Overview of Female

Reproductive System

Dr.Dilrukshi Thavin
 Objectives

At the end of the lecture, students should be able to

i. Describe the structure and function of the ovaries, uterine tubes, uterus and
vagina
ii. Discuss the structural changes in ovarian and uterine cycles
iii. Describe the external genitalia
iv. Describe anatomy of the female breast
 FALSE or
Internal Reproductive GREATER PELVIS
Organs in Female LESSER PELVIS
Pelvic Brim
• Internal organs lie within TRUE PELVIS
• Uterus
• Vagina
• Uterine tube (Fallopian tube)
• Ovaries
--Unlike male reproductive organs which are outside the body
(under thermal insulation of scrotum), female organs are deep
inside pelvic cavity (warm)
--Both male & female organs mature and become functional
during puberty
--Healthy male can continuously produces spermatozoa after
puberty (2 types 23, X & 23, Y)
--Female: pre-determined no of oogonia (2 million at birth)
remain dormant arrested in prophase of 1st meiotic division
until puberty at each cycle few primacy oocyte complete 1st
Meiotic division (unequal) at ovulation, 2ndary oocyte begins
2nd Meiotic division (only till metaphase) If fertilisation,
mature oocyte is formed after completing 2nd division (23,X)
 BROAD LIGAMENT - double layer of peritoneum that “drapes” over
suspensory ligament the uterus and uterine tubes (like a rain poncho)

mesosalpinx

Proper ovarian
ligaments

mesovarium –
Ovary is attached
located along posterior layer of
anterior aspect of Broad ligament by
ovary Mesovarium

mesometrium –
along sides of
uterus to pelvic
walls/floor
ureter
K. Kryger
 Ovary
• Ovaries are located in the pelvic cavity
• Almond shaped, 3 cm X 2 cm X 1 cm (weight 14 gm)
• Suspended posterior surface of Broad ligament by
mesovarium carrying blood vessels
• Surface Epithelium (Germinal Epithelium) Low Cuboidal
cells
• Beneath it Tunica Albuginea—collagenous connective
tissue capsule
• Divided into Outer Cortex, Inner Medulla
• Cortex: Ovarian Follicles in various stages of
development, Connective tissue Stroma
• Stroma: cells & Fibres form a whorl-like pattern
• Medulla (Blood vessels)
Blood supply:
Ovarian artery- direct branch from abdominal aorta
Ovarian veins- right ovarian vein ends in the inferior vena cava. Left
ovarian vein ends in the left renal vein.
Lymphatic drainage- end in the lateral aortic lymph nodes
 Primordial follicle
At ovulation, LH surge, increase blood flow: Follicular phase of ovary
Primary oocyte completes first meiotic division

Secondary oocyte + First Polar body

Secondary oocyte enters 2nd meiotic division &
arrested in Metaphase

Day of ovulation (12-16 day of cycle) it extrudes

out with corona radiate peritoneal cavity
enters Fallopian tube (wait for union)

Remaining Theca in follicle corpus luteum
(blood clot, endocrine cells) secretes
PROGESTERONE which maintains uterine
endometrium in secretory phase until 9 days
Secondary Follicle Mature Graafian follicle:
Follicular antrum with fluid, Thick outer layer: theca
Luteal
interna, theca extena, Secondary oocyte eccentric Phase
covered by zona pellucida & corona radiate cells of ovary
• Corpus luteum
• Cavity of follicle invaded by connective tissue & blood
vessels
• Cells of Membrana granulosa convert into Granuosa-Lutein
Cells (Large Pale-staining cells)– capable of producing
PROGESTERONE
• Theca-lutein cells at periphery—dark staining—also secrete
Progesterone, some androgen
FUNCTION:
• Progesterone & oestrogen secreted by lutein cells INHIBIT
Pituitary to secrete FSH/LH No new follicles NO NEW
OVULATION
• If NO PREGNANCY Absence of LH  Degeneration of
Corpus Luteum (Corpus Luteum of Menstruation)
• If Pregnancy, HCG from Placenta maintain Corpus lutem
for 3 months
 UTERUS
LOCATION:
Lesser Pelvis
Oblique, Fundus directed forward & Upward, lower
end back & down
• Towards broad upper end paired uterine tube
• Normal: 7.5 cm long, 5 cm broad, 2.5 cm thick
• Fundus—rounded part above joining of uterine tube
• Body- Broad part where uterine tube joins
• Cervix-narrow circular part that projects into vagina
• Body + Fundus=
• Outer Adventitia (Perimetrium)
• Myometrium ,
• Inner Endometrium
Cervix: Lower cylindrical part, projects into vagina—Supraviaginal, Position & Angulation:
Vaginal Part Anteversion 90 degree
Upper narrow end: Internal Os (angle with vagina)
Lower end: External Os Anteflexion 125 degree
Mucosa of cervix-folds with longitudinal ridge (angle between body &
Vaginal Fornices: Anterior, Lateral, Posterior cervix)
• Endometrium
• Mucosal lining of uterus, TWO layers
• Simple Columnar Epithelium + Lamina Propria
----Basal 1/3rd = STRATUM BASALE
---Superficial 2/3rd = STRATUM FUNCTIONALIS
Stratum functionalis sheds away during menstruation
LAMINA PROPRIA:
Simple Tubular Glands supported by Endometrial
STROMA [ dense irregular connective tissue, Stromal
cells, macrophages, reticular fibres]

Under Oestrogen & Progesterone, Cyclical changes

in endometrium during ovarian cycle
THREE Principal Phases:
Menstrual
Proliferative Myometrium: INNER & OUTER LONGITUDINAL, MIDDLE CIRCULAR
Secretory Normal muscle cells 50 µ length, Pregnancy: hypertrophy 500 µ, hyperplasia
 Menstrual Phase (about 1 to 5 days)
• Uterine arteries give rise to STRAIGHT & SPIRAL
branches to endometrium
• Straight supplies basal layer, short
• Spiral supplies functional layer, long
• Spiral arteries more sensitive to lack of progesterone
in menstrual phase –causes iscahemia by
vasoconstriction 1 day before menses followed by
degeneration-shedding off of functional layer
OVULATION • During proliferative phase these spiral arteries again
regenerate

Proliferative Phase (4-14 day)

--Thickness 2-3mm, reconstruction of stratum functionalis
--Simple columnar, --Uterine glands: Few simple
straight tubular glands with narrow lumen
Spiral arteries regrow
Secretory Phase: (15-28 Day)
After ovulation,Thickness 4-6mm., Hypertrophied simple columnar
Proliferative Secretory --Uterine glands: many highly tortuous tubular glands
--synthesis or storage of glycogen
-- Spiral arteries MORE coiled, reach the surface
• Relations of Uterus Pouch of Douglas
• Body: Anterior surface: FLAT, Related to Urinary bladder
• Posterior Surface: CONVEX, coils of terminal ileum, sigmoid
colon, anterior wall of recto-uterine pouch of Douglas
(Deepest part of Peritoneal sac—Exudate collect here)
• Lateral border: Broad ligament, uterine tube
• Round ligament—Anteroinferior
• Ligament of ovary---Posteroinferior

Blood supply of the uterus:

 Arterial supply:
Uterine arteries- branches of the internal iliac arteries. Ovarian
arteries – prominent during pregnancy
 
Venous drainage:
Uterine and vaginal veins which drain to the ovarian and internal iliac
veins
 USG showing 10 weeks pregnancy with foetus inside amniotic
fluid

Normal site of Implantation of zygote in Posterior wall of Body of

Uterus
USG showing 36weeks pregnancy with mature foetus
 VAGINA
• Upper and lower ends
• posterior and anterior wall
• two lateral walls.
• Lower end opens into the vestibule
• Upper end is pierced more anteriorly by the
cervix.
• 4 recesses between the cervix and the wall
of the vagina- vaginal fornices.
• They are – anterior, posterior, and 2 lateral
fornices.
• POSTERIOR FORNIX DEEPER on P/V
examination
• Lymphatic drainage of vagina
Upper & Middle one-third: External
& Internal Iliac nodes (Pelvis)
But any ulcers or STD in Lower
one-third of vagina Superficial
Inguinal Lymph Nodes will be
enlarged (Root of Thigh)
Only Glans of Clitoris Deep
Inguinal nodes
 l a
---Each tube lies in upper border of Broad
UTERINE TUBE u l
ligament m
---Connects peritoneal cavity with Cavity of Isthmus A p
uterus Intramural
--Potential source of infection from exterior
to interior (pelvic cavity—Salpingitis) (also
site for ECTOPIC PREGNANCY)
4 parts

 Infundibulum: funnel shaped with

FIMBRIA to catch the oocyte Infundibulum
 Ampulla: Widest part
Fertilization occurs at the
 Isthmus: Narrowest part
junction of the lateral 1/3
 Intramural part: pierces uterine wall and medial 2/3 of the
uterine tube- in the
Simple columnar with large numbers of ampulla.
CILIA helps to transport both oocyte and
spermatozoa (also thick layer of smooth
muscles to propel)
Blood supply: uterine and ovarian blood
vessels K. Kryger
 Female External gaenitalia [pudendum / vulva] Mons pubis – fatty eminence anterior to the
pubic symphysis
labia majora
Mons pubis
Bulbospongiosus
muscle
glans of clitoris

urethral orifice
Labium minora

vagina

vestibule

Perineal
Labia majora – folds of skin with subcutaneous fat that bound labia minora [enclosed by the labia majora] – Body
the pudendal cleft (Equivalent of Scrotum) surround the vestibule.
Vestibule – space between the labia minora  openings of urethra & CLITORIS: Median rod like
vagina. Miniature penis—Glans, Body, Root
Bulb of Vestibule – along the sides of the vestibule [corresponds to bulb of Erectile mass plays role in sexual arousal
penis]
Greater Vestibular Gland (Bartholin Gland)
Mammary Gland
(Exocrine gland, Modified Sweat Gland)
Accessory organ of Reproduction in
female
Male (No function, only few ducts)
Size, Shape related to GENETIC
(Racial),Dietary factors- Left slightly bigger
Anatomical location & extent
Beneath the skin, in front of Pectoral Fascia covering
pectoralis major, serratus anterior, External Oblique
muscles
(MAMMARY BED, potential retro-mammary space)
Horizontal Extent
Lateral border of sternum to mid-axillary line
Vertical= 2nd to 6th ribs
Between the overlying skin &
underlying deep fascia
(Pectoral Fascia)—Strands of
connective tissue-Suspensory
ligaments or Cooper’s ligament
(Support the gland)
Structure
Parenchyma
gland tissue, Basic unit is ALVEOLI (Few
mm)
Composed of 15-20 lobules of glandular
tissue; Each lobule drained by Lactiferous
Duct which opens in nipple.
Stroma
Fibrous tissue connecting lobes and fatty
tissue in the intervals between the lobes.
Lactiferous sinus=dilated part of duct
Nipple (prominent apical part) is
surrounded by circular pigmented area
called AREOLA (Rosy color in virgin, black
once pregnant; sebaceous glands open on
surface)
The superior lateral quadrant of the
breast extends diagonally upwards
towards the axilla and is known as
the tail of Spence or AXILLARY TAIL
Blood Supply
Lateral Thoracic branch from 2nd part of Axillary artery
Medial mammary branches from Perforating branches of (Internal
Thoracic artery & Anterior Intercostal artery)
Lateral mammary branch from Posterior intercostal arteries
VEINS
Mostly to AXILLARY VEIN
some go to Internal thoracic vein
Veins draining to posterior intercostal can carry metastasis to vertebrae
(vertebral venous plexus)
Nerve Supply: 4th to 6th Intercostal nerves

Lymphatic Drainage
 Important because of metastasis in cancer breast, From nipple, areola,
lobules of gland Subareolar plexus
 75% drains to Axillary Lymph nodes 20%,
mostly from medial quadrant drains to Parasternal (Internal Mammary)
Lymph nodes or goes to opposite breast
 5% to the Posterior Intercostal Nodes
 From Lower Medial Quadrant, goes to Abdominal wall  pelvic
organs