ANATOMY AND PHYSIOLOGY

UTERUS - ENDOMETRIUM
• Inner lining of uterus
• Rich supply of blood about 1.5 mm thick.
• DECIDUA – after implantation the endometrium.
• After delivery it shed-off known as LOCHIA:
- Lochia RUBRA
- Lochia SEROSA
- Lochia ALBA
POSITION OF THE UTERUS
 POSITION OF THE UTERUS
• ANTEVERSION: Fundus is tipped
forward. The normal.
• RETROVERSION: Fundus is tipped
back
• ANTEFLEXION: Body of the uterus is
bent sharply at the junction with the
Cervix.
• RETROFLEXION: The body is bent
sharply just above the Cervix.
 PELVIS
• Serves to support and
protect the reproductive
and other pelvic organs
• Right and Left Innominate
Bones (Flaring hip bones)
forms the anterior and
lateral portion of the ring.
 PELVIS
• Ilium - Ilium forms the
upper and lateral
portion, the flaring
superior border forms
the prominence of the
hip (crest of the ilium)
 PELVIS
• For obstetric purposes, the
pelvis is further subdivided by
an imaginary line, the line
terminalis:
➢ Sacral prominence
➢ Superior aspect of the
symphysis pubis
➢ False Pelvis
➢ True Pelvis
 PELVIS
• FALSE PELVIS - Shallow upper part if
the pelvis that supports the uterus
during the late months of pregnancy.
Aids in directing the fetus into the true
pelvis for birth.

• TRUE PELVIS (inferior half) - Lower,

smaller but deeper part of the pelvis that
must be adequate for the delivery
process. Lies below the linea terminalis.
It is also known as the bony birth canal.
 PELVIS
OTHER TERMS:
INLET - Entrance to the True
Pelvis. It is at the level of the
linea terminalis marked by
the sacral prominence in the
back the ilium on the sides
superior aspect the
symphysis pubis in the front.
 PELVIS
OTHER TERMS:
INLET
Its transverse diameter is wider
than its anteroposterior diameter.
Thus,
Transverse diameter = 13.5 cm,
Anteroposterior diameter = 11 cm,
Right and Left oblique
diameter = 13.75 cm.
 PELVIS
OTHER TERMS:
OUTLET - It is the inferior
portion of the pelvis.
Boundaries: Coccyx, Ischial
Tuberosities, and the inferior
aspect of the Symphysis pubis
and the Pubic arch. Its
anteroposterior (AP) diameter is
wider than its transverse
 PELVIS
OTHER TERMS:
PELVIC CAVITY - The
space between the Inlet
and Outlet. It is curved,
not a straight passage. It
also slows and controls
the speed of the birth.
 TYPES/VARIATIONS OF THE PELVIS
1. GYNECOID
● "normal" female pelvis.
● Inlet is well rounded
forward and back.
● Most ideal for childbirth.
 TYPES/VARIATIONS OF THE PELVIS
2. ANTHROPOID
Transverse diameter is
narrow, AP diameter is
larger than normal.
 TYPES/VARIATIONS OF THE PELVIS
3. Platypelloid
● Inlet has an oval shape,
AP diameter is shallow.
 TYPES/VARIATIONS OF THE PELVIS
4. ANDROID
● "male" pelvis.
● Inlet has a narrow,
shallow posterior portion
and pointed anterior
portion.
ANDROID
PLATYPELLOID
GYNECOID
ANTHROPOID
NEUROENDOCRINOLOGY
OF REPRODUCTION AND
MENSTRUATION
SPERMATOGENESIS
SPERMATOGENESIS

•The process by which the Seminiferous

tubules of the Testes produce sperm.
•Begins in males at puberty.
 SPERM
• 300 million sperm complete the process of
Spermatogenesis each day.
• Structures that are highly adapted for reaching
and penetrating secondary oocytes.
 PARTS OF THE SPERM
• Head - It contains a nucleus
with 23 chromosomes.
Acrosome - It covers the
anterior two thirds of the
nucleus.
Filled with enzymes that help a
sperm penetrate secondary
oocytes for fertilization.
Hyaluronidase and proteases
 PARTS OF THE SPERM
● TAIL
• Neck - Constricted region just behind
the head that contains centrioles.
• Middle Piece - Contains the
Mitochondria which provide the
energy (ATP) for locomotion of sperm.
• Principal Piece - Longest portion.
• End Piece - Terminal, tapering portion
of the tail.
 OOGENESIS
•Formation of the gametes in the ovaries.
•Begins in females before they are born.
 OOGENESIS
• Mature (graafian) Follicle soon ruptures and releases its Secondary
oocytes
• Ovulation
• Mature (graafian) follicle releases secondary oocytes during
ovulation.
• Secondary oocyte is expelled into the pelvic cavity together with the
first polar body.
• Swept into the uterine tube.
• If fertilization does not occur, it degenerates.
 OOGENESIS
• If sperms are present In the uterine tube and one
penetrates the secondary oocytes, meiosis II resumes.
• Ovum or mature egg unite with sperm cells forming diploid,
zygote.
• Corpus luteum – contains the remnants of a mature follicle
after ovulation.
• Produces progesterone, estrogens, relaxin and inhibin until
it degenerates into fibrous scar tissue called corpus
albicans.
OOGENESIS
Hypothalamic Pituitary
Ovarian/Testicular Axis
 GONADOTROPIN RELEASING HORMONE
• Secreted by the hypothalamus.
• Controls the ovarian and uterine
cycles.
• Stimulates the release, synthesis
and storage of follicle stimulating
hormone (FSH) and luteinizing
hormone (LH) from the anterior
pituitary.
 GONADOTROPIN HORMONE
• Involved mainly in ovarian
functions.
Follicle Stimulating Hormone (FSH)
• Released from the anterior
pituitary gland
• Initiates follicular growth.
• Receptors of FSH exist primarily
on the cell membrane of the
granulosa cells of the ovarian
follicle.
LUTEINIZING HORMONE (LH)
• Main Action:
• Stimulates androgen synthesis
by the theca cells.
• Progesterone synthesis by the
corpus luteum.
• Stimulates prostaglandin
synthesis by intracellular
production of cAMP.
• Triggers ovulation and formation
of corpus luteum.
 ESTROGEN
•Secreted by ovarian follicles.
PROGESTERONE
•Secreted mainly by cells of the corpus
luteum.
MENSTRUATION
 MENSTRUATION
• Is an episodic uterine bleeding in response to cyclic
hormonal changes
• The purpose is to bring an ovum to maturity and
renew a uterine tissue bed that will be responsible
for the ova’s growth should it be fertilized
• That allows for conception and implantation of a
new life
 MENSTRUATION
• MENARCHE – first menstrual period in girls. May
occur as early as 9 years old or as late as 17
years old. Average onset at 12.4 years
• Normal menstrual Cycle: 23 to 35 days, average
of 28 days.
• Length/duration: 2 to 7 days, ranges of 1-9 days
• Average amount blood loss of 30 to 80 ml
• Color of menstrual flow: Dark red; a combination
of blood, mucus and endometrial cells.
• Odor: Similar to marigolds.
 MENSTRUATION
BODY STRUCTURES INVOLVED:
● Hypothalamus
● Pituitary gland
● Ovaries
● Uterus
PHASES OF THE
FEMALE
REPRODUCTIVE
CYCLE
MENSTRUATION