brief and easy discussion on FRS

3. It is consists of
• two ovaries,
• two uterine tube,
• the uterus,
• the vagina and
• the external genitalia.
• Mammary glands are not part of the
reproductive system but connected to the
functional state of the reproductive system

5. • Shape: almond
• Size : vertical: ant-pos: transverse= 3*1.5*1

7. •It is covered by
Simple cuboidal epithelium

8. Positions of ovaries
In nulliparous adult Below the pelvic brim, in
the ovarian fossa
The newborn Above the pelvic brim
Multiparous female May prolapsed in the
recto-uterine pouch
Ectopic ovary In the inguinal canal or in
the labium majus

9. Presenting parts of ovaries
Parts Name of parts Relations
Two ends Tubal ends Directed upwards and related with
uterine tube and suspensory ligament
uterine ends Directed below and related with the
uterus and ligament of ovary
Two borders Mesovarian
border
It is attached with the posterior layer of
broad ligament
posterior free
border
Related with ureter and internal iliac
vessels
Two surfaces Medial
surface
Related with the terminal parts of
uterine tube
lateral surface Rest on ovarian fossa

10. What is ovarian fossa?
• It is a peritoneal depression of the lateral
pelvic wall where lateral surface of ovaries
are rest.

12. Boundaries of ovarian fossa
• Above : external iliac vein
• Behind : ureter and internal iliac vessels
• Floor : obturator nerve and vessels
• Above and in front : obliterated umbilical
artery

13. Blood supply of the ovary
Arterial supply
Ovary
Ovarian artery
Uterine A

14. Venous drainage of ovaries
Rt
Lt
IVC Left renal vein
Pampiniform plexus

15. Lymphatic drainage of ovary
Pre –aortic
and
para – aortic
lymph node

16. Nerve supply of ovary
• Mainly sympathetic system from
T10 to T11 segment of spinal cord

17. Histology of ovaries
Ovary is covered by simple
cuboidal epithelium
Cortex of ovary contains
different stages of ovarian
follicles
Medulla of ovary is formed
by loose connective tissue
and blood and lymphatic
vessels

18. • It is covered by germinal epithelim -
simple cuboidal epithelium
• Tunica albuginea: is a dense
connective tissue under the germinal
epithelium
• Cortical region : contain ovarian
follicles
• Medullary region : contain a rich
vascular bed within a loose
connective tissue

21. Ovary of a woman of reproductive age showing
its main components: germinal epithelium, tunica
albuginea, cortical region, and medullary region.

24. Ovulation
Release of secondary oocyte from
graafian follicle .

25. When and why ovulation is
occurred?
• Takes place about 14th of menstral cycle in
humans.
• 2. Occurs in response to a peak in production
of leutinizing hormone by cells
called gonadotrophs that are located in the
anterior lobe (pars distalis) of the pituitary
gland.

26. During ovulation,
oocyte and corona
radiata released from
graafian follicles
Remaining portion of
graafian follicle is formed
corpus luteum

27. What is corpus luteum ?
• It is a temporary endocrine glands
• After ovulation remaining granulosa and
theca cells of Graafian follicle increase in
size and form corpus luteum .
• Corpus luteum secrete progesterone and
estrogens

28. What is corpus luteum of menstruation ?
It fertilization and implantation don’t
occur c.luteum remain active for only 14
days.
14days after ovulation c.luteum
degenerates and form a white scar which
is known as corpus albicans.

30. What is corpus luteum of
pregnancy?
• If fertilization and implantation occur the
corpus luteum increases in size to form
corpus luteum of pregnancy
• Its degeneration prevent by human
chorionic gonadotropin hormone which
secreted from placenta.
• C .luteum of pregnancy : it functions
decline after 8 wk of pregnancy.

31. What is the function of ovary?

32. Uterine tube :
The oviducts (also called uterine
tubes or fallopian tubes)These tubes are about 10
cm long and extend to the ovaries. They are
highly mobile due to a layer of smooth muscle in
wall. The oviducts can be divided into 4 segments

33. Parts of uterine tube Length
intermural portion (pars
interstitialis) - portion of the
oviduct that lies within the
uterine wall, opens into the
uterus at distal end.
1cm
isthmus - portion of tube
adjacent to uterus
3cm Narrowest part of u.
tube
ampulla - more dialated portion
that extends to infundibulum
5cm Most dilated part of u.
tube.
Fertilization take place
infundibulum - funnel shaped,
next to ovary, has finger like
processes called fimbria.
1cm Collect ovum

34. Lymphatic drainage
• Intra-mural part drain into the superficial
inguinal lymph notes
• Rest of the parts drain into the pre-aortic
and para-aortic LN

35. Nerve supply of uterine tube
• Sympathetic: T10- L2 segments of spinal
cord
• Parasympathetic :
lateral part: from vagus
Medial part from pelvic splanchnic nerve

36. The wall of the oviduct has 3 layers
A mucosa adjacent to the oviduct lumen.
• a. Consists of long, longitudinal folds that are
most numerous in the ampulla.
• b. The mucosal epithelium is simple columnar and
contains two types of cells.
• * Columnar ciliated cells
• * Secretory cells - peg cells.
• 2. A muscularis - muscular layers
• a. Inner circular and outer logitudinal layer of
smooth muscle.
• b. Only the inner circular layer is well developed.
• 3. An outer serosa

38. Mammary gland
• They are modified apocrine sweat glands
• There are 15-20 lobes in each mammary
glands
• Types of gland: branched tubuloalveolar
glands

39. Different parts of mammary glands
• Nipple : an elevation where lactiferous
ducts are opened
• Areola : a dark stain area which surround
the nipple. It contain sebaceous glands,
sweat glands and glands of Montgomery.
Beneath the areola lactiferous sinuses are
present

40. Composition of mammary glands
It has two parts
• Parenchyma: Glandular
part(tubuloalveolar type) and duct
• Stroma: Dense collagenous connective
tissue and Fat

42. Mammary glands
Topic Inactive Pregnancy Lactating
Duct Numerous Proliferation of
duct
Numerous duct
Gland Buds of
alveoli
Development of
alveoli
Alveoli enlarge
and filled with
secretion
Connective
tissue
More Less Less
Fat More Less Less

43. Changes during pregnancy
• Nipple Change: nipple became larger and
darker. Montgomery's tubercules: they are
small, pimple like white areas on areola.
• Larger Breasts

44. Stroma more
developed
Gland and
duct system
more
developed

49. Part of the uterus
• Fundus: is the part of
the body that lies
above an imaginary
horizontal line
passing through the
entrance of uterine
tubes.
• Body : part of the
uterus from fundus to
the isthmus
• Cervix: part of the
uterus lies below the
isthmus. It is divided
by vaginal wall into
two part : the
supravaginal part and
the vaginal parts
• Two lateral border: is non
peritoneal, attached to the broad
ligament and related with the uterine
artery
• It has two angles or cornua: they are
situated it the junction of the fundus
and body. It is related with the three
structures
• i) anterior inferiorly – round
ligament of uterus ( other end of this
end into the labia majora of the
female external genitalia
• ii) uterine tube
• iii) posterior inferiorly ligament of
the ovary (its other end is related
with the uterine end of the ovary)

50. Cervical Canal
• terminal portion of uterine cavity
• has impermeable plug of mucus,
– helps prevent entrance of pathogens
– that becomes permeable during ovulation –
– does allow sperm to penetrate
•
Epith of cervix isn’t shed in menstruation like the epith of rest of
uterus = simple columnar, and cervical glands remain intact in this area
– they secret the mucus to make mucus plug

51. • Uterus contain a T shaped uterine cavity
which is continuous with the cavities of the
uterine tube and by internal os to the
cervical canal

52. Uterus
Anteflexon:
• it is the forward angle
between the body of
the uterus and cervix.
Measuring about
125°

53. • Anteversion :
forward angle between
the axis of the cervix
and that of the vagina.
It is measuring about
90°
Anteversion

60. Peritoneal covering of the uterus
• In front, the peritoneum covers the superior
surface o f the urinary bladder and goes to
isthmus of the uterus. Then it cover
anterior surface of the uterus, fundus,
posterior surface of the uterus upto
the posterior fornix of the vagina then it
goes to the middle third of the rectum

61. Relation of the uterus
• Anterior surface is rest on the superior
surface of the urinary bladder separated by
vesicouterine pouch
• Posterior surface is related with the sigmoid
colon and small intestine
• Laterally it is related with uterine artery and
ureter near the cervix

62. Histology of the uterus
• Endometrium {mucous membrane of the
uterus)=
i)lining epithelium : simple columnar
epithelium
ii)Lamina propria contain uterine glands
• Myometrium contain smooth muscle cells
which are randomly oriented
• Perimetrium is the visceral peritoneum

63. Endometrium of uterus
• Stratum functionale
• Stratum basale

64. The menstruation phase (1rst to
the 4th day)
• distinguishes the beginning of each
menstruation cycle. When an implantation
does not occur, the back-formation of the
yellow body (corpus luteum) lowers the
amounts of circulating estradiol and
progesterone hormones, which leads to the
expulsion of the functional layer of the
endometrium.

65. Vascular mechanisms basic to menstruation
• the reduction in the estrogen and progesterone level
• Causes
• constriction of spiral arteries
• Result
• necrosis of the tissue.
Only the functional layer affected but the basal layer
remains intact.
• The radial and basal arterioles do not react to the
hormonal variations, but the spiral arteries functional
layer are hormone sensitive and constrict when the
progesterone concentration decreases.
• So interruption of the blood supply (ischemia), which
results in the dying out of the functional layer of the
endometrium. Together with blood, which does not
coagulate due to a local fibrinolytic factor, the necrotic
tissue is eliminated

66. During the proliferative or follicular phase
(4th to 14th day)
• the secretion of estrogen through the growing ovarian
follicle is responsible for the proliferation of the
endometrium
• The uterus epithelium covers the surface again.
• The glands grow longer and
• the spiral arteries begin to grow
• At the end of the proliferative phase the estradiol peak
(released by the growing follicles) triggers a positive
feedback mechanism at the level of the pituitary and the
ovulation commences 35 to 44 hours after the initial LH
increase (cyclic hormonal changes).

68. The secretory phase (14th to 28th day)
•
During the secretory phase the endometrium
differentiated due to the influence of progesterone
(from the corpus luteum) and attains its full
maturity.
• Gland enlarge and corkscrew shaped.gland
epithelium rich in glycogen. Spiral artery become
more coiled

72. Support of uterus
• Structural support
• Ligaments: Mackenrodt’s ligaments. It is
the cardinal ligament of uterus prevent
downward displacement of the uterus
through vagina
• Muscles : levator ani .(pelvic diaphram)
• Perineal body
• Functional support

77. Vagina
• Within outward
1. Mucosa : lining epithelium : non keratinized
stratified squamous epithe
Lamina propria contain numerous blood vessels
but no gland
1. Muscular layer: smooth muscles arranged in
inner circular and outer longitudinal layer
2. Adventitia

78. Vagina
• Anterior wall : short
7.5 cm and non
peritoneal
• Posterior wall long
9cm and peritoneal
• Upper ¼ part of
posterior surface is
covered by peritoneum
Lateral wall is related to the
following from above
downwards
1) Ureter and uterine artery
2) Mackenrodt’s ligament
3) Levator ani
4) Muscles of urogenital
diaphragm
5) Bulb of vestible

79. Fornices of vagina
• Upper part of vagina is surrounded the
cervix of uterus and the area between the
cervix and vagina
• Four fornix
• Ant, pos and two lateral
• Pos fornix is 2cm deeper than ant fornix

80. Blood supply of vagina
• Arterial supply
• Vaginal a bra of inter iliac a
• Vaginal bra of uterine a
• Inter pudendal a
• Middle rectal a
• Inf vesicle a
• Vein : vaginal vein drain into inter iliac vein

81. Lymphatic drainage
• Lower 1/3 drain into superficial inguinal
lymph node
• Upper 2/3 internal and exter iliac ln

82. Nerve supply
• Upper 2/3 is pain insensative
• Sym L1,2 parasympathetic : S2,3
• Lower 1/3 is extremely sensitive and
supplied by inf rectal and pos labial bra of
pudendal nerve

83. Hymen
• It is an incomplete mucous fold which is
situated close to the external orifice of
vagina
• Shape
• annular
• Crescentic
• Cribriform
• Sometime it may imperforated

85. Blood supply of vulva
• Superficial and deep External pudendal
artery branch of femoral artery
• Posterior labial artery branch of internal
pudendal artery

86. NS of vulva
• Anterior third of the scrotum is supplied by
ilio-inguinal and genitofemoral nerves
• Posterior 2/3 is supplied by scrotal branches
of pudendal nerve and perineal branches of
pos femoral cutanteous nerve

87. 196. Describe the relation of the ovary to the uterine tube!
The upper or tubal end of the ovary is closely related to the uterine tube. The infundibulum has irregular fringes called
fimbriae that project from the margin of the infundibulum to the ovary.
197. Define the term “broad ligament of the uterus” and list those structures that are located within its substance!
A double layered peritoneal ligament extending from the sides of the uterus to the lateral walls and the floor of the pelvis.
Structures: uterine tube, round lig. of uterus, ovarian lig., epoophoron, paroophoron, uterine vessels, uterovaginal venous
plexus, nerves.
198. Define the term “parametrium”!
The loose connective tissue found between the two diverging layers of the broad ligament of uterus, which connects the
lateral part of the cervix with the pelvic wall.
199. Define the position of the uterus under normal conditions?
In the axis of the true pelvic, in anteflexion (bends forward) and anterversion (inclines forward)
200. Define the term anteflexion and anteversion of the uterus!
Anteversion: the cervix is inclined anteriorly at an acute angle (appr. 60°-70°) to the vagina.
Anteflexion: the body of the uterus is bent anteriorly at an acute angle (appr. 60’-70’) to the cervix.
201. Describe visceral relations of the uterus!
anterior : posterior wall of bladder,

88. • posterior : anterior surface of rectum, small intestines,
above : small intestines,
lateral : ureter, before its opening into the urinary bladder.
• 202. What is the epithelium of the a.) cervical canal and b.) vaginal portion of the uterus?
simple columnar mucous producing epithelium, with scatterd ciliated cells,
stratified squamous non keratinizing epithelium.
• 203. Describe the peritoneal relations of the uterus!
The body and the posterior aspect of the supravaginal portion of the cervix is enclosed between the
two layers of the broad ligament. The peritoneum reflects from the uterus posteriorly to the rectum
and anteriorly to the urinary bladder forming the rectouterine and vesicouterine pouches,
respectively.
• 204. Define the term “Douglas pouch”?
Rectouterine pouch. Reflection of the peritoneum from the rectum to the uterus. The deepest point of
the peritoneal cavity.
• 205. List those structures that help to fix the uterus in its original position!
Vagina, pelvic and urogenital diaphragms, round lig., ovarian lig., vesicouterine fold, rectouterine
fold, thickenings of the visceral pelvic fascia, broad lig., parametrium.
• 206. Which lymph nodes receive lymph from the a.) fundus, b.) body and c.) cervix of the
uterus?
aortc, external iliac, superficial inguinal lymph nodes,
external iliac lymph nodes,
internal iliac and sacral lymph nodes.