The Female Reproductive System

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First Institute, Ch. 17

adnexa

-tissues or structures in the body that are next to or near another.
-as in the uterus, the adnexa consists of the fallopian tubes, ovaries, and ligaments of the uterus

areola

-the darker pigmented, circular area surrounding the nipple of each breast; also known as the areola mammae or the areola papillaris

Bartholin's glands

-two small, mucus-secreting glands located on the posterior and lateral aspects of the entrance to the vagina

cervix

-the part of the uterus that protrudes into the cavity of the vagina; the neck of the uterus

climacteric

-the cessation of menstruation

clitoris

-the vaginal erectile tissue (structure) corresponding to the male penis

coitus

aka sexual intercourse/copulation

-the sexual union of two people of the opposite sex in which the penis is introduced into the vagina

corpus luteum

-a yellowish mass that forms within the ruptured ovarian follicle after ovulation, containing high levels of progesterone and some estrogen.
-functions as a temporary endocrine gland for the purpose of secreting estrogen and large amounts of progesterone, which will sustain pregnancy (should it occur) until the placenta forms. If pregnancy does not occur, the corpus luteum will degenerate approximately 3 days prior to the beginning of menstruation.

cul-de-sac

-a pouch located between the uterus and rectum within the peritoneal cavity.
-this pouch is formed by one of the ligaments that serves as support to the uterus
-because it is the lowest part of the abdominal cavity, blood, pus, and other drainage collects in the cul-de-sac

diaphragm

-a term used in gynecology to represent a form of contraception

endometrium

-the inner lining of the uterus

estrogen

-one of the female hormones that promotes the development of the female secondary sex characteristics

fallopian tubes

-one of a pair of tubes opening at one end into the uterus and at the other end into the peritoneal cavity, over the ovary

fertilization

-the union of a male sperm and a female ovum

fimbriae

-the fringe-like end of the fallopian tube

fourchette

-a tense band of mucous membranes at the posterior rim of the vaginal opening: the point at which the labia minora connect

fundus

-the dome-shaped central, upper portion of the uterus between the points of insertion of the fallopian tubes.

gamete

-a mature sperm or ovum

gonads

-a gamete-producing gland, such as an ovary or a testis

graafian follicles

-a mature, fully developed ovarian cyst containing the ripe ovum

gynecologist

-a physician who specializes in diseases and disorders of the female reproductive system

gynecology

-branch of medicine that deals with the study of diseases and disorders of the female reproductive system

hymen

-a thin layer of elastic, connective tissue membrane that forms a border around the outer opening of the vagina and may partially cover the vaginal opening

labia majora

-two folds of skin containing fatty tissue and covered with hair that lie on either side of the vaginal opening, extending from the mons pubis to the perineum
-outer surface of the labia majora is covered by pubic hair; inner surface is smooth and moist

labia minora

-two folds of hairless skin located within the folds of the labia majora
-extends from the clitoris downward toward the perineum

lumpectomy

-surgical removal of only the tumor and the immediate adjacent breast tissue; a method of treatment for breast cancer when detected in the early stage of the disease.

mammary glands

-the female breasts

mastectomy

-surgical removal of the breast as a treatment method for breast cancer; can be simple (breast only), modified radical (breast plus lymph nodes in axilla), or radical (breast, lymph nodes, and chest muscles on affected side)

mastitis

-inflammation of the breast

menarche

-onset of menstruation; the first menstrual period

menopause

-the permanent cessation (stopping) of the menstrual cycles

menorrhea

-menstrual flow; menstruation

menses

aka menstrual flow/ menstruation

menstruation

-the periodic shedding of the lining of the nonpregnant uterus through a bloody discharge that passes through the vagina to the outside of the body
-occurs at monthly intervals and lasts for 3-5 days

myometrium

-the muscular layer of the uterine wall

ovary

-one of a pair of female gonads responsible for producing mature ova (eggs) and releasing them at monthly intervals (ovulation); also responsible for producing the female hormones estrogen and progesterone

ovulation

-the release of the mature ovum from the ovary, occurring approximately 14 days prior to the beginning of menses

ovum

-the female reproductive cell; female sex cell or egg

perineum

- the area between the vaginal orifice and the anus that consists of muscular and fibrous tissue and serves as support for the pelvic structures

pregnancy

-the period of intrauterine development of the fetus from conception through birth. The average pregnancy lasts approximately 40 weeks; also known as the gestational period

premenstrual syndrome

-a group of symptoms that include irritability, fluid retention, tenderness of the breasts, and a general feeling of depression occurring shortly before the onset of menstruation; also called PMS

progesterone

-one of the female hormones secreted by the corpus luteum and the placenta. It is primarily responsible for the changes that occur in the endometrium in anticipation of a fertilized ovum, and for development of the maternal placenta after implantation of a fertilized ovum

puberty

-the period of life at which the ability to reproduce begins; that is, in the female it is the period when the female reproductive organs are fully developed.

sperm

-a mature male germ cell; spermatozoon

testes

-the paired male gonads that produce sperm. They are suspended in the scrotal sac in the adult male

uterus

-the hollow, pear-shaped organ of the female reproductive system that houses the fertilized, implanted ovum as it develops throughout pregnancy; also the source of the monthly menstrual flow from the nonpregnant uterus

vagina

-the muscular tube that connects the uterus with the vulva
-approximately 3 inches long, and rests between the bladder (anteriorly) and the rectum (posteriorly)

vulva

aka pudendum

-the external genitalia that consists of the mons pubis, labia majora, clitoris, labia minora, vestibule, urinary meatus, vaginal orifice, Bartholin's glands, and the perineum

amenorrhea

-absence of menstrual flow

dysmenorrhea

-painful menstrual flow

menorrhagia

-abnormally long or very heavy periods
-chronic menorrhagia can result in anemia, due to recurrent excessive loss of blood

metrorrhagia

-uterine bleeding at times other than the menstrual periods

oligomenorrhea

-abnormally light or infrequent menstruation

oral contraceptives

-birth control pills, contain synthetic forms of the hormones estrogen and progesterone and are taken by mouth
-need to be taken at the same time every day

Depo-Provera injection

-form of contraception administered intramuscularly, approximately once every 12 weeks

intrauterine device (IUD)

-small plastic T-shaped object with strings attached to the leg of the T
-inserted into the uterus, through the vagina, and remains in place in the uterus

birth control patch

-a thin, flexible square patch that continuously delivers hormones through the skin and into the bloodstream for a full seven days to prevent pregnancy
-the birth control patch contains hormones similar to those in birth control pills, but must be changed every 7 days

contraceptive ring

-a flexible contraceptive ring (placed into the vagina) that slowly releases a low dose of hormones that prevent pregnancy

barrier methods

-methods of birth control that place physical barriers between the cervix and the sperm so that the sperm cannot pass the cervix and enter the uterus, and thus the fallopian tubes

tubal ligation

-surgically cutting and tying the fallopian tubes to prevent passage of ova or sperm through the tubes, consequently preventing pregnancy; female sterilization

micro-insert system

-an alternative to tubal ligation that provides bilateral occlusion of the fallopian tubes by inserting a soft, flexible micro-insert into each fallopian tube.

vasectomy

-also known as a male sterilization
-surgically cutting and tying the vas deferens to prevent the passage of sperm, consequently preventing pregnancy

carcinoma of the breast

-a malignant (cancerous) tumor of the breast tissue.
-ductal carcinoma is the most common form and it originates in the mammary ducts. This tumor has the ability to invade surrounding tissue if not detected early enough. Once the cancer cells penetrate the duct, they will metastasize (spread) through the surrounding breast tissue--eventually reaching the axillary lymph nodes. Through the lymph vessels, the cancer cells can spread to distant parts of the body

cervical carcinoma

-a malignant tumor of the cervix
-one of the most common malignancies of the female reproductive tract

Symptoms: abnormal pap smears and bleeding between menstrual periods, after sexual intercourse, or after menopause

cervicitis

-an acute or chronic inflammation of the uterine cervix

Symptoms: thick, foul-smelling vaginal discharge, pelvic pressure or pain, scant bleeding after sexual intercourse, and itching or burning of the external genitalia. Upon exam, cervix will appear red and swollen and bleed on contact

cystocele

-herniation or downward protrusion of the urinary bladder through the wall of the vagina
-develops over a period of years as a result of weakening of the anterior wall of the vagina, often after giving birth to several babies
-anterior wall of the vagina can no longer support the weight of the urine in the bladder causing the bladder to protrude into the vagina

endometrial carcinoma

aka adenocarcinoma of the uterus

-malignant tumor of the inner lining of the uterus
-most common cancer of the female reproductive tract occurring in women during or after menopause

Symptom: abnormal uterine bleeding, abnormal discharge (mucoid or watery) may precede the bleeding by weeks or months
Treatments: total abdominal hysterectomy (TAH), followed by radiation

endometriosis

-the presence and growth of endometrial tissue in areas outside the endometrium (lining of the uterus)
-generally found in the abdominal cavity

Symptoms: dysmenorrhea with constant pain and discomfort in the lower abdomen, back, and vagina. Pain may begin before menstruation and continue for several days after the end of menstruation. May also experience heavy menstrual periods, and pelvic pain during sexual intercourse.

fibrocystic breast disease

fibr/o= fiber cyst/o= bladder, sac, or cyst

-the presence of single or multiple fluid-filled benign cysts that are palpable in the breast

fibroid tumor

fibr/o= fiber -oid= resembling

-a benign, fibrous tumor of the uterus
-vary in size, number, and location within the uterus (occurring only in premenopausal women)

leiomyoma

lei/o= smooth my/o= muscle -oma= tumor

-a benign, smooth muscle tumor of the uterus. Uterine leiomyomas are often mislabeled as fibroid tumors.

Symptoms: range from none to pelvic pain and pressure accompanied by menorrhagia or metrorrhagia
Treatment: ranges from surgery to remove the tumors to a hysterectomy

ovarian carcinoma

ovari/o= ovary -an= characteristic of carcin/o= cancer

-A malignant tumor of the ovaries, most commonly occurring in women in their 50s. It is rarely detected in the early stage and is usually far advanced when diagnosed

ovarian cysts

-benign, globular sacs (cysts) that form on or near the ovaries. These cysts may be fluid filled or they may contain semisolid material.

Symptom: painless swelling of the lower abdomen that feels firm to the touch, pain during sexual intercourse, pelvic pain, low back pain, and an acute colicky abdominal pain.
Treatment: most ovarian cysts will disappear by themselves. If it doesn't disappear in a few months, laparoscopy with visualization may be performed to rule out other possible causes or malignancies. May be removed surgically for biopsy.

pelvic inflammatory disease (PID)

-infection of the fallopian tube
-occurs mainly in women under 35 that are sexually active
-usually the result of STDs
-begins with a cervical infection that spreads by surface invasion along the uterine lining and then out to the fallopian tubes and ovaries

Symptoms: fever, chills, malaise, abdominal tenderness, backache, and a foul-smelling vaginal discharge
Treatment: antibiotics, analgesics, and bed rest

salpingitis

salping/o= refers to fallopian tubes -itis= inflammation

aka pelvic inflammatory disease

stress incontinence, urinary

-the inability to hold urine when the bladder is stressed by sneezing, coughing, laughing, or lifting
-result of a weakening in the urethral muscles and bladder sphincter control (esp. if patient has had several babies)

Treatment: exercises to strengthen perineal muscles, use of perineal pads, and reducing caffeine intake

vaginitis

-inflammation of the vagina and the vulva
-occurs when there is a disturbance in the normal flora or pH of the vagina that allows microorganisms to flourish
-3 types include:
1. candidiasis (aka moniliasis or yeast infection): the most common form of vaginitis
Symptoms: foul-smelling vaginal discharge accompanied by itching, burning, and soreness of the area. Discharge typically appears like cottage cheese and the vulvar and vaginal walls appear red and inflamed
Treatment: applications of vaginal creams to destroy yeast/fungal infections
trichomoniasis:
2. bacterial vaginosis (or Gardnerella vaginitis): extremely contagious
Symptoms: increased vaginal discharge, which is usually thin, watery, and a grayish white or yellow color and has a strong fishy odor (may be more noticeable after intercourse)
Treatment: antibiotics or antibacterial medications

aspiration biopsy

-An invasive procedure in which a needle is inserted into an area of the body, such as the breast, to withdraw a tissue or fluid sample for microscopic examination and diagnosis
-usually performed under local anesthetic

breast self-examination

-a procedure in which the woman examines her breasts and surrounding tissue for evidence of any changes that could indicate the possibility of malignancy
-performed 7-10 days after the menstrual period

colposcopy

-visual examination of the vagina and cervix with a colposcope (a lighted binocular microscope)

cone biopsy

aka conization

-surgical removal of a cone-shaped segment of the cervix for diagnosis or treatment
-cone-shaped segment contains the abnormal tissue and a margin of healthy tissue

cryosurgery

-the destruction of tissue by rapid freezing with substances such as liquid nitrogen
-frequently used to remove benign and/or malignant tumors or warts

culdocentesis

-the surgical puncture through the posterior wall of the vagina into the cul-de-sac to withdraw intraperitoneal fluid for examination

dilation and curettage

aka D&C

-dilation or widening of the cervical canal with a dilator, followed by scraping of the uterine lining with a curet

endometrial biopsy

-an invasive test for obtaining a sample of endometrial tissue (with a small curet) for examination

hysterosalpingography

-x-ray of the uterus and fallopian tubes by injecting a contrast material into these structures

laparoscopy

-the process of viewing the abdominal cavity with a laparoscope (a thin-walled flexible tube with a telescopic lens and light)
-used for diagnosing unexplained pelvic or abdominal pain, confirming or ruling out suspected cases of tubal pregnancy or endometriosis, assessing female reproductive organs for fertility studies, and performing therapeutic procedures such as tubal ligations and other types of minor surgery

Loop electrosurgical excision procedure (LEEP)

-a procedure used to remove abnormal cells from the surface of the cervix using a thin wire loop that acts like a scalpel. A painless electrical current passes through the loop as it cuts away a thin layer of surface cells from the cervix
-local anesthetic used on cervix

mammography

-the process of examining with x-ray the soft tissue of the breast to detect various benign and/or malignant growth before they can be felt
-takes 15-30 minutes
-should begin having them annually after 40yrs old

Papanicolaou (Pap) smear

-a diagnostic test for cervical cancer; that is, a microscopic examination of cells scraped from within the cervix, around the cervix, and from the posterior part of the vagina

Liquid-based Pap (LBP)

-a process of collecting a tissue sample from the endocervix with a sampling device that is placed directly into a liquid fixative instead of being spread onto a glass slide.
-this process provides immediate fixation and improves specimen adequacy. The LBP has not completely replaced the traditional Pap smear but is an increasingly popular alternative to conventional cervical cytology smears.

pelvic ultrasound

-a noninvasive procedure that uses high-frequency sound waves to examine the abdomen and pelvis
-used to locate a pelvic mass, an ectopic pregnancy, or an intrauterine device, to inspect and assess the uterus, ovaries, and fallopian tubes

pelvimetry

-the process of measuring the female pelvis, manually or by x-ray, to determine its adequacy for childbearing

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