2 reproductive system
—commonly designated the _________—includes all structures visible externally from the pubis to the perineal body. This includes the mons pubis, labia majora and minora, clitoris, hymen, vestibule, urethral opening, and greater vestibular or Bartholin glands, minor vestibular glands, and paraurethral glands
vulva or pudenda
Also called the ____, literally, “the mountain of Venus”—suitably named the ancients thought, because Venus was the goddess of love.
This fat-filled cushion overlies the symphysis pubis.
mons veneris
After puberty, the skin of the mons pubis is covered by curly hair that forms the escutcheon. In women, it is distributed in a triangular area, the base of which is formed by the upper margin of the symphysis. In men and in some hirsute women, the ______ is not so well circumscribed and extends onto the anterior abdominal wall toward the umbilicus.
escutcheon
These structures vary somewhat in appearance, principally according to the amount of fat they contain. The outer surface of the labia majora is covered with hair, whereas on their inner surface, it is absent. In addition, sweat and sebaceous glands are abundant. Embryologically, the labia majora are homologous with the male scrotum.
Labia Majora (major lips)
Each is a thin fold of tissue, which lies medial to each labia majora. They are supplied with a variety of nerve endings and are extremely sensitive.
Labia Minora (minor lips)
The labia minora extend superiorly, where each divides into two lamellae. The lower pair fuses to form the ______1______, and the upper pair merges to form the __2___. Inferiorly, the labia minora extend to approach the midline as low ridges of tissue that fuse to form the ___3____-.
- frenulum of the clitoris
- prepuce
- fourchette
This principal female erogenous organ is the erectile homologue of the penis. It projects downward between the labia minora,
Clitoris
The pair of Bartholin glands, also termed greater vestibular glands, are the major glands. They lie inferior to the vestibular bulbs and deep to the inferior ends of the bulbocavernosus muscle on either side of the vaginal opening. Their ducts are 1.5 to 2 cm long and open distal to the hymenal ring at 5 and 7 o'clock. Following trauma or infection, either duct may swell and obstruct to form a cyst or if infected, an abscess.
Vestibular Glands
The ______1_____ are collectively an arborization of glands whose ducts open predominantly along the entire inferior aspect of the urethra. The two largest are called _______2_____, and their ducts typically lie distally near the urethral meatus. Inflammation and duct obstruction of any of the paraurethral glands can lead to urethral diverticulum formation. The ____3______ are shallow glands lined by simple mucin-secreting epithelium and open along Hart line.
1. paraurethral glands
2. Skene glands
3. minor vestibular glands
The vaginal opening is rimmed by the ____ or its remnants. In adult women, the hymen is a membrane of varying thickness that surrounds the vaginal opening more or less completely. It is composed mainly of elastic and collagenous connective tissue. Imperforate hymen is a rare lesion in which the vaginal orifice is occluded completely, causing retention of menstrual blood .
Vaginal Opening and Hymen
As a rule, however, the hymen is torn at several sites during first coitus. Identical tears may occur by other penetration, for example, tampons used during menstruation. Over time, the hymen consists of several nodules of various sizes, also termed ________-.
hymenal caruncles
no hymenal opening; it will require minor surgery if it has not corrected itself by puberty to allow menstrual fluids to escape.
Imperforate:
sometimes confused for imperforate, the hymenal opening appears to be nonexistent, but has, under close examination, small openings.
Cribriform, or microperforate:
the hymenal opening has one or more bands of tissue extending across the opening.
Septate:
normal hymen
annular
after childbirth hymen
parous introitus
This musculomembranous structure extends from the vulva to the uterus and is interposed anteriorly and posteriorly between the bladder and the rectum.
Vagina
Anteriorly, the vagina is separated from the bladder and urethra by connective tissue—the ______1______. Posteriorly, between the lower portion of the vagina and the rectum, there are similar tissues that together form the ____2______-. The upper fourth of the vagina is separated from the rectum by the 𝙧𝙚𝙘𝙩𝙤-𝙪𝙩𝙚𝙧𝙞𝙣𝙚 𝙥𝙤𝙪𝙘𝙝, also called the ___________.
1. vesicovaginal septum.
2. rectovaginal septum
3. cul-de-sac of Douglas
is the diamond-shaped area between the thighs. The anterior, posterior, and lateral boundaries of the perineum are the same as those of the bony pelvic outlet: the pubic symphysis anteriorly, ischiopubic rami and ischial tuberosities anterolaterally, sacrotuberous ligaments posterolaterally, and coccyx posteriorly.
Perineum
The nonpregnant________ is situated in the pelvic cavity between the bladder anteriorly and the rectum posteriorly. Almost the entire posterior wall of the uterus is covered by 𝙨𝙚𝙧𝙤𝙨𝙖, that is, visceral peritoneum.
Uterus
The uterus is described as being_____1________. It consists of two major but unequal parts: an upper triangular portion—the ____2____-, and a lower, cylindrical portion—the ____3_____, which projects into the vagina.
1. pyriform or pear-shaped
2. body or corpus
3. cervix
The ________- is that portion of the uterus between the internal cervical os and the endometrial cavity. It is of special obstetrical significance because it forms the lower uterine segment during pregnancy.
isthmus
The fallopian tubes, also called ____1_____, emerge from the 𝙘𝙤𝙧𝙣𝙪𝙖 of the uterus at the junction of the superior and lateral margins. The ____2_____ is the convex upper segment between the points of insertion of the fallopian tubes.
1. oviducts
2. 𝙛𝙪𝙣𝙙𝙪𝙨
The uterus of adult nulliparous women measures ___1____- cm in length as compared with __2_____ cm in multiparous women. In nonparous women, the uterus averages ___3____- g, whereas in parous women it averages __4__ g or more. In nulliparous women, the fundus and cervix are approximately equal length, but in multiparous women, the cervix is only a little more than a third of the total length.
1. 6 to 8
2. 9 to 10
3. 50 to 70
4. 80
The cervical portion of the uterus is fusiform and open at each end by small apertures—the internal and external os.
Cervix
The portion of the cervix exterior to the external os is called the _______ and is lined predominantly by nonkeratinized stratified squamous epithelium. In contrast, the endocervical canal is covered by a single layer of mucin-secreting columnar epithelium, which creates deep cleftlike infoldings or "glands." Mucus produced by the endocervical epithelia changes during pregnancy. It becomes thick and forms a mucus plug within the endocervical canal.
ectocervix
This mucosal layer lines the uterine cavity in nonpregnant women. It is a thin, pink, velvet-like membrane, which on close examination, is perforated by many minute ostia of the uterine glands. The _________- normally varies greatly in thickness. It is composed of surface epithelium, glands, and interglandular mesenchymal tissue in which there are numerous blood vessels.
Endometrium
This layer comprises most of the uterus. It is composed of bundles of smooth muscle united by connective tissue in which there are many elastic fibers. The interlacing myometrial fibers that surround the myometrial vessels are integral to control of bleeding from the placental site during the third stage of labor.
Myometrium
Several ligaments extend from the lateral surface of the uterus toward the pelvic sidewalls and include the ____________
round
broad,
cardinal ligaments.
The _______- originate somewhat below and anterior to the origin of the fallopian tubes. Each round ligament extends laterally and downward to the inguinal canal, through which it passes to terminate in the upper portion of the labium majus. Sampson artery, a branch of the uterine artery, runs within this ligament.
round ligaments
The _______ are composed of two winglike structures that extend from the lateral uterine margins of the uterus to the pelvic sidewalls. They divide the pelvic cavity into anterior and posterior compartments. Each broad ligament consists of a fold of peritoneum termed the anterior and posterior leaves.
broad ligaments
Each ___________ extends from an attachment posterolaterally to the supravaginal portion of the cervix and inserts into the fascia over the sacrum.The ligaments are composed of connective tissue, small bundles of vessels and nerves, and some smooth muscle. They are covered by peritoneum and form the lateral boundaries of the pouch of Douglas.
uterosacral ligament
is a permanent form of birth control. During this surgical procedure, the fallopian tubes are cut, tied, blocked, or removed to prevent pregnancy for the rest of a woman's life
Tubal ligation
Fallopian Tubes- These tubular extensions from the uterus vary in length from 8 to 14 cm, and each tube is divided into an
interstitial portion, isthmus, ampulla, and infundibulum and fimbria
The lower portion of this peritoneum forms the anterior boundary of the ______1_____. Only the upper portion of the anterior wall of the uterus is so covered. The peritoneum in this area reflects forward onto the bladder dome to create the __2______. The lower portion of the anterior uterine wall is united to the posterior wall of the bladder by a well-defined loose layer of connective tissue. This is the _____3______.
1. recto-uterine cul-de-sac, or pouch of Douglas
2. vesicouterine pouch
3. vesicouterine space
finger like ciliated projection that capture the ovum from the surface of the ovary
fimbriae
funnel shape opening near the ovary to which fimbriae are attached
infundibulum
the widest section of the uterine tubes commonly the sites of fertilization
ampulla
the segment closest to the uterus
isthmus