Female Reproductive System

Objectives
• Describe the anatomy of the female reproductive
system
• Describe the histology of the ovary including
polycystic ovary syndrome, ovarian cancer
• Describe the hormonal control of the ovary and
how it interacts with the uterus
• Describe the uterine tubes including ectopic
pregnancy
• Describe the uterus including fibroids,
endometrial cancer and endometriosis
• Describe the histology of the cervix including
cervical cancer
• Describe the histology of the vagina
 Key Word List Female Repro
Ovary, Uterine/Fallopian tube, uterus, broad ligament, peritoneum, fertilization, ovarian &
Uterine artery, fimbriae, infundibulum, ampulla, isthmus, intramural part, peg cells, ciliated
Cells, endometrium, Myometrium, perimetrium, GNRH, portal system, FSH, LH, estrogen,
progesterone, germinal epithelium, cortex, medulla, follicles, primary oocyte, primordial
follicle, primary follicle, zona pellucida, antral/secondary follicle, Graafian/mature follicle,
granulosa cells, theca cells, corpus luteum, ovulation, corpus albicans, atretic follicle, antrum,
Liquor folliculi, corona radiata, androstenedione, polycystic ovaries, amennorhea, ovarian
cancer, BRCA 1, 2, ovarian cycle, uterine/endometrial/menstrual cycle, meiosis, fertilization,
zona reaction, zygote, ectopic pregnancy, endometriosis, tubular glands, stratum functionalis,
stratum basalis, menarche, menopause, menstruation, proliferative phase, secretory phase,
menstrual phase, ‘saw-tooth’ appearance, endometrial cancer, biopsy, adenocarcinoma,
oxytocin, uterine fibroids, leiomyosarcoma, cervix, endocervix, ectocervix, transformation
Zone, SCJ (squamocolumnar junction) Pap smear, cervical glands, Nabothian cysts, cervical
Cancer, HPV, cervical neoplasia, vagina, glycogen, lactic acid,
Describe the anatomy of the
female reproductive system
Ovaries

Oviducts
(Fallopian tubes)

Uterus
Cervix

Vagina

External Genitalia

“MENARCHE,

MENOPAUSE”
Ovaries

“Fimbriae”

Uterine Tube

Uterus

Bladder
The ovary, uterine tube and much of the uterus are
overlain by peritoneum and therefore have a serosa
Anastomotic blood supply from the ovarian,
uterine and vaginal arteries
Gartner’s Histology
Gartner’s Histology
 Describe the histology of the ovary
including polycystic ovary syndrome
and ovarian cancer
Endocrine
Activity of
Ovary
Follicle
Types
FSH, LH Antral follicle Graafian follicle

Multilaminar
Primary follicle

Primary
follicle
Medulla

Primordial
follicle

Germinal
epithelium
Corpus albicans Corpus luteum
 Primordial follicles
• Most abundant before
birth
• Primary oocyte
arrested in the
prophase stage of
meiosis I
• Surrounded by a single
layer of squamous
follicular cells (have
receptors for FSH)
Primordial ovarian follicles. surface epithelium (SE), tunica albuginea (TA), oocyte (O)
surrounded by a layer of flat epithelial follicular cells (arrows), are present in the ovarian
connective tissue (stroma).
 Primary follicle
•Follicular cells change from squamous to cuboidal.
•Simple cuboidal epithelium = unilaminar primary
follicle.
•When the follicular cells proliferate and stratify,
forming several layers of cells around the primary
oocyte, the follicle is called a multilaminar primary
follicle, and the follicular cells are referred to as
granulosa cells.
•During this stage, a glycoprotein coat called the
zona pellucida surrounds the oocyte.
•Microvilli of the oocyte and filopodia of the
follicular cells invade the zona pellucida and form
gap junctions through which they communicate
throughout follicular development.
Cuboidal follicular cells
Primary follicles. primordial follicles (PF) and their flattened follicles cells (arrows), unilaminar
primary follicles (UF) granulosa cells (G) primary oocyte (O). ZP (zona pellucida)
Secondary Follicle
Antrum is present.
Many become
“atretic”
Corona
Radiata cells
 Mature (Graafian) follicle
• Antrum is large
• Oocyte and corona radiata extend into the
antrum supported by granulosa cells (cumulus
oophorus)
• Stromal cells next to the granulosa cells
surrounding the antrum begin to differentiate
into the “theca interna”
• The theca interna is highly vascular and produces
androstenedione (a male hormone) which
granulosa cells convert to estrogen
 Theca interna and externa
• The theca interna is
separated from the
granulosa cells by a
thickened basement
membrane
• The theca externa is the
surrounding connective tissue
A = antrum containing
‘liquor folliculi’
Antrum surrounds the oocyte
ESTROGEN
Granulosa cell
Following ovulation, the remaining
granulosa cells and theca interna
form the CORPUS LUTEUM which
secretes progesterone.

Theca lutein cells

Granulosa lutein cells

Granulosa
lutein cell Corpus Luteum:
In addition to estrogens, granulosa lutein
cells produce progesterone
Ovary 20x
Developing
follicles

Corpus
Luteum
(a postovulatory
structure)

Ovary
• If pregnancy does not occur (hCG is not
produced) the corpus luteum degenerates
and forms the corpus albicans.
 Polycystic ovary syndrome (PCOS)
• Genetic
• High circulating androgen levels
• Failure to ovulate- “cysts”

• Menstrual disorders- oligo-, a-menorrhea

• Infertility
• Metabolic syndrome
 Ovarian cancer
• Usually arises from germinal epithelium
• Theoretical cause: repeated rupture/healing due to ovulation
without pauses during pregnancy
• Risk factors:
– Increased age and lack of children
– Genetics (esp BRCA1 or 2)
• Few initial symptoms, no test
• Poor prognosis- deadliest gynecological cancer
 Describe the hormonal control of
the ovary and how it interacts with
the uterus
Pituitary Hormones

Effect on Ovary

Ovarian Hormones

Effect on Endometrium
Estrogen and progesterone produced by ovarian follicles regulate
the menstrual cycle (aka “uterine ”, “endometrial”)
2) Primary Oocyte
arrested at Prophase Meiosis I
(fetal ovary to puberty) 3) Completion of
Meiosis I during
ovulation
First polar body

4) Secondary
Oocyte
arrested at
Metaphase of
Meiosis II

5) Completion
of Meiosis II
1) Development of following
Primordial Follicle in the Second polar body sperm entry
fetal ovary
Gray’s Anatomy Fertilization of (2° oocyte)

Zona Reaction: Cortical

granules cause ZP to
become a barrier (“sperm
Block”)
Describe the uterine tubes including
ectopic pregnancy
 Severe lower abdomen pain…
• Patient “PS” 25 year old -presents to the
Emergency with sudden onset severe pain
abdomen with fainting attack. She is in a shock-
like state with cold and clammy extremities, rapid
pulse and low blood pressure.

• She has continuous vaginal bleeding

• She has a history of missed menstrual bleeding

 Severe lower abdomen pain…
• Ultrasound reveals a ruptured ectopic pregnancy

97% are tubal pregnancies.

An Ectopic
Pregnancy
Location
 Fallopian (uterine) Tubes
• Paired muscular tubes,
10-12 cm in length

1. Trap the released

ovum
– fimbrial end
2. Site of fertilization of
the oocyte
- ampulla
3. Transportation of the
zygote to the uterine
cavity
 Fallopian (a.k.a.,uterine, oviduct)
Tubes
• Mucosa
– Thrown into numerous folds
especially in the ampulla.
– Epithelium is simple
columnar with
• ciliated cells
• secretory non-ciliated cells
“PEG CELLS”

• Muscularis - Inner circular &

outer longitudinal.

• Serosa – outermost covering

containing mesothelium.
Uterine tube (Fallopian)
12x Bacus 83

LP
Lumen

CC NCC
Short, non-ciliated cells: Peg cells
(nourishment, immunity, sperm
capacitation) 100x

Fallopian (uterine tube): ciliated cells, non-ciliated cells (Peg).

Aid in oocyte transport, nutrient secretion for oocyte/zygote.
 Describe the uterus including
fibroids, endometrial cancer and
endometriosis
 Uterus
• Parts
– Fundus
– Body
– Isthmus
– Cervix

• Layers :
– Endometrium Isthmus
– Myometrium
– Perimetrium
serosa (or
adventitia)
 Uterine glands

Stratum
vasculare
• The endometrium, or mucosal lining of the
uterus, is composed of a simple columnar
epithelium and a lamina propria.
• The epithelium is composed of nonciliated
secretory columnar cells and ciliated cells.
• The lamina propria houses simple branched
tubular glands that extend as far as the
myometrium .
• The morphological and physiological
alterations that occur in the endometrium
during the phases of the menstrual (uterine)
cycle are controlled by hormones.
 Endometrium
• Epithelium and lamina propria
with tubular glands (simple but
with branches in the deeper
portions)

• Divided into the basal and

functional layers.

– Stratum Functionalis –
replaced every menstrual
cycle

– Stratum Basalis –
renewal of the
endometrium, remains
relatively unchanged
 Blood Vessels of the Endometrium
• Uterine artery -
Arcuate arteries are
circumferentially oriented
arteries in the middle layers
of myometrium

• Radial artery -
From them straight
and coiled arteries branch

– Spiral – supply the

functionalis

– Straight – supply the

basalis layer—are
constant feature
 Menstrual Cycle Onset/End
Cyclical changes of endometrium

Menarche – first menstrual cycle between

(12 to 15 years of age but can occur as early
as 9 yrs)

Menopause – cessation of menstrual cycle as the

ovaries cease to function (45 to 50 years of
age)

Duration of monthly cycle – variable, but the

average is 28 days
 Monthly Menstrual Cycle

• Menstrual phase – from

day 1 to day 5

• Proliferative phase –
& follicular phase, from
day 6 to day 14

• Secretory phase –
& luteal phase, from day
15 to day 28
• Menstruation, which begins on the day
bleeding from the uterus starts, occurs when
fertilization does not take place.
• The corpus luteum becomes nonfunctional
about 14 days POSTovulation, thus reducing
the levels of progesterone and estrogen.
• Although the entire functionalis layer of the
endometrium is sloughed, it is not completely
released from the wall immediately; rather,
this process continues for 3 to 4 days.
 Proliferative phase of Endometrium
• Occurs at the same time as
the follicular phase
• Begins when the menstrual
flow ceases (~day 4) and
continues through day 14
when the functionalis layer
is regenerated.
• Full complement of
epithelium, glands, stroma,
and SPIRAL arteries now
exists.
 Proliferative phase of Endometrium
• Day 5-14 (right after menses)
• Coincides with follicular phase of ovarian cycle.
• Stratum functionalis regenerates - high mitotic activity
in the cells of the basal glands.
• Glands are straight & lined by simple columnar
epithelium.
• Spiral arteries elongate but remain convoluted; extend
from the basal layer into the functional layer

• Under influence of estrogen.

Early proliferative
phase
Glandular changes

Late
proliferative
Phase
Glandular changes
 Secretory phase of Endometrium
• Commences after ovulation
• Endometrium continues to thicken

• Secretory products cause

“saw tooth” appearance of
uterine glands

• Glycogen-rich secretions provide

nourishment for the conceptus before the
formation of the placenta

• Completes the menstrual cycle as the 28th

day approaches, presaging the menstrual
phase of a new menstrual cycle
Secretory Phase of Endometrium
• After ovulation, when the glands have already
developed, progesterone stimulates them to secrete
glycoproteins. Mitoses are rare

• At the end, the endometrium reaches its maximal

thickness, and the glands become highly coiled - take
on a characteristic “saw tooth” appearance

• Epithelial cells accumulate glycogen below the

nuclei. The secretion dilates the lumen of the glands

• Coiled arteries growth continue and they reach the

superficial portion of endometrium.

• Progesterone inhibits the contraction of myometrium

Mucosal Surface, Secretory Phase Endomentrium
“Sawtooth” Pattern Endometrium secretory
 Menstrual phase of endometrium
 If fertilization and/or implantation fails, corpus
luteum ceases to function.
 Drop of levels of estrogen and progesterone
induces the involution of endometrium.
 Coiled arteries contract, inducing ischemia
and then necrosis
 Endometrium becomes partially detached but
stratum basale remains intact
 Menstrual blood does not clot because of the
presence of anticoagulants in it.
 Menses composed of dead cells, blood &
functionalis stroma
Menstrual phase of endometrium
Menstrual phase
of endometrium
Proliferative Phase Secretory Phase Menstrual Phase

Estrogen Influence Progesterone of CL No Progesterone CL Gone

 Endometriosis
• Endometrial cells grow outside the uterus
• Influenced by hormonal changes similar to cells
inside the uterus
• Symptoms typically timed to menstrual cycle
• Usually occurs during the reproductive years
• Common occurring 5–10% of women
• Symptoms include pelvic pain and depend
upon location
• Often associated with infertility
Endometriosis:

Endometrial tissue
present in abnormal
locations

responds to hormonal
changes

Robbins’ Pathology
Endometriosis and adhesions
 Endometrial cancer
• Endometrial cancers are the most common gynecologic cancers
in the United States, with over 35,000 women diagnosed each year.
The incidence is on a slow rise secondary to the obesity epidemic.
• The most common subtype, endometrioid
adenocarcinoma, typically occurs within a few decades of
menopause, is associated with obesity,
excessive estrogen exposure, often develops in the setting
of endometrial hyperplasia, and presents most often with vaginal
bleeding. Endometrial carcinoma is the third most common cause
of gynecologic cancer death (behind ovarian and cervical
cancer).
• Type 1 (~90%) occurs at menopause and is less aggressive than type
2 (~10%) which occurs a number of years after menopause.
• A total abdominal hysterectomy (surgical removal of the uterus)
with bilateral salpingo-oophorectomy is the most common
therapeutic approach.
Endometrial Cancer
Endometrial cancer can present in a
number of forms
 Myometrium
• Middle layer – smooth muscle
– stratum vasculare

• Three layers not well defined

– Inner and outer
longitudinal
– Middle circular Endometrium

• Elevated oxytocin &

prostaglandin levels during
parturition stimulate
contractions
The myometrium is composed of inner
longitudinal, middle circular, and outer
longitudinal layers of smooth muscle.
(oxytocin “target”) (Source?)

The anterior, inferior portion of the uterus is covered by

adventitia.

The fundus and posterior portion of the body are covered by a

serosa.
 Uterine fibroids
• Benign tumors that originate from the myometrium
and the accompanying connective tissue of
the uterus.
• Fibroids are the most common benign tumors in
females and typically found during the middle and
later reproductive years.
• While most fibroids are asymptomatic, they can
grow and cause heavy and painful menstruation,
painful sexual intercourse, and urinary frequency
and urgency.
• Some fibroids may interfere with pregnancy
although this appears to be very rare.
 Uterine
Fibroids

“Leiomyoma”
 Describe the histology of the
cervix including cervical cancer
 Uterine cervix
• Endocervix: mucus-secreting
simple columnar epithelium
• Ectocervix: lined by stratified
squamous epithelium
• Cervical glands – extensively Endo
branched mucous glands
• 85% is made of dense
connective tissue

Ecto
 Cervical - Cervical canal –
Histology endocervix lined
by simple
columnar
epithelium

Ectocervix – lined by
stratified squamous
epithelium
 Cervical glands

MRI
Blockage of the openings of the cervical
mucosal glands frequently results in the
accumulation of secretory products within
the glands, leading to the formation of
dilated Nabothian cysts – benign cysts
 Cervix
• Branched cervical glands
secrete a serous fluid
close to ovulation.

• During pregnancy, these

glands secrete a thick
viscous secretion that
hinders the entry of
sperms &
microorganisms.
 Cervical cancer
• Approximately 15,700 cases of cervical
cancer and
• 4,900 deaths due to cervical cancer each
year in the United States.
• Among all races in the United States,
– the rate is 2.5 per 100,000 women,
– Native Americans the rate is 3.8 per
100,000 women.
• Worldwide the number of new cases is
471,000 per year.

• Virtually all deaths from cervical

cancer are preventable
 Causes of cervical cancer
• Human papilloma virus infection (HPV)
– HPV causes the production of 2 proteins known as E6 and
E7
• Smoking
• Immunosuppression
• Chlamydia infection
• Diet
• Oral contraceptives (birth control pills)
• Multiple pregnancies
• Low socioeconomic status
• Family history of cervical cancer
Epithelial cells are scraped from the lining of the cervix & vagina &
examined.
 Pap smear

Normal Abnormal
• In a study of 108,000 women ages 12-26,
those who got all three HPV vaccinations
had an overall 54% decreased level of
cervical dysplasia.
• E. Crowe et al. Effectiveness of quadrivalent
human papillomavirus vaccine for the
prevention of cervical abnormalities: case-
control study nested within a population
based screening programme in
Australia. BMJ. Vol. 348, March 4, 2014. doi:
10.1136/bmj.g1458.
Describe the histology of the vagina
VAGINA: Lumen
Mucosa, muscularis, adventitia

Aglandular

Few sensory nerve endings

Stratified squamous
epithelium-
contains GLYCOGEN used to
create an acidic environment
(pH 3.8 – 4.5)

Highly vascular lamina propria

 Vagina
• No clear differentiation between mucosa and
submucosa

• Muscular layer is composed of poorly defined

inner circular and predominant outer
longitudinal muscles with interspersed elastic
fibers.

• Adventitia is fibroelastic connective tissue.

Vagina
Mammary gland
 Objectives
• Describe the development of the mammary gland
• List the basic tissue types found in the mammary
gland
• Describe the structure of the mammary gland
• Describe the hormonal regulation of the
mammary gland
• Describe the secretions of the mammary gland
• Discuss lactational amenorrhea and cessation of
lactation
• Discuss breast cancer
Describe the development of the
mammary gland
 Mammary gland development
• Modified sweat gland
• Thickened epidermis- mammary lines, week 7
• Most disappears
• Invaginations create lactiferous ducts
• Nipple created by proliferation of surrounding
mesenchyme shortly after birth
• At puberty, estrogen and progesterone
stimulate branching from ducts to form
alveoli with secretory cells (inhibited by
testosterone)
1. Dermal mesenchymal
cells induce formation of
epithelial bud 2. Adipose cells
stimulate branching of
epithelial mammary cords

Development of the
3. Mammary cords
Mammary Gland become hollow and some
luminal epithelial cells
differentiate into
myoepithelium cells
List the basic tissue types found
in the mammary gland
• Epithelium
– Integument (skin)
– Ducts and secretory portion of glands
• Connective tissue
– Dense connective tissue (Cooper’s ligaments)
– Loose connective tissue
– Adipose tissue
• Muscle
– Myoepithelial cells
– Smooth muscle
• Nerve
– Sympathetic innervation
– Sensory innervation
Describe the structure of the
mammary gland
Mammary Gland:

Glandular appearance
at different stages
of function

Pathway:

Alveolus
Duct
Lactiferous Duct
Lactiferous Sinus
Nipple
Glandular epithelium (ducts
and lobules) surrounded and
supported by dense irregular
and adipose connective tissue
The nipple: The duct system of an
•many lactiferous sinuses inactive gland blindly
•smooth muscle ends in small alveoli
•sympathetic nerve fibers

A lobule consists of one

duct and several alveoli

A lobe consists of several lobules

connected to a lactiferous sinus
by a lactiferous duct
The Nipple Lactiferous sinus:
Stratified cuboidal epithelium

Sebaceous glands:
Not associated with hair follicles
 Changes in the mammary gland

During pregnancy
In non-pregnant During lactation alveoli are
alveoli proliferate
women the gland fully differentiated with
at the ends of
has an inactive abundant milk secretion.
ducts and prepare
duct system.
for milk secretion.
Nonpregnant Pregnant Postpartum

Mammary Gland
 The Mammary Gland during Pregnancy:
Proliferation of ducts and development of secretory alveoli

Alveoli surrounded by
Interlobular dense irregular intralobular loose connective tissue
connective tissue
http://faculty.tcc.edu/mmitchell/histo/mam2.htm
The lactating Mammary Gland:
Prolactin stimulates secretion of milk by alveolar cells

Lactiferous duct

Distended alveoli
Inactive
Active
Describe the hormonal regulation of
the mammary gland
• Estrogen- mesenchymal cell
proliferation especially adipose
cells
• Progesterone- maturation of
secretory capability
• Prolactin- initiation of secretion
• Oxytocin- milk ejection (tgt:
myoepithelium)
The Mammary Gland at Puberty and Pregnancy

Progesterone
stimulates the
formation of
alveolar buds
 Transition from development to
lactation
• Estrogen and progesterone inhibit the
lactogenic (milk producing) effect of prolactin
• The placenta is the primary source of these
hormones during the fetal period
• At birth, the placenta is extruded and the
levels of estrogen and progesterone drop
dramatically
• The lactogenic effect of prolactin is no longer
inhibited and milk production ensues
 Note
• If the entire placenta is not extruded
during birth, the remnants may produce
enough progesterone to inhibit milk
production.
 Anterior Pituitary

Acidophilic mammotrophs
 Sensory (neural) regulation of
hormones
Sensation from the nipple due to suckling:
• Inhibits the release of PIF (prolactin-
inhibiting factor): Result: more prolactin
available
• Stimulates the release of oxytocin which
causes contraction of myoepithelial cells
which results in milk ejection
Neurohormonal Reflex of
OXYTOCIN:

Sucking stimulus to CNS to

HYPOTHALAMIC CELLS
for OXYTOCIN secretion
in bloodstream, travels to
MAMMARY GLAND to
Stimulate MYOEPITHELIAL
MILK EXPRESSION, also
known as MILK LETDOWN.

At parturition, OXYTOCIN
stimulates UTERINE SMOOTH
MUSCLE contraction to
expel fetus and fetal membranes.
Netter’s
Describe the secretions of the
mammary gland
LIPIDS: LACTOSE:
released surrounded by a rim of produced in the Golgi and
cytoplasm (apocrine secretion) released into the alveolar lumen

PROTEINS:
IgA: (casein, lactalbumin)
produced by plasma secreted by a
cells is shuttled merocrine mechanism
across the epithelium
PROLACTIN:
First Milk= stimulates milk production
Colostrum OXYTOCIN:
stimulates milk release
by inducing contraction of
myoepithelial cells
Discuss lactational amenorrhea
and cessation of lactation
 Lactational amenorrhea
• ~50% of women do not experience menstrual
cycles during lactation
• High prolactin levels inhibit LH
• As a result they will not become pregnant
while nursing
• Used as a form of birth control in some
cultures
• Most effective during first 6 months after
pregnancy
 Cessation of lactation
• Neural stimulation from suckling promotes
prolactin release
• Cessation of suckling discontinues prolactin
release
• Glandular tissue becomes inactive
Discuss Breast cancer
 Breast Cancer
• Hormonal exposure (increases with age, early
menarche, late menopause)
• Genetic predisposition- BRCA1, BRCA2 (1 in 20
cases) HER2 (more aggressive cancers)
• Usually forms from ductal epithelium (ductal
carcinoma) or lobules (lobular carcinoma)
• Most common cancer in women (~30% of cancers
in females)
• 200,000 cases in the US per year (1,700 in males)
• 5 year survival rate about 4 out of 5
 Staging
• Stage 0 is a pre-cancerous or marker
condition, either ductal carcinoma in
situ (DCIS) or lobular carcinoma in situ (LCIS).
• Stages 1–3 are within the breast or regional
lymph nodes.
• Stage 4 is 'metastatic' cancer that has a less
favorable prognosis.
One use of lymph
node knowledge
Ductal carcinoma in situ
Ductal carcinoma
Ductal cancer metastasis
Invasive/in situ ductal carcinoma
http://www.sciencedaily.com/releases
/2011/04/110419164213.htm
• "There is an inherent connection between
inflammation and cancer," explained Li. "In
the case of breast cancers, a medical review
systematically tabulated IL-6 levels in various
categories of cancer patients, all showing that
IL-6 levels elevated up to 40-fold, especially in
later stages, metastatic cases and recurrent
cases."
Fallopian Tubes Uterus:
• 10 cm long and 1 cm in diameter • Muscular pear shaped organ on top of bladder
• Receive mature ovum from ovary • Linings: Perimetrium, Myometrium and Endometrium.
• Provide site for fertilization – Peri: peritoneal,
• Enter uterus through isthmus – Myo: Muscular,
– Endo: innermost
• Other end, is ampulla ends in infundibulum • Sphincter of uterus=Cervix
with fimbriae
• Not directly connected to ovaries

Vagina:
Ovaries: • Receptive organ for penis
• Produce Gamete • Opening between urethra, and anus.
• Rich in Glycogen and bacterial
• 3 cm long solid mass of cells conversion to lactic acid keeps vagina
acidic.
• Suspended in the abdomen
by ligaments and
mesenteries External genitalia
• Clitoris: Penis-like organ, chiefly erectile tissue.
• Labia: folds of skin
• L. Majora: Thick and is covered with pubic hair, protective
function
• L. Minora: thin membranes
Ovary- Summary
• Germinal epithelium (CA),
tunica albuginea, stroma,
medulla
• Ova, granulosa cells,
theca interna
• Follicular maturation,
ovulation, corpus luteum,
corpus albicans
• Production of estrogen
and progesterone
regulated by FSH and LH
 Fallopian tube - Summary
• Fallopian tube:
– Fimbrial end – to receive released
ovum
– Ampulla site of fertilization
• Mucosa consists of
– Thrown into numerous folds
especially in the ampulla.
– ciliated &
– secretory non-ciliated cells –
nutrient rich fluid
• Inner circular & outer longitudinal
muscle layer.
• Serosa – outermost covering
containing mesothelium.
 Uterus - Summary
• Endometrium – cyclical changes
• Proliferative – regrowth of stratum
functionalis
– simple tubular glands
– Mitosis seen
– Estrogen

• Secretory – prepares for

implantation
– coiled tubular, saw tooth
appearance
– Stroma and glands thicken
– Accumulation of glycogen
– Progesterone & estrogen

• Menstrual – shedding of stratum

functionale
– Abrupt withdrawal of estrogen and
progesterone in the absence of
implantation
– Stroma, RBC’s and leucocytes
 Endometrial Blood Supply
• Uterine arteries branch
to form arcuate arteries
in the myometrium.

• Arcuate arteries give

rise to straight arteries
in the str. Basalis &
coiled arteries in the
str. functionalis.

• Coiled arteries undergo

cyclical changes during
menses.
 Uterus Myometrium - Summary
• Thickest layer composed of
smooth muscle cells.
• Outer & inner longitudinal &
middle circular layers.
• Middle layer has many blood
vessels in it……stratum vasculare.
• Undergoes hyperplasia &
hypertrophy during pregnancy.
• Elevated oxytocin &
prostaglandin levels during
parturition stimulate
contractions.
 Cervix - Summary
• Wall is composed mainly of dense collagenous
tissue interspersed with elastic fibers & few smooth
muscle cells.
• Endocervix – lined by simple columnar
epithelium containing mucus secreting cells.
• Ectocervix – non keratinized stratified squamous
epithelium.
• Branched cervical glands secrete a serous fluid
close to ovulation.
- During pregnancy, these glands secrete a thick
viscous secretion that hinders the entry of sperms &
microorganisms.
- Thin secretion at the time of ovulation
 Vagina - Summary
 Mucosa – str sq non-
keratinized epithelium.

 Epithelial cells secrete

glycogen- converted to
lactic acid by bacteria –
acidic pH prevents
infection

 Muscular layer - poorly

defined circular & longitudinal
muscles interspersed elastic
fibers.

 Adventitia is fibroelastic
connective tissue.
 Key Word List Female Repro
Ovary, Uterine/Fallopian tube, uterus, broad ligament, peritoneum, fertilization, ovarian &
Uterine artery, fimbriae, infundibulum, ampulla, isthmus, intramural part, peg cells, ciliated
Cells, endometrium, Myometrium, perimetrium, GNRH, portal system, FSH, LH, estrogen,
progesterone, germinal epithelium, cortex, medulla, follicles, primary oocyte, primordial
follicle, primary follicle, zona pellucida, antral/secondary follicle, Graafian/mature follicle,
granulosa cells, theca cells, corpus luteum, ovulation, corpus albicans, atretic follicle, antrum,
Liquor folliculi, corona radiata, androstenedione, polycystic ovaries, amennorhea, ovarian
cancer, BRCA 1, 2, ovarian cycle, uterine/endometrial/menstrual cycle, meiosis, fertilization,
zona reaction, zygote, ectopic pregnancy, endometriosis, tubular glands, stratum functionalis,
stratum basalis, menarche, menopause, menstruation, proliferative phase, secretory phase,
menstrual phase, ‘saw-tooth’ appearance, endometrial cancer, biopsy, adenocarcinoma,
oxytocin, uterine fibroids, leiomyosarcoma, cervix, endocervix, ectocervix, transformation
Zone, SCJ (squamocolumnar junction) Pap smear, cervical glands, Nabothian cysts, cervical
Cancer, HPV, cervical neoplasia, vagina, glycogen, lactic acid,
Fallopian Tubes Uterus:
• 10 cm long and 1 cm in diameter • Muscular pear shaped organ on top of bladder
• Receive mature ovum from ovary • Linings: Perimetrium, Myometrium and Endometrium.
• Provide site for fertilization – Peri: peritoneal,
• Enter uterus through isthmus – Myo: Muscular,
– Endo: innermost
• Other end, is ampulla ends in infundibulum • Sphincter of uterus=Cervix
with fimbriae
• Not directly connected to ovaries

Vagina:
Ovaries: • Receptive organ for penis
• Produce Gamete • Opening between urethra, and anus.
• Rich in Glycogen and bacterial
• 3 cm long solid mass of cells conversion to lactic acid keeps vagina
acidic.
• Suspended in the abdomen
by ligaments and
mesenteries External genitalia
• Clitoris: Penis-like organ, chiefly erectile tissue.
• Labia: folds of skin
• L. Majora: Thick and is covered with pubic hair, protective
function
• L. Minora: thin membranes
Ovary- Summary
• Germinal epithelium (CA),
tunica albuginea, stroma,
medulla
• Ova, granulosa cells,
theca interna
• Follicular maturation,
ovulation, corpus luteum,
corpus albicans
• Production of estrogen
and progesterone
regulated by FSH and LH
 Fallopian tube - Summary
• Fallopian tube:
– Fimbrial end – to receive released
ovum
– Ampulla site of fertilization
• Mucosa consists of
– Thrown into numerous folds
especially in the ampulla.
– ciliated &
– secretory non-ciliated cells –
nutrient rich fluid
• Inner circular & outer longitudinal
muscle layer.
• Serosa – outermost covering
containing mesothelium.
 Uterus - Summary
• Endometrium – cyclical changes
• Proliferative – regrowth of stratum
functionalis
– simple tubular glands
– Mitosis seen
– Estrogen

• Secretory – prepares for

implantation
– coiled tubular, saw tooth
appearance
– Stroma and glands thicken
– Accumulation of glycogen
– Progesterone & estrogen

• Menstrual – shedding of stratum

functionale
– Abrupt withdrawal of estrogen and
progesterone in the absence of
implantation
– Stroma, RBC’s and leucocytes
 Endometrial Blood Supply
• Uterine arteries branch
to form arcuate arteries
in the myometrium.

• Arcuate arteries give

rise to straight arteries
in the str. Basalis &
coiled arteries in the
str. functionalis.

• Coiled arteries undergo

cyclical changes during
menses.
 Uterus Myometrium - Summary
• Thickest layer composed of
smooth muscle cells.
• Outer & inner longitudinal &
middle circular layers.
• Middle layer has many blood
vessels in it……stratum vasculare.
• Undergoes hyperplasia &
hypertrophy during pregnancy.
• Elevated oxytocin &
prostaglandin levels during
parturition stimulate
contractions.
 Cervix - Summary
• Wall is composed mainly of dense collagenous
tissue interspersed with elastic fibers & few smooth
muscle cells.
• Endocervix – lined by simple columnar
epithelium containing mucus secreting cells.
• Ectocervix – non keratinized stratified squamous
epithelium.
• Branched cervical glands secrete a serous fluid
close to ovulation.
- During pregnancy, these glands secrete a thick
viscous secretion that hinders the entry of sperms &
microorganisms.
- Thin secretion at the time of ovulation
 Vagina - Summary
 Mucosa – str sq non-
keratinized epithelium.

 Epithelial cells secrete

glycogen- converted to
lactic acid by bacteria –
acidic pH prevents
infection

 Muscular layer - poorly

defined circular & longitudinal
muscles interspersed elastic
fibers.

 Adventitia is fibroelastic
connective tissue.
 Key Word List Female Repro
Ovary, Uterine/Fallopian tube, uterus, broad ligament, peritoneum, fertilization, ovarian &
Uterine artery, fimbriae, infundibulum, ampulla, isthmus, intramural part, peg cells, ciliated
Cells, endometrium, Myometrium, perimetrium, GNRH, portal system, FSH, LH, estrogen,
progesterone, germinal epithelium, cortex, medulla, follicles, primary oocyte, primordial
follicle, primary follicle, zona pellucida, antral/secondary follicle, Graafian/mature follicle,
granulosa cells, theca cells, corpus luteum, ovulation, corpus albicans, atretic follicle, antrum,
Liquor folliculi, corona radiata, androstenedione, polycystic ovaries, amennorhea, ovarian
cancer, BRCA 1, 2, ovarian cycle, uterine/endometrial/menstrual cycle, meiosis, fertilization,
zona reaction, zygote, ectopic pregnancy, endometriosis, tubular glands, stratum functionalis,
stratum basalis, menarche, menopause, menstruation, proliferative phase, secretory phase,
menstrual phase, ‘saw-tooth’ appearance, endometrial cancer, biopsy, adenocarcinoma,
oxytocin, uterine fibroids, leiomyosarcoma, cervix, endocervix, ectocervix, transformation
Zone, SCJ (squamocolumnar junction) Pap smear, cervical glands, Nabothian cysts, cervical
Cancer, HPV, cervical neoplasia, vagina, glycogen, lactic acid,