Female Reproductive System: 1. Structural Plan: A. Ovaries: Produce Sex Cells The Ova (Eggs) B.

Accessory Organs Of Reproduction: 1. Fallopian Tubes 2. Uterus 3. Cervix 4. Vagina C. Sex Glands: 1. Breasts D. External Genitalia: Mons Pubis Labia Majora Labia Minora Hymen Bartholins Glands Urethra: Part Of Urinary System Clitoris: Sexual Organ

2. Ovaries: A. Structure & Location: 1. Paired Glands In The Pelvic Cavity Weighing About 3 Grams Each 2. Resemble Large Almonds 3. Attached By Ligaments In The Pelvic Cavity On Each Side Of The Uterus The Uteroovarian Ligaments. B. Microscopic Structure Of The Ovary: 1. Ovarian Follicles: Contain The Oocyte Which Is An Immature Sex Cell Appx. 1 Million At Birth 2. Primary Follicles: Are Covered With Granulosa Cells & Number About 400,000 In Puberty 3. Mature Follicles: About 350-500 Mature Follicles Ovulate During The Reproductive Lifetime Of Most Women 4. Secondary Follicles Form & Have A Hollow Chamber Called The Antrum 5. The Corpus Luteum Forms After Ovulation (Day 15)

C. Functions Of The Ovary: 1. Oogenesis A. A Meiotic (Reduce Chromosome Number In Half) Cell Division Producing Daughter Cells With Equal Chromosome Numbers 23 B. The Ovum Is Formed and It is Larger & Polar Bodies Are Formed & They Are Small & Degenerate. 2. Production of Estrogen & Progesterone: A. Granulosa Cells Surrounding The Oocyte In The Mature & Growing Follicles Produce Estrogen. B. The Corpus Luteum Produces Progesterone After Ovulation C. Estrogens Cause Development & Maintainance Of The Secondary Sex Characteristics. D. Progesterone Stimulates The Secretory Activity Of The Uterine Lining Epithelial Cells & Assists Estrogen In Initiating The Menses.

D. Reproductive Organs: 1. Fallopian Tubes A. Connect The Uterus To The Ovary B. Expanded Distal End At the Ovary Is Surrounded By The Fimbriae C. Mucosal Lining Of The Fallopian Tubes Is Directly Continuous With The Lining Of The Abdominal Cavity D. Ectopic Pregnancy: 1. Can Occur With Implantation Of The Growing Fetus In The Fallopian Tube 2. Often Present With Intense Abdominal & Pelvic Pain 3. Dx: HCG Levels & Diagnostic Ultrasound 4.Rx: Often Surgical Treatment Is Required 2. Uterus: A. Is Attached To the Fallopian Tubes & The Vagina B. Lies In The Pelvic Cavity Posterior To The Bladder & Anterior To The Sigmoid Colon and Rectum C. Histologic Structure: 1. Endometrium: Inner Lining Of The Uterus: Mucosal Lining Is Formed During the Menstrual Cycle & Is Expelled At The End Of The Menstrual Cycle A. Pathology: 1. Endometrial Polyps 2. Endometrial Cancer 2. Myometrium: Smoth Muscle Outer Layer Of The Uterus A. Pathology: 1. Smooth Muscle Tumor: A. Benign: Leiomyoma: Fibroids Rx: 1. Suture Ligature 2. Hysterectomy 3. Uterine Artery Embolization B. Malignant: Leiomyosarcoma D. Menopause: End Of Repetitive Mentrual Cycles In Women Occurs Around Age 45 to 50 Years of Age

3. Cervix: a. Opening Of The Uterus b. Often Used To Determine The Period Of Delivery ie 2 Cm Dilated , 3 cm Dilated Etc C. Pathology: 1. Cervicitis 2. Cervical Cancer: PAP Smear A. Multiple Sexual Partners B. HPV: Human Papilloma Virus 4. Vagina: A. Distensible Tube About 10 cm Long B. Located Between The Bladder & The Rectum In The Pelvis Attached To The Uterus. C. Functions: 1. Birth Canal For Normal Delivery Of Baby At Term Of Pregnancy 2. Receives Penis During Sexual Intercourse D. Pathology: 1. Vaginismus 2. Vaginitis: Example : Trichomonas Vaginitis 3. Vaginal Cancer: Vaginal Adenocarcinoma In The Offspring of Mothers Who Used DES During Pregnancy

E. Accessory Or Supportive Sex Glands: 1. Bartholins Glands:

A. Ducts Open Between Labia Minora B. Secrete Mucus Like Lubricating Fluids

C. Pathology: Bartholins Gland Cyst 2. Breasts: A. Located Over The Pectoralis Muscles B. Size Determined By Fat Quantity C. Breast Tissue Stimulated Growth & Milk Production Stimulated by Prolactin Made By Anterior Pituitary Gland D. Oxytocin Made By Posterior Pituitary Gland Stimulates Milk Letdown E. Lactiferous Ducts Drain At The Nipple Which Is Surrounded By The Areola F. Lymphatic Drainage Determines Spread Of Breast Cancer Often To Axilla & Opposite Breast Breast Cancer: Estrogen Dependent Tumor Dx: Lump In The Breast Mammogram: Calcifications On Mammography Ultrasound & Ultrasound Guided Biopsy CXR CT/MRI Rx: Surgical: Varies From Lumpectomy / Mastectomy/ Modified Radical Mastectomy Chemotherapy: Aromatase Inhibitors :Anti Estrogena (Letrozole Or Femara) + Tamoxifen: for Estrogen Positive and Progesterone Positive Tumors Avastin: Angiogenesis Inhibitors Radiation Therapy: Bone Marrow & Stem Cell Transplantation Ovarian Ablation:

F. Menstrual Cycle: 1. Length: 28 Days: Varies From Month to Month Among Individuals And In The Same Individual 2.Phases: A. Proliferative: Days 6-13 1. Days Between The End Of Menses & The Secretory Phase 2. Involves Growth Of The Endometrial Lining Of The Uterus Stimulated By Estrogen 3. Estrogen Rises During The Proliferative Phase Due To Stimulation Of The Ovarian Follicle By FSH B. Ovulation 1. Ovum Is Released From The Ovary & Moves Into The Fallopian Tube For Possible Fertilization 2. FSH & LH Hormones From The Anterior Pituitary Gland Peak At This Event In The Memstrual Cycle. C Secretory Phase: 1. Days Between Ovulation & Beginning Of Next Menses 2. Characterized By Thickening Of The Endometrium & Secretion By Its Glands To Prepare For Implantation Of A Possible Fertilized Ovum 3. Progesterone Rises During The Secretory Phase & Then Decreases If There Is No Pregnancy 4. Sudden Sharp Decreases In Estrogen & Progesterone Bring On Menstruation. D Menses: 1. About The First 3-4 Days Of The Cycle 2. Estrogen & Progesterone Are At Their Lowest Levels During This Period. 3. Sloughing Of The Endometrial Lining (Uterine Lining) With Bleeding Occurs During the Menses