Chapter V ANATOMY AND PHYSIOLOGY

THE FEMALE REPRODUCTIVE SYSTEM

The internal organs of the female consists of the uterus, vagina, fallopian tubes, and the ovaries

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.

1) Location. The uterus is located between the urinary bladder and the rectum. It is suspended in the pelvis by broad ligaments.

2) 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.

3) 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.

1) Location. 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.

2) Function. The vagina provides the passageway for childbirth and menstrual flow; it receives the penis and semen during sexual intercourse.

c. Fallopian Tubes

1) Location. Each tube is about 4 inches long and extends medially from each ovary to empty into the superior region of the uterus.

2) Function. The fallopian tubes transport ovum from the ovaries to the uterus. There is no contact of fallopian tubes with the ovaries.

3) Description. 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

1) Functions. The ovaries are for oogenesis - the production of eggs (female sex cells) and for hormone production (estrogen and progesterone).

2) Location and gross anatomy. 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 saclike 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.

3) Process of egg production--oogenesis

a) 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.

b) 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.

c) 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.

d) 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.

e) 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.

f) 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.

(4) Process of hormone production by the ovaries.

a) 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 or menstrual cycle.

b) 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.

The female reproductive system enables a woman to:

produce eggs (ova) have sexual intercourse

protect and nourish the fertilized egg until it is fully developed give birth Sexual reproduction couldn't happen without the sexual organs called the

gonads. Although most people think of the gonads as the male testicles, both sexes actually have gonads: In females the gonads are the ovaries. The female gonads produce female gametes (eggs); the male gonads produce male gametes (sperm). After an egg is fertilized by the sperm, the fertilized egg is called the zygote.

When a baby girl is born, her ovaries contain hundreds of thousands of eggs, which remain inactive until puberty begins. At puberty, the pituitary gland, located in the central part of the brain, starts making hormones that stimulate the ovaries to produce female sex hormones, including estrogen. The secretion of these hormones causes a girl to develop into a sexually mature woman.

Toward the end of puberty, girls begin to release eggs as part of a monthly period called the menstrual cycle. Approximately once a month, during ovulation, an ovary sends a tiny egg into one of the fallopian tubes.

Unless the egg is fertilized by a sperm while in the fallopian tube, the egg dries up and leaves the body about 2 weeks later through the uterus this is menstruation. Blood and tissues from the inner lining of the uterus combine to form the menstrual flow, which in most girls lasts from 3 to 5 days. A girl's first period is called menarche.

It's common for women and girls to experience some discomfort in the days leading to their periods. Premenstrual syndrome (PMS) includes both physical and emotional symptoms that many girls and women get right before their periods, such as acne, bloating, fatigue, backaches, sore breasts, headaches, constipation, diarrhea, food cravings, depression, irritability, or difficulty

concentrating or handling stress. PMS is usually at its worst during the 7 days before a girl's period starts and disappears once it begins.

Many girls also experience abdominal cramps during the first few days of their periods caused by prostaglandins, chemicals in the body that make the smooth muscle in the uterus contract. These involuntary contractions can be either dull or sharp and intense.

It can take up to 2 years from menarche for a girl's body to develop a regular menstrual cycle. During that time, her body is adjusting to the hormones puberty brings. On average, the monthly cycle for an adult woman is 28 days, but the range is from 23 to 35 days.

Fertilization If a female and male have sex within several days of the female's ovulation, fertilization can occur. When the male ejaculates (when semen leaves a male's penis), between 0.05 and 0.2 fluid ounces (1.5 to 6.0 milliliters) of semen is deposited into the vagina. Between 75 and 900 million sperm are in this small amount of semen, and they "swim" up from the vagina through the cervix and

uterus to meet the egg in the fallopian tube. It takes only one sperm to fertilize the egg.

About a week after the sperm fertilizes the egg, the fertilized egg (zygote) has become a multicelled blastocyst. A blastocyst is about the size of a pinhead, and it's a hollow ball of cells with fluid inside. The blastocyst burrows itself into the lining of the uterus, called the endometrium. The hormone estrogen causes the endometrium to become thick and rich with blood. Progesterone, another hormone released by the ovaries, keeps the endometrium thick with blood so that the blastocyst can attach to the uterus and absorb nutrients from it. This process is called implantation.

As cells from the blastocyst take in nourishment, another stage of development, the embryonic stage, begins. The inner cells form a flattened circular shape called the embryonic disk, which will develop into a baby. The outer cells become thin membranes that form around the baby. The cells multiply thousands of times and move to new positions to eventually become the embryo.

After approximately 8 weeks, the embryo is about the size of an adult's thumb, but almost all of its parts the brain and nerves, the heart and blood, the stomach and intestines, and the muscles and skin have formed.

During the fetal stage, which lasts from 9 weeks after fertilization to birth, development continues as cells multiply, move, and change. The fetus floats in amniotic fluid inside the amniotic sac. The fetus receives oxygen and nourishment

from the mother's blood via the placenta, a disk-like structure that sticks to the inner lining of the uterus and connects to the fetus via the umbilical cord. The amniotic fluid and membrane cushion the fetus against bumps and jolts to the mother's body.

Pregnancy lasts an average of 280 days about 9 months. When the baby is ready for birth, its head presses on the cervix, which begins to relax and widen to get ready for the baby to pass into and through the vagina. The mucus that has formed a plug in the cervix loosens, and with amniotic fluid, comes out through the vagina when the mother's water breaks.

When the contractions of labor begin, the walls of the uterus contract that are stimulated by the pituitary hormone, oxytocin. The contractions cause the cervix to widen and begin to open. After several hours of this widening, the cervix is dilated (opened) enough for the baby to come through. The baby is pushed out of the uterus, through the cervix, and along the birth canal. The baby's head usually comes first; the umbilical cord comes out with the baby and is cut after the baby is delivered.

The last stage of the birth process involves the delivery of the placenta, which at that point is called the afterbirth. After it has separated from the inner lining of the uterus, contractions of the uterus push it out, along with its membranes and fluids.