying the symphysis pubis and covered with thick coarse hair. b) Labia Majora The labia majora run posteriorly from the mons pubis. They are the 2 elongated hair covered skin folds. They enclose and protect other external reproductive organs. c) Labia Minora The labia minora are 2 smaller folds enclosed by the labia majora. They protect the opening of the vagina and urethra. d) Vestibule The vestibule consists of the clitoris, urethral meatus, and the vaginal introitus. The clitoris is a short erectile organ at the top of the vaginal vestibule whose function is sexual excitation. The urethral meatus is the mouth or opening of the urethra. The urethra is a small tubular structure that drains urine from the bladder. The vaginal introitus is the vaginal entrance. e) Perineum This is the skin covered muscular area between the vaginal opening (introitus) and the anus. It aids in constricting the urinary, vaginal, and anal opening. It also helps support the pelvic contents. f) Bartholin s Glands (Vulvovaginal or Vestibular Glands) The Bartholin s glands lie on either side of the vaginal opening. They produce a mucoid substance, which provides lubrication for intercourse. 3. Blood Supply The blood supply is derived from the uterine and ovarian arteries that extend from the internal iliac arteries and the aorta. The increased demands of pregnancy necessitate a rich supply of blood to the uterus. New, larger blood vessels develop to accommodate the need of the growing uterus. The venous circulation is accomplished via the internal iliac and common iliac vein. 4. The Menstrual Cycle Menstruation is the periodic discharge of blood, mucus, and epithelial cells from the uterus. It usually occurs at monthly intervals throughout the reproductive period, except during pregnancy and lactation, when it is usually suppressed. The menstrual cycle is controlled by the cyclic activity of follicle stimulating hormone (FSH) and LH from the anterior pituitary and progesterone and estrogen from the ovaries. In other words, FSH acts upon the ovary to stimulate the maturation of a follicle, and during this development, the follicular cells secrete increasing amounts of estrogen Hormonal interactions of the female cycle are as follows

Days 1-5. This is known as the menses phase. A lack of signal from a fertilized egg influences the drop in estrogen and progesterone production. A drop in progesterone results in the sloughing off of the thick endometrial lining which is the menstrual flow. This occurs for 3 to 5 days. Days 6-14. This is known as the proliferative phase. A drop in progesterone and estrogen stimulates the release of FSH from the anterior pituitary. FSH stimulates the maturation of an ovum with graafian follicle. Near the end of this phase, the release of LH increases causing a sudden burst like release of the ovum, which is known as ovulation. Days 15-28. This is known as the secretory phase. High levels of LH cause the empty graafian follicle to develop into the corpus luteum. The corpus luteum releases progesterone, which increases the endometrial blood supply. Endometrial arrival of the fertilized egg. If the egg is fertilized, the embryo produces human chorionic gonadotropin (HCG). Thehuman chorionic gonadotropin signals the corpus luteum to continue to supply progesterone to maintain the uterine lining. Continuous levels of progesterone prevent the release of FSH and ovulation ceases. Additional Information The length of the menstrual cycle is highly variable. It may be as short as 21 days or as long as 39 days. Only one interval is fairly constant in all females, the time from ovulation to the beginning of menses, which is almost always 14-15 days. The menstrual cycle usually ends when or before a woman reaches her fifties. This is known as menopause. 5. Ovulation Ovulation is the release of an egg cell from a mature ovarian follicle. Ovulation is stimulated by hormones from the anterior pituitary gland, which apparently causes the mature follicle to swell rapidly and eventually rupture. When this happens, the follicular fluid, accompanied by the egg cell, oozes outward from the surface of the ovary and enters the peritoneal cavity. After it is expelled from the ovary, the egg cell and one or two layers of follicular cells surrounding it are usually propelled to the opening of a nearby uterine tube. If the cell is not fertilized by union of a sperm cell within a relatively short time, it will degenerate.
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What are Ovaries, Definition and Function Ovaries - The female organs of reproduction, also called the female gonads. The ovaries produce OVA(eggs) and sex hormones, predominantly ESTROGENS and PROGESTERONE as well as small amounts of ANDROGENS. A woman has two ovaries, one ovary on each side of theUTERUS in the lower abdomen. Ligaments suspend the ovaries in place within the abdominal cavity. Each ovary is about the size, shape, and consistency of a large olive. At birth it contains the full complement of ova that will supply a woman for all her years of FERTILITY. The ovary has two distinct layers of structure, an outer cortex and an inner medulla. The ovarian cortex contains the ovarian follicles, each of which holds an immature ovum (egg), also called a GAMETE or germ cell. The fibrous tissue of the ovarian medulla, made up of stroma cells, contains the ovary s BLOOD vessels,LYMPH vessels, and nerves. The layer of cells covering the ovary is the epithelium; it is made up of epithelial cells (the same type of cell that makes up the SKIN and mucous membranes throughout the body). Beginning during PUBERTY with the onset of MENSTRUATION, hormonal influences ripen one ovum (sometimes called an oocyte) each MENSTRUAL CYCLE. The ovary releases the ovum into a pocket of fluid that surrounds it. The fimbriae of the fallopian tube (fluted edges of the tube s open end) float in this fluid, extending toward but not touching the ovary. The undulating movements of the fimbriae pull the released ovum into the fallopian tube where, if SPERM are also present, fertilization may occur. The PITUITARY GLAND releases FOLLICLE-STIMULATING HORMONE (FSH) and LUTEINIZING HORMONE (LH) at different phases of the menstrual cycle to stimulate the sequence of events that will cause the maturation of an ovum. Several ova typically begin the maturation process during each menstrual cycle though usually only one will complete it. The follicle expels the mature, or ripe, ovum. The cells of the follicle produce estrogens and proteins. The developing ovum is a haploid cell that is, is contains precisely one half the complement of chromosomes (23) necessary to support human life. When the ovum merges with the sperm, the resulting ZYGOTEcontains the full complement of chromosomes (46).
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What is Ovarian Cyst and Definiton Ovarian Cyst is a noncancerous, fluid-filled growth that forms within an ovary. Ovarian cysts are common and many are transient (come and go). The most common type of ovarian cyst is a follicular cyst, which develops in an ovarian follicle. Typically the follicle fills with fluid. Over time the fluid reabsorbs into the follicle and the cyst goes away. Sometimes a follicular cyst ruptures, causing sudden PAIN. Cysts may also form in the corpus luteum, the structure of endocrine tissue that supports a ripened ovum. Such a cyst, called a luteal cyst, typically goes away when the corpus luteum involutes (turns in on itself) and becomes absorbed into the ovarian follicle immediately preceding MENSTRUATION. Follicular cysts and luteal cysts are usually functional-that is, they come and go with the hormonal shifts of the MENSTRUAL CYCLE. Ovarian cysts are occasionally pedunculated (growing on the end of stalks). Such cysts may twist on their peduncles and become gangrenous, which is an emergency situation requiring surgery.

Dermoid Ovarian Cyst Dermoid cysts, also called teratomas or germ cell cysts, are much less common though more troublesome because they can grow quite large. The key characteristic of a dermoid cyst is that it consists primarily of epithelial tissue though may also contain fatty tissue and fragments of HAIR, CARTILAGE, BONE, and sometimes TEETH. Dermoid cysts are congenital (present from birth). Doctors do not know how they occur though believe they arise from cells that escape migration when the three layers of the early EMBRYO(mesoderm, ectoderm, and endoderm) develop. Symptoms of Ovarian Cyst and Diagnosis The doctor detects most ovarian cysts incidentally during routine PELVIC EXAMINATION or ULTRASOUND of the lower abdomen done for other reasons. When a woman does have symptoms they are often nonspecific in nature, such as abdominal bloating or pressure, CONSTIPATION,URINARY INCONTINENCE or URINARY FREQUENCY, or pain during SEXUAL INTERCOURSE(dyspareunia). Abdominal or transvaginal ultrasound or abdominal COMPUTED TOMOGRAPHY (CT) SCAN help the doctor confirm the diagnosis. When these diagnostic imaging procedures are not conclusive, the doctor may perform diagnostic laparoscopy to look at the cyst and take a tissue sample for biopsy. Ovarian Cyst Treatment and Surgical Removal Most ovarian cysts go away without treatment or intervention. The gynecologist may recommend surgical removal of an ovarian cyst that is large, persistent, or symptomatic (causes discomfort, irregular menstrual periods, or bleeding) or when the cyst has suspicious features that cause the gynecologist to want to rule out OVARIAN CANCER. Though ovarian cysts are not cancerous and very seldom become cancerous, they can co-exist with cancerous tumors. As well, ovarian cancer tumors commonly have cystic characteristics. Often it is possible to remove the cyst without damaging the ovary. When the cyst is large or questionable the surgeon may need to remove the entire ovary (OOPHORECTOMY). As long as the remaining ovary is healthy and functional, removing a single ovary does not affect the menstrual cycle or FERTILITY.
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Abdominal pain is often the first ovarian dermoid cyst symptom. You may have pain or feels pressure or heaviness in the lower abdomen, if the cyst is large enough. Ovarian dermoid cysts can often bring on lower abdominal pain during intercourse. A process called torsion is another possible cause of pain. In this situation, the stem that forms on some ovarian dermoid cysts becomes twisted, normal flow of blood is stopped, which cause severe pain. Ruptured ovarian dermoid cysts can cause severe lower abdominal pain. You may feel nausea and vomiting. If these pains are severe enough, you should immediately go to hospital for emergency surgery.
Ovarian Dermoid Cyst Symptoms You CANNOT Ignore December 28th, 2009 http://www.ovarian-dermoid-cyst.com/

A dermoid, or mature teratoma, is a benign type of ovarian tumor. Dermoids are common, constituting about one-third of all benign ovarian tumors. They are often found in young women. Dermoids rarely become cancerous. Cancer occurs in only 1-2 percent of cases, usually in women over 40. There is a similar tumor called an immature teratoma that is cancerous but rare (accounting for 1 percent of all ovarian cancers). In roughly 10 percent of cases of dermoids, these cysts will be found in both ovaries. Dermoid ovarian cysts are bizarre because they contain many different types of cells. They arise from a single cell that has the potential to become anything in the body. They are often filled with a greasy, thick fluid and may contain hair, cartilage and even well-formed teeth! Sweat glands, thyroid tissue and muscle fibers may also be found. Old textbooks showed dermoids as a tiny "humunculous," or human being within the ovary. Dermoids often cause no symptoms and are noted as an enlargement of the ovary on a routine pelvic exam. However, they may twist on themselves and cause severe pain, and occasionally they rupture, producing peritonitis, or irritation of the abdominal and pelvic cavity. In order to prevent these complications, it's best to remove dermoids when they are found. The surgery will involve removing the dermoid itself; unless it involves the entire ovary, the rest of the ovary is left behind. The surgeon may use either laparoscopy (surgery using miniature tools through tiny incisions) or an open approach, depending on the size and location of the dermoid as well as the surgeon's skill. Removal of a dermoid should not affect your fertility. As with any pelvic surgery, care must be taken to prevent the formation of adhesions (scar tissue). As long as you have some normal ovarian tissue left -- even if part of both ovaries are removed -- you will still ovulate, and you may become pregnant. What is a Dermoid Cyst? ON OCT 5, 2011 AT 12:41AM http://www.ivillage.com/what-dermoid-cyst/4-n-142345#ixzz1mfPSpEVA by Kelly Shanahan Copyright 2009-2010 Ovarian-cancer-facts.com | All rights reserved Dermoid cysts often grow very slowly and don't become tender unless they rupture. Most women only develop dermoid cysts in one ovary, but approximately 10 to 15 percent of women who develop ovarian dermoid cysts have them occur in both ovaries. Ovarian Dermoid Cysts And Pregnancy Ovarian dermoid cysts and dermoid cyst removal usually doesn't affect fertility or pregnancy. However, their size can cause problems that require surgical removal. Dermoid Cyst Symptoms And Treatment Ovarian dermoid cysts most often don't require treatment or removal. However, they may become inflamed or cause the ovary to twist, a condition known as ovarian torsion. Ovarian torsion can cut off blood

supply to the ovary, resulting in ovarian ischemia and necrosis, and may cause severe pain. This condition may require emergency surgery. Some doctors might recommend limiting strenuous activity that could rupture an ovarian dermoid cyst. Traditional surgery or laparoscopy can both be used to remove ovarian dermoid cysts. The larger the dermoid cyst, the more complicated the surgery. A larger ovarian cyst may have a higher risk of rupture, which spills the cysts contents into the surrounding ovary and body cavity. A ruptured dermoid cyst can cause ovarian: y Adhesions y Infection y Pain. A laparoscopy is a minimally invasive surgical technique sometimes called keyhole surgery or pinhole surgery. Laparoscopy incisions are usually very small, and several are made in the lower abdominal area. A thin tube is inserted through the incision. A fiber-optic camera and surgical tools are then threaded through the tube. When removing ovarian dermoid cysts, a laparoscopy tends to: y Cause less pain y Have shorter recovery time y Reduce surgical scarring. A large ovarian dermoid cyst, however, may require more conventional surgical techniques to safely remove it. Ovarian Cancer And Dermoid Cysts A small percentage of dermoid cysts, about 2 percent, develop into ovarian cancer. These dermoid cysts usually occur in women over the age of 40, and require surgical removal. Due to the risk of ovarian cancer, dermoid ovarian cysts should be closely monitored for changes in size and shape. Although most will disappear over time, women with a family history of ovarian cancer should have all cysts checked carefully by a physician.
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