1. MATERNAL AND CHILD HEALTH NURSING
ANATOMY AND PHYSIOLOGY OF THE FEMALE REPRODUCTIVE SYSTEM
Lecturer: Mark Fredderick R. Abejo RN,MAN
__________________________________________________________________________
FEMALE REPRODUCTIVE SYSTEM
I. External Genitalia (Vulva/Pudendum)
MONS PUBIS
-Soft fatty tissue, lies directly over symphysis pubis & becomes covered w/ hair just before puberty
It is where the pubic hair grows.
LABIA MAJORA LABIA MINORA
-W/ hair outside but smooth inside
-Thin, pink, smooth, hairless, extremely
fatty skin folds from MONS PUBIS to
sensitive to pressure, touch and
PERINEUM and protects the labia minora
temperature. The glands of labia minora
, urinary meatus & vagina
lubricate the vulva. It is formed by the
frenulum and the prepuce of the clitoris
which is also very sensitive because it has
rich nerve supply.
Covers and protects VESTIBULE
VAGINAL INTROITUS
CLITORIS
URETHRAL MEATUS TWO GLANDS THAT LUBRICATE DURING SEX -Composed of glans &
shaft that is partially
-Entrance of urethra,  1. SKENES GLANDS (Paraurethral Glands): lubricates the covered by prepuce
opens approximately external genitalia
1cm below clitoris  2. Bartholins Gland (Vulvovaginal Glands): alkaline in ph, -GLANS is small and
helps improve sperm survival round and is filled w/
many nerve endings and
 Doderleins Bacillus: causes the vaginal ph to be acidic, which rich blood supply
forms lactic acid
-SHAFT is a cord
Hymen: the elastic tissue, symbolizes virginity. Thorn & connecting the glans to
bloody during forced sexual act the pubic bone; w/in it is
the major blood supply
 RUGAE: thick folds of membranous stratified epitheliums on of clitoris
the internal wall of the vagina, capable of stretching during
the birth process, to accommodate the delivery of the fetus.
MCHN Mark Abejo

2. II. Internal Genitalia
ORGAN FUNCTIONS STRUCTURE NOTES
Divisions of the Uterus Layers of the Uterus:
Pear shape muscular
organ which has I. Cervix : lowest portion , 1/3 of the 1. Endometrium:
Uterus three(3) main total uterus inner layer, most
functions vascular,
1. receive the ova External Os: where the nurse obtain SHED DURING
from the fallopian the Pap Smear to the MENSTRUATION.THE
tube SQUAMOCOLUMNAR JUNCTION NON-PREGNANT
2. provide a place for cells. This is where the cerclage is UTERUS
implantation of the done for incompetent cervix.
ova 2. Myometrium:
3. Nourishment for Namely: LARGEST PORTION
fetal growth. A. Shirodkar Barter Suture- permanent EXPELS THE FETUS
closure of the internal cervical os, DURING THE BIRTH
until the 38th week after which is PROCESS. The part
separated – TREATMENT FOR that contracts during
INCOMPETENT CERVIX and hemorrhage. Prevents
PREVIOUS ABORTION. hemorrhage.
B. Mc Donalds or Purse String
Cerclage of the external os: usually 3. Perimetrium:
Normal spontaneous delivery will be Outer most layer. Aids
done for the patient. for support & added
strength.
II. Isthmus: shortest portion of the
uterus, the portion that is cut when the
fetus is delivered during cesarean
birth.
III. Fundus: Upper segment, this is the
most vascular, the portion also where
palpation is done. Also touching it by
the tip of the fingers during contraction
is the best method to determine the
intensity of contractions during labor.
Bandl’s Ring ( Pathological Retraction
Ring): seen in Prolonged Labor or
Dystocia
MCHN Mark Abejo

3. Fallopian Site of fertilization of 4 Parts of the Fallopian tubes Fallopian tubes
tubes the ovum with perm 1. Interstitial : lies within the uterine transport the ova from
wall the ovaries to the
2. Isthmus: the portion that is cut or uterus.
sealed in TUBAL LIGATION
( site for sterilization)
3. Ampulla: where fertilization occurs ,
this is also the LONGEST portion,
frequent site for ectopic pregnancy.
4. Infundibular: covered by the
Fimbriae cells that help guide the ova
to the Fallopian Tube.
Ovaries Ovulation (the release Pair of follicle containing organs on The ovaries lie in the
of an ovum); Steroid the other side of the uterus upper pelvic cavity.
hormone production Ovaries: 4 by 2 cm in diameter, 1.5
cm thick. Responsible for
the production,
Maturation, and
discharge of ova
 Secretion of estrogen
and progesterone
 Cortex of the Ovaries; developing
and graafian follicles are found here.
Vagina Organ for coitus; Tube extending from the introitus to Fibromuscular organ
Birth canal; Conduit cervix lined with mucus
for menstrual flow. membrane
III. THE PELVIS
A. Structures
1. Two Os Coxae or Innominate Bones- it is made up of:
a. Ilium- is the upper, extended part which has a curved upper border called Iliac Crest.
b. Ischium- is the under part which when sitting, the body rests on the ischial tuberosities and an
important landmark is the ischial spines.
c. Pubis- is the front part that joins to form an articulation of the pelvis called the Symphysis Pubis.
2. Sacrum- a wedge-shaped that forms the back part of the pelvis that consists of 5 fused vertebrae, the first
having a prominent upper margin called the Sacral Promontory; it articulates with the ilium and sacroiliac
joint.
3. Coccyx- is the lowest part of the spine with a degree of movement between the sacrum and coccyx which is
made possible by the third articulation of the pelvis called Sacrococcygeal joint which allows room for
delivery of the fetal head
B. Divisions
1. False Pelvis- the superior half formed by the ilia offers landmarks for pelvic measurements; it supports the
growing uterus during pregnancy and directs the fetus into the true pelvis near the end of gestation.
2. True Pelvis- the inferior half formed by the pubes in front, the ilia and the ischia on the sides and the
sacrum and coccyx behind; it is made up of three parts:
a. Inlet- the entrance way to the true pelvis wherein its transverse diameter is wider than its
anteroposterior diameter, thus
Transverse diameter = 13.5 cm
Antero-posterior diameter = 11 cm
Right and left oblique diameter = 12.75 cm
b. Cavity- the space between the inlet and outlet
c. Outlet- the inferior portion of the pelvis bounded in the back by the coccyx, on the sides by the ischial
tuberosities and in front by the inferior aspect of the symphysis pubis and the pubic arch; its
anteroposterior diameter is wider than its transverse diameter
C. Types
1. Gynecoid- “normal” female pelvis where inlet is well rounded forward and back; it is most ideal for
childbirth.
2. Anthropoid- transverse diameter is narrow, AP diameter is larger than normal.
3. Platypelloid- inlet is oval, AP diameter is shallow.
4. Android- “male” pelvis where inlet has a narrow, shallow posterior portion and pointed anterior portion
MCHN Mark Abejo

4. D. Types of Pelvic Ligaments
1. Round: remain lax during non-pregnancy & become HYPERTROPHIED & elongated during pregnancy.
2. Cardinal: chief uterine supports
3. Broad ligaments: drapes over the fallopian tubes, uterus & ovaries
D. Measurements
1. External- suggestive only of pelvic size
a. Intercristal- distance between the middle points of the iliac crests with an average= 28 cm.
b. Interspinous- distance between the anterosuperior iliac spines with an average= 25 cm.
c. Intertrochanteric- distance between the trochanters of the femur with an average= 31 cm.
d. External Conjugate or Baudelocque’s- the distance between the anterior aspect of the symphysis
pubis and depression below L5 with an
average= 18-20 cm.
2. Internal- gives the actual diameter of the inlet and outlet
a. Diagonal Conjugate- distance between the sacral promontory and inferior margin of the symphysis
pubis with an average= 12.5 cm.
b. True Conjugate or Conjugata Vera- distance between the anterior surface of the sacral promontory
and the superior margin of the symphysis pubis; it is very important measurement because it is the
diameter of the pelvic inlet with an average=10.5-11 cm.
c. Bi-ischial diameter or Tuberischii- transverse diameter of the pelvic outlet and measured at the level
of the anus with an average= 11 cm.
MALE REPRODUCTIVE SYSTEM
External Features:
2 Erectile Tissues in the penis:
a. Corpus cavernosa
b. corpus spongiosum
Internal Features:
Epididymis: totals 20 ft. WHERE SPERMS ARE STORED
Vas / Ductus Deferens: carries the sperm to the inguinal canal
Seminal Gland / Vesicle: Secretes SEMEN
Prostrate Gland: secretes SEMEN also.
Cowpers Gland/ Bulbo-urethral: secretes also semen
SEMEN sources: 1. Prostrate gland : 60%
2. Seminal vesicles : 30%
3. Epididymis : 5%
4. Cowpers : 5%
MCHN Mark Abejo

5. Accessory Structures
Mammary Gland
III. Mammary Glands
MAMMARY GLANDS
-2 mammary glands located on each side of chest wall
-Each breast 15-20 lobes containing clusters of ALVEOLI
ACINI DUCTULES NIPPLES
-Saclike end of -Exit alveoli & join -Sinuses merge into
the glandular to form larger canals openings on nipple
system LACTIFEROUS
-Lined both w/ DUCTS
epithelial cells -During lactation,
that secrete milk flows to the
colostrum( alveoli and then thru
which is rich in the duct system
IgA) & milk & further going to the
w/ muscles that balloon like storage
expel milk sacs called
LACTIFEROUS
SINUSES
MCHN Mark Abejo

6. Female Reproductive Hormones
HORMONES
Lutenizing Estrogen
Follicle Stimulating Hormone -Produce from ovaries,
Hormone -When follicle is adrenal cortex, and Progesterone
*Stimulates ripe and mature, placenta *Produce from corpus
Graafian follicle to triggers follicular -Assists in maturation of luteum, placenta
mature and resulting rupture and release Graafian follicle -Secretes thick/viscous
in increase levels of of ovum -Stimulates thickening of cervical secretions.
estrogen -Peaks at 16-18 endometrium.
hours before Other functions A. Preparation of the
ovulation. uterus to receive a
-stimulates a. Contracts smooth fertilized ovum
ovulation & muscles Inhibits the B.  Decrease uterine
development of secretion of FSH motility/
corpus luteum b. Responsible for the contractility during
increase vaginal pregnancy
secretion in the vagina C.  Increases basal
(LEUKORRHEA) metabolism
c. Thickens the D. Enhances
endometrium placental growth
d. SUPPRESSES THE E.  Stimulates the
FSH & Prolactin dev’t of acini cells
e. Responsible for the in the
dev’t of 2ndary sex breast(major cells
characteristics in for breast milk)
females  Increase the
f. Stimulates uterine endometriums
contractions & supply of
smuscular peristalsis glycogen, oxygen
of the fallopian tubes & amino acids for
for the passage of the maintaining
ovum to the uterus. pregnancy
g. Mildly increases Na &
water reabsorption
h. Stimulates LH
secretion &
responsible for the
production of cervical
mucus associated in
ferning & spinnbarkeit
LUTENIZING HORMONE AND ESTROGEN peak immediately before ovulation
 Most women ovulate two weeks before the beginning of the next period.
Other Reproductive Hormones
1. Lactogenic Hormone (Prolactin)
-Stimulates lactation
2. Melanocyte Stimulating Hormone
-Responsible for the linea nigra & chloasma in pregnancy
-Secreted by the anterior pituitary hormone MELANOTROPIN
-Will end on the 2nd month of pregnancy
3. Human Chorionic Gonadotropin
-Increases in nausea and vomiting
 Responsible for Hyperemesis Gravidarum
MCHN Mark Abejo

7. MENSTRUATION
Menarche: 1st menstrual period, usually age 12, but may begin as early as 9.
Menopause: cessation of menstrual cycle that occurs normally from 40 & 55 y.o.
Menstrual Cycle:
1. Menstrual Phase ( 1 – 14 days)
-Corpus luteum dies.
-Progesterone & Estrogen vanishes- triggers/stimulate the production of FSH.
-Endometrium degenerated/ sheds- menstruation occurs.
Sexual intercourse during menstruation is not harmful.
2. Proliferative Phase- Estrogen Phase ( 6 – 14 days) Graafian Follicle: Estrogen
Anterior Pituitary Gland secretes FSH stimulates the development of
the Graafian follicle (secretes Estrogen) suppresses FSH &
stimulates LH LH stimulates ovulation Increase Estrogen
kills/decreases FSH
3. Secretory Phase (15 to 21 days) Progesterone Phase (Corpus Luteum: Progesterone)
Other Books it is called: Luteal Phase
After Ovulation-----release of mature ovum from the Graafian follicle-----
Graafian Follicles die and replaced by Corpus Luteum-----secretes
progesterone Functions of Progesterone:
4. Pre-Menstrual Phase (22 days to 28 days)
-If fertilization does not occur, corpus luteum begins to die
-Progesterone & Estrogen decreases
-Endometrium degenerates
-Menstruation stops during pregnancy because there is decrease secretion of
hormones by the ovary.
OVARIAN CYCLE
(ACORDING TO HORMONAL ACTIVITY)
0 7 14 21 28
DEVELOPING FOLLICLES OVULATION CORPUS LUTEUM LUTEAL
REGRESSION
FOLLICULAR PHASE LUTEAL PHASE
Ovarian follicles mature under influence -mittelshmerz
of FSH and estrogen -cervical changes
LH surge causes ovulation -increase BBT
ENDOMETRIAL/UTERINE CYCLE
(Described by varying thickness of the endometrium)
MENSTRUAL PROLEFERATIVE SECRETORY PHASE
PHASE -Formation of corpus luteum PRE-
PHASE
-Menstruation -Increase progesterone MENSTRUAL
-Decrease estrogen -NO FERTILIZATION; corpus PHASE
-Hypothalamus
-Decrease luteum degenerates 10 days after -endometrium
secretes FSH
progesterone -APG (anterior ovulation degenerates
pituitary gland) -WITH FERTILIZATION;
secretes FSH concepts produces HCG that
-Maturation of sustains life corpus luteum;
Graafian follicle progesterone level is maintained at
-Increased estrogen high level
-Hypothalamus stops -Progesterone level decreases
FSH & starts LH -Corpus albicans
-APG stops FSH & Sloughing off of endometrial
starts LH secretion lining
MCHN Mark Abejo

8. Menstrual Cycle
Menstrual Disorders
Dysmenorrhea Premenstrual Amenorrhea Menorrhagia Metrorrhagia
Syndrome
- Primary- -Edema of Primary- -Excessive or - Irregular
No known cause lower Never prolonged bleeding in
- Secondary- extremities menstruated; bleeding between
May be caused by - Abdominal structural/congenit periods
tumor/inflammatory bloating al abnormality
conditions - Weight gain Secondary–
- Headache Cessation of
-Breast menstruation
tenderness
- Depression
- Crying
- Loss of
concentrati
on
MCHN Mark Abejo