Anatomy and Physiology of Female Reproductive System:

In the reproductive process, two kinds of sex cells or gametes are involved. The male sperm, and
the female egg or ovum. These two cells meet in the female's reproductive system to create a new
individual. The egg is fertilized in the uterine tube and implanted in the uterus. Both the male and
female reproductive systems are essential for reproduction. The female needs a male to fertilize
her egg, even though she is the one who carries the offspring through pregnancy and childbirth.

Vagina:
The vaginal wall is a thick, fibromusclar tube that forms the inferior- most region of the female-
reproductive tract and measures about 4 inches in length in an adult female. It connects the uterus
with the outside of the body anteromedially, and thus functions as a entry point for the penis
during sexual intercourse. It is also the exit canal for blood discharge during menstruation and the
baby during a vaginal childbirth. It's tube like structure helps connect the internal reproductive
organs to the external genitalia.

Cervix:
The cervix is situated between the vagina and the uterus. It mucous membranes helps to either
allow for the passage of sperm or the obstruction of sperm. The sperm must pass through the
cervix to reach an unfertilized egg. When a baby is born it must pass through the cervix as it exits
the uterus and enters the vagina. Cervical cancer is the greatest cancer concern for woman. Yearly
pap smear cultures can monitor and detect abnormalities. It is common to have cervical cysts that
cause no difficulties to cause concern. They can be monitored for changes and enlargement.

Uterus:
This muscular organ is made up of three layers from deep to superficial: endometrium,
myometrium, perimetrium. The Endometrium can be further divided into Stratum Basalis and
Stratum Functionalis which is the growth filled with blood and sluffed out on the next
menstartion. A fertilized egg implants itself into the wall of the endometrium where it will
develop throughout the pregnancy. Its also made up of 2 main parts. The Fundus which it the
dome top of the uterus and the Body which is inferior to the fundus and superior to the cervix.

Fallopian Tubes or uterine tubes:

The fallopian tubes extend superiolaterally off the uterus and connects with the ovaries. These
tubes have finger like projection's called Fimbrae at the end of the tube near the ovary. These
finger like projections help to collect mature eggs released by the ovaries. Fertilization of the egg
happens mostly in the first one third of the fallopian tube.

Ovaries:
Women have an ovary on each side of the uterus. Each month the ovaries release an egg which is
then fertilized or sloughed off. They also produce estrogen and progesterone which help with
reproductive function. Sometimes 2 eggs are released and if fertilized by sperm, non-identical or
fraternal twins (could be two boys, two girls, or a boy and a girl) develop in the uterus. Ovarian
cysts form when an egg in the ovary begins to mature and grow but is not released. It can cause
pain if it twists and infection and possible death if it bursts. Generally the body will reabsorb
these eggs, but if it continues to grow it must be surgically drained or removed. Surgery includes
removal of the ovary in many cases. Sometimes this ovarian cyst occurs when a woman is
pregnant. Other times it can be brought on due to extreme stress or a predisposed genetic
condition. If one ovary is removed, there is still a good chance of becoming pregnant and
releasing enough estrogen to help regulate body needs.
Mammary Glands:
Mammary glands, which are part of the breasts, are very high modified suderiferous (sweat)
glands, which appear in mostly all vertebrates, but are developed in their own ways. The glands
are also somewhat different from species to different animals. Each mammal may secrete milk in
different ways when they produce it.
All of these organs are major and critical parts of the female reproductive system. They are
housed internally within the body. These organs work together to help the ovaries release the egg
follicle which is then either implanted in the uterus or is sloughed out. Humans are the only
mammal to have enlarged breasts when they are not lactating. This is due to the large content of
fat (adipose tissue) contained in a breast surrounding the mammary gland.

Internal Genitals

Vagina
The vagina is a muscular, hollow tube that extends from the vaginal opening to the cervix of the
uterus. It is situated between the urinary bladder and the rectum. It is about three to five inches
long in a grown woman. The muscular wall allows the vagina to expand and contract. The
muscular walls are lined with mucous membranes, which keep it protected and moist. A thin
sheet of tissue with one or more holes in it, called the hymen, partially covers the opening of the
vagina.

The vagina receives sperm during sexual intercourse from the penis. The sperm that survive the
acidic condition of the vagina continue on through to the fallopian tubes where fertilization may
occur. The vagina is made up of three layers. The perimetrium (outermost layer), myometrium
(middle layer), endometrium (innermost layer). The endometrium is made of vaginal rugae that
stretch and allow penetration to occur. These also help with stimulation of the penis. The
myometrium layer has glands that secrete an acidic mucus (pH of around 4.0.) that keeps
bacterial growth down. The perimetrium layer is especially important with delivery of a fetus and
placenta because of it's muscular walls.

Cervix

The cervix (from Latin "neck") is the lower, narrow portion of the uterus where it joins with the
top end of the vagina. The location where they meet forms an almost 90 degree angle. It is
cylindrical or conical in shape and protrudes through the upper anterior vaginal wall.

Approximately half its length is visible with appropriate medical equipment; the remainder lies
above the vagina beyond view. It is occasionally called "cervix uteri", or "neck of the uterus".

During menstruation, the cervix stretches open slightly to allow the endometrium to be shed. This
stretching is believed to be part of the cramping pain that many women experience. Evidence for
this is given by the fact that some women's cramps subside or disappear after their first vaginal
birth because the cervical opening has widened.

The portion projecting into the vagina is referred to as the portio vaginalis or exocervix. On
average, the exocervix is three cm long and two and a half cm wide. It has a convex, elliptical
surface and is divided into anterior and posterior lips. The exocervix's opening is called the
external os. The size and shape of the external os and the exocervix varies widely with age,
hormonal state, and whether the woman has had a vaginal birth. In women who have not had a
vaginal birth the external os appears as a small, circular opening. In women who have had a
vaginal birth, the exocervix appears bulkier and the external os appears wider, more slit-like and
gaping. The passageway between the external os and the uterine cavity is referred to as the
endocervical canal. It varies widely in length and width, along with the cervix overall. Flattened
anterior to posterior, the endocervical canal measures seven to eight mm at its widest in
reproductive-aged women. The endocervical canal terminates at the internal os which is the
opening of the cervix inside the uterine cavity. During childbirth, contractions of the uterus will
dilate the cervix up to 10 cm in diameter to allow the child to pass through. During orgasm, the
cervix convulses and the external os dilates.

Uterus

The uterus is shaped like an upside-down pear, with a thick lining and muscular walls. Located
near the floor of the pelvic cavity, it is hollow to allow a blastocyte, or fertilized egg, to implant
and grow. It also allows for the inner lining of the uterus to build up until a fertilized egg is
implanted, or it is sloughed off during menses.

The uterus contains some of the strongest muscles in the female body. These muscles are able to
expand and contract to accommodate a growing fetus and then help push the baby out during
labor. These muscles also contract rhythmically during an orgasm in a wave like action. It is
thought that this is to help push or guide the sperm up the uterus to the fallopian tubes where
fertilization may be possible.

The uterus is only about three inches long and two inches wide, but during pregnancy it changes
rapidly and dramatically.

The top rim of the uterus is called the fundus and is a landmark for many doctors to track the
progress of a pregnancy and massaged by nurses after the baby is born to help return the uterus to
normal size. Massaging helps to stimulate contractions.

The uterine cavity refers to the fundus of the uterus and the body of the uterus.

Helping support the uterus are ligaments that attach from the body of the uterus to the pelvic wall
and abdominal wall. During pregnancy the ligaments prolapse due to the growing uterus, but
retract after childbirth. In some cases after menopause, they may lose elasticity and uterine
prolapse may occur. This can be fixed with surgery.
Some problems of the uterus include uterine fibroids, pelvic pain (including endometriosis,
adenomyosis), pelvic relaxation (or prolapse), heavy or abnormal menstrual bleeding, and cancer.
It is only after all alternative options have been considered that surgery is recommended in these
cases. This surgery is called hysterectomy. Hysterectomy is the removal of the uterus, and may
include the removal of one or both of the ovaries and the cervix may or may not be removed.
Once performed it is irreversible. After a hysterectomy, many women begin a form of alternate
hormone therapy due to the lack of ovaries and hormone production. This is not always necessary
and can be monitored with blood analysis.

Fallopian Tubes or uterine tubes

At the upper corners of the uterus are the fallopian tubes (uterine tubes). There are a total of two
uterine tubes. One on each side of the uterus. Each uterine attaches to a side of the uterus and
connects to an ovary on the same side of attachment. They are positioned between the ligaments
that support the uterus.

The uterine tubes are about four inches long and about as wide as a piece of spaghetti. Within
each tube is a tiny passageway no wider than a sewing needle. At the other end of each uterine
tube is a fringed area that looks like a funnel. This fringed area, called the infundibulum, lies
close to the ovary, but is not attached.

The ovaries generally alternately release an egg every month. When an ovary does ovulate, or
release an egg, it is swept into the lumen of the uterine tube by the frimbriae.

Once the egg is in the uterine tube, tiny hairs in the tube's lining help push it down the narrow
passageway toward the uterus. The oocyte, or developing egg cell, takes four to five days to
travel down the length of the uterine tube.
If enough sperm are ejaculated during sexual intercourse and there is an oocyte in the uterine
tube, fertilization will occur. Fertilization most often occurs in the fallopian tube. After
fertilization occurs, the zygote, or fertilized egg, will continue down to the uterus and implant
itself in the uterine wall where it will grow and develop until birth. If a zygote doesn't move down
to the uterus and implants itself in the uterine tube, it is called a ectopic or tubal pregnancy. If this
occurs, the pregnancy will need to be terminated and the tube generally removed to prevent
permanent damage to the fallopian tube, possible hemorrhage and possible death of the mother.

The picture below shows the uterus on the left side of the picture, the vagina just inferior to the
uterus, the ovary which is lateral to the uterus. The broad ligament connects the uterus to the
ovary. The uterine tube is located superior to the ovary.

Ovaries
The ovaries are paired, oval organs located within the pelvic cavity lateral to the uterus. In an
adult, ovaries are slightly larger than an almond about 2 to 3 centimeters long, 2 cm wide, and 1
to 1.5 cm thick. Their size usually varies during each menstrual cycle as well as during
pregnancy.

The ovaries are anchored within the pelvic cavity by special "cords" and sheets of connection
tissue. A double fold of peritonuem called the mesovarium, attaches to each ovary at its hilum.
The hilum is the anterior surface of the ovary where blood vessels and nerves enter the ovary.

The mesovarium secures each ovary to a broad ligament, which is a drape of peritonuem that
hangs over the uterus. Each ovary is anchored to the posterior aspect of the broad ligament by an
ovarian ligament, which is the superior portion of the round ligament of the uterus.

A suspensory ligament attaches to the lateral edge of each ovary and projects superolaterally to
the pelvic wall. The ovarian blood vessels and nerves are housed within each suspensory
ligament, and they join the ovary at its hilum.
Smooth muscle fibers within both the mesovarium and the suspensory ligament contract at the
time of ovulation to bring the ovaries into close proximity with the uterine tube openings. Each
ovary is supplied by an ovarian vein and artery. The ovarian arteries are branches that come
directly off the aorta immediately inferior to the renal vessel. The ovarian veins exit the ovary and
drain into either the inferior cava or one of the renal veins.

Traveling with the ovarian artery and vein are autonomic nerves. Sympathetic axons come from
the T10 segments of the spinal cord whereas parasympathetic axons come from CN X.

External genitalia
The female external genitalia are collectively known as the vulva or pudendum. They consist of
paired folds called the labia majora, which are thickly padded with subcutaneous fat, covered by
skin and pubic hair, and have a moist internal lining. The labia majora join and continue over the
symphysis pubis as the mons pubis, a small mound raised by a thick underlying pad of fat.

The labia minora are freshly folds within the labia majora that lie on either side of the vestibule
containing the vaginal and urinary opening and the opening of the greater vestibular glands. The
clitoris is erectile tissue, like the penis. The upper ends of the labia minora join around the clitoris
to form a prepuce (foreskin).

Breast-
Mammory glands are composed of glandular tissue and a variable amount of fat. They are also
have a complex secretory product called breast milk. Breast milk travels through a passageway
called the Lactiferous duct, which travels from the alveoli to the nipple. The nipple is a centrally
located projection on the breast comprised partly of erectile tissue. The Areola is the darkened
region of the breast that surrounds the nipple. An areola may vary in color depending on whether
or not a woman has given birth.