ANATOMY AND PHYSIOLOGY OF FEMALE

REPRODUCTIVE SYSTEM
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BY
EMAN SAIF SOLIMAN ASHOUR
ASSIT.PROF. OF MATERNAL AND NEWBORN HEALTH
NURSING
FACULTY OF NURSING – MENOUFIA UNIVERSITY
 Introduction
Reproduction is the process by which life
continues. Human reproduction requires the
union of two different germ cells or gametes.
These germ cells, the spermatozoon in males
and the ovum in females, are formed by
meiosis, a type of cell division in which the
chromosome number is reduced to one half.
Functions of Female Reproductive System
1- Enabling the sperm to enter the body.
2- Protecting the internal genital organs from infectious
organisms.
3- Copulation.
4- Oogenesis (gamete production) and hormone
production.
5- Provide sites for egg fertilization, implantation and
development (pregnancy).
6- Menstruation.
 Female Reproductive System
1- External genital organs.
2- Internal genital organs.
3- Accessory reproductive organs.
MONS PUBIS
It is a mass of fat covered
by skin and hair and overlies
the symphysis pubis.
The pubic hair may be
feminine with an upper
straight border or masculine
with a convex upper border.
 LABIA MAJORA
 The labia majora are two prominent
longitudinal cutaneous folds that extend
downward and backward from the mons
pubis to the perineum.
 Each labium major contains a mass of fat
and the skin is covered with hair and contains
sebaceous and sweat glands.
 LABIA MINORA
 Small, soft folds of
tissue beneath the
labia majora that
directly cover the
vaginal introitus.
 CLITORIS
 Small (6mm x 6mm)
erectile tissue with rich
in blood & nerve
supply covered by the
labia minora.
 Plays a role in sexual
excitement.
 Homologous to penis.
 Vestibule
• It is a triangular area lying
within the labia minora with
the clitoris at its apex.
Vestibule contains:-
 The external urethral meatus.
 Vaginal introitus.
 Bartholin's glands.
 The External
Urethral Meatus
• Present in the
anterior part of the
vestibule. 4-6 mm
in diameter. The
length of female
urethra is 3-4 cm.
Vaginal orifice and hymen
• Lies in the posterior end of the vestibule.
• It is partially enclosed by a septum of mucus
membrane called hymen.
• Hymen located just inside the vaginal opening.
• No known function, not always present.
Hymen
 The hymen is a fold of mucous membrane,
which partially closes the vaginal orifice in the
virgin. It has one or more openings to allow
escape of menstrual blood.
 The hymen is torn as a result of sexual
intercourse unless it is abnormally elastic. The
bleeding is usually slight as it is relatively
avascular. During delivery the hymen becomes
destroyed leaving small tags or nodules of
fibrous tissue around the vaginal orifice
 TYPES
Hymen is classified as follows:
1- Annular: the opening is in the center
(the most common shape).
2- Crescentic or semilunar: the opening is
placed anteriorly.
3- Cribriform: in this type, the hymen has
multiple opening.
4- Septate: a thin strip of tissue is present
in-between two lateral opening.
5- Imperforate: hymen with no opening.
 BARTHOLIN GLANDS
 Two in number, one on either side. The gland
is oval and the size of a pea (1 cm in
diameter), it has a duct one inch in length
which passes medially to open in the floor of
the vestibule lateral to the hymen at the 5 and
7 o’clock positions.
 Normally, the gland is not felt unless diseased
and the opening of the duct is not seen. It is a
compound gland. In response to sexual
excitement the gland produces a mucoid
colorless secretion to act as a lubricant for
coitus.
Perineum
• Extends from fourchette anteriorly to the anus
posteriorly
• Varies in length from 2-5 centimeters.
• Is the most posterior part of the external
female reproductive organs.
• Is composed of fibrous and connective tissues
that support pelvic structures.
Blood Supply
• Artery: internal pudental artery.
• Vein: internal pudental vein.
• Lymphatic drainage: inguinal lymph nodes
 Vagina
• It is an elastic fibromuscular tube about 8-10
cm long. It is directed upwards and backwards
forming an angle of 60 degree with the horizon.
• Lying between the bladder anteriorly and the
rectum posteriorly.
• It connects the external genitalia with cervix &
uterus, also called the birth canal.
• The vaginal lining has multiple folds, or rugae
and muscle layer. These folds allow the
vagina to stretch during childbirth.
• The reaction of the vagina is acidic; the pH is
4 that protect the vagina against infection.
• The anterior vaginal wall is about 3 inches in
length and the posterior wall is 4 inches in
length.
 Vagina
• Functions of the vagina:-
- It is the organ of copulation.
- It is the passageway for sperm to the egg,
discharge of the menstrual flow during
menstruation and the fetus from the uterus during
childbirth.
- It forms the birth canal during childbirth.
 Uterus
• It is a hollow pear shaped muscular organ at
the superior end of the vagina; also called
womb; sheds endometrium with menstrual
cycles & holds fetus during pregnancy;
superior portion known as the fundus.
• It measures 1 × 2 × 3 inch 7.5 cm length, 5 cm
width and 2.5 cm thickness and weight 50 gm.
 Parts of the uterus
- The uterus is divided into three parts
consisted of the cervix and the main
body (corpus):-
A) Body of the uterus (Corpus):-
• The upper of the uterus.
• The Fundus is the superior portion of the body
(part of the body or corpus above the area
where the fallopian tubes enter the uterus).
• Length about 5 cm.
B- Isthmus:-

• A narrower
transition zone
located between
the corpus of the
uterus and cervix.
• During late
pregnancy, the
isthmus elongates
and is known as the
lower uterine
segment.
C) Cervix
 The cervix is the lower portion or neck of the
uterus located between the internal os from
one side and the external os from the other
side (runs between the uterus and vagina).
Length is about 2.5 to 3 cm.
 The cervix extends down into the vagina;
consists of fibrous tissue that distends during
labor.
 The cervical mucus is alkaline (pH 8.5),
contains proteins and fructose for nutrition
of spermatozoa. It has bactericidal
properties to prevent ascent of infection.
 It is consisted of two parts:- Part projecting
into the vagina called portio-vaginalis and
the other part is above the vagina and
called supra-vaginal part.
 Layers of the body of the uterus

from outer to inner:-

Perimetrium (serous layer)

Myometrium (muscle layer)

Endometrum (inner mucous layer)

 PERIMETRIUM:
The peritoneum is adherent to the uterus from
outside (visceral peritoneum). The uterus is
related anteriorly to the utero-vesical pouch (the
peritoneal vault between the uterus and the
urinary bladder) and posteriorly to the
rectouterine pouch of the douglas ( the peritoneal
vault between the uterus and the rectum).
MYOMETRIUM:
The myometrium is divided into 3 layers
of smooth muscle (outer longitudinal
layer, inner circular layer and the middle
is oblique layer thickest in fundus and
thinnest in cervix for expulsion at labor
ENDOMETRIUM: It is a mucosal highly
vascular surface layer and the inner lining
of uterus, nourishes developing embryo,
built up each month for pregnancy, if not,
shed during menstruation. It is a gland
capable of cyclic changes according to
the change in levels of estrogen and
progesterone monthly.
Position of the uterus: (AVF)
Its normal position is anteverted antiflexed
position (flexed forward).
Ante-version means the whole uterus is directed
on the vagina (rotated forward) forming an angel
of about 90 degree and
Ante-flexion means the body of the uterus is
directed on the cervix (flexed forward) forming an
angle of about 160-170 degree.
Support of the uterus

1- Position of the uterus and the vagina

(Ante-version ante-flexion).
2- Peritoneal attachment.
3- Position of the surrounding viscera.
4- Levator ani muscles.
5-Uterine ligaments true only.
Uterine ligaments

False ligaments True ligaments

1- Broad ligaments 1- Pubo-cervical
ligaments
2- Round ligaments 2- Utero-sacral
ligaments
3- Ovarian ligaments 3- Machenroad
ligaments
 BLOOD SUPPLY

 Uterine artery Arteries:

 Uterine vein Veins:
 Lymphatic drainage: Paraaortic lymph
nodes, internal iliac lymph nodes and
inguinal lymph nodes
Fallopian tubes: (oviducts , salpinges or
uterine tubes)
• There are two very fine tubes extend from the
cornu of the uterus to the ovary. They run in
the upper free border of the broad ligament.
• It is about 4 inches in length (10 cm) in
average.
• The fallopian tubes are lined with tiny hairlike
projections (cilia). The cilia and the muscles in
the tube’s wall propel an egg downward
through the tube to the uterus. The egg may be
fertilized by a sperm in the fallopian tube.
 Parts of fallopian tubes
It is composed of four parts:
Interstitial: which runs in the uterine wall, about
1-2cm in length and 1 mm in diameter.
Isthmus: The part immediately lateral to the
uterus, it is the narrowest part of the tube, about
2-3 cm in length and 2 mm in diameter.
Ampulla: The middle portion of the tube
connects the isthmus with the infundibulum. It is
the widest part about 5 cm in length. Fertilization
occurs in the ampulla or the egg will die within 24
hours.
 Infundibulum: It is the outer portion that
opens into the abdominal cavity, it is a funnel
shaped. It has an opening which is surrounded
by a number of finger like projections or
fimbriae, one of these is longer than the others
and is adherent to the ovary sweep the egg
down towards the uterus.
Relations
Anterior, Posterior and Superior – the
peritoneal cavity and intestine
Laterally – the sidewall of pelvis
Inferior – the broad ligament and the
ovaries
Medial – the uterus lies between the
uterine tubes
 Ovaries or female gonads or sex glands
The ovaries are almond-sized gland oval solid
structure, placed on each side of the uterus below and
behind the uterine tubes.
They are an endocrine functioning glands that secrete
estrogen& progesterone; mature one follicle & ovum
during each menstrual cycle from menarche to
menopause, except during pregnancy. It is the female
gonad; produce eggs and sex hormones (estrogens and
progesterone).
The ovary measures 1.5 × 2.5 × 3.5 cm 3.5 cm
length, 2.5 cm width and 1.5 cm thickness.
Each weighs about 5 gm. The ovary is the
only organ in the abdomen which is not
covered by peritoneum.
 It is the female gonad; produce eggs and sex
hormones (estrogens and progesterone).
Follicles:- structure that makes the egg and
progesterone. Each follicle contains one oocyte.
Oocyte:- the developing egg. the developing
eggs (oocytes) are contained in a fluid-filled
cavities (follicles) in the wall of the ovaries.
Egg:- female sex cell.
Structure
1- Hilum:
Through which the blood vessels, lymphatics
and nerve pass through it.
2- Medulla:
Consists of connective tissue and is
surrounded by the cortex.
3- Cortex: Contains primary follicles in various
stages of development.
Accessory reproductive organs
Breast:
Breast is a mass of glandular, fatty and
connective tissue. The female breasts (mammary
glands) are specialized sebaceous glands that
produce milk after childbirth (lactation).
Structure of the Breast:
1- Lobules.
2- Lactiferous duct.
3- Fatty and connective tissue.
4- Areola.
5- Nipple.
The breast is made up of:
Lobules: glands that produce milk. Each breast
has 15-20 lobes.
Ducts: tubes that carry milk from the lobules to
the nipple.
Fatty and connective tissue: surrounds and
protects the ducts and lobules.
Areola: circular area around the nipple.
Nipple: center of the areola, the nipple contains
bout 15-20 lactiferous ducts.
Function of the breast
• Lactation