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Obstetrics Cardinal

Female Reproductive Organ Round 4 pairs of ligaments that


Uterosacral support the Uterus
External Structures Broad
Uterus
Mons Pubis- is a fatty pad that lies over the anterior surface
of the symphysis pubis covered with curly hair (puberty) Corpus isthmus
Cervix
Labia Majora- are two rounded folds of fatty tissue covered
with skin that extend downward and backward from the mons Uterine walls
pubis *Endometrium-shed during menstruation

Labia Minora- are two flat, reddishfolds of tissue visible *Myometrium-Extends longitudinal, transverse,
whenthe labia majora are separated oblique

Prepuce- hoodlike covering of the clitoris formed by fusing Longitudinal Fibers- mostly found in the fundus
of labia minora and this arrangement assist in
expelling the fetus duringbirth
Frenulum- fold tissue under the clitoris process
Middle layer-has fibers that form a figure 8 and
Fourchette – a thin flat tissue, junction of two labia minora this arrangement assist in
underneath the vaginal opening at midline. constricting blod vessels after
childbirth and control blood loss.
Clitoris- is located underneath the prepuce composed of Circular Fibers- help keep the cervix closed
erectile tissue with numerous sensory nerve endings. during pregnancy and prevent
menstrual blood from flowing back
Viginal Vistibule- is an “almond-shaped” area enclosed by the into the uterine tubes during
labia minora that contains opening to the urethra, Skene menstruation.
glands, Vagina, and Bartholin Glands. *Peritoneum

Urethra-2.5 cm below the clitoris

Skene Glands- are located on each side of the urethra and Cul-de-sac of Douglas - deep pouch, or recess posterior to the
produce mucus, which aids in lubrication of the vagina. cervix and formed by the posterior ligament.

Hymen- a connective tissue membrane, surrounds the vaginal Fundus- dome shaped, top of the uterus, site where the uterine
opening. tubes enter the uterus.

Bartholin glands- lie under the constrictor muscles of the Isthmus-(lower uterine segment) separate the
vagina and are located posteriorly on the sides of the vaginal Corpus and the Cervix
opening, also secreting mucus during sexual arousalto
lubricate the vaginal introitus Cervix- made mostly with fibrous connective tissue and
elastic tissue, making it possible for the cervix to stretch
Perineum- found between the fourchette and the anus, a skin during vaginal childbirth
covered muscular area tha t covers the pelvic structure. Pelvic
organs are supported by mucles and ligaments to for a sling. Internal OS- the opening between the uterine cavity and the
canal that connects the uterine cavity to the vagina 9
Internal Structures endocervical canal

Vagina - is a fibromuscular, collapsible tubular structure that Enternal OS- narrowed opening between the endocervix and
extends from the vulva to the uterus and lies between the the vagina, a small circular opening in women who have never
bladder and the rectum. been pregnant. Fells like the nose with a dimple on the center.
- serves as a passageway for menstrual flow,
copulation and birthcanal Outer Cervix- covered with a layer os squamos epithelium.
Mucosa of the cerviacal canal- coverd with columnar
Rugae- allow the vagina to expad during childbirth epithelium and contains numerous glans that secrete mucus in
Estrogen Deprivation= after childbirth, during lactation, and response to ovarian hormones.
menopause causes dryness and thinnes of the vaginal walls
and smoothing of the rugae. Squamocolumnar junction (transformation jxn)- where
pH 4-5 acidic vaginal secretion. two types of cells meet is usually located just inside th
cervical os.
Fornices- pockets (anterior, posterior & lateral) palpation area - Common site os neoplastic changes and site for Pap Smear.

Uterus- is a muscular organ shaped like and upsidedown pear Fallopian tube- attach to the utertine fundus supported by
that sits midline in the pelvic cavitybetween the bladder and braod ligaments (8-14 cm in leght)
the rectum above the vagina. - provide a passage between the ovaries
- serves for reception, implantation, retention, and and the uterus for the passage of the
nutrition of ther fertilized ovumand later the fetus during ovum.
pregnancy and expulsion of the fetus during childbirth,
Ovaries- are two almond-shaped organs located on each side
also for cyclic menstruation. of the uterine tubes
- for ovulation and production of Estrogen,
Progesterone, and Androgen.
PCPS/07-2409
Breast Ovarian Cycle
- paired mammary glands loc. @ 2nd and 6th ribs Primutive graafian follicles- contains immature
- lies over the pectoralis major b/w strnum and midmaxillary oocytes(primordial ova)
line 1-30 follicles begin to mature before ovulationin each
-attatced to the muscles by a connective tissue called Fascia. ovaryunder the influence of FSH and estrogen
Tail of Spence- extension to the axilla Preovulatory LH surge- affect the selected follicle.
Serratus anterior muscle-where the lowest third of the breast Follicular Phase- - oocytes mature, ovulation occurs and the
overlies empty follicles begins its transformation in to the corpus
Estrogen stimulates growth of the breast and increases luteum.
vascularity of breast tissue Midcycle bleeding exp. By 10% of women where in there is
Progesterone- Increase of this hormone @ pubety causes sufficient bleeding
maturation of mammary gland tissue specifically lobules and Luteal Phase (Postovulatory phase)- begins immediately after
acinar structures. the ovulation and ends with the start of menstruation. It
Fat deposition- during adolescence may contribute to increase requires 13, 14, 15 days.
in size. Corpus letuem – reaches its peak of fxnal activity 8 days after
15-20 lobes- each breast is made of.. ovulation, secreting both estrogen and progesterone
Lobules- division of lobes, cluster of acini * with no implantation in the endometrium it regresses,
Acinus – a sac-like terminal part of a compound gland steroids level drop, and menstruation occurs.
emptying through a narrow lumen or duct.
Acini- lined lined with epithelial cells that secrete colostrun Endometrial Cycle
abd milk. 4 faces
Myoepitheilium- expels milk from acini by cxn 1) Menstrual phase- periodic vasoconstriction in the upper
Mamary papilla- “single nipple” surrounded by areola. layers of the endometrium occurs to shed fxnal 2/3 of the
Contains 15-20 openings of lactiferous ducts endometrium.
Areola- rough looking due to sebaceous glands, Montgomery Basalis- the remaining glandular remnant or
tubercles directly beneath the skin that secrete substance stromal cells
believed to lubricate the nipples.
Lactiferous sinuses/ampullae – formed when ducts converge 2) Proliferative phase – rapid growth lasting fr. 5 th day to the
and dilate which servers a milk reservoir. time of ovulation.
Cooper’s Ligaments- provide support to the mammary glands -Endometrial surface is completely restored
while permitting their mobility on the chest wall. in approx. 4days or slight bere bleeding ceases
-8fold to 10fold thickening occurs with
Menstruation leveling off of growth at ovulation.
Puberty- transitional stage between childhood and sexual - depends on estrogen stimulation derived
maturity. from ovarian follicles.
8-11y/o secretions of small amounst of estrogen is visible.
Menarche- “first menstruation.” 3) Secretory Phase - extends from the day of ovulation to
approx. 3days before the next menstrual period
Menstrual Cycle *-after ovulation larger amount of
Menstruation is a periodic uterine bleeding that begins approx. progesterone is produced.
14 days of ovulation. -endometrium thickens and becomes
-Adequate prodxn of estrogen is needed for regular luxuriant of blood and glandular secretions, a suitable
menstruation. protective and nutritive bed for a fertilized ovum.
-It is a complex interplay of events that occur simultaneously
in the endometrium, hypothalamus, ovaries and the pituitary Implantation- 7-10days after ovulation
glands.
- prepares the uterus for pregnancy. 4) Ischemic Phase – the blood supply to the fxnal
-28 day cycle (some may vary) endometrium is blocked and necrosis develops.
-ave. 5days (ranges 3-6days)
-ave. 50ml (20-80ml) of blood Other Cyclic Changes
Factors: physical emotional environmental
Spinnbarkeit- stretchable quality
Hypothalamus-pituitary cycle
Occurs when there is no fertilization and implantation and Mittelschmerz- localized abdominal pain.
levels of progesterone and estrogen decline, menstruation
occurs and the hypothalamus is once again stimulated to Climacteric- is a transitional phase during which ovarian fxn
secrete GnRH and prdxn of hormone decline.
Gonadotropin Releasing Hormone (GnRH)
-it stimulates the pituitary secretion of Menopause- refers to the final menstruation with an ave. of
foliicle-stimulating hormone (FSH) 51.4y/o (35-60 y/o)
FSH- stimulates the development of ovarian graafian
follicles and their prodxn of estrogen Perimenopause- ovarian fxn declines, ova slowly diminish
Luteinizing Hormone (LH)- from pituitary gland and menstrual cycles are an ovulatory, resulting in irregular
triggered by decrease of estrogen level and bleeding; ovary stops producing estrogen and eventually
Hypothalamin GnRH menses no longer occurs.
- for expulsion of the ovum from the
graafian follicle by approx. 24-36hrs.
- peaks @ 13-14day of a 28-day cycle.
Corpus luteum- regresses if fertilization and
implantation does not occur by the time of ovulation
period.
PCPS/07-2409

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