Female reproductive system

 UTERUS
 Is thick walled interposed
between fallopian tubes and
vagina.
 Receives fertilized ovum, &
all embryonic & fetal
development occurs in it.
 Pear shaped, flattened in a
dorsoventral direction, 8 cm
4 cm, 2 cm.
 Female reproductive system
 Two main portions:
 (1) expanded upper portion,
body (corpus uteri),
 (2) lowermost, cylindrical
portion, neck (cervix), a part of
which projects into vagina as
the portio vaginalis.
 Fundus is rounded upper end of
body, from which fallopian
tubes extend.
 Isthmus is narrow zone of
transition between body &
cervix.
 Cervical canal passes through
cervix and communicates
above with uterine cavity at the
internal os, below with vagina
at external os.
 Female reproductive system
 Wall of uterus has three
layers:
 1.Outer layer, serosa
(perimetrium).
 2. Middle layer, muscularis
(myometrium).
 3. Inner layer, mucosa
(endometrium).
 Female reproductive system
 Perimetrium
 Is a typical serosa,
mesothelial cells supported
by a thin layer of c. tissue.
 Continuous on each side
with peritoneum of broad
ligament
 Is deficient over the lower
half of the anterior surface,
where lies urinary bladder.
 Here, in the absence of
peritoneum, myometrium is
covered by c. tissue, or
adventitia.
Female reproductive
system

 Myometrium
 Smooth muscle, 12 to 15 mm
in thickness.
 Muscle fibers are arranged
in bundles, separated by c.
tissue.
 During pregnancy fibers
increase greatly in size &
length.
 In spite of increase in
muscle mass, myometrium
is thinned during pregnancy.
 Female reproductive system
 Three layers of muscle may
be distinguished, although
ill-defined due to presence
of interconnecting bundles:
 1. An inner muscular layer,
mostly of longitudinally
arranged fibers, stratum
subvasculare
 2. A thick middle layer,
circular & oblique ms. fibers
with numerous b. vs,
stratum vasculare.
 3. An outer, thin, longitudinal
muscle layer immediately
beneath perimetrium,
stratum supravasculare
 Female reproductive
system

 Endometrium (mucosa),
 Firmly adherent to underlying
myometrium, goes under
cyclic changes in response to
ovarian secretory activity.

 These changes result in

partial destruction of mucosa,
leading to tissue necrosis &
hemorrhage,  menstruation.
 Female reproductive system
 Endometrium, epithelium is
invaginated to form tubular
uterine glands, has a thick lamina
propria & endometrial stroma.
 Is a simple col. with scattered
groups of ciliated cells.
 From surface epithelium, uterine
glands extend through full
thickness of stroma.
 Female reproductive system
 Uterine glands are simple
tubules that may branch
toward their basal ends,
separated from each other by
c. tissue of stroma.
 Stromal cells, are irregular,
stellate cells, have large,
ovoid nuclei.
 Lie within a framework of
reticular fibers, condensed
beneath epithelium to form a
basal lamina.
 Lymphocytes, granular
leukocytes, and macrophages
also are seen in stroma
 ENDOMETRIUM
BLOOD SUPPLY:
 Uterine Arteries: enter
myometrium.
 Arcuate Arteries: anterior and
posterior, ramify as they run
circumferentially in stratum
vasculare and approach the
anterior and posterior midline.
 Radial Arteries : pass radially
into endometrium and divides
into…….
 Female reproductive system
 At myometrial-endometrial
junction, radial arteries give
off basal or straight arteries
to supply basal part of
endometrium.
 Radial arteries continue
upward into endometrium as
highly coiled spiral arteries.
 Spiral arteries form a rich
capillary bed in superficial
portion of the endometrium
and thin-walled dilated
vascular units, the lacunae.
 Female reproductive system

 Veins form network of venules

& sinusoids in endometrium.
 drains to large veins in
myometrium.
 Lymph vessels form plexuses
throughout layers of uterus.
 Myelinated nerve fibers form
a plexus beneath epithelium.
 Unmyelinated nerve fibers
supply b. vs & ms. bundles.
 Cyclic Changes in
Endometrium Female reproductive
 Four stages, and each stage system
passes gradually into the next.
 1. Proliferative (follicular)
stage, shows follicular growth
and secretion of estrogens.
 2. Progestational (luteal) stage,
associated with an active
corpus luteum, secreting
progesterone.
 3. Ischemic (premenstrual)
stage, when there is
interruption of blood flow in
the coiled (spiral) arteries.
 4. Menstrual stage, during
which there is external
menstrual discharge.
 Female reproductive system

 Proliferative (Follicular) Stage.

Begins at end of a menstrual
flow with rapid regeneration of
endometrium.

 Epithelial cells from remnants

of torn glands move over
broken surface of mucosa.
 Female reproductive system

 Mitoses occur in cells of

glands & endometrial stroma.
 Mucosa increases in thickness
from 1 mm to 2 mm or more.
 Glands proliferate, lengthen
rapidly, & are closely packed.
 Lamina propria rebuilds due to
mitotic activity of stromal cells
and accumulation of ground
substance
 Female reproductive system
 Lumina of glands widen, &
become wavy in outline.
 Glycogen accumulates in
basal region of glandular
cells.
 Coiled arteries grow into the
regenerating tissue.
 Proliferative phase extends
until about middle of cycle
(day 14 of a 28-day cycle).
Female reproductive
system
 Progestational (Secretory, or
Luteal) Stage. Occurs in
response to formation of
corpus luteum (after
ovulation), which secretes
progesterone.
 Endometrium increases in
thickness to 4 mm or more.
 There is hypertrophy of
gland cells & increase of
edema fluid.
 Glands swell and secrete
profusely.
 Female reproductive
system

 Secretion moves to apical

zone of cells & then  lumen.
 Secretion is thick, mucoid,
rich in glycogen.
 Glands become tortuous,
wide lumen. Coiled arteries
grow nearly to the surface.
 At end of this stage, stromal
cells enlarge to become
decidual cells, with numerous
free ribosomes, abundant
GER, and scattered glycogen.
 Female reproductive system
 At this stage, endometrium shows
three zones:
 1. Compact layer, near surface,
narrow zone. shows straight
necks glands with little edema.
 2. Spongy layer, thick, with
tortuous portions of glands,
edematous lamina propria.
 Compact and spongy layers
together  functional layer, is lost
at menstruation & parturition
 3. Basal layer, deepest, has blind
ends of glands. is not lost at
menstruation or parturition.
 Female reproductive system
 Ischemic (Premenstrual)
Stage.
 Occurs 13 to 14 days after
ovulation, in response to a
reduction in progesterone
levels, with early involution
of corpus luteum.
 Coiled (spiral) arteries
constrict intermittently.
 Functional layer becomes
pale & shrinks.
 Stroma increases in density.
However, blood continues to
flow into basal layer of
endometrium through
straight arteries.
 Female reproductive system

 Menstrual Stage.
 Functional layer necrosis &
is shed.
 After few hours, spiral
arteries relax, their walls
break, blood is added to
secretion of glands &
necrotic endometrial tissue.
 Patches of tissue separate &
are lost. Blood oozes from
veins exposed by shedding
process.
 Female reproductive system
 Menstrual discharge thus
contains arterial & venous
blood, disintegrated
epithelial & stromal cells,&
glandular secretions.
 Finally, entire functional
layer is lost, leaving a raw
surface.
 Surviving basal layer
remains intact, surface
epithelium is restored after
menstrual discharge ceases.