The Female Reproductive System : an Introduction
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Chapter 28 *Lecture Powepoint
Chapter 28 *Lecture PowePoint The Female Reproductive System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • The female reproductive system is more complex than the male system because it serves more purposes – Produces and delivers gametes – Provides nutrition and safe harbor for fetal development – Gives birth – Nourishes infant • Female system is more cyclic, and the hormones are secreted in a more complex sequence than the relatively steady secretion in the male 28-2 Sexual Differentiation • The two sexes indistinguishable for first 8 to 10 weeks of development • Female reproductive tract develops from the paramesonephric ducts – Not because of the positive action of any hormone – Because of the absence of testosterone and müllerian-inhibiting factor (MIF) 28-3 Reproductive Anatomy • Expected Learning Outcomes – Describe the structure of the ovary – Trace the female reproductive tract and describe the gross anatomy and histology of each organ – Identify the ligaments that support the female reproductive organs – Describe the blood supply to the female reproductive tract – Identify the external genitalia of the female – Describe the structure of the nonlactating breast 28-4 Sexual Differentiation • Without testosterone: – Causes mesonephric ducts to degenerate – Genital tubercle becomes the glans clitoris – Urogenital folds become the labia minora – Labioscrotal folds -
A Case of Non-Communicating Uterine Horn Containing Functional Endometrium
logy & Ob o st ec e tr n i y c s G Rani et al., Gynecol Obstet (Sunnyvale) 2015, 5:9 Gynecology & Obstetrics DOI: 10.4172/2161-0932.1000320 ISSN: 2161-0932 Case Report Open Access A Case of Non-Communicating Uterine Horn Containing Functional Endometrium Anjali Rani*, Madhu Kumari and Shipra Department of Obstetrics and Gynaecology, Institute Of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India Abstract Uterine anoamalies are very rare. They can present with complains of amebnorrhoea, dysmenorrhoea, bad obstetrical outcome and infertility etc. Unicornuate uterus with rudimentary horn is very rare. The incidence of this is 1/100,000. Normally rudimentary horns are non- functional and non-communicating. But if they have functional endometrium they can develop hematometra. We are presenting a case of hematometra and pain in a patient with rudimentary non communicating horn with functional endometrium. Rudimentary horn should be kept as a differential diagnosis in pelvic pain. Keywords: Unicornuate uterus; Rudimentary horn; Dysmenorrhea were found in the pelvis. Exploratory laparotomy was decided and the rudimentary horn was excised by applying clamps (Figure 2). Histo- Introduction pathological examination of the specimen was reported as uterine Uterine anomalies are very rarely seen. Unicornuate uterus is a very udimentary horn with functional endometrium with haematometra. rare uterine anomaly. The incidence of congenital uterine anomalies The patient was discharged on the fifth postoperative day. She came in in fertile population is 1/200 to 1/600. The incidence of rudimentary follow up her nomal menses after 6 weeks. horn is very very rare (1:100,000). -
The Cyclist's Vulva
The Cyclist’s Vulva Dr. Chimsom T. Oleka, MD FACOG Board Certified OBGYN Fellowship Trained Pediatric and Adolescent Gynecologist National Medical Network –USOPC Houston, TX DEPARTMENT NAME DISCLOSURES None [email protected] DEPARTMENT NAME PRONOUNS The use of “female” and “woman” in this talk, as well as in the highlighted studies refer to cis gender females with vulvas DEPARTMENT NAME GOALS To highlight an issue To discuss why this issue matters To inspire future research and exploration To normalize the conversation DEPARTMENT NAME The consensus is that when you first start cycling on your good‐as‐new, unbruised foof, it is going to hurt. After a “breaking‐in” period, the pain‐to‐numbness ratio becomes favourable. As long as you protect against infection, wear padded shorts with a generous layer of chamois cream, no underwear and make regular offerings to the ingrown hair goddess, things are manageable. This is wrong. Hannah Dines British T2 trike rider who competed at the 2016 Summer Paralympics DEPARTMENT NAME MY INTRODUCTION TO CYCLING Childhood Adolescence Adult Life DEPARTMENT NAME THE CYCLIST’S VULVA The Issue Vulva Anatomy Vulva Trauma Prevention DEPARTMENT NAME CYCLING HAS POSITIVE BENEFITS Popular Means of Exercise Has gained popularity among Ideal nonimpact women in the past aerobic exercise decade Increases Lowers all cause cardiorespiratory mortality risks fitness DEPARTMENT NAME Hermans TJN, Wijn RPWF, Winkens B, et al. Urogenital and Sexual complaints in female club cyclists‐a cross‐sectional study. J Sex Med 2016 CYCLING ALSO PREDISPOSES TO VULVAR TRAUMA • Significant decreases in pudendal nerve sensory function in women cyclists • Similar to men, women cyclists suffer from compression injuries that compromise normal function of the main neurovascular bundle of the vulva • Buller et al. -
Sexual Assault
Sexual Assault Victimization Across the Life Span A Color Atlas Barbara W. Girardin, RN, PhD Forensic Health Care Palomar Pomerado Health Escondido, California Diana K. Faugno, RN, BSN, CPN, FAAFS, SANE-A District Director Pediatrics/Nicu Forensic Health Service Palomar Pomerado Health Escondido, California Mary J. Spencer, MD Clinical Professor of Pediatrics University of California San Diego School of Medicine Medical Director Child Abuse Prevention and Sexual Assault Response Team Palomar Pomerado Health Escondido, California Angelo P. Giardino, MD, PhD Associate Chair - Pediatrics Associate Physician-in-Chief St. Christopher's Hospital for Children Associate Professor in Pediatrics Drexel University College of Medicine Philadelphia, Pennsylvania G.W. Medical Publishing, Inc. St. Louis FOREWORD Whether in the pediatric emergency room, the adult sexual assault clinic, the nursing home or even the morgue, high quality photography of visible lesions remains an essential documentation and investigation tool. The value of photographic documentation cannot be overstated. Indeed, all medical providers who evaluate sexual assault victims should be familiar with the basic principles and techniques of clinical photography and should assure adequate photographic documentation of visible lesions. Such images, whether still or video, may be used in court, although less commonly than photographs of physical abuse (sometimes judges and juries have a hard time understanding the significance of, for example, a subtle hymenal tear). Photographs are also important for peer review, peer consultation and teaching. Perhaps most significantly, photographs may allow a second opinion by opposing council experts without subjecting the victim to a repeat examination. The evolution in photodocumentation techniques in sexual assault has often followed, sometimes paralleled, and even sometimes led the evolution in the medical examination and interpretation of sexual assault injuries. -
The Reproductive System
27 The Reproductive System PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • The reproductive system is designed to perpetuate the species • The male produces gametes called sperm cells • The female produces gametes called ova • The joining of a sperm cell and an ovum is fertilization • Fertilization results in the formation of a zygote © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • Overview of the Male Reproductive System • Testis • Epididymis • Ductus deferens • Ejaculatory duct • Spongy urethra (penile urethra) • Seminal gland • Prostate gland • Bulbo-urethral gland © 2012 Pearson Education, Inc. Figure 27.1 The Male Reproductive System, Part I Pubic symphysis Ureter Urinary bladder Prostatic urethra Seminal gland Membranous urethra Rectum Corpus cavernosum Prostate gland Corpus spongiosum Spongy urethra Ejaculatory duct Ductus deferens Penis Bulbo-urethral gland Epididymis Anus Testis External urethral orifice Scrotum Sigmoid colon (cut) Rectum Internal urethral orifice Rectus abdominis Prostatic urethra Urinary bladder Prostate gland Pubic symphysis Bristle within ejaculatory duct Membranous urethra Penis Spongy urethra Spongy urethra within corpus spongiosum Bulbospongiosus muscle Corpus cavernosum Ductus deferens Epididymis Scrotum Testis © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • The Testes • Testes hang inside a pouch called the scrotum, which is on the outside of the body -
Understanding Cancer of the Vulva
Understanding Cancer of the Vulva An information sheet for women with cancer, their families and friends. This information has been prepared to help you If something goes wrong with the genes that understand more about cancer of the vulva control a cell, that cell may start behaving (vulvar cancer). It is an introduction to the strangely. Instead of growing normally, it may diagnosis, treatment and effects of this cancer. grow and divide in an uncontrolled way, forming a mass of cells. The mass of cells looks We cannot advise you about the best treatment and feels like a lump, and is called a tumour. for you. You need to discuss this with your doctors. However, we hope this information A tumour can be benign (not cancer) or it can will answer some of your questions and help be malignant (cancer). The difference is that you think about the questions you want to ask benign tumours do not spread to other parts of your doctors. the body, while malignant tumours can. For more detailed information on cancer of the A malignant tumour is made up of cancer cells. vulva, you may wish to contact the Cancer When it first develops, the tumour stays in one Council Helpline on 13 11 20 or refer to the place. This is called the primary tumour. list of recommended websites under the heading Information on the Internet on the If the cancer cells that make up the primary back page of this booklet. tumour are not treated, they may start to spread to other areas of the body and form new tumours. -
The Mythical G-Spot: Past, Present and Future by Dr
Global Journal of Medical research: E Gynecology and Obstetrics Volume 14 Issue 2 Version 1.0 Year 2014 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc. (USA) Online ISSN: 2249-4618 & Print ISSN: 0975-5888 The Mythical G-Spot: Past, Present and Future By Dr. Franklin J. Espitia De La Hoz & Dra. Lilian Orozco Santiago Universidad Militar Nueva Granada, Colombia Summary- The so-called point Gräfenberg popularly known as "G-spot" corresponds to a vaginal area 1-2 cm wide, behind the pubis in intimate relationship with the anterior vaginal wall and around the urethra (complex clitoral) that when the woman is aroused becomes more sensitive than the rest of the vagina. Some women report that it is an erogenous area which, once stimulated, can lead to strong sexual arousal, intense orgasms and female ejaculation. Although the G-spot has been studied since the 40s, disagreement persists regarding the translation, localization and its existence as a distinct structure. Objective: Understand the operation and establish the anatomical points where the point G from embryology to adulthood. Methodology: A literature search in the electronic databases PubMed, Ovid, Elsevier, Interscience, EBSCO, Scopus, SciELO was performed. Results: descriptive articles and observational studies were reviewed which showed a significant number of patients. Conclusion: Sexual pleasure is a right we all have, and women must find a way to feel or experience orgasm as a possible experience of their sexuality, which necessitates effective stimulation. Keywords: G Spot; vaginal anatomy; clitoris; skene’s glands. GJMR-E Classification : NLMC Code: WP 250 TheMythicalG-SpotPastPresentandFuture Strictly as per the compliance and regulations of: © 2014. -
Normal Imaging Findings of the Uterus 3
Normal Image Findings of the Uterus 37 Normal Imaging Findings of the Uterus 3 Claudia Klüner and Bernd Hamm CONTENTS the strong muscle coat forming the mass of the organ. The myometrium is mostly comprised of spindle- 3.1 Embryonic Development and shaped smooth muscle cells and additionally con- Normal Anatomy of the Uterus 37 tains reserve connective tissue cells, which give rise 3.2 Imaging Findings: Uterine Corpus 40 to additional myometrial cells in pregnancy through 3.3 Imaging Findings: Uterine Cervix 44 hyperplasia. The uterine cavity is only a thin cleft and References 47 is lined by endometrium (Fig. 3.2). Functionally, the endometrium consists of basal and functional layers. The isthmus of uterus (lower uterine segment), 3.1 together with the internal os, forms the junction be- Embryonic Development and tween the corpus and cervix. In nonpregnant wom- Normal Anatomy of the Uterus en the isthmus is only about 5 mm high and is less muscular than the corpus. Unlike the uterine cervix, During embryonal life, fusion of the two Müllerian the isthmus becomes overproportionally large in the ducts gives rise to the uterine corpus, isthmus, cervix, course of pregnancy and serves as a kind of reserve and the upper third of the vagina. The Müllerian ducts for fetal development in addition to the uterine cor- are of mesodermal origin and arise in the 4th week pus. The endometrium of the isthmus consists of a of gestation. They course on both sides lateral to the single layer of columnar epithelium and only under- ducts of the mesonephros (Wolffi an ducts). -
Clinical Pelvic Anatomy
SECTION ONE • Fundamentals 1 Clinical pelvic anatomy Introduction 1 Anatomical points for obstetric analgesia 3 Obstetric anatomy 1 Gynaecological anatomy 5 The pelvic organs during pregnancy 1 Anatomy of the lower urinary tract 13 the necks of the femora tends to compress the pelvis Introduction from the sides, reducing the transverse diameters of this part of the pelvis (Fig. 1.1). At an intermediate level, opposite A thorough understanding of pelvic anatomy is essential for the third segment of the sacrum, the canal retains a circular clinical practice. Not only does it facilitate an understanding cross-section. With this picture in mind, the ‘average’ of the process of labour, it also allows an appreciation of diameters of the pelvis at brim, cavity, and outlet levels can the mechanisms of sexual function and reproduction, and be readily understood (Table 1.1). establishes a background to the understanding of gynae- The distortions from a circular cross-section, however, cological pathology. Congenital abnormalities are discussed are very modest. If, in circumstances of malnutrition or in Chapter 3. metabolic bone disease, the consolidation of bone is impaired, more gross distortion of the pelvic shape is liable to occur, and labour is likely to involve mechanical difficulty. Obstetric anatomy This is termed cephalopelvic disproportion. The changing cross-sectional shape of the true pelvis at different levels The bony pelvis – transverse oval at the brim and anteroposterior oval at the outlet – usually determines a fundamental feature of The girdle of bones formed by the sacrum and the two labour, i.e. that the ovoid fetal head enters the brim with its innominate bones has several important functions (Fig. -
Left Vaginal Obstruction and Complex Left Uterine Horn Communication in a 12 Year Old Female Barry E
Perlman et al. Obstet Gynecol cases Rev 2015, 2:7 ISSN: 2377-9004 Obstetrics and Gynaecology Cases - Reviews Case Report: Open Access Left Vaginal Obstruction and Complex Left Uterine Horn Communication in a 12 Year Old Female Barry E. Perlman*, Amy S. Dhesi and Gerson Weiss Department of Obstetrics, Gynecology and Women’s Health, Rutgers - New Jersey Medical School, Newark, USA *Corresponding author: Barry E. Perlman DO, Department of Obstetrics, Gynecology and Women’s Health, Rutgers - New Jersey Medical School, MSB E-506, 185 South Orange Avenue, Newark, NJ 07101-1709, USA, Tel: 732 233 0997, E-mail: [email protected] Transabdominal pelvic sonogram revealed two prominent uterine Abstract cornua with an endometrial thickness of 3 mm in each horn. The Obstructive Müllerian duct anomalies are an infrequently right cornu measured 11.4 x 2.0 x 3.6 cm and the left cornu measured encountered clinical problem. The use of imaging and surgical 10.4 x 2.8 x 4.1 cm. A 7 cm mass in the endocervical canal, concerning exploration allowed for diagnosis and treatment of symptoms of a for hematocolpos, represented an occlusion extending to the left complex obstructive müllerian anomaly. We present a case of a 12 vagina (Figure 1). year old female with a history of intermittent lower abdominal pain and absent left kidney who was found to have an obstructed left She underwent further imaging with two MRI studies that were vagina and complex left uterine horn communications resulting in mutually inconclusive and inconsistent in regards to her pelvic hematocolpos, hematometra, and endometriosis. -
Advanced-Pelvic-Exams1.Pdf
8/3/2014 Describe at least two techniques for performing pelvic examination with a patient who has Jacki Witt, JD, MSN, WHNP-BC, SANE-A, FAANP experienced sexual assault/abuse Caroline Hewitt, DNS, RN, NP Practice at least two new pelvic examination techniques with a standardized patient Select appropriate screening and diagnostic testing for women with specific pelvic organ symptoms Jacki Witt Watson Pharmaceuticals – Honorarium – Advisory Board Agile Pharmaceuticals – Honorarium – Advisory WHO Afaxus Pharmaceuticals – Honorarium – Advisory Committee Bayer Pharmaceuticals – Honorarium – Advisory Board WHAT WHEN Caroline Hewitt WHERE Prior to February 5, 2014 disclosures: Watson Pharmaceuticals – Honorarium-Advisory Board HOW After February 5, 2014: Nothing to disclose WHY Identify the indications for a pelvic examination -Lithotomy common in US Describe at least two techniques for performing -Some patients pelvic examination with an obese patient find it disempowering, Describe at least two techniques for performing abusive & humiliating pelvic examination with a patient who has Haar, et al 1997 signs/symptoms of decreased estrogen stimulation -Patient’s have to vaginal tissues described metal Describe at least two techniques for performing stirrups as ‘cold’ pelvic examination with a & ‘hard’; say their use developmentally/cognitively disabled person is impersonal, sterile or degrading Olson 1981 1 8/3/2014 • 197 adult women having routine cervical cytology • Patients reported less discomfort and feelings of vulnerability if: PLASTIC : direct lamp connection, • Semi-reclining vs. supine transparency facilitates visualization, • No stirrup method used audible and sensible clicks distressing and • No significant differences in quality of cyto specimen considered not ‘green’ (but study not powered to definitively look at this outcome) • Routine in UK, Australia, N. -
REPRODUCTIVE SYSTEM Vasco Dominic
REPRODUCTIVE SYSTEM Vasco Dominic ORGANISATION Reproductive organs which produce gametes and hormones. Reproductive tract consisting of ducts, store and transport gametes. Accessory glands and organs that secrete fluids into the ducts of the reproductive system or into other secretory ducts. Perineal structures associated with the reproductive system, collectively known as external genitalia. The male and female systems are functionally different. In the male the gonads are the testes that secrete androgens, principally testosterone and produce a half billion sperms per day. After storage the sperm travel along a lengthy duct and mixed with secretions of the glands to form semen. In the female the gonads are the ovaries which produce only one mature gamete per month. The oocyte travels via a short duct into the muscular uterus. THE MALE REPRODUCTIVE SYSTEM TESTES Each has the shape of a flattened egg rougly 5cm long, 3cm wide and 2.5 cms thick and weighs 10-15 gms. They hang within the scrotum. During development the testes form inside the body cavity adjacent to the kidneys. As the foetus grows they move inferiorly and anteriorly towards the anterior abdominal wall. The gubernaculum testis is a cord of connective tissue and muscle fibers that extend from the inferior part of each testis to the posterior wall of a small, inferior pocket of the peritoneum. As growth proceeds the gubernacula do not elongate and the testes are held in position. During the seventh developmental month: growth continues at a rapid pace, circulating hormones stimulate contraction of the gubernaculum testis. Over this period the testes move through the abdominal musculature accompanied by small pockets of the peritoneal cavity.