DR MACHARIA P.W , FEMALE AND MALE REPRODUCTIVE ANATOMY & PHYSIOLOGY

1 Rationale

 Knowledge of the anatomy of female and male reproductive systems is essential in clinical assessment, counseling, patient and community education, as well as in diagnosis and treatment of obstetric and gynaecological conditions.

2 Terminal Objective

 By the end of this presentation, the student will be able to apply the knowledge of reproductive anatomy in history taking, counseling, patient and public education, and in management of obstetric and gynaecological conditions

3 Enabling objectives

1. Identify and name parts of female and male reproductive organs 2. Describe the functions of each of the above parts 3. Describe the variations in the anatomy of the female reproductive organs due to  Childbirth trauma  Illness/diseases  FGM

4 Female and Male

Female:  External  Internal  Accessory reproductive organs Male:  External  Internal

5 Female External Genitalia

Vulva or pudendum:  majora  (hood+prepuce)  Fouchette(area btwn vaginal orifice and anus)  Vestibule  Vaginal orifice (introitus)

6 Female External Genitalia cont ..   External urethral meatus  Bartholin’s glands openings(btwn the labiae at 7 and 5 o’clock)  Skene’s glands openings(within )  Perineum

7 8 Female Internal Genitalia

 Vaginal canal  (ectocervix)  (endocervix)  (isthmus, corpus)  Fallopian tubes (oviducts, uterine tubes) 

9 10 Female Accessory Reproductive Organs Breasts (mammary glands):  Anatomy  Changes during the life cycle, pregnancy, postpartum and lactation, and in disease conditions

11 Male External Genitalia

 Scrotum  Penis (including prepuce and glans)

12 13 14 Male internal genitalia

 Testicles/testes  Epididymis  Vas deferens  Seminal vesicles(ejaculatory duct)  Urethra  Cowper’s gland(at memb.urethra)  Prostate

15 16 Mons pubis

 Rounded median elevation in front of symphysis pubis  Consists of fat accumulation  Acts as a cushion during intercourse  Covered by coarse hair after puberty  Sometimes involved in severe type of FGM (type III)

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 A pair of elongated folds running down from the mons pubis  Enclose the median cleft  United in front by the anterior commissure  Comprises of fat, smooth muscles, terminations of round , blood vessels, nerves, skin has many sebaceous glands, is pigmented, covered by hair  Is homologous with the scrotum of the male  May be partially cut and stitched together in severe forms of FGM (type III) 18 Labia minora

 Smaller folds inner to the labia majora  Anteriorly form the prepuce (hood) and the frenulum of clitoris  Are erectile during sexual excitation  Have no fat  May be wholly or partially removed in FGM

19 Clitoris

 Homologous to penis of male  Consists mainly of erectile tissue,capable of enlargement with blood on sexual excitation  Formed by 2 crura that join to form, the body, the corpora cavernosa  Glans at end of corpora, very sensitive  Has a hood (prepuce) above and frenulum below. Supplied by dorsal artery of clitoris and others  Removed, partially or wholly, in FGM

20 Hymen

 Membrane at junction of and vestibule; variable shape and openings:  Annular, semilunar (crescentric), cribriform, septate, vertical, imperforate  After delivery or coitus, remnant tags called carunculae myrtiformes  Presence or absence not related to virginity

21 Bartholin’s (greater vestibular) glands  A pair, one on each side of introitus  Produce a lubricant for vagina during sexual excitation  Infection may cause blockage of duct leading formation of very painful abscess

22 Vagina

 Female organ of copulation, lower end of birth canal, excretory duct for menses  Direction 60 degrees to horizontal and 90 to uterus  Highly dilatable during coitus or birth  Anterior and posterior walls apposed, posterior wall longer 9cm (vs 7.5cm)  Fornices round cervix at upper end  Related to urethra, rectum, bladder, ureters  Supplied by uterine and vaginal arteries 23

Uterus (hystera, Greek)

 Fertilized ovum embeds and develops and is nourished here; upper birth canal  Has fundus, corpus (body), and cervix  Cervix dilates in labour to alllow birth  Positions anteverted, retroverted, anteflexed, retroflexed  Supports: cardinal, uterosacral , pelvic diaphragm  Supplied by uterine and ovarian arteries

24 (uterine tube, oviduct, salpinx)  Conveys ova from to uterus and sperms in opposite direction.  Fertilization occurs in the tube; nourishes and transports zygote  About 10cm long, ensheathed in broad ligament;  4 parts: uterine, isthmus, ampulla infundibulum  Patency necessary for fertility

25 Ovaries

 Paired produce ova,female hormones (oestrogen, progesterone), relaxin and a little testosterone  Consists of germinal epithelium, cortex and medulla  Blood supply from ovaria and uterine arteries  Innervation by ovarian plexus

26 27 Scrotum

 Thin sac of skin and muscle in which lie the testicles  Provides cooler environment optimal for sperm development  Cremasteric muscle move testicles slightly within scrotum depending on surrounding temperature  Pigmented and covered with hair

28 Penis

 Male organ of copulation  Consists of 3 parts: root, body, glans  Root attached to abd and pelvic wall  Body is the middle portion made of 2 corpora cavernosa and 1 spongiosum  Glans cone shaped end of corpus spongiosum  Corona: a small ridge separating glans from the shaft

29 Testicles/testis

 Testicle is testis plus vas and epididymis  Testis are 2, olive sized, have 2 functions: 1. Produce sperms (male sex cells) 2. Produce testosterone (male sex hormone)  Testis is homologous with ovary  Epididymis and vas facilitate transport of sperms after they mature

30 Seminal vesicles

 Located behind prostate and bladder  Produce fluid that nourishes sperms and lubricates urethra – mixes with other fluids e.g. prostatic to form semen  During ejaculation surrounding muscles contract and eject sperm and semen

31 Prostate

 Lies below bladder and surrounds urethra.  Along with S.V. produces fluid that contains, protects, nourishes, and supports sperms – the only known function of the gland  Grows throughout life, BPH, causing micturition difficulties  Produces prostate specific antigen (PSA) used as test for prostate cancer

32 33 34 Take Home Message

 Female and Male Reproductive Anatomy including:  Female external and internal genitalia  Female internal genitalia  Male external and internal genitalia, and  Explained their functions in reproduction

35 The End

Thank you

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