Female Reproductive System anatomy and physiology || ONI

Female reproductive system anatomy and physiology 

the female reproductive system is  made up by external and internal genital organs and also accessory organs of female reproductive system.these organs are concerned with copulation, fertilization, growth and development of the fetus. 

The female reproductive system is immature at birth and develope to maturity at puberty. 

It produce the female egg cells called ova or oocyte. The structure of female reproductive system helps to ova for transport to fertilization site which occur in fallopian tube and the other function of female reproductive system is to produce sex hormone. 

The internal female reproductive system include vagina, fallopian tube, uterus, ovary and external structure of female reproductive system include vulva and in accessory organ include breast, urinary bladder, female urethra. 

External genitals of female reproductive system 

External genitals are the accesory structure of female that are external to the vagina and it's occupy large part of female perineum. 

       •Perineum:- A surface or region in both female and male between the pubic symphysis and coccyx. 

External genitals are synonyms to vulva or pudendum. 

       

Fig 1.external genitals

Parts and functions of external genitals:-

Vulva or pudendum:-

•The vulva or pudendum is the outer part of the female genitals in perineum. 

•In Latin word vulva means wrapper or covering. 

       

Fig 2.Vulva

   Boundaries of vulva:-

• Anterior     :- mons pubis 
• Laterally    :- labia majora
• Posteriorly:- perineum

   Functions of vulva:- 

• The main function of vulva is protection of  internal organs of female reproductive system.

Parts and functions of vulva:-           

1.Mons pubis :-

mons pubis is also known as mons veneris and mons pubis is a pad of subcutaneous adipose connective tissue and it is situated in the anterio-posterior to pubic symphysis . 

         

            •After puberty(Average age 11 but some time the process can take up to 4 year so the age may be 8 to 14 year) it is covered by coarse(thicker) hair in escutcheon pattern(triangular 

base directed upward) in third sign of puberty pubarche. 

      

➡Functions of mons pubis:-  

•protection of pubis and sexual arousal. 

➡What is cause of large mons pubis:-

•the cause of large mons pubis may be simple weight gain, hormonal factors and even genetic deposition 

•It is rare to find an obese woman or man who does not store excess fat in the pubic area.

4.Labia majora:-

Labia majora is also known as larger outer lip of vulva it is thick elevated fold of skin. 

           

Fig.4 labia majora

            •They are composed of skin, fibrous tissue, fat & large number of sebaceous gland (but no hair follicle). 

            •It is homologous(similar in fundamental structure and in origin but not necessarily in function) to scrotum in the male 

➡Functions of labia majora :-

protection of inner structure and sexual arousal. 

➡colour of labia majora:-  

The labia majora also may change in color. In adults, the color can range from light pink to dark brown-red or black.

Many light-skinned women have brown or purplish labia majora

If you want to know basics introduction of obg then click now 

3.Labia minora :- 

labia minora is also known as small inner lip of vulva. There are two thin elevated folds of skin without fat. 

• Anteriorly it divided and enclosed by clitoris. 
• Posteriorly it makes  thin skin folds known as fourchette.  

         

Fig 5.labia minora

• Labia minora is homologous to penile urethra and parts of the penis in male. 
• It is made up of erectile connective tissue and containing numerous sebaceous gland. 

➡location of labia minora:-

• Labia minora located inside the labia majora

➡Development of labia minora:-

• Development of labia minora occurs at period of third month of pregnancy from urogenital folds

➡Functions of labia minora:- 

• protection of vagina. 

4.Clitoris:-

clitoris is a small cylindrical erectile body and consist two small cylindrical erectile tissue Corpora and cavernosa. 

           

Fig. 5 Clitoris

    •Erectile tissue means spongy tissue, the space filled with blood that cause it's harden and expand

   •Clitoris is homologous to penis in the male and is is attached to the under surface to the pubic symphysis by the suspensory ligament.  

➡Location of clitoris:-

   •Clitoris is situated anteriorly of vulva

➡Length of clitoris:-

• The length of clitoris is about 1.5cm to 2cm

 

 

➡Functions of clitoris:-

  •To give sexual arousal and pleasure during    intercorse.

 

➡Enlarged clitoris- 

•In the conditions of sexual excitement or   arousal the flow of blood in clitoris is more   than normal conditions due to the blood filled   the clitoris are large in their size but after   orgasm the blood are normal and also clitoris   size

5.Vestibule :- 

Vestibule is the inner portion of vulva. It is a area that is enclosed by labia minora

         

Fig. 6 Vestibule

➡Shape of vestibule :- 

Vestibule is a almond-shaped (triangular) space. 

➡Boundaries of vestibule :-

• Anteriorly  :- Clitoris
• Posteriorly :- Fourchette
• Either side :- labia minora

➡Opening of vestibule :- 

•There are four opening in the vestibule. 

• Anteriorly    :- urethra
• Mid portion :- vaginal orifice
• Lateral side  :- bartholin gland
• "" "" "" "" ""    :- skenes gland

6. Vaginal orifice :- 

The vaginal orifice lies in the posterior end of the vestibule. It is completely closed by hymen

           

Fig. 7 vaginal orifice

• Hymen :- A thin layer of mucous membrane that is partially cover opening of vaginal in virgin female during sexual intercourse and child birth it may rupture. It is not present in some women Like:- Athletic girl, sports women and after coital Act. 

➡Relations of vaginal orifice :- 

• Anterior  :- Bladder or urethra
• Posterior :- Rectum and anal canal

7.Bartholin gland :-

• Bartholin gland first described by casper bartholin (1677) . 
• It is two small pea sized compound mucous glands and it is greater vestibule gland.  
• The duct is lined by columnar epithelium but near it's opening by stratified squamous epithelium
• Bartholin gland carry the secretions of alkaline that is suitable for sperm activities
• It is homologous to bulb of penis. 

➡Colour of bartholin gland :- 

The colour of bartholin duct is yellowish white.

 

       

Fig. 8 Bartholin gland

➡Location of bartholin gland :- 

The bartholin gland ia located in each lateral wall of the vestibule of the vagina, near the vaginal opening at the base of the labia majora. 

➡Functions of bartholin gland:- 

• Help in easy fertilization 
• Lubricant the vagina 
• Secretions increase with sexual excitement

8. Skene's gland :-

• SKene's gland is lesser vestibule gland and largest para urethral. 
• Two skene's duct open in the vestibule on either side of the external urethral meatus (female ejaculation) 
• It is homologous to prostate in male 

➡Purpose of skene's gland :- 

The purpose of skene's gland is secrete mucous containing fluid substance these substance help in lubricant of urethra. 

       

Fig. 9 Skene's gland

9.Vestibule bulbs :- 

• These are bilateral elongated masses of erectile tissue beneath the mucous membrane of the vestibule and infront of the bartholin gland. 
• They are homologous to the male corus spongiosum. 

Internal genitals of female reproductive system

The internal genitals of female reproductive system include 

• Vagina
• Uterus
• Fallopian tube
• Ovary

VAGINA

Defination of vagina :-

• Vagina is a fibromuscular membranous sheath that is located between bladder and rectum. 
• Vagina runs obliquely upward and backward at the angle of 45°(horizontal) 
• The diameter of vaginal canal is 2.5cm that is widest in upper part and narrowest at its introitus(An entrance in the canal such as vagina). In adults anterior wall 7cm long and posterior wall 9cm long 
• Vagina is a communication channel(between cervix and vulva)that is formed by stratified squamous epithelium. 
• An abnormal opening between vagina and rectum called recto-vaginal fistula, which can be identify by culdoscopy. 

Fig. 1 midsagittal section of vagina        

Ph of vagina :-

• The acidic ph of vagina is 3.5 to 4.5 in reproductive age due to doderlein's bacilli (normal flora of vagina) which is a bacteria of lactobacilli species (due to conversion of glycogen into lactic acid). 
• The vaginal ph before reproductive age and after menopause is neutralize and alkaline. 

Reproductive age:-

• It is a period of getting menstrual period to menopause between the age of 15 to 45 year. 

Menopause :- 

• It is a period of women life when menstruation ceases typically between the 45 to 50 year of age. 

Structure of vagina :-

The vagina are look like H shaped on transverse action and it has three layer 

• Outer layer or adventitia composed of areolar tissue 
• Middle layer composed of smooth muscle
• Inner layer composed of stratified squamous epithelium. 

           

Fig.2 Layer of vagina

1.Outer layer :-

The outer layer of vagina is composed of areolar tissue and also known as adventitia that provides structural support to vagina and allows for expansion of the vagina during sexual intercourse and child birth. 

2.Middel layer :-

The middle layer of vagina is composed of smooth muscle and also called muscularis 

It provides supports to nerve bundle, control blood flow and contraction of vaginal tissues

3.Inner layer :-

Inner layer is composed of stratified squamous epithelium and also called mucosa that produce mucosa and have nutrients in rich amount that protects the skin inside vagina.

Relations of vagina :-

• Anterior :- The upper one-third part of the vagina is related to the base of bladder and lower two third part related to urethra 
• Posterior :- The upper one third part of vagina is related to the pouch of Douglas and middle third part of vagina related to the recto-vaginal septum. 
• Lateral walls :- The upper one-third part of vagina is related to the ureter and middle third part is related to the levator ani muscle

Functions of vagina :-

The vagina has three main functions 

• Sexual intercourse:- The vagina has a function of copulation by accepting penis and  provide a place for ejaculation.                                   
• Child birth :- The vagina provides a way for delivery of new born from uterus by expands.       
• Menopause :- vagina also helps in uterine secretions and menstrual blood as a channel. 

Development of vagina :-

The development of vagina are occur in following steps 

• The fourth-fifth upper part of vagina developed from mullerian duct. 
• The lower one-fifth part of vagina developed from urogenital sinus. 
• External vaginal orifice is formed from the genital fold ectoderm after rupture of the urogenital membrane. 

Blood supply of vagina 

Arteries:-  

There are four arteries that supplies the vagina

• Cervicovaginal branch of the uterine artery
• Vaginal artery 
• Middle rectal artery 
• Internal pudendal artery 

Veins:-

• Internal iliac veins
• Internal pudendal veins

Vaginal Tests :-

Colposcopy :- 

• Colposcopy is used to fined a cancerous cells and abnormal cell by using an instrument called colposcope. 
• The colposcopy is also used for the diagnosis of         vulva, vagina and cervix. 

         

Fig. 3 colposcope

Pelvic examination :-

• Pelvic examination is used for the examination of reproductive organs ( vulva, vagina and cervix) by using speculum. 

         

Fig. 4 speculum

• In this procedure your doctor will insert two lubricants gloved finger into the vagina by using one hand , the other hand used to press lower abdomen for check the size of your reproductive organs. 

Vaginal biopsy :-

• In this procedure a tissue sample is collect to diagnosis of cancer by using both way (needle and surgery). 

Uterus 

Introduction of Uterus :-

• Uterus is a pyriform hollow muscular organ of female reproductive system which is situated between urinary bladder(Anterior) and rectum(posterior). 
• Uterus is a secondary sex organ and synonyms with metro and hystero. 
• Uterus is place where fetus develops by and also called womb. 
• in pregnancy when uterus is grow due to fetus implantation than a women able to feel his uterus
• Uterus is connected to vagina by cervix

Fig. 1 midsagittal section of uterus         

Size of uterus :-

Length	7.5CM(in pregnancy it increases 5times 35to40cm)
Width	3.5CM
Thickness	2.5CM
Weight	50 to 80gm (avarage 60gm) In pregnancy 900 to 1000gm due to hyperplasia.

Position of uterus :-

Uterus is situated in two positions in pelvic area

• Anteversion (at 90° angle with Vagina) 
• Anteflexion (at 120° angle with own body of uterus

Fig. 2 position of uterus

Types of uterus :- 

1.Duplex :-

• In duplex,uterus horns are completely separated and have separate cervix opening into vagina and one fallopian tube it is found in kangaroo , rabbits , hares etc. 

2.Bipartite :-

• In bipartite,uterus horns are largely separate and have a single cervix opening into vagina. It found in cats and horses etc. 

3.Bicornuate :-

• In bicornuate,uterus appears like a heart-shaped the lower parts are fused into a single cervix
• A bicornuate uterus is a type of congenital uterine malformation and it found in elephant, dolphins, dogs etc. 

4.Simplex :-

• In simplex,uterus consisting of a single cavity and found in higher primates(human and chimpanzees. 

Relations of uterus :-

Anterior relation of uterus :-

• Above internal OS uterovesical pouch 
• Below internal OS base of the bladder

Posterior relation of uterus :-

It is covered with peritoneum and forms the anterior wall of pouch of Douglas containing coils of intestine. 

Layer of uterus :-

1.Perimetrium :- 

• It is outer most layer of serous (peritoneum) coat which is lies over the fundus and it is anteriorly makes a folds over the urinary urinary bladder to form vesico-uterine pouch. 
• Posteriorly it also makes a folds known as Recto-uterine pouch that is infront of rectum and behind the uterus . (See in fig. 1) 
• The Recto-uterine pouch is also known as cul-de-sac or pouch of Douglas. 
• In ectopic pregnancy fluid is aspirated from pouch of Douglas, called culdocentesis. 

2.Myometrium :-

• Myometrium layer of uterus is the thickest layer of smooth muscles fibers which is divided into three types as follows.....

(A) Outer layer :- 

• This layer of myometrium consisting of longitudinal muscles fibers. 

(B) Middle layer :-

• It is also known as living liguture of uterus because the oxytocin (muscular contracter) contract the muscles fibers and compress the uterine artery, which is lies in figur of eight muscles fibers and prevent from postpartum hemorrhage. 

(C) Inner layer :-

• This layer of myometrium consisting circular muscles fibers. 

3.Endometrium :-

• Endometrium is inner most layer of uterus and mucous membrane which is consist of columnar epithelium. 
• It is consist of two layer, these are

(A) stratum functionalis or functional layer:- It present in uterine cavity and shed off during menstruation. 

(B) stratum basalis or basal layer :-

A permanant layer which regulate the regeneration of new stratum functionalis layer after menstruation. 

Parts of uterus :-

Fig. 3 Coronal section of uterus         

•The uterus has three parts these are

1.Corpus :-

Corpus is a 5cm long part of uterus that has two parts 

(A) Fundus :- fundus is a most upper part of corpus that lies above the opening of uterine tube of uterine tube in dome shaped. The length of fundus is about 1.5cm.

(B) Body cavity :- Body cavities is a triangular part and lies between isthmus and opening of uterine tube. 

• The internal triangular 6-7cm part called uterine cavity. 
• Body cavity is about 3.5cm long part
• The implantation of fetus also occur in this part of corpus. 

2.Isthmus :-

• It is a narrowing part of the uterus that is situated between body and cervix. 
• It is limited to above by anatomical OS (OS mean  mouth like opening) and below by histological internal OS (Aschoff) 
• The length of isthmus is about 0.5cm long. 

3.Cervix :-

• Cervix is a cylindrical part of uterus which is also known as neck of uterus and it is measure about 2.5cm long. 
• It is located between isthmus and internal OS and end with external OS and continue with vagina. 
• It may be torn in child birth, especially in primigravida (a woman who is pregnant for the for the first time. 
• It secrets 20-60ml/day cervical mucus which is favorable during ovulation and later become thick to prevent entry of sperm by forming cervical plug. 
• The cervix part of the uterus has two parts, endocervix(supravaginal part) and ectocervix(vaginal part). 

Development of uterus :-

• The uterus is developed from the fused vertical part of the two mullerian ducts. 

Functions of uterus :-

• It is Provide a place to fetus for implantation
• Providing nutrition to fetus 
• Maintain menstruation cycle
• Expulsion of fetus

Blood supply of uterus :-

Atrial supply :-

• The blood supply is from the uterine arteries one each side. The artery from the anterior division of the internal iliac or in common with superior vesical artery. 
• The other sources are ovarian and vaginal artery. 

Venous supply :-

• The venous channel correspond to the atrial course and drain into internal iliac veins. 

Uterus problem :-

Uterine fibroids :- 

• It is also known as uterus myoma 
• It is a condition of non-cancerous growth of uterus that can develop in child bearing age. 
• Uterine fibroids occur due to the some risk factor like obesity, family history, early onset of puberty. 
• Some symptoms are occur during uterine fibroids like pain in abdomen, abnormal menstruation, prolonged priods etc. 
• The treatment of uterine fibroids included progestin IUD (a device that is placed inside your womb for prevent pregnancy by realising progesterone hormone.) and some medication such as oral contraceptives, NSAIDs 
• If uterine fibroids can not treated by medication than your doctor suggest surgical treatment that includes hysterectomy (surgical removal of your  womb) , uterine myomectomy (surgical removal of non-cancerous tumor from uterus). 

Endometriosis :- 

• Endometriosis is a disorder in which a tissue similar to the tissue that form inside of uterus but in location outside the uterus. 

Uterine prolapse :-

• Uterine prolapse, it is a condition of displacement of the part of uterus especially downward into vagina and some time it also protrude from orifice. 

Click here to get pdf of uterus 

Some others uterus problem :-

• HIV/AIDS
• Sexual violence
• Interstitial cystitis 
• Gynecologic cancer
• Uterine tuberculosis

Fallopian tube 

Introduction of fallopian tube 

• Fallopian tube is a part of woman's reproductive system that is also known as uterine tube, oviduct, salpinges, mullerion duct. 
• Fallopian tube is a hollow and cylindrical part that is extend from the lateral angal of fundus and terminates near the ovary.

 Position of fallopian tube

• Fallopian tube is a 'j shaped' tube and it is lies in the three-fourth superior border of broad ligament (lateral folds of perimetrium) 

Size of fallopian tube 

• Each fallopian tube length is about 10cm (4inch) and 1 to 4 mm in diameter. 

Openings of fallopian tube

The fallopian tube has two opening

1.Uterine opening :-

• The tube that is communicating with the lateral angle of the uterine cavity called uterine opening. 
• It is measure about 1mm in diameter. 

2.Pelvic opening :-

• The lateral end of the tube, called pelvic opening or abdominal ostium. 
• It is measure about 2mm in diameter. 

Histology of fallopian tube 

The fallopian tube has three layer, these are

• Outer layer(serous membrane, consist folds of peritoneum. 
• Muscular layer(outer longitudinal and inner circular) 
• Mucous membrane (lined by ciliated columnar epithelium) 

Note:- mucus membrane of fallopian tube also contain these cells

• Columnar ciliated epithelial cell (contain cilia that created a fluid channel to push ovum) 
• Non ciliated cells (secretary cells, provide nutrition to prevent death of ovum) 
• Pegs cells (known as special cell of fallopian tube) 

Parts of fallopian tube 

             

Fallopian tube

1.Intramural :- 

• The intramural part of fallopian tube is also known as interstitial. 
• It is a narrowing and narrowest part of fallopian tube that is lying in the uterine walls.
• It is anatomical sphincter. 
• It is 1.25cm long and 1mm in diameter. 

2.Isthmus :-

• It is second narrowest part of fallopian tube that connect the uterus and uterine tube. 
• It is 2.5cm long and 2mm in diameter. It is place where tubectomy is done. 
• It is a physiological sphincter. 

3.Ampulla :- 

• It is a widest and longest part of fallopian tube where fertilization take place. 
• Ampulla is 5cm long and 5mm in diameter and most common site of ectopic pregnancy. 

4.Infundibulum :-

• Infundibulum is a funnel (wide at top and narrow at bottom ) shaped opening at the lateral end of uterine tube. 
• It consist of a finger like project called fimbriae. one of these than the rest are attached to outer pole of ovary called ovarian fimbriae (larget fimbriae that function is transportation of ovum to fallopian tube from ovary). 
• In fallopian tube , it is 1.25cm long and 6mm in diameter. 

Development of fallopian tube 

• It developed from mullarian duct at 6-10 weeks like uterus and vagina.

Function of fallopian tube 

• Helps in transfer of gamates by columnar ciliated epithelial cells. 
• Helps in survival of zygote by non ciliated cells. 

Blood supply of fallopian tube 

Atrial supply is  from the uterine and ovarian artery that is shown in diagram and venous drainage is through the pampiniform plexus into the ovarian artery.

Some other query related to fallopian tube

Blocked of fallopian tube 

• Blocked fallopian tube is also known as tubal factor infertility and tubal occlusion. 
• Most commonly cause of blocked fallopian tube is scarring on the walls of tubes that leads to end portion of tube fluid filled and become swollen. 
• The Fallopian tube carry an egg from an overy to the uterus and conception also happens in the fallopian tube 
• If a fallopian tube is blocked fertilization as well as the path of back to uterus for the fertilized egg 🥚is blocked and become a cause of infertility 

Can you still get pregnant with one fallopian tube 

• Pregnancy is absolutely possible with one fallopian tube if  you are healthy and have a regular menstrual priod and trying two years consistency for concive a child. 

What happens if you lose fallopian tube 

• If you lose your fallopian tube due to any disease conditions it cause infertility means you can't concive a child and won't need contraception. 

• In this condition if you want to consive a child you have a another way of IVF if you still have your uterus

ovary

Introduction of ovary :-

• The ovary is a paired sex glands or gonads which is fundamental structure of female reproductive system
• Each ovary is oval in shaped and pinkish gray in colour which produce reproductive cell (ovum). 
• The ovary are attached to broad ligament by mesovarium and to pelvis by suspensory ligament 
• On the surface of the ovary female having cuboidal type of cells known as germinal epithelium and in nullipara women having intraperitoneal structures. 
• It is also called primary sex gland in female.

size or weight of ovary :- 

• The ovary measures about 3cm in length, 2cm in breadth and 1cm in thickness. 
• Weight of ovary is measures about 0.14 to 0.3ownce (2 to 3 in gm) 

Location of ovary :-

• The ovary lies in the ovarian fossa on the lateral pelvic wall. 

Borders of ovary :-

• Each ovary has two borders first is mesovarium and second is free posterior. 

Relations of ovary :-

Anterior and mesovarium :- 

• ovary anteriorly related to the fold of peritoneum from the posterior leaf of the broad ligament. 

Posterior relation :- 

• The posterior border is related to the ampulla part of fallopian tube and separated by the peritoneum Frome the ureter and the iliac artery. 

Lateral relation :-

• The lateral surface is related to the ovarian fossa on lateral pelvic wall. 

Structure of ovary :-

The structure of ovary consist of two part (stroma :- cortex, medulla) 

1.Cortex :-

• Cortex is outer portion of ovary. It contains ovarian follicle in various stages of maturity (primordial follicle, maturing follicle and graffian follicle) corpus luteum and corpus albicans(white body) , corpus luteum (yellow body). 

Oocyte :- a cells which undergo in meiotic development to form ovum

         

Ovary-diagram 

2.Medulla :-

• Medulla is a center portion of ovary which consist blood vessels, nerves and lymphatic vesseles and some smooth tissue
• There are small collection of cells called hilus cells which is homologous to the interstitial cells of the testes. 

Development of ovary :- 

• Ovary is developed from the cortex of the undifferentiated genital ridges by about 9th week. 

Functions of ovary :- 

• The primary function of ovary is releases of ovum  (germ cell) for fertilization in fallopian tube and implantation of zygote in uterus and the secondary function is realising of hormone estrogen and projestron (help in development of secondary sexual characterstics). 

Blood supply of ovary :-

Atrial supply :-

• Ovary recieves atrial supply from ovarian artery, a branch of the abdominal aorta. 

Venous supply :-

• Venous drainage occur through ovarian veins which drain into inferior vana cava on right side and left renal vein on the  left side. 

Some others query related to ovary :-

Ovary pain :-

• Ovary pain, you will most likely fell in your lower abdominal because ovary is located your lower abdomen. Many women experience pain in their ovary time to time typically related to their menstrual cycle. Ovary pain may be acute or chronic. Acute means pain occur for short duration and chronic means pain occur for long duration

Common causes of ovary pain :-

• Menstrual pain :- menstrual pain may be occur during in a menstrual cycle due releases of prostaglandin and hormone. This cramping pain that a women apper just prior of menstruation called dysmenorrhea 
• Mittelschmerz pain :-if ovary pain occur during regular ovulation than known as mittelschmerz pain which comes from German words for pain and middle. This type of ovary pain  uncomfortable but harmless. Other name of mittelschmerz pain includes mid cycle pain, ovulation pain. 
• Endrometriosis :- Endrometriosis is  a condition, where endometrial tissue is found outside the uterus and cause ovary pain. 
• Ovarian cyst :- Ovary pain also occur due to ovarian cyst, A solid or fluid filled sac within the ovary. 

Hormones of ovary :-

• Estrogen and progestrone  their are two hormones which is secreted from ovary, these hormones play a important role in mensturation and trigger by hypothalamus
• Estrogen refers to a group of three hormone estradiol (which is male female hormone), estriol (which increased in pregnancy), estrone (main form of estrogen after menopuase). 
• Progestrone prepare the uterus for pragnancy by thickening the lining of uterus.

Do you need ovary to get pregnancy :-

• Yes you need ovary to get pregnancy because fertilization is necessary for getting pregnancy which is occur by fusion of sperm and ovum. Sperm you get from male but ovum is recieves by ovary from ovulation process. So if you not have your both ovary than is not possible to releases an ovum by ovulation process which a part of process of getting pregnancy. 

Can a baby be in ovary :-

• A baby can be in a ovary. This type of pregnancy  refers to ectopic pregnancy which means egg cell not released by ovary and fertilization occur within the ovary and pregnancy occur outside the uterus in ovary. so it is possible that a baby can be in ovary
• What is urinary bladder

Accessory organ of female reproductive system

The female reproductive system include some accessory organ in the relation of reproductive organs 

These organs are..........

    

                          Breast

Introduction of breast 

Breast are considered as a accessory reproductive organs. The breast are large, modified sebaceous (sweat) gland which is hemi-spherical in shape 

A lateral projection of breast towards the axilla known as axillary tail of Spence. It is lies in superficial fascia of pectoral region and on pectoral fossa. 

Breast is also known as mammary gland. 

Breast situation at external surface fig. 1       

Extends of breast

(a) Vertical :- The breast are extends from 2nd to 6th rib in midclavicular line. 

(b) Horizontal :- The breast are extends at horizontal from lateral boarder of sternum to mid axillary line. 

Weight of breast 

The shape of the breast varies in women and weight is 200 to 300 approximatly. 

Deep relations of breast

(a) Muscles :- The breast is attached deeply to pectoralis major by suspensory ligament of copper. 

It is attached to serratus anterior from lateral side and to external abdomen oblique at inferior side. 

(b) Retromammary space :- Deep to breast tissue is retromammary space which provides free movement to breast by alveolar tissue. It is the site of breast implantation.

Structure of breast 

Internal structure of breast diagram fig-2       

The areola is a pigmented skin and placed about the center of the breast which contain Montgomery gland (a portion of sebaceous gland that is visible on skin surface it enlarge during pregnancy) in surrounded line. It is about 2.5cm in diameter. Montgomery glands also has a function of lubricant nipple during lactation by its secretions. 

The nipple of breast is muscular projection covered by pigmented skin. It is vascular and surrounded by unstriated muscles which make it erectile. It accomodates about 15-20 lactiferous ducts and their openings. Each milk duct (lactiferous duct) are pulled in to the teat during nursing, the infants tongue, facial muscles and mouth squeeze the milk from the sinuses into the infants oropharynx. The whole breast is embedded in the subcutaneous fat. The fat is,however, absent beneath the nipple and areola. 

The mature breast consist of about 20% glandular tissue and the rest connective tissue. The breast is composed of 12-20 lobes. Each lobe has one excretory duct (lactiferous duct) that opens at the nipple. Each lobe has about 10-100 lobules. Cooper's ligaments are the fibrous septa, that extend from the skin to the underlying pectoral fascia. These ligament provide support to the breast. One lactiferous duct drains a lobe. The lining epithelium of the duct is cubical, becomes stratified squamous near the openings. Each alveolus is lined by columnar epithelium where milk secretion occurs. A network of branching longitudinal striated cells called myoepithelial cells surround the alveoli and the smaller ducts. There is a dense network of capillaries surrounding the alveoli. These are situated between the basement membrane and epithelial lining. Contraction of these cells squeezes the alveoli and ejects the milk into the larger duct. Behind the nipple, the main duct (lactiferous) dilates to form ampulla where the milk is stored. 

Breast tissue is sensitive to the cycle changes of hormones estrogen and progesterone. Women often feel breast tenderness and fullness during the luteal phase of the cycle. During the follicular phase, there is proliferation of the ductal system whereas during the luteal phase there is dilation of the ductal system and differentiation of the alveolar cells into secretory cells. In postmenopausal women the breast lobules and ducts atrophy. Accessory breast or nipple can occur along the breast or milk line which extends from the axilla to the groin. Supernumerary nipples (polythelia) are associated with renal abnormalities (10%). Asymmetry of breast is normal variation. Massive hypertrophy of the breast is a rare problem

Urinary bladder

The urinary bladder is a hollow muscular organ with considerable power of distension. It's capacity is about 450 mL (15oz) but can retain as much as 3-4 liters  of urine. When distended it is ovoid in shape . It has got an apex, superior surface, base, two inferolateral surfaces and neck, which is continuous with urethra. The base and the neck remain fixed even when the bladder is distended. 

Location of urinary bladder 

The triangle shaped urinary bladder is located in lower abdomen at in front of vagina and below uterus in women. 

Structure/histology of urinary bladder

From outside inwards - (1) Outer-visceral layer of the pelvic fascia. (2) Muscle layer composed  of muscles running in various directions. Near the internal urethra opening the circular muscle fibers provide involuntary sphincter. (3) Mucous coat is lined by transitional epithelium with no gland. There is no submucous coat. 

Openings of urinary bladder

Urinary bladder has three opening , these opening forms trigone of the bladder

• Two ureter orifices
• One urethral orifice(opening) 

Urinary bladder diagram         

Relations of urinary bladder

The superior surface of bladder is related with peritoneum of the uterovesical pouch. The base of bladder is related with the supra vaginal cervix and the anterior fornix. The ureters, after crossing the pelvic floor at the sides of cervix, enter the bladder on its lateral angles. In the interior of bladder, the inferolateral surfaces are related with the space of Retzius. The neck rests on the superior layer of the urogenital diaphragm. 

Parts of urinary bladder

The urinary bladder is broadly divided into four parts. 

• The fundus is posterioinferior part of bladder. 
• The body is large are which situated between apex and fundus part. 
• The neck of the bladder is the constricted part of bladder. 
• The apex is directed forward the upper part of pubic symphysis. 

Development of urinary bladder

The urinary bladder is developed from the upper part of the urogenital sinus. 

Functions of bladder

The main function of urinary bladder is temporary storage of urine after complete filtration process in kidney and another function is exit out of urine from urethra by ureter which is connected by urinary bladder and carring urine from bladder to urethra.

Bloody supply of urinary bladder

The blood supply is through superior and inferior vesical arteries. The veins drain into vesical and vaginal plexus and thence to internal iliac veins. 

Lymphatics drainage of bladder

Lymphatics drain into external and internal iliac lymph nodes.

Nerve supply of urinary bladder

The sympathetic supply is from the pelvic plexus and the parasympathetic via the pelvic plexus from the nervi erigentes(S2, 3,4).The parasympathetic produces contraction of the detrusor muscles and relaxation of the internal   sphincter (nerve of evacuation). Sympathetic conveys afferent painful stimuli of overdistension. 

Problems of urinary bladder

• Cystitis: cystitis is defined as the infection and inflammation of urinary bladder. It can be acute and chronic and cause pain, discomfort, pain during urination, urinary frequency . 
• Urinary incontinence: lack of voluntary control on urination, urinary incontinence result from many causes. 
• Hematuria: The term hematuria is refers to blood in urine during urination. It may be caused by infection or other serious condition like bladder cancer. 
• Bladder cancer: Bladder cancer is defined as the abnormal cells growth in inner lining of bladder. It is typically begins in older adults. 
• Urinary stones: Urinary stones are deposition of calcium, oxalate, phosphorus. A stone may be stay in kidney and travel in urinary tract. It can block the urine passage and cause severe pain in lower abdomen and during urination. 
• Overactive bladder: Overactive bladder is a urinary symptoms not a disease. It is a sudden and repeated need of urination which can occur due to risk factor of enlarged prostate. In this condition doctors can do Augmentation Cystoplasty surgery. 
• Bed wetting: When a person eliminate the urine during night time on bed due to involuntary movement of bladder know as bed wetting. It is also called nocturnal enuresis. 
• Urinary retention: Urinary retention is a condition where your bladder doesn't empty all the way or at all when you urinate. An infection in any part of urinary tract can cause urinary retention. 
• Urinary Bladder infection: Urinary bladder infection is a type of urinary tract infections ,which is an infection in any part of urinary tract. It is mostly occur in women than women.     
• Dysuria: Dysuria is a medical term for pain and discomfort which is mainly caused by bacterial infection in urinary tract and more common in women than men. 
• Cystocele: Cystocele is a medical condition in which a women bladder are bluge into her vagina. It is also known as bladder prolapse 

Sign and symptoms of bladder problem

• Pain and burning during after and before urination
• Inability to hold urine
• Blood in urine
• Trouble emptying the bladder
• Pain in lower abdominal
• Bed wetting during night time sleeping
• Pain during sexual intercourse
• Cloudy urine
• Strong smell in urine
• Urinate frequently, usually eight or more time in 24 hours. 

Test for bladder problems

• Urodynamic testing: Urodynamic test take pictures and videos of bladder during filling and emptying.To recognize how well the bladder, sphincter, urethra store and release urine. 
• Cystoscopy: In this procedure a hollow tube inserting into your urethra to bladder which measure lining of bladder and ureters that carries the urine. 
• Urinalysis: A urinalysis is a laboratory test to examine urine which used to detect your bladder problems such as urinary tract infection, cystitis. 

Treatment of bladder problems

• Anti-spasm medication
• Bladder catheterization
• Cystoscopy
• Surgery
• Kegel exercise

Other query related to bladder

Can you live without your bladder? 

Yes, you can live without bladder but you need a another way to pass your urine from body such as urostomy bag and neo bladder. It is   also necessary that you able to change your daily routine with new way to pass. 

What can you not do after bladder surgery?      

After a bladder surgery you need several weeks to recover( approximately 3-weeks) and this period of recover you must not do high activity that strain your bladder such as bicycle riding, heavy weight lifting, running etc. 

     

Can a bladder be replaced? 

If you have bladder cancer and any other sever disease condition then your surgeon can do cystectomy. After this surgery your surgeons make a new way to exit out urine from your body such as neo bladder. 

What causes of enlarged bladder? 

The most common cause of bladder is an obstruction between the passage of urine which is usually occur in ureter or urethra.It is also occur due to inflammation, diabetes and in a obese gaining person. 

Can underactive bladder be cured? 

In this time the treatment exact of underactive bladder is unknown but your doctors you suggest some medications to treat this condition and also suggest you for self catheterization. 

How do you pee if your bladder is removed?

If you bladder is removed you need to neo bladder and urostomy bag to collect urine from kidney and exit out it from body

What happens if your bladder brusts? 

In rare conditions your bladder is burst if you hold urine for several hours. This condition is a life threatening condition and you need immediate care by going an hospital. This condition also lead to bacterial infection which is very harmful for your life

What happens if your bladder stop working? 

Your bladder can stop if nerve are damaged which lead to stop message to bladder and causing urinary retention.Urinary retention is a condition in which urine is back to the kidney and damaged your kidney. 

How many is normal to urinate at night and day? 

It is depend how much you drink water and it is defferent in varies people. In adults the avarage rate of urinate is four to seven time in a day but if your bladder is smaller than normal range due to any disease condition then It is possible that you urinate more time in comparison to avarage rate. 

How do you tell if your bladder is not emptying fully?

If your bladder is not completely emptying fully then you can tell your doctors about this by telling your symptoms such as difficulty in start urine, small amount urine comming, increased abdominal pressure. 

What to do if urine is not coming out? 

If urine is not coming out then you can trying some remedies to treat this such as drinking water when urinate, rubbing the inner thigh, trapping the area between nevel and pubic bone, drink enough fluids, do kegel exercise. 

Click here to download PDF

Female urethra

What is female urethra

The female urethra is a part of renal system. It is a tube that extends from the neck of bladder to external meatus for the removal of urine. Which opens into vestibule about 2.5cm below the clitoris. It measure about 4cm and has a diameter of 6mm.

The upper half of female urethra is separated from the anterior vaginal wall by loose areolar tissue and the lower half is firmly embedded in its wall. 

The anatomy of urethra is different in male and women because it closely linked with reproductive organs. 

In the distal wall of female urethra some numerous tubular glands are situated called para-urethral glands . Of these, two are larger called skene's ducts which open either on posterior wall just inside the external meatus or into the vestibule.

What is the Relations of female urethra

Anterior relation :- pubic symphysis

Posterior relation:- vagina

Lateral relation    :- puborectalis muscle

What is the Structure of female urethra

The wall of female urethra is made up of three layer. 

Mucous membrane in the distal one-third is lined by stratified squamous epithelium but in the proximal two-third stratified transitional epithelium. Submucous coat is vascular. Muscle coat is arranged as inner longitudinal and outer circular. 

What does a female urethra look like

Female urethra diagram 

What is the Functions of female urethra

The purpose of female urethra is collecting urine from bladder and passout it from body And this process is done by sending single bladder to the brain and taking out urine from it.

What is the Difference between male and female urethra 

Male	Female
It opens out at the tip of the penis by urogenital aperture.	it opens by urinary aperture.
It is longer than female and it approximately 15 to 20 cm long.	it is about 4cm in length.
It is approximately 8to9mm in diameter.	It is approximately 6mm in diameter.
It has four region's.	Not differentiated in region.
The secretions of male urethra include both urine and semen.	Female urethra include only urine secretions.
Catheterization is complex.	Catheterization is simple.
Bacterial infection is common in male  urethra	More prone to bacterial infection.
Sphincter regulates both movement of urine and semen.	Sphincter regulates movement only of urine

Blood supply of female urethra 

Atrial supply:- 

Proximal parts are supplied by the inferior vesical branch and the distal part by a branch of internal pudendal artery. 

Venous supply:-

The veins drain into vesical plexus and into internal pudendal veins. 

Development of female urethra

The urethra is developed from the vesico-urethral portion of the cloaca. 

Urethral Conditions/Problems

1.Urethritis:-

•Defination of urethritis:- It is defined as the infection and inflammation of urethra causes swelling and irritation urethra is a tube carrying urine out of the bladder. The most common cause of urethritis is sexually transmitted diseases. 

•Causes of urethritis:-

• Bacterial infection (gonococcus, chlamydia) 
• Viral infection (herpes simplex virus) 
• Reiter's syndrome
• Trauma
• Engage in high-risk behaviour 
• Sexually transmitted diseases
• Uropathogenic escherichia coli(E-Coli) 
• Sensitivity to the chemical used in spermicides, contraceptives, jellies or foams. 
• Fungal infection 
• Surgery
• Catheter placement

•Risk factors urethritis:-

• Oral sex
• Being a female
• Having many sexual partners

•Symptoms of urethritis:- 

The most common symptoms of urethritis is urethral discharge. 

   Symptoms in men

• Painful ejaculation and intercorse
• Burning sensation while urination
• Discharge from penis
• Fever in rare condition
• Itching, tenderness
• Enlarged lymph nodes in the groin area
• Swelling in the penis

  Symptoms in women 

• Pelvic and abdominal pain
• Pain with intercorse
• Unusual vaginal discharge
• Frequent or urgent urination
• Itching
• Fever chills

  Treatment of urethritis:-

• Antibiotics medicine
• Antiviral medicine
• Antiinflammatory medicine 

2.Urethral cancer:-

Urethral cancer is characterized by abnormal cell growth in the lining of urethra. It is most commonly occur in women. 

Cause of urethral cancer:-

The exact cause of urethral cancer is unknown but some risk factors is responsible to cause urethral cancer.

 

• Being a women
• Being african american
• Older age
• Urinary tract infections (UTI) 
• chronic inflammation of urethra
• Sexually transmitted disease
• History of bladder cancer
• Urethral stricture 

Treatment of urethral cancer:-

• Radiation 
• Chemotherapy 
• Surgery 

3.Urethral syndrome:-

Urethral syndrome is defined as the group of symptoms that affects urethra. 

4.Urethral stricture:-

Urethral stricture is a medical disease in which tube that carries urine from urinary bladder becomes narrowing due presence of scar tissue and restricts the urine flow from bladder.

5.Urethral caruncle:- 

It is the most commonly found in post-menopausal  female in which fleshy outgrowth of urethral meatus occur. 

Symptoms of urethral conditions/Problems

• Painful urination
• Blood in urine
• Decrease urine flow
• Pelvic or abdominal pain
• Fowl smelling urine
• Cloudy urine
• Persistent need to urine
• A feeling of pressor in the abdominal 

Diagnosis of Urethral Conditions/Problems

• Cystoscopy
• Urethral ultrasound 
• Measure urine flow
• Urinalysis 

Treatment of urethral Conditions/problems 

The treatment of urethral problem is depend upon the condition of patients and patient problem from which affected (such as urethritis, urethral cancer etc.) 

I hope you like our article on Female Reproductive System anatomy and physiology that include external (vulva,mons pubis, labia majora,labia minora,clitoris,vestibule,skene's gland,bartholine gland,vaginal orifice) and internal (vagina,uterus,fallopian tube, ovary)  female reproductive system please watch above video to better understand about Female Reproductive System anatomy and physiology