ANATOMY AND PHYSIOLOGY

OF
REPRODUCTIVE SYSTEM

Prepared by: Melizza Fajardo Bañano

BS-Midwifery 1
REPRODUCTIVE SYSTEM

 Genital System which is a system of sex organs (internal

and external organs) within an organism which work
together for the purpose of sexual reproduction.

 Produces egg and sperm cells

 Transport and sustain these cells
 Nurture the developing offspring
 Produce hormones
Female Reproductive System
Female External Organs

EXTERNAL GENITALIA
“VULVA” – female external genitalia
“PUDENDA” – external genitalia of either sex
FEMALE EXTERNAL GENITALIA
MONS PUBIS OR MONS VENERIS

 “MOUNTAIN OF VENUS”
 Is a pad of fat above the symphysis pubis

 Protects the symphysis pubis from trauma.

 Is richly supplied with sebaceous glands.

MONS PUBIS OR MONS VENERIS

 ESCUTCHEON - curly hair

 Hair pattern of hair growth:
 Female : triangular with base up
 Male: diamond-shape

 Hair growth: testosterone

 Pattern of hair growth: estrogen.
LABIA MAJORA

 “LARGE LIPS”

 Two thick folds of adipose tissues originating from the

mons and terminating in the perineum.

 Unites to form the anterior commissure and posteriorly

to form the posterior commissure.

 Outer surface - thick & covered by hair

 Inner aspect - thin, smooth, and moist.
LABIA MAJORA

 Provide covering and protection to the external

organs located under it.

 In nulliparous women, it is in close apposition to each

other but it tends to gape wider after childbirth.

 DARTUS MULIEBRIS – responsible for the wrinkle –

like appearance of labia majora
LABIA MINORA

 “NYMPHAE”

 Two soft and thin folds of connective tissue that joins anteriorly
to form the prepuce and posteriorly to form the fourchette.

 FRENULUM -lower border of the upper portion

 Moist, highly vascular, sensitive, and richly supplied with

sebaceous glands.
LABIA MINORA

 In nulliparous women, the labia minora covers the

vaginal delivery.

 Being very fragile, it is usually torn during vaginal

delivery.
CLITORIS
 Greek word means “KEY”

 Pea-shaped, highly sensitive and erectile tissue

situated under the prepuce of the labia minora.

 Known to be the “SEAT OF A WOMAN’S SEXUAL

AROUSAL AND ORGASM”
 Highly sensitive to both touch and temperature.
CLITORIS

 Composed of two erectile tissues called CORPOSA

CAVERNOSA that are connected to the pubic bone.
During sexual arousal, the ischiocavernous muscle
surrounding it contracts blocking the flow of blood and
this result in clitorial congestion and erection.
 Supplied with many sebaceous glands that produce a
cheese-like secretion called SMEGMA.
FOURCHETTE

 Formed by the posterior joining of the labia minora

and majora
 Very sensitive to manipulation, often torn during
vaginal delivery
 Common site for episiotomy
FOSSA NAVICULARIS

 Space between the fourchette and vaginal introitus

that usually obliterated during childbirth.
VESTIBULE
 An almond-shaped area & a triangular space between
the labia minora when the vaginal introitus, urethral
meatus, Bartholin’s glands and Skene’s glands are
located.
BARTHOLIN’S GLANDS

 Also known as vulvovaginal glands, paravaginal and major

vestibular glands.

 Each inner side of the vagina

 Secretes mucus that helps to keep the vaginal introitus
lubricated
 Its alkaline nature enhances sperm survival.

 DODERLEINE’S BACILLUS – responsible for maintaining

the acidic environment of the vagina
SKENE’S GLANDS

 Also known as paraurethral and minor vestibular glands.

 Each inner side of the urethral meatus

 Secretes small amounts of mucous which functions as

lubrication during sexual intercourse or coitus.

 Most common site of external infection in females

VAGINAL ORIFICE

 External opening of the vagina located just below the

urethral meatus.

 The GRAFENBERG or G-SPOT is a very sensitive

area located at the inner anterior surface of the
vagina.
HYMEN
 Thin circular membrane made of elastic tissue
situated at the vaginal opening
 Separates the female internal organs from the
external organs.
HYMEN

 Imperforate hymen is a hymen that completely

covers the vaginal introitus preventing the passage of
menstrual discharge or sexual intercourse.
 HYMENOTOMY or HYMENECTOMY is the surgical
incision of an imperforate hymen.
 CARUNCULAE MYRTIFORMES (HYMENAL
CARUNCLES) – residual tags of the torn hymen post-
instrumentation, use of tampons, coitus, or vaginal
delivery.
URETHRAL MEATUS

 The external opening of the female urethra is located

just below the clitoris.

 Urethral opening for urination

 The shortness of the female urethra makes women

more susceptible to urinary tract infection (UTI) than
men.
PERINEUM

 Muscular structure in between vagina and anus

 Contains arteries and veins that supply blood
 Consists of pubococcygeal muscles and levator ani
muscles for support and pudendal nerve for pudendal
anesthesia
 In males, it is behind the scrotum.
NERVE SUPPLY

 The anterior portion’s nerve supply is derived from the

L1 (and the posterior portion is derived from S3.
BLOOD SUPPLY

 BLOOD SUPPLY to the vulva is provided by the

pudental artery and inferior rectus artery.

 Facilitates rapid healing during the postpartum period.

 Predisposes the woman to hemorrhage causes by
lacerations of childbirth.
FEMALE INTERNAL ORGANS
 Click icon to add picture

FEMALE INTERNAL ORGANS

VAGINA
 Hollow, membranous and muscular canal
 3 – 4 inches or 8 - 12 cm long located in front of the
rectum and behind the bladder
 Upper portion is separated from the rectum by the
cul-de-sac of Douglas (pouch of Douglas).
 Composed of connective and elastic tissues, and
muscle fibers.
 Surface is lined by stratified squamous epithelium.
VAGINA

 External opening is encircled by the bulbocavenous

muscle that acts as a voluntary sphincter. Kegel’s
exercise lacerations during the birth of the baby.
 Vaginal vault is the upper end of the vagina.
 Lymphatic drainage is via the inguinal, internal iliac
and sacral glands.
FUNCTIONS OF VAGINA

1. Organ of copulation
2. Discharges menstrual flow
3. Birth canal
 RUGAE
 Transverse folds of the skin in the vaginal wall absent
in childhood, appear after puberty and disappear
menopause.
 Most numerous in nulliparous women and lessen each
childbirth and advancing age.
 Allow the vaginal canal stretch and enlarge
considerably during delivery.
 VAGINAL COLUMN

 Longitudinal folds of skin in the vaginal canal

 Allows vaginal canal to enlarge during delivery
in order to accommodate fetus
FORNIX/FORNICES

 The cervix projects into the vagina forming four

recesses depression around the vagina’s upper
portion called fornice, anterior fornix, lateral
fornices, and posterior fornix.
 Posterior wall (10 cm)
 Anterior wall (7cm)
 Causing the posterior fornix to be deeper to the other
fornices, as a result, it is in this area that vaginal
secretions collect and semen pools.
VAGINAL pH

 Before puberty - 6.8 to 7.2 (alkaline)

 Puberty vaginal pH becomes acidic, going down to a
pH 4-5.
 The change to acidic pH during puberty is due to the
fact before puberty, a girl does not produce
substantial estrogen stimulate cervical mucus
secretion but with the advent of puberty, her ovary
begins to produce increasing amounts of estrogen
which stimulates mucus production in the cervix.
VAGINAL pH

3. Cervical mucus is rich in glycogen. The glycogen

content of vaginal mucus is converted to lactic acid
by Doderlein bacili (a bacteria normally present in
the vagina) making the vaginal environment acidic –
Low vaginal pH helps control the growth of
pathogenic that can cause vaginal infections.
BLOOD SUPPLY

 Vaginal arteries which is a branch of the uterine arteries.

 Can cause massive hemorrhage if external vaginal
lacerations are not repaired.
 Facilitates rapid healing after delivery
 UPPER PORTION – cervicovaginal branch of uterine
artery
 MIDDLE PORTION – inferior vesical arteries
 LOWER PORTION – rectal and pudental arteries
UTERUS

 Hollow muscular canal

 Inverted pear
 Situated in the true pelvis
 Designed for implantation, containment and
nourishment of the developing fetus
 Varies in size, shape, and weight
 Mainly for menstruation, pregnancy, and labor
UTERUS

 Uterine contraction to expel the fetus during labor

and to seal torn blood vessels after delivery of the
placenta. The uterus has an intrinsic motility which
making it capable of contraction even if the nerves
that supply it are cut.
UTERUS
 Size: 1” thick x 2” wide x 3” long
 Shape:
 Non-pregnant: pear-shaped or inverted avocado
 Pregnant: ovoid
 Position: anteflexed or anteverted (bent or tipped forward)
 Weight:
 Non-pregnant: 50-60 g
 Pregnant: 1000 g
 4th stage of labor: 1000 g
 2 weeks after delivery: 500 g
 3 weeks after delivery: 300 g
 5-6 weeks after delivery: 50-60 g
PARTS OF THE UTERUS

1. Fundus
2. Cornua
3. Isthmus
4. Corpus
5. Cervix
PARTS OF THE UTERUS

1. FUNDUS
 Uppermost convex portion located between the
insertions of the fallopian tubes
 Most muscular area of the uterus
 Thickest and the most contractile portion
 Used as an obstetrical landmark
PARTS OF THE UTERUS

2. CORNUA – Where fallopian tubes are attached

3. ISTHMUS – upper third of the cervix, very thin becoming

prominent only near the end of pregnancy and during
labor to form the lower uterine segment together with the
cervix.

4. CORPUS – body of the uterus, one-third of the organ

– houses the fetus during pregnancy
PARTS OF THE UTERUS

5. CERVIX – neck of the uterus

 Size: 2.5 cm long, 2.5 cm in diameter
 Composed of elastic and collagenous tissues and only 10%
muscle fibers.
 Upper portion: mucous membrane similar to uterus
 Lower portion: squammous epithelium similar to vagina
 Contains many sebaceous glands that secretes a clear,
viscid and alkaline mucus.
 Sometimes these glands are occluded giving rise to non-
pathogenic cyst-like structures called NABOTHIAN
CYSTS.
PARTS OF THE CERVIX

A. INTERNAL OS – opens the corpus

B. CERVICAL CANAL – spindle-shaped actually a
continuation of the triangular shape and located
between the external and internal.
C. EXTERNAL OS – opens the vagina
LAYERS OF THE UTERUS

1. PERIMETRIUM – outermost serosal layer attached

to ligaments; protects the entire uterus (parietal
peritoneum)
2. MYOMETRIUM – middle muscular layer responsible
for contractions during labor “POWER OF LABOR”;
thick fundal area of uterus; its smooth muscles are
“LIVING LIGATURE” of the body; largest portion of
uterus
3. ENDOMETRIUM – innermost ciliated mucosal layer
with numerous uterine glands that secrete a thin
alkaline the uterine cavity moist.
LAYERS OF THE UTERUS

3. ENDOMETRIUM – undergoes response to the

hormones at different phases of the cycle to prepare
the uterus for implantation.
2 LAYERS OF ENDOMETRIUM
1. GLANDULAR LAYER – composed of columnar
epithelium layer peels off during menstruation and
thickens the proliferative and secretory phase.
2. BASAL LAYER – adjacent to the myometrium; gives
rise to the new endometrium after mens and delivery.
FALLOPIAN TUBES (OVIDUCTS)

 Pair of tube-like structures originating from the

cornua of the uterus with distal ends located near the
ovaries.
 About 4 inches (10cm) long and ¼ inch in diameter.
 Blood supply is derived from the ovarian artery and
drainage is via the ovarian and uterine arteries.
 Transport ovum from ovary to the uterus
 Site of fertilization
 Provides nourishment to the ovum during its journey
FALLOPIAN TUBES (OVIDUCTS)

PARTS OF FALLOPIAN TUBE

1. INTERSTITIAL/INTRAMURAL: Thick-walled, located

inside the uterus; 1 cm long
2. ISTHMUS: narrowest portion of the uterus; 1 cm long;
site of tubal ligation
3. AMPULLA: middle portion and widest part; site of
fertilization
4. INFUNDIBULUM: most distal; has projections called
fimbria; longest fimbria called ovarica is attached to
the ovary to guide the ovum to during ovulation.
FALLOPIAN TUBES (OVIDUCTS)

LAYERS OF FALLOPIAN TUBES

1. MUCOSAL LAYER: composed of secretory cells that

secretes mucus which lubricates the fallopian tube;
ciliated move in sweeping motion to assist in the
transportation of ovum from the ovary to the uterus.
2. MUSCULAR LAYER: responsible for peristaltic
movement ; contractions of fallopian tubes are strongest
at the ovulation and weakest during pregnancy.
3. PERITONEAL LAYER: outermost layer attached ligaments
that keep the fallopian tube suspended in the position.
OVARIES

 Almond-shape glandular organs located on e of the

uterus for ovulation and production of 2 hormones:
progesterone and estrogen.
 Movable organs on palpation
 Weight: between 6-9 g
 Size: 1.5 to 3 cm wide and cm long
OVARIES

 FUNCTIONS OF OVARIES:

1. OOGENESIS: responsible for development and

maturation of ovum.
2. OVULATION: release of ovum from the ovary
3. HORMONE PRODUCTION: main source of estrogen
and progesterone in nonpregnant women.
OVARIES

 LAYERS OF OVARIES:

1. TUNICA ALBUGINEA: outermost protective layer

surrounded by a single layer of cuboidal epithelium
called germinal layer of Waldeyer.
2. CORTEX: functional layer; site of ovum formation
and maturation; consists of primordial follicles,
Graafian follicles, corpus luteum and corpus albicans.
3. MEDULLA: contains blood vessels, lymphatics,
nerves and muscle fibers
Male Reproductive System
PENIS

 Male organ for copulation and urination.

 Composed of 3 longitudinal erectile tissues: 2
corposa cavernosa & 1 corposa spongiosum
 Blood flow: Autonomic nervous system
 Blood supply: penile artery
 Parasympathetic nervous system(vasodilation):
penile erection
PENIS

 PARTS OF PENIS:
1. SHAFT or BODY
2. GLANS PENIS: enlarged end; most sensitive part
3. PREPUCE or FORESKIN: fold of retractile skin
covering the glans removed during circumcision
• PHIMOSIS – prepuce is too tight, cannot be retracted
over the glans
4. URETHRAL MEATUS: slit-like opening at the tip of
penis as passageway of both semen and urine.
SCROTUM

 Sac-like structure containing the testes that

hangs behind the penis
 Covered by sparse hair after puberty,
wrinkled and has a darker coloration than the
rest of the body
 Supplied abundantly by sweat and sebaceous
glands
 Has no subcutaneous fat because the testes
must be kept cool
SCROTUM

 Skin of scrotum is lined by fascia and smooth

muscle layer – DARTOS, which contracts
when environmental temperature is cold to
pull the testes closer to the body to absorb
more heat
TESTES

 Two testes are oval-shaped glandular organs

lying within the abdominal cavity in early fetal
life and descend in scrotum after 28 weeks
gestation.
 Temperature: cooler being 1°c (2 ° - 3 ° F)
lower than body temperature
 4-5 cm long
 Covered by a sac of serous membrane –
TUNICA VAGINALIS
TESTES
 HYDROCELE – inflammation of tunica vaginalis
caused by accumulation of fluid within it
 TUNICA ALBUGINEA – fibrous covering which
divides the testis into 200-300 lobules. Lobules
contain seminiferous tubules which sperm cells
develop.
 LEYDIG CELLS or INTERSTITIAL CELLS –
connective tissue which produce testosterone
surround the seminiferous tubules
 TUNICA VASCULOSA – inner layer of connective
tissue containing blood vessels
PARTS OF TESTES
1. SEMINIFEROUS TUBULES – long coiled tubes
where spermatogenesis takes place; testes
produce about 176 sperm cells a day lead to
the tightly coiled epididymis where sperm cells
continue their travel and maturation
2. LEYDIG OR INTERSTITIAL CELLS – produce
testosterone, found around seminiferous
tubules
3. SERTOLI CELLS OR SUPPORTING CELLS -
plays a role in sperm transport
EPIDIDYMIS
 Long coiled tube approximately 20 ft long
 Sperm travels for 12 – 20 days after it leaves
the testis
 Takes 64 days for sperm to become mature
 EPIDIDYMITIS due to STDs can cause
narrowing and contracture of the epididymis
which can prevent the passage of sperm cells
resulting in sterility or infertility
VAS DEFERENS
 Forms the passageway of the sperm cells from
the epididymis in the testis to the urethra
 Surrounded by arteries, veins, and a thick
fibrous covering
 Ends at the seminal vesicles and ejaculatory
duct
 At the end, just before it joins the seminal
vesicles, there is a dilated portion which
functions as a storage area of sperm cells
before ejaculation.
VAS DEFERENS
 Presence of acidic secretions in this portion
causes the sperm not to be very motile
 Part of the duct system cut during vasectomy
 VARICOCELE of a blood vessel can cause
congestion in the testes that can result in
infertility.
EJACULATORY DUCT

 Two ejaculatory ducts pass through the

urethra, connect seminal vesicles to the
urethra carrying secretions
 Passageway of semen
SEMINAL VESICLE
 Two potch-like organs consisting of many sac-like
structures located next to the ductus deferens and
lying behind the bladder and in front of the rectum
 4 cm long
 Thick, mucoid secretion is high in sugar and
protein, has low pH
 Secretions contain PROSTAGLANDIN, substance
which causes contractions of the female
reproductive tract to help transport the sperm
cells.
PROSTATE GLANDS
 Walnut-shaped body lying below the bladder
surrounding the urethra and the two
ejaculatory ducts
 Secretes thin milky alkaline fluid that
neutralizes the acidic nature of the male
urethra caused by the urine that passes
through it enhancing sperm survival
COWPER’S/BULBORETHRAL
GLAND
 Two small glands located below the prostate
and secrete an alkaline fluid that neutralizes
the acidic nature of the urethra and provides
additional lubrication during intercourse
SEMEN or SEMINAL FLUID
 Mixture of secretions from the seminal
vesicles, prostate gland, Cowper’s gland,
ejaculatory duct and sperm cells
 EMISSION – discharge of semen from the
urethra
 EJACULATION – forceful expulsion of semen
from the urethra caused by contraction of
muscles in the penis
SEMEN or SEMINAL FLUID
 Seminal vesicles - 60% of the fluid
 Prostate gland – 30%
 Testes – 5%
 Bulbourethral gland - 5%
 Normal volume: 2-5 ml (each milliliter about
100 million sperm cells)
 Abnormal: sperm count below 20 million
 Nature: alkaline, high in basic sugar and
protein (mucin)
THE PELVIS
THE PELVIS

 BONY PELVIS OR PECTORAL GIRDLE

 Basin-shaped complex of bones that connects
the trunk and the legs
 Lower part of abdomen, located between the
hip bones
 Supports and balances the trunk
 Contains and supports the intestines, urinary
bladder, and internal sex organs
 PELVIC BONES
 2 innominate bones:
 Ilium - large flared-out part
 Ischium - thick lower part
 Pubis - anterior part
 1 sacrum – wedge-shaped bone with 5 fused
vertebrae
 1 coccyx – vestigial tail; four fused vertebrae
(small triangular bone)
 PELVIC LIGAMENTS
 RELAXIN – hormone which gradually loosens all pelvic
ligaments allowing slight pelvic movement providing
more room for the fetal head as it passes through the
pelvis.
 SACROILIAC – connecting sacrum & ilium
 SACROTUBEROUS & SACROSPINOUS
– passing between sacrum & ischium
 SACROCOCCYGEAL – uniting the sacrum
& coccyx
 INTERPUBIC – between 2 pubic bones
 FEATURES GYNAECOID ANDROID ANTHROPOID PLATYPELLOI
D
Brim Rounded Heart-shaped Long oval Kidney-shaped
Forepelvis Generous Narrow Narrowed Wide
Side walls Straight Convergent Divergent Divergent
Ischial spines Blunt Prominent Blunt Blunt
Sciatic notch Rounded Narrow Wide Wide
Sub-pubic 90° < 90° > 90° > 90°
angle
Incidence 50% 20% 25% (50% in 5%
non-caucasian)
THE TRUE PELVIS

 Bony canal through which the fetus must pass

during birth
 Divided into BRIM, CAVITY, & OUTLET
 PELVIC BRIM
 Superior circumference
 Inlet – included space
 Round

 (1) Sacral promontory

 (2) Sacral ala or wing
 (3) Sacroiliac joint
 (4) Iliopectineal bone- edge formed at the inward aspect of ilium
 (5) Iliopectineal eminence – roughened area formed where the
superior ramos of the pubic bone meets ilium
 (6) Superior ramus of the pubic bone
 (7) Upper inner border of the body of the pubic bone
 (8) Upper inner border of the symphysis pubis
 PELVIC CAVITY
 Extends from brim superiorly to the outlet
inferiorly
 Anterior wall: pubic bones, symphysis pubis
(depth: 4cm)
 Posterior wall: curve of the sacrum (length: 12
cm)
 Lateral walls: side of pelvis, covered by obturator
internus muscle
 Contains pelvic colon, rectum(posterior),
bladder(anterior), and some reproductive organs
 PELVIC OUTLET
 Space enclosed by the lower circumference
(irregular)
 Has 2 outlets: ANATOMICAL & OBSTETRICAL
 ANATOMICAL: lower borders of each of the
bones together with sacratuberous ligament
 OBSTETRICAL: narrow pelvic strait in which
fetus pass; between the sacrococcygeal joint;
space between narrow pelvic strait and
anatomical outlet; diamond-shaped
 FALSE PELVIS

 Situated above the pelvic brim

 Formed by the upper flared-out portions of the
iliac bones
 Protects abdominal organs
 PELVIC DIAMETER
 TRANSVERSE DIAMETER – greatest width of the brim (13
cm)
 OBLIQUE DIAMETER – iliopectineal eminence of one side to
the sacroiliac articulation of the opposite side (12cm)
 ANTEROPOSTERIOR DIAMETER or CONJUGATE
DIAMETER – sacral promontory to symphysis pubis
3 conjugate diameters
1. Anatomical – 12 cm, sacral promontory to symphysis pubis
2. Obstetrical – 11 cm, sacral promontory to posterior border
of the upper of symphysis pubis (1.5 cm)
3. Internal or diagonal – 12-13cm, lower border of symphysis
to sacral promontory
 PELVIC PLANES
 Imaginary flat surfaces at the brim, cavity, and outlet

PELVIC AXIS
 line drawn exactly half-way between anterior &
posterior wall of pelvic canal
 PELVIC FLOOR
 Soft tissues that fill the outlet of pelvis
 Strong diaphragm of muscle slung like a hammock
from the walls of the pelvis
 Pass urethra, vagina, anal canal
 Provide support for pelvic organs
 Maintenance and continence as part of urinary & anal
sphincters
 PELVIC MUSCLE LAYERS
 SUPERFICIAL LAYER– 5 muscles
1. External anal sphincter – encircles anus
2. Transverse perineal muscles – ischial tuberosities to
center of perineum
3. Bulbocavernosus muscles – perineum forwards around
vagina to corposa cavernosa of clitoris under pubic arch
4. Ischiocavernous muscles – ischial tuberosities along
pubic arch to corpora cavernosa
5. Membranous sphincter – muscle fibers above & below
urethra; attached to pubic bones
 PELVIC MUSCLE LAYERS
 DEEP MUSCLE LAYER – 4 pairs
• Pubococcygeus & Puborectalis – posterior inferior pubic
rami, continue posteriorly interlaced to becoming
inseparable
 Pubococcygeus – rectum , insertion: coccyx
 Puborectalis – posterior; encircling rectum becoming part of
anorectal ring
• Iliococcygeus – fascial covering of obturator internus
muscle (posterior & medial)
• Ischiococcygeus – ischial spine, adjacent sacroiliac fascia.