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 m 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 PLATYPELLOID
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 angle 90° < 90° > 90° > 90°

Incidence 50% 20% 25% (50% in non- 5%

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
 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.