chapter 28 lecture 7 is the female reproductive system anatomy the uterus is about the size of an inverted pair it's also called the womb and its functions include the transporter spermatozoa menstruation implantation of fertilized ovum development of fetus during pregnancy and labor it has four subdivisions fundus which is the hump at the top and body which makes up most of it the east must which is a narrowing area and the cervix so here we can see here's the fundus the body makes up most of it excuse me um the um cervix is is the tissue down here now there are two areas in here that are um narrowings one is the internal os and the other is the external os okay the cervix is tissue the internal and external us are openings okay so if on the lab practical i'm pointing at the tissue as cervix if i'm pointing at the the opening the hole it's either internal loss or external loss um up in here is the uterine cavity and down here is the cervical canal the vagina has ridges in it it's a tube it has ridges in it and called rugi just like we saw with the stomach except these ridges don't expand the way that they do in the stomach the here you can see the ligaments on the outside of the uterus that help to hold it in place as well as the three layers of the uterus we have the endometrium which is the innermost layer then a thick layer of muscle called the myometrium and then on top of it connective tissue called the perimetrium so it's endo myo and peri uterus is about three inches long by two inches wide and about an inch thick the uterus normally projects anterior and superior so it's called anti-flexion but if um in older women particularly women who've had a lot of children the uterus the ligaments that hold it in place can stretch and the uterus can slip out of position and actually go down through the vagina this is called prolapse and uterine prolapse can be first degree which is just it's coming down a little bit second degree where you can you can see it more easily you can feel it more easily and then third degree where the entire uterus um has uh it comes out through the vagina through the vaginal opening so the treatment generally is to kind of tie it back in place the way it was um but it depends on how bad it is what what's actually done so the uterus sits right by the urinary bladder and there's anti-flexion so it projects anteriorly and superiorly over the urinary bladder and then also retroflex flexion because it tilts it's not straight across it has a tape to it as i said there's three layers we have the parametrium myometrium and endometrium the endometrium and the myometrium has three layers of muscle the endometrium has two layers as well there's the stratum basalis which gives rise to uh the stratum functionalis strong functionalist is the layer that's shed during menstruation so during um a woman's menstrual cycle this whole layer is building up during the uterine cycle it's building up building up building up in preparation for the implantation of a fertilized egg but if an egg isn't implanted then it's shed and then it starts the process over again so here you can see the myometrium the stratum basalis and then the stratum functionalis the stratum functionalis has glands in it blood vessels and we'll look at this more um in more detail in a little bit it's this a stroma has a stream of connective tissue and glands remember stroma structural parenchyma is functional the uterine arteries branch out as the arcuate arteries and the radial arteries it's important that the uterus has a very good blood supply because of having to supply the baby a growing baby with with nutrients and oxygen and take away the waste during pregnancy there are so we have the uterine artery here then we have the arcuate arteries as well as the radial arteries and in the stratum functionalis we have spiral arteries and the spiral arteries you know actually do kind of spiral up when the the stratum functionalis is shed those spiral arteries um are what provide the blood that accompanies menstruation the tissue so menstrual flow would consist of the tissue here as well as blood that comes from bleeding from these spiral arteries when the spiral arteries constrict because of hormones they cut off the blood supply to this area and the cells die and shed and then when they do the these arteries rupture as well and that's what releases the blood a hysterectomy is a surgical removal of the uterus and there's lots of different reasons women get hysterectomies certainly one of the most common is endometriosis and we'll talk about that a little bit later ovarian cysts can also be a problem excessive bleeding cancer the cervix or cancer of the uterus or the ovaries may all uh give indications that a hysterectomy should be performed this is not a small surgery this is major surgery and it has quite a long recovery time mostly it's done laparoscopically now through the belly button but you can expect a woman who has a hysterectomy to be out excuse me out um recuperating for about six to eight weeks following the procedure um a complete hysterectomy is the uterus plus the cervix radical hysterectomy is uterus the tubes the ovaries part of the vagina the pelvic lymph nodes and supporting ligaments and that's generally what happens if there's cancer this is the most common gynecological operation