HUMAN ANATOMY & PHYSIOLOGYII
Dr. Ngong N. Amet (PT)
MSc. HSM
BSc in Rehabilitation Medicine
St. Mary’s University College _ Juba
Higher Diploma in Medical Education
College of Physicians & Surgeons _ Juba
1
Objectives
• Define reproductive system
• Describe the main structure of the external genitalia
• Explain the structure and functions of internal
genitalia
• Draw and label the male and female reproductive
organs
• Describe the process of ovulation and the hormones
that control it
• Outline the changes that occur at puberty
• Describe the structure and function of female breast.
2
HUMAN REPRODUCTIVE SYSTEM
Introduction: The human reproductive system
usually involves internal fertilization by sexual
intercourse.
• During this process, the male inserts his erect
penis into the female's vagina and ejaculates
semen, which contains sperm.
• The sperm then travels through the vagina
and cervix into the uterus or fallopian tubes
for fertilization of the ovum.
3
Introduction cont…
• Upon successful fertilization and implantation,
gestation of the foetus then occurs within the
female's uterus for approximately nine
months, this process is known as pregnancy in
humans.
• Gestation ends with birth, the process of birth
is known as labour.
4
Introduction cont…
• Labour consists of the muscles of the uterus
contracting, the cervix dilating, and the baby
passing out of the vagina (the female genital
organ).
• Human's babies and children are nearly
helpless and require high levels of parental
care for many years.
5
Introduction cont……
• One important type of parental care is the use
of the mammary glands in the female breasts
to nurse the baby.
Functions of female reproductive system
1. Formation of ova
2. Reception of spermatozoa
3. Provision of suitable environment for
fertilization and fetal development
6
Functions cont….
4. Parturition (child birth)
5. Lactation which provides nourishment for the
baby in its early life
Functions of male reproductive system
• Production of spermatozoa
• Transmission of sperm to the female
7
HUMAN REPRODUCTIVE SYSTEM
8
Male external genitalia
9
Female external genitalia(vulva)
10
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Reproduction
• Reproduction is a process by which living thing
produce their offspring through sexual or
a sexual reproduction.
• Sexual reproduction is a form of reproduction
which involves the fusion of male and female
reproductive cells to create a zygote in a
process called fertilization.
12
Female reproductive system
• Female reproductive organs or genitalia include; eternal
and internal genitalia
External genitalia consists of;
• Labia majora
• Labia minora
• Clitoris
• Vagina orifice
• Vestibule
• Hymen vestibular glands(bartholin’s glands)
• Urethral opening
13
Female external genitalia(vulva)
14
External genitalia
• Labia majora; the two large folds forming the
boundary of the vulva, it composed of skin, fibrous
tissue, fat and large numbers of sebaceous glands.
• Labia minora; these are two smaller folds of skin
between labia majora, containing numerous
sebaceous glands, between the labia minora is the
vestibule.
• Clitoris; this corresponds to penis in the male,
contains sensory nerve endings and erectile tissue.
15
External genitalia cont…….
• Hymen; is a thin layer of mucous membrane
that partially occludes the opening of vagina,
it is normally incomplete to allow passage for
menstrual flow.
• Vestibular glands (barttholin’s glands) this
situated one on each side near vagina
opening, they secrete mucus that keeps the
vulva moist.
16
Blood, lymph and nerve supply
• Arterial from internal pudendal arteries that branch
from internal iliac arteries and external pudendal
arteries a branch of femoral arteries.
• Venous drainage; a large plexus which drains into
internal iliac veins.
• Lymph drainage; through superficial inguinal nodes.
• Nerve supply; by branch from pudendal nerves.
NB: perineum; is the area that extends from labia
minora to the anal canal.
17
Female internal genitalia
18
Female internal genitalia
The internal organs of female reproductive
system lie in the pelvic cavity and consists of;
• Vagina
• Uterus
• Two uterine tube
• Two ovaries
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Vagina
• It is a muscular tube lined with stratified
squamous epithelium
• Connecting the external and internal organs of
reproduction
• It runs oblique upwards and backwards at angle
of 45⁰ with bladder in front and rectum and
anus behind
• Interiorly 7.5cm long in adults and posterior
9cm long.
20
Structure of vagina
Vagina has three layers
• Outer covering areola tissue
• Middle layer of smooth muscle
• Inner lining of stratified squamous epithelium
that forms ridges or ragae.
It has no secretory glands but the surface is kept
moist by cervical secretions.
21
Structure of vagina cont…
• Between puberty and menopause,
lactobacillus acidophilus bacteria are normally
present, they secret lactic acid, maintaining PH
of vagina between 4.9-3.5
• The acidity inhibits growth of micro-organisms
that may enter vagina from perineum.
22
Blood supply, lymph drainage and nerve
supply
• Arterial supply by plexus from uterine and
vagina arteries a branch of internal iliac arteries
• Venous drainage; b venous plexus situated in
muscular wall, drains into internal iliac veins.
• Lymph drains through deep and superficial iliac
glands
• Nerve supply from parasympathetic fibres from
sacral outflow, sympathetic from lumbar outflow
sensory, somatic fibres from pudendal nerves.
23
Functions of vagina
• Receptacle of penis during sexual inter-course
• Provides elastic passage way for the baby to
pass during child birth.
24
Uterus
• Is a muscular hollow pear-shaped organ
• It lies in pelvic cavity between bladder and
rectum.
• It leans forwards and bends forward in most
women at right angle to vagina
• When body is upright it lies in horizontal
position
• It is about 7.5 cm long 5cm wide 2.5 cm thick
25
Uterus cont…….
• It weight 30-40 grams
• The part of uterus are; fundus, body and cervix
1. Fundus; is dome-shaped part of uterus above
the openings of uterine tube
2. Body; it the main part , it is narrowest
inferiorly at internal os
3. Cervix (neck of uterus); this protrudes through
the anterior wall of vagina opening.
26
Female internal genitalia and associated
structure
27
Structure of uterus
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Structure of uterus
• The wall of uterus composed of three layers;
1. Perimetrium ; this is peritoneum which is
distributed differently on various surface of
uterus
• anterior it lies over the fundus and body
where it folded on the upper surface of
urinary bladder, the folds forms the vesico-
uterine pouch
29
Structure of uterus cont…….
• Posterior; the peritoneum covers the fundus,
body and cervix, the it folds back on to the
rectum to form the recto-uterine pouch(of
douglas).
• Laterally peritoneum forms a double fold with
the uterine tubes in the upper free border
(the broad ligament)
30
Structure of uterus cont…
2. Myometrium;
• is the thickest layer of tissue in the uterine
wall
• It a mass of smooth muscle fibres interlaced
with areolar tissue, blood vessels and nerves
3. Endometrium; consists of columnar
epithelium containing large number of mucus
secreting tubular glands
31
Structure of uterus cont…..
• It is divided functionally into two layers
• Functional layer is upper layer and is thickens
and becomes rich in blood vessels in the first
half of menstrual cycle
• Basal layer; lies next to myometrium and is
not lost during menstruation, it is the layer
from which the function layer is regenerated
during each cycle. The upper part of cervical
canal is lined with this mucus membrane.
32
Blood supply, lymph drainage and nerve
supply
• Arterial supply is by uterine arteries branches of
internal iliac arteries.
• Venous drainage, veins follow the same route of as
the arteries and drains into internal iliac veins.
• Lymph drainage; deep and superficial lymph vessels
drain lymph from uterus and uterine tube to aortic
lymph nodes
• Nerve supply; parasympathetic fibres by sacral
outflow and sympathetic fibres from lumbar
outflow.
33
Supporting structures of uterus
34
The main ligaments supporting the uterus
• Broad ligaments; is formed by double fold of
peritoneum, one on each side of uterus they
hang down from uterine tubes, at their lateral
wall they are attached to the sides of pelvis
• Uterine tubes are enclosed in the upper free
border, near the lateral ends they penetrate
posterior wall of broad ligament and open into
peritoneal cavity.
35
Main ligaments cont….
• The ovaries attached to posterior wall, one on
each side
• Blood, lymph and nerves pass to the uterus and
uterine tubes between layers of broad ligaments.
Round ligaments; these are bands of fibrous
tissue between the two layers of broad
ligaments, one on each side of uterus,
• They pass to pelvis through inguinal canal to nd
by fusing with labia majora.
36
Main ligaments cont…
• Uteroscral ligaments; these originate from posterior
walls of the cervix and vagina and extends backwards,
one on each side of rectum to the sacrum.
• Transverse cervical (cardinal) ligaments; extends from
each side of the cervix and vagina to the side wall of
the pelvis.
• Pubo-cervical fascia; extends forward from transverse
cervical ligaments on each side of bladder and is
attached by posterior surface of pubic bone.
37
Functions of uterus
• Reception of fertilized ovum
• Uterus is the place where the embryo gets
attached itself and developed
• Developing baby gets oxygen and nutrition
through uterus.
• Uterus allows the excretion of carbon dioxide
and nitrogenous wastes from the baby.
38
Functions of uterus cont…..
• Uterus supplies antibodies to protect the
young one from infectious diseases.
• During pregnancy, uterus produces
progesterone, a hormone for the maintenance
of pregnancy.
• Expelling unfertilized ovum during ovulation
• Expelling fetus at term by rhythmical
contraction.
39
Uterine tubes/follopian tubes
• Uterine tubes (fallopian tubes are 10cm long
• Extends from sides of uterus between body and
fundus
• It lies in the free border of broad ligament
• The trumpet-shaped ends penetrate the posterior
wall opening into peritoneal cavity close to ovaries
• The end of each tube has projections called
fambria ovarian fambria is in close contact with
ovary.
40
Structure
• Outer covering of peritoneum(broad ligament)
• Middle layer of smooth muscle
• Lined with ciliated epithelium
Blood, lymph drainage and nerve supply
These are as for uterus
41
Functions of uterine tubes
• Moves ovum from ovary by peristalsis and
ciliary movement
• Secrete mucus that provide ideal condition for
movement of ova and spermatozoa
• Fertilization usually takes place in uterine tube
• Propelling zygote into the uterus for
plantation.
42
Ovaries
• Ovaries are female gonads(glands producing sex
hormones and the ova).
• They lie in a shallow fossa on lateral wall of pelvis
• They are 2.5-3.5cm long 2cm wide and 1cm thick
• Each is attached to upper part by ovarian ligament
and to the back of broad ligament by a broad
band of tissue, mesovarian, blood nerve pass to
ovary through mesovarian.
43
Structure of ovaries
• Ovaries have two layers of tissue
1. Medulla; this lies in the centre and consists of
fibrous tissue, blood vessels and nerves
2. Cortex; this surrounds the medulla,
• it has a framework of connective tissue or
stroma
• Covered by germinal epithelium
• It contains ovarian follicles in various stages of
maturity each contains ovum
44
Structure of ovaries cont…..
• Before puberty the ovaries are inactive, but
the stroma already contains immature
(primordial) follicles, which the female has
from birth
• During childbearing years every 28 days, one
ovarian follicle matures, ruptures and releases
its ovum into peritoneal cavity(ovulation)
occurs during menstrual cycle
45
Structure of ovaries cont…
• Following ovulation, the ruptured follicle
develops into corpus luteum(yellow body)
which in turn leave a small permanent scar of
fibrous tissue(corpus albicans or white body)
46
47
Blood, lymph drainage and nerve supply
• Arterial supply by ovarian arteries, branch of
abdominal aorta
• Venous drainage; into plexus of veins behind
uterus, right ovarian vein opens into inferior vena
cava, left ovarian vein into left renal vein
• Lymph drainage; to lateral aortic and Para-aortic
lymph nodes.
• Nerve supply; parasympathetic nerves from sacral
outflow, sympathetic nerves from lumbar outflow.
48
Functions of ovaries
• Storage of female gametes
• development of female gametes
• Releases hormones essential to physiological
changes during reproductive cycle.
The source of these hormones oestrogen and
progesterone is a follicle itself.
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MALE REPRODUCTIVE SYSTEM
Objectives;
• Describe the structure and function of the testes
• Outline the structure and function of the
spermatic cords
• Describe the secretion that pass into the spermatic
fluid
• Explain the process of ejaculation
• List the main changes occurring at puberty in male.
50
Male external genitalia
51
52
Parts of male reproductive system
• Scrotum
• Testes
• Spermatic cords
• Vas deferens
• Ejaculatory ducts
• Urethra and penis
53
54
Accessory organs
• Three accessory glands provide fluids that
lubricate the duct system and nourish the
sperm cells.
These are;
• Seminal vesicles,
• The prostate gland,
• the bulbo-urethral glands (Cowper glands).
55
Male external and internal structure
56
Scrotum
• The scrotum is a pouch-like structure that
hangs behind the penis, it is deeply pigmented
skin, fibrous and connective tissue and
smooth muscle
• It is divided into two compartments each
contains one testes, one epididymis and
testicular end of spermatic cord.
57
Scrotum cont……
• It holds and protects the testes, it also
contains numerous nerves and blood vessels.
• During times of lower temperatures, the
Cremaster muscle contracts and pulls the
scrotum closer to the body, while the Dartos
muscle gives it a wrinkled appearance.
•
58
Scrotum cont………
• When the temperature increases, the
Cremaster and Dartos muscles relax to bring
down the scrotum away from the body and
remove the wrinkles respectively.
59
60
Testes
• Testes are reproductive gland of male they are
equivalent of the ovaries in female
• They are 4.5cm long 2.5cm wide and 3cm
thick and are suspended in the scrotum by
spermatic cords.
61
Three layers of testes
• Tunica vaginalis; form the outer covering the
testes it is double membrane down-growth of
abdominal and pelvic peritoneum.
• During fetal life, testes develop in lumbar
region of abdominal cavity and descends into
scrotum, taking with them peritoneum, blood
vessels, nerves and vas deferent duct.
Descend of testes should be completed by 8
months of fetal life.
62
Layers of testes cont……
• Tunica albuginea; is a fibrous covering beneath
tunica vaginalis that surrounds testes.
Ingrowths form septa, dividing the glandular
structure of the testes into lobules.
• Tunica vasculosa; this consists of network of
capillaries supported by delicate connective
tissue.
63
Longitudinal section of testes
64
Structure of testes
• Each testes consists of 200-300 lobules, within
lobules are 1-4 convoluted loops composed of
germinal epithelial cells called seminiferous
tubules.
• Between them are tubules groups of
interstitial cells (of leydig) that secrete
hormone testosterone after puberty.
65
Structure of testes cont…..
• At upper pole of the testis the tubules
combine to form a single tubule.
• Tubule is about 6m in its full length, is
repeatedly folded and tightly packed into a
mass called epididymis.
• It leaves the scrotum as the deferent duct (vas
deferens) in the spermatic cord. Blood, lymph
vessel pass to testes in spermatic cords.
66
Functions of testes
• Production of spermatozoa controlled by FSH
at temperature about 3⁰c below normal body
temperature.
• Storage of matured sperm
• Secretion of hormone testosterone during
puberty.
67
Mature sperm
68
Spermatic cords
• Spermatic cords suspend the testes in the
scrotum
• Each consists of testicular artery, testicular
veins, lymphatic's, a deferent duct and testicular
nerves, which come together to form the cord
from their various origin in the abdomen.
• The cord is covered in a sheath of smooth
muscle and connective fibrous tissue extends
through inguinal canal.
69
Blood , lymph and nerve supply
• Arterial supply; testicular artery branch from
abdominal aorta
• Venous drainage; testicular vein pass into
abdominal cavity, left vein opens into left renal
vein, right into inferior vena cava
• Lymph drainage; through lymph node from
around aorta
• Nerve supply; by branches from the 10th - 11th
thoracic nerves.
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Epididymis
• The epididymis, a whitish mass of tightly
coiled tubes cupped against the testicles, acts
as a maturation and storage for sperm before
they pass into the vas deferens that carry
sperm to the ampullary gland and prostatic
ducts.
71
Deferent duct/Vas deferens
• The vas deferens, also known as the sperm
duct, is a thin tube 45cm long, it passes
upward from the testis through inguinal canal
and ascends medially towards posterior
aspect of bladder where it joined by duct of
seminal vesicle to form ejaculatory duct.
72
Ejaculatory duct
• These are two tubes 2cm long, ach formed by
the union of duct from seminal vesicle and vas
deferent duct.
• They pass through prostate gland and join
prostatic urethra, carrying seminal fluid and
spermatozoa to the urethra, the layers are the
same as seminal vesicles.
73
Accessory glands
• Three accessory glands provide fluids that
lubricate the duct system and nourish the
sperm cells.
• These are the seminal vesicles, the prostate
gland, and the bulbo-urethral glands (Cowper
glands).
74
Seminal vesicles
• Seminal vesicles are sac-like structures, two small
fibro-muscular pouches lined with columnar
epithelium, attached to the vas deferens at one side
of the bladder.
• They produce a sticky, yellowish fluid that contain
fructose. This fluid provides sperm cells energy and
aids in their motility. 60% of the semen is its
secretion.
75
Bulbourethral glands
• The bulbo-urethral glands, or Cowper’s glands,
are pea-sized structures located on the sides of
the urethra just below the prostate gland.
• These glands produce a clear, slippery fluid that
empties directly into the urethra.
• This fluid serves to lubricate the urethra and to
neutralize any acidity that may be present due
to residual drops of urine in the urethra.
76
Prostate gland
• The prostate gland surrounds the ejaculatory
ducts at the base of the male urethra, just
below the bladder.
• The prostate gland is responsible for the proof
semen, a liquid mixture of sperm cells,
prostate fluid makes about 30% of semen
77
Prostate glands cont……
• This gland is also responsible for making the
semen milky in appearance by mixing calcium
to the semen coming from seminal vesicle.
78
Urethra
• Male urethra provides a common pathway for flow
of urine and semen
• Urethra is about 19-20cm long and consists of three
parts;
1. prostatic urethra originate at orifice of bladder and
passes through prostate gland.
2. Membranous urethra; is the shortest and
narrowest part extend from prostate gland bulb of
penis, after passing through perineal membrane.
79
Parts of urethra cont…
3. Spongiosum or penile urethra; lies within
corpus spongiosum of penis and terminates
at external urethral orifice in glans of penis
• Urethra has two sphincters; internal
sphincter, consists of smooth muscle fibres at
neck of bladder above prostate gland,
external sphincter, consists of skeletal muscle
fibres surrounding the membranous part.
80
Penis
• Penis has a root and body, the root lies in
perineum and body surrounds the urethra
• It is formed by three cylindrical mass of erectile
tissue and smooth muscle
• The erectile tissue is supported by fibrous tissue
covered with skin and has a rich blood supply.
• The two lateral columns are called corpora
cavernosa and the column between them
containing urethra is corpus spongiosum.
81
Penis cont...
• Flaccid lengths ranged around 7 to 10
centimeters (2.8 to 3.9 inches)
• Erect lengths ranged around 12 to 16
centimeters (4.7 to 6.3 inches)
82
Penis cont……
• Its tip is expanded into triangular structure i.e
the glans penis
• Above the glans the skin is folded and form a
removable double layer(foreskin or prepuce).
Blood supply
• Arterial blood supply by; deep dorsal and
bulbar arteries of penis, which are branches
from internal pedundal arteries.
83
Blood supply cont……
• Veins drain blood to the internal pedundal and
internal iliac veins.
• Nerve supply by autonomic and somatic nerves
• Parasympathetic stimulation leads to filling of the
spongy erectile tissue with blood, caused by
arteriolar dilation and vasoconstriction, which
increases blood flow into penis and obstruct
outflow.
• The penis becomes engorged and erect, essential
for intercourse.
84
Erection
• An erection begins in the brain. Physical
and/or mental stimulation cause nerves in the
brain to send chemical messages to nerves in
the penis telling the penile blood vessels to
relax so that blood can flow freely into the
penis.
85
Erection cont……
• Once in the penis, high pressure traps the
blood within both corpora cavernosa.
• This causes the penis to expand and sustain an
erection.
• An erection is reversed when the inflow of
blood is stopped and opening outflow
channels open, allowing the penis to become
soft.
86
Process of ejaculation
• Ejaculation, the release of semen at climax, is
triggered when the man reaches a critical level
of excitement.
• Sexual stimulation causes nerves in the penis
to send chemical messages or impulses to the
spinal cord and into the brain where other
chemical messages are sent back to the penis
-- via the spinal cord -- causing ejaculation.
87
Ejaculation
88
Process of ejaculation cont….
• Ejaculation has two phases -- During the first
phase, the vas deferens, which are the tubes
which store and transport sperm from the
testes, contract to squeeze sperm toward the
back of the urethra.
• The seminal vesicles also release secretions
into the back of the urethra
89
Process of ejaculation cont…..
• During the second phase, the posterior
urethra senses the secretions within it (at the
height of sexual excitement) and sends signals
to the spinal cord to, in turn, send powerful
signals to the muscles at the base of penis to
vigorously contract every 0.8 seconds and
force the semen out of the penis.
90
Pathway for sperm during ejaculation
91
Thanks
Any question??
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