ANATOMY AND PHYSIOLOGY

REPRODUCTIVE SYSTEM: The female reproductive system produces gametes may unite with a
male gamete to form the first cell of the offspring. The female reproductive system also provides
protection and nutrition to the developing offspring. The most essential organ is the ovary which
carries the ova. The uterus, the fallopian tubes and the vulva are accessory organs.

Functions:

Puberty: It is the time of life in which the

individual capable of sexual reproduction.
It occurs on average between the ages of 10 and 14
years. It marked the maturation of the reproductive
organs and development of secondary sex
characteristics or external physical evidence of
sexual maturity.

Menstrual cycle: Refers to the recurring

changes that take place in the womans
reproductive tract that associated with menstruation
and intermenstruation. Hormones and pituitary gland
regulate these cyclical changes. There are two main components of the menstrual
cycle, the ovarian and uterine cycle.

Ovarian cycle: Occurs in response to two anterior pituitary hormones: follicle-stimulating

hormone (FSH) and luteinizing hormone (LH).

FOLLICULAR PHASE: at the beginning of each menstrual cycle, a follicle on one of the ovaries
begins to develop in response to rising of FSH level. The follicle produces estrogen, which causes
the ovum contained within the follicle to mature. When the pituitary gland detects high level of
estrogen from the mature follicle, it releases LH. This now causes the follicle to burst open,
releasing the mature ovum called ovulation; occurs on a day of 14 of a 28 day cycle.

LUTEAL PHASE: LH remains increase and cause the remnants of the follicle to develop into a
yellow body called the corpus luteum. It secretes a hormone called progesterone. If fertilization
does take place, the corpus luteum begins to degenerate and estrogen and progesterone levels
fall. It leads back to the day 1 of the cycle and the follicular begins anew.

Uterine cycle: Changes in the uterine lining.

MENSTRUAL PHASE: Day 1 of the menstrual cycle is marked by the onset of menstruation. During
the menstrual phase of the uterine cycle, the uterine lining is shed because of low levels of
progesterone and estrogen. At the same, a follicle is beginning to develop and starts producing
estrogen. The menstrual phase ends when the menstrual period stops on approximately 5 days.

PROLIFERATIVE PHASE: When estrogen levels are high enough, the endometrium begins to
regenerate. Estrogen stimulates blood vessels to develop. The blood vessels in turn bring
nutrients and oxygen to the uterine lining and it begins to grow and become thicker. The
proliferative phase ends with ovulation on day 14.

SECRETORY PASE: After ovulation, the corpus luteum begins to produce progesterone. This
hormone causes the uterine lining to become rich in nutrients in preparation for
pregnancy. Estrogen levels also remain high so that the lining is maintained. If pregnancy
does not occur, the corpus luteum gradually degenerates and the woman enters the
ischemic phase of the menstrual cycle.

ISCHEMIC PHASE: On days 27 and 28, estrogen and progesterone levels fall because th
corpus luteum is no longer producing them. Without these hormones to maintain the blood
vessel network, the uterine lining becomes ischemic. When the lining starts to slough, the
woman have come full cycle and is once again at day 1 of the menstrual cycle.

A. External Structures:

Mons pubis: A rounded fatty pad located atop at the symphysis pubis. Coarse pubic hair
and skin cover the mons. It protects the pelvic bones during sexual intercourse.

Labia major and minora:

The labia majora; are paired fatty tissue folds that extend anteriorly from the mons pubis and
then join posteriorly to the true perineum, covered by the pubic hair , vascular and contain oil
and sweat glands.

Labia minora; paired erectile tissue folds that extend anteriorly from the clitoris and then join
posteriorly to the fourchette, where the labia meet. Their thinner than the majora, are hairless,
contain oil glands and are sensitive to stimulation.

Clitoris: The most sensitive part, compose of an erectile tissue, allows the woman to
experience sexual pleasure and orgasm during sexual stimulation.

Vestibule: It is the area between the labia minora. The urethral meatus, paraurethral
glands, vaginal opening, and bartholin glands are located here.

Perineum: The perineum and the muscles of the pelvic floor are capable of great
expansion during birth to allow for the delivery of the fetus. It is the site of episiotomy is
sometimes done.

B. Internal Structures:

Vagina: It leads from the vulva to uterus. The opening lies within the vestibule from which
slopes up and backward to the cervix. The inner folds or the rugae, allow the vagina to
stretch during birth to accommodate the full-term infant. It has ph of 5 and it is acidic to
protect the vagina from infection. It receives the penis during intercourse and the exit
point of menstrual flow.

Uterus: A hollow-pear shape muscular structure located within the pelvic cavity between
the bladder and the rectum. It rest just above the urinary bladder. It prepares the
pregnancy each month, protect and nourish the growing fetus and to id in childbirth.

Divisions of the Uterus:

1. Fundus upper rounded, dome-shaped portion that can be palpated to determine

uterine growth during pregnancy and the force of contractions and for the
assessment that the uterus is returning to its non-pregnant state following child
birth.

2. Corpus body of the uterus.

3. Isthmus area between corpus and cervix which forms part of the lower uterine
segment. It enlarges greatly to aid in accommodating the fetus. The portion that is
cut when a fetus is delivered by a caesarian section.

4. Cervix lower cylindrical portion that represents 1/3 of the total uterus. Half of it
lies above the vagina; half of it extends to the vagina. The cavity is termed the
cervical canal. It has 2 openings/Os: internal os that open to the uterine cavity and
the external os that opens to the vagina.

5. Vagina a 3-4 inch long dilatable canal located between the bladder and the
rectum, it contains rugnae which permit considerable stretching without tearing. It
acts as a organ of intercourse/copulation and passageway for menstrual discharges
and fetus. Doderleins bacillus is the normal flora of the vagina which makes the pH
of vagina acidic, detrimental to the growth of pathologic bacteria.

CERVIX: Tubular structure that connects the vagina and the uterus. It allows the sperm to
enter and menstrual flow to exit. During childbirth, it must fully dilate so that the baby can
be born.

UTERINE ISTHMUS: It connects the cervix to the main body of the uterus. It is
referred to the lower uterine segment. Thinnest portion of the uterus, does not
participate in contraction during labor but it is the most likely to rupture.

CORPUS and FUNDUS: It is the main body of the uterus and the fudus is the top
most portion of the uterus. They are made up of three layers. The perineum,
myometrium, and the endometrium. Perineum is the tough outer layer that supports
the uterus, myometriun is the mscular layer that is responsible for the contractions
during labor, endometrium is the vascular mucosal inner layer, it changes under
 hormonal influence every month in preparation for possible conception and
pregnancy.

FALLOPIAN TUBES: (AKA oviducts) Tiny and muscular corridors that arise from a lateral
position on the superior surface of the uterus near the fundus and extend out on either
side toward the ovaries. The functions are to provide a site for fertilization, a passageway
and nourishing, warm environment for the fertilized egg to travel to the uterus.

ISTHMUS: It is the one third of the tube that connects to the uterus
AMPULA: It is the middle portion of the tube and connects the isthmus with the
infundibullum.
INFUNDIBULLUM: the outer layer that opens into the lower abdominal cavity.

OVARIES: Located on either side of the uterus. The function is to produce the female
hormones estrogen and progesterone which are responsible for female secondary sex
characteristics and for regulating menstrual cycle in response to anterior pituitary
hormones.