CHAPTER 17 Female Reproductive System Female Reproductive System

CHAPTER 17 Female Reproductive System

Female Reproductive System Overview • Purpose of female reproductive system – Reproduction – Secretes hormones that support secondary sex characteristic changes – Secretes hormones that sustain pregnancy should fertilization occur 2

External Genitalia • Mons pubis – Fatty tissue that covers and cushions symphysis pubis • Labia majora – Two folds of skin containing fatty tissue and covered with hair • Located on either side of the vaginal opening, extending from the mons pubis to the perineum 3

External Genitalia • Labia minora – Two thin folds of tissue located within the folds of the labia majora • Extends from the clitoris downward toward the perineum • Bartholin’s glands – Located on either side of the vaginal orifice • Secrete a mucous substance that lubricates the vagina 4

External Genitalia • Clitoris – Short, elongated organ composed of erectile tissue – Located just behind the upper junction of the labia minora – Homologous to the penis • Urinary orifice – Not true part of female reproductive system, but part of the vulva 5

External Genitalia • Vaginal orifice – Located in lower portion of the vestibule, below the urinary meatus – Also known as the vaginal introitus • Perineum – Area between vaginal orifice and anus – Consists of muscular and fibrous tissue and serves as support for pelvic structures 6

Internal Genitalia • Vagina – Muscular tube that connects the uterus with the vulva • Rests between bladder (anteriorly) and rectum (posteriorly) – Stretchable folds of inner lining known as rugae • Capable of expanding during childbirth to permit passage of baby’s head without tearing lining 7

Internal Genitalia • Uterus – Pear-shaped, hollow, muscular organ that houses the fertilized implanted ovum as it develops throughout pregnancy • Source of monthly menstrual flow if pregnancy does not occur 8

Internal Genitalia • Uterus – Three identifiable portions • Fundus – Small dome-shaped upper portion • Body – Central portion • Cervix – Narrower, necklike portion at lower end 9

Internal Genitalia • Wall of uterus contains three layers – Perimetrium • Outermost serous membrane layer – Myometrium • Middle, muscular layer – Endometrium • Innermost layer, highly vascular 10

Internal Genitalia • Fallopian tubes – Also known as uterine tubes or oviducts – Serve as passageway for the ova as they exit the ovary enroute to the uterus – Free end of each tube ends in fingerlike projections called fimbriae • Fimbriated ends draw ovum into tube through wavelike motions when ovum is released from ovary 11

Internal Genitalia • Ovaries – Female sex cells = female gonads – Almond-shaped pair of ovaries, held in place by ligaments – Responsible for: • Producing mature ova and releasing them at monthly intervals • Producing hormones necessary for normal growth and development of female • Producing hormones necessary for maintaining pregnancy should it occur 12

Mammary Glands (Breasts) • Mammary glands – Known as the breasts – Responsible for production of milk (lactation) – Consist of glandular tissue with supporting adipose tissue and fibrous connective tissue, covered with skin 13

Mammary Glands (Breasts) • Structures of the breasts – Nipple • Located at center of each breast • Consists of sensitive erectile tissue – Areola • Darker pigmented area surrounding the nipple • Montgomery’s tubercles – Small sebaceous glands present in areola 14

Mammary Glands (Breasts) • Tissues of the breasts – Adipose – Connective – Glandular • Lactiferous ducts – Narrow tubular structures of the breast that transport milk to the nipple for breastfeeding 15

Female Pelvis • Landmarks of the pelvis – True pelvis boundaries – Sacrum, coccyx, pubic bone, ischial spines – Serve as reference points for measuring across pelvic outlet from varying angles – Measurement determines size of pelvic 16

Puberty and the Menstrual Cycle • Puberty – Period of life at which the ability to reproduce begins – Female reproductive organs are fully developed – Secondary sex characteristic changes occur 17

Puberty and the Menstrual Cycle • Menstrual cycle – Menstrual Phase • Days 1 – 5 • Menstrual flow occurs on day one and last for 3 to 5 days – Postmenstrual Phase • Days 6 – 12 • Interval between menses and ovulation 18

Puberty and the Menstrual Cycle • Menstrual cycle – Ovulatory Phase • Days 13 – 14 • Graafian follicle ruptures, releasing mature ovum into pelvic cavity = ovulation – Premenstrual Phase • Days 15 – 28 • Phase between ovulatory phase and onset of menstrual flow 19

Common Signs and Symptoms • Amenorrhea – Absence of menstrual flow • Dysmenorrhea – Painful menstrual flow • Menorrhagia – Abnormally long or very heavy menstrual periods 20

Common Signs and Symptoms • Metrorrhagia – Uterine bleeding at times other than the menstrual period • Oligomenorrhea – Abnormally light or infrequent menstruation 21

Forms of Contraception • Abstinence – Abstaining from having vaginal intercourse – Advantage: • 100 percent effective 22

Forms of Contraception • Oral contraceptives – Birth control pills – Contain synthetic forms of the hormones, estrogen and progesterone • Advantages • Disadvantage 23

Forms of Contraception • Depro-Provera injection – Form of contraception administered intramuscularly, approximately once every 12 weeks • Advantages • Disadvantages 24

Forms of Contraception • Intrauterine device – Small plastic T-shaped device inserted into the uterus to prevent implantation of an ovum into the uterus • Advantages • Disadvantages 25

Forms of Contraception • Birth control patch – Thin, flexible square skin patch that continuously delivers hormones into the bloodstream for a full seven days to prevent pregnancy • Advantages • Disadvantages 26

Forms of Contraception • Barrier methods – Methods of birth control that place physical barriers between the cervix and the sperm – Sperm cannot pass the cervix and enter the uterus, and thus the fallopian tubes – Examples: • Spermicidal jellies and creams • Condoms • Diaphragms 27

Forms of Contraception • Permanent methods of birth control – Tubal ligation – Surgically cutting and tying the fallopian tubes to prevent passage of ova or sperm through the tubes • Prevents pregnancy • Known as female sterilization 28

Forms of Contraception Tubal Ligation 29

Forms of Contraception • Permanent methods of birth control • Micro-insert system • Alternate to tubal ligation • Provides bilateral occlusion of fallopian tubes by inserting a soft, flexible micro-insert into each fallopian tube • Requires no incisions and can be performed without general anesthesia 30

Forms of Contraception • Permanent methods of birth control – Vasectomy – Male sterilization – Surgically cutting and tying the vas deferens to prevent passage of sperm • Prevents pregnancy 31

Permanent Methods of Birth Control Vasectomy 32

PATHOLOGICAL CONDITIONS Female Reproductive System

Carcinoma of the Breast • Pronounced – (car-sin-OH-mah of the breast) • Defined – Malignant tumor of the breast tissue – Most common type (ductal carcinoma) originates in the mammary ducts • Has ability to invade surrounding tissue if not detected early enough 34

Cervical Carcinoma • Pronounced – (SER-vih-kal car-sin-OH-mah) • Defined – Malignant tumor of the cervix • Symptoms include bleeding between menstrual periods, after sexual intercourse, after menopause, and an abnormal Pap smear 35

Cervicitis • Pronounced – (ser-vih-SIGH-tis) • Defined – Acute or chronic inflammation of the uterine cervix 36

Cystocele • Pronounced – (SIS-toh-seel) • Defined – Herniation or downward protrusion of the urinary bladder through the wall of the vagina 37

Endometrial Carcinoma • Pronounced – (en-doh-MEE-tree-al car-sin-OH-mah) • Defined – Malignant tumor of the inner lining of the uterus – Also known as adenocarcinoma of the uterus 38

Endometriosis • Pronounced – (en-doh-mee-tree-OH-sis) • Defined – Presence and growth of endometrial tissue in areas outside the endometrium • Lining of the uterus 39

Fibrocystic Breast Disease • Pronounced – (figh-broh-SIS-tik breast dih-ZEEZ) • Defined – Presence of single or multiple fluid-filled cysts that are palpable in the breasts • Cysts are benign and fluctuate in size with the menstrual period 40

Fibroid Tumor • Pronounced – (FIGH-broyd tumor) • Defined – A benign, fribous tumor of the uterus 41

Leiomyoma • Pronounced – (ligh-oh-my-OH-mah) • Defined – Benign, smooth muscle tumor of the uterus 42

Ovarian Carcinoma • Pronounced – (oh-VAY-ree-an car-sin-OH-mah) • Defined – Malignant tumor of the ovaries, most commonly occurring in women in their 50 s • Rarely detected in early stage 43

Ovarian Cysts • Pronounced – (oh-VAY-ree-an SISTS) • Defined – Benign, globular sacs (cysts) that form on or near the ovaries • May be fluid filled or may contain semisolid materials 44

Pelvic Inflammatory Disease (PID) • Pronounced – (PELL-vik in-FLAM-mah-toh-ree dih. ZEEZ) • Defined – Infection of the fallopian tubes – Salpingitis 45

Stress Incontinence, Urinary • Pronounced – STRESS in-CON-tin-ens YOO-rih-nair-ee) • Defined – Inability to hold urine when the bladder is stressed by sneezing, coughing, laughing, or lifting 46

Vaginitis • Pronounced – (vaj-in-EYE-tis) • Defined – Inflammation of the vagina and the vulva 47

DIAGNOSTIC TECHNIQUES, TREATMENTS AND PROCEDURES Female Reproductive System

Diagnostic Techniques, Treatments, and Procedures • Aspiration biopsy – Invasive procedure in which a needle is inserted into an area of the body, such as the breast – Withdraws tissue or fluid sample for microscopic examination and diagnosis 49

Diagnostic Techniques, Treatments, and Procedures • Breast self-examination – Procedure in which the woman examines her breasts and surrounding tissue for evidence of any changes that could indicate the possibility of malignancy 50

Diagnostic Techniques, Treatments, and Procedures • Colposcopy – Visual examination of the vagina and cervix with a colposcope • Lighted binocular microscope used for direct examination of the surfaces of the vagina and cervix 51

Diagnostic Techniques, Treatments, and Procedures • Cone biopsy – Surgical removal of a cone-shaped segment of the cervix for diagnosis or treatment • Also known as conization • Cryosurgery – Destruction of tissue by rapid freezing with substances such as liquid nitrogen 52

Diagnostic Techniques, Treatments, and Procedures • Culdocentesis – Surgical puncture through the posterior wall of the vagina into the cul-de-sac to withdraw intraperitoneal fluid for examination • Checking for evidence of inflammation, purulent drainage, bleeding, ovarian cysts, ectopic pregnancy, or ovarian malignancy 53

Diagnostic Techniques, Treatments, and Procedures • Dilation and Curettage – Dilatation or widening of the cervical canal with a dilator, followed by scraping of the uterine lining with a curet – Also termed D & C 54

Diagnostic Techniques, Treatments, and Procedures • Endometrial biopsy – Invasive test for obtaining a sample of endometrial tissue with a small curet, for examination • Hysterosalpingography – X-ray of the uterus and the fallopian tubes, by injecting a contrast material into these structures 55

Diagnostic Techniques, Treatments, and Procedures • Laparosopy – Process of viewing the abdominal cavity with a laparoscope 56

Diagnostic Techniques, Treatments, and Procedures • Loop Electrosurgical Excision Procedure (LEEP) – Procedure used to remove abnormal cells from the surface of the cervix using a thin wire loop that acts like a scalpel • Painless electrical current passes through the loop as it cuts away a thin layer of surface cells from the cervix 57

Diagnostic Techniques, Treatments, and Procedures • Mammography – Process of examining with x-ray the soft tissue of the breast to detect various benign and/or malignant growths before they can be felt 58

Diagnostic Techniques, Treatments, and Procedures • Papanicolaou smear – Microscopic examination of cells scraped from within the cervix, from around the cervix, and from the posterior part of the vagina to test for cervical cancer – Pap Smear 59

Diagnostic Techniques, Treatments, and Procedures • Liquid-based pap (LBP) – Process of collecting a tissue sample from the endocervix and the exocervix with a sampling device that is placed directly into a liquid fixative instead of being spread onto a glass slide • Process provides immediate fixation and improves specimen adequacy 60

Diagnostic Techniques, Treatments, and Procedures • Pelvic ultrasound – Noninvasive procedure that used highfrequency sound waves to examine the abdomen and pelvis • Pelvimetry – Process of measuring the female pelvis, manually or by x-ray, to determine its adequacy for childbearing 61