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Gynecological Anatomy & Physiology
 

Gynecological Anatomy & Physiology

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Gynecological Anatomy & Physiology

Gynecological Anatomy & Physiology

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    Gynecological Anatomy & Physiology Gynecological Anatomy & Physiology Presentation Transcript

      • Gynecological Anatomy & Physiology
    •  
    • REPRODUCTIVE AND SEXUAL HEALTH
      • PUBERTAL DEVELOPMENT:
      • Puberty is the stage of life at which the secondary sex changes
      • Girls - age 10 to13 years
      • Theory: must reach a critical weight of approx. 95lbs (43kgs)
      • Boys - age 12 to 14 years
        • The role of Androgen- hormones responsible for :
          • Muscular development
          • Physical growth
          • Increase sebaceous gland secretion (acne)
        • “ Testosterone -1° androgenic hormone”
        • In girls, testosterone influences the development of
        • labia majora, clitoris, and axillary & pubic hair latter termed as (adrenarche)
    • REPRODUCTIVE AND SEXUAL HEALTH
      • Secondary sex characteristic of boys occurs in order:
          • increase in weight
          • growth of testes
          • growth of face, axillary, and pubic hair
          • voice changes
          • penile growth
          • increase in height
          • spermatogenesis
      • Secondary sex characteristic of girls occurs in order:
      • 1. growth spurt
      • 2. increase in the traverse diameter of the pelvis
      • 3. breast development (thelarche)
      • 4. growth of pubic hair (adrenarche)
      • 5. onset of menstruation (menarche 12.5 y/o ave.)
      • 6. Ovulation occurs 1 – 2 years after menarche
      • 7. growth of axillary hair (adrenarche)
      • 8. vaginal secretion
    • FEMALE REPRODUCTIVE SYSTEM: GYNECOLOGY
      • External Structures
        • Mons pubis/ Mons veneris – pad of adipose tissues, which lives over the symphysis pubis, which protects the surrounding delicate tissue from trauma.
        • Labia majora – longitudal folds of pigmented skin extending from the mons pubis to the perineum. Contains the Bartholin’s gland that secretes yellowish mucus that acts as a lubricant during sexual activity.
        • Labia minora – soft longitudal skin folds between the Labia majora.
        • Glans clitoris – erectile tissue located at the upper end of Labia minora; primary site of sexual arousal.
    • FEMALE REPRODUCTIVE SYSTEM:
      • External Structures continue
        • 5. Vestibule – a narrow space seen when labia minora are separated that also contains the vaginal introitus, Bartholin’s gland and urethral meatus.
        • 6. Urethral Meatus – small opening bet, the clitoris and vaginal orifice for the purpose of urination.
        • 7. Vaginal orifice/introitus/opening – external opening of the vagina that contains the hymen.
        • 8. Hymen – a membranous tissue ringing the vaginal introitus
        • 9. Perineum – tissue between the anus and vagina. Site of episiotomy
        • The external genitalia’s blood supply:
        • Arteries: a. pudental artery b. inferior rectus artery.
        • Vein: Pudendal vein
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    • FEMALE REPRODUCTIVE SYSTEM:
      • B. Internal Structures
      • Ovaries – female sex glands located on each side of the uterus with two ovaries (4 x 2 x 1.5 cm thick).
        • Ovaries are formed with 3 principal divisions:
        • a. A protective layer of surface epithelium
        • b. The cortex filled with the ovarian and graafian follicle
        • c. The central medulla containing nerves, blood vessels, lymphatic tissue and some smooth muscle tissue
        • Fxn: - Ovulation (release of ovum) and Secretion of hormones like estrogen and progesterone .
        • Estrogen - help to prevents osteoporosis, and atherosclerosis
        • and potential risk for breast cancer endometrial cancer
    • FEMALE REPRODUCTIVE SYSTEM:
      • B. Internal Structures continue
      • 2. Fallopian Tubes – 4 inches (10 cm) long from each sides of the fundus;
      • Divided on four separate part:
        • 1. Intramural portion- most proximal (1cm in length)
        • 2. Isthmus portion- extremely narrow (2cm)
        • Important: tubal ligation
        • 3. Ampulla- longest portion (5cm) and widest part
        • Function: site of fertilization
        • 4. Infundibular portion- funnel shape with Fimbrae (2cm) finger like projections.
        • Function: responsible for the transport of mature ovum from ovary to uterus.
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    • FEMALE REPRODUCTIVE SYSTEM:
      • B. Internal Structures continue
      • 3. Uterus – hollow pear-shaped muscular organ.
        • Size: 3 inches long (5-7cm), 2 inches wide(5cm) and 1 inch thick (3x2x1)
        • Wt: 60 gms. in non pregnant Location: lower pelvis
        • Parts: Corpus, Isthmus, and Cervix
        • Position: anteverted and anteflexed
        • Layers: perimetrium, myometrium and endometrium
        • Function:
        • 1. to receive the ova to fallopian tube place for implantation and nourishment during fetal growth furnish protection to a growing fetus
        • 2. aids in labor and delivery
      • Cervix (2-5cm long)
      • Internal cervical os -an impt. relationship in estimating the External cervical os level of dilatation of the fetus in the birth canal before birth.
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    • FEMALE REPRODUCTIVE SYSTEM:
      • Uterus continue
      • Nerve Supply:
        • Efferent (motor) nerve- spinal ganglia (T5 to T10)
        • Afferent (sensory) nerve - hypogastric plexus (T-11 & T-12)
        • Impt: Controlling pain in labor ( Epidural anesthesia)
      • Uterine Ligaments:
        • 1. Broad Ligaments – fr. the sides of uterus to pelvic walls
        • 2. Round Ligaments – fr. sides of uterus to mons pubis.
        • 3. Cardinal and uterosacral ligaments- provides middle support
        • 4. Pelvic muscular floor ligaments- provide lower support
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    • FEMALE REPRODUCTIVE SYSTEM:
      • 3. Vaginal Canal – 3-4 inch long dilatable canal between the bladder and the rectum; contains rugae that permits stretching without tearing.
      • Anterior Vaginal wall- 6-7 cm (anterior fornices)
      • Posterior Vaginal wall- 8-9 cm (posterior fornices)
        • Function: 1. passageway for menstrual discharges
        • 2. receives penis during intercourse and
        • 3. serves as birth canal.
        • - lined with stratified squamous epithelium
        • - Bulbocavernosus : a circular muscle acts as voluntary sphincter (Kegel exercises)
      • Blood supply to the vagina:
      • Arteries: vaginal artery branch of internal iliac artery
      • Vein: pudental vein
    • FEMALE REPRODUCTIVE SYSTEM:
      • Vagina continue …
      • The external genitalia’s blood supply : mainly from the
      • a. pudental artery and
      • b. a portion of inferior rectus artery.
      • Nerve supply: has both parasympathetic & sympathetic
      • (S-1 to S-3 levels)
        • Nerve supply of the anterior portion: (L1)
        • a. Ilio-inguinal nerves b. Genito-femoral nerves
        • Nerve supply of the posterior portion: (S3)
        • Pudendal nerves
      • “ This is the reason why one type of anesthesia used for childbirth is called Pudendal block.”
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    • MALE REPRODUCTIVE SYSTEM: ANDROLOGY
      • A. External Structures
        • 1. Penis : the male organ of copulation; a cylindrical shaft consisting of:
        • a. corpora cavernosa - t wo lateral columns of erectile tissue
        • b. corpus spongiosum - encases the urethra
          • -The glans penis , a cone-shaped expansion of the corpus spongiosum that is highly in express males.
          • - Erection is stimulated by parasympathetic nerve
        • Scrotum : a pouch hanging below the penis that contains the testes .
        • 3. Testes: two solid ovoid organs 4-5 cm long and 2-3 wide , divided into lobes containing
        • Seminiferous tubules - produce spermatozoa.
        • Leydig cells - testosterone production .
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    • MALE REPRODUCTIVE SYSTEM:
    • MALE REPRODUCTIVE SYSTEM: A. External Structures continue SPERMATOZOA are produced by: Hypothalamus Control by GnRH (+/-) feedback Anterior Pituitary gland FSH / LH Testes FSH - release of Androgen Binding Protein (ABP) which promote SPERMATOGENESIS LH - release of Testosterone. “ Spermatozoa does not survive at body temperature. They usually survive 1°F lower than body temperature”.
    • MALE REPRODUCTIVE SYSTEM:
      • B. Internal Structures
        • 1. Epididymis: serves as reservoir for sperm storage and maturation. Approximately 20 ft. it takes 12-20 days for the sperm to travel the length of Epididymis.
        • A total of 64 days before they reach maturity.
        • (“Treatment= 2 months” ).
          • Aspermia - (absence of sperm)
          • Oligospermia- if < 20 million sperm/ ml
        • 2. Vas deferens: a duct extending from epididymis to the ejaculatory duct and seminal vesicle, providing a passageway for sperm. (sperm mature).
          • Varicocele- varicosity of internal spermatic cord
          • Vasectomy (male birth control)
        • 3. Seminal vesical: are two convoluted pouches that lie along the lower portion of the bladder and empty into the urethra by the way of ejaculatory ducts
    • MALE REPRODUCTIVE SYSTEM: B. Internal Structures continue 4. Ejaculatory duct: the canal formed by the union of the vas deferens and the excretory duct of the seminal vesicle, which enters the urethra at the prostate gland. 5. Prostate Gland: located just below the urinal bladder. Secretes alkaline and most of the seminal fluid. 6. Bulbourethral glands or Cowper’s Gland: adds alkaline fluid to the semen. 7. Urethra: the passageway for both urine and semen, extending from the bladder to the urethral meatus . (8 inches in long)
    • MALE REPRODUCTIVE SYSTEM:
      • B. Internal Structures continue
      • SEMEN:
        • Is a thick whitish fluid ejaculated by the male during orgasm, contains spermatozoa and fructose-rich nutrients.
        • During ejaculation, semen receives contributions of fluid from
        • Prostate gland (60%)
        • Seminal vesicle (30%)
        • Epididymis ( 5%)
        • Bulbourethral gland (5%)
        • Average pH = 7.5
        • The average amount of semen released during ejaculation is 2.5 -5 ml . It can live with in the female genital tract for about 24 to 72 hours .
        • (50-200 million/ml of ejaculation ave. of 400 million/ ejaculation )
        • 90 seconds- cervix
        • 5 mins.- end of fallopian tube
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