The female reproductive system is a group of internal and external organs that work together for the processes of reproduction, menstruation, fertilization, and childbirth.
🔹 A. External Genital Organs (Vulva):
· Mons Pubis – Fatty tissue over the pubic bone, covered with hair.
· Labia Majora – Outer, hair-covered folds of skin.
The vagina is a fibromuscular tubular structure that forms part of the female reproductive tract. It extends from the external genitalia (vulva) to the uterine cervix and serves as the female copulatory organ, birth canal, and the passage for menstrual flow.
✅ 2. Location:
Lies between the urinary bladder (anteriorly) and the rectum (posteriorly).
Extends from the external vaginal orifice to the external os of the cervix.
✅ 3. Structure:
Length: Approximately 7–10 cm (varies with parity and hormonal status)
Shape: Flattened anteroposteriorly
Walls: Anterior and posterior walls lie in contact
Orientation: Directed upward and backward
🔹 Layers of Vaginal Wall:
Mucosa – Lined by stratified squamous epithelium (non-keratinized)
Muscular layer – Smooth muscle (inner circular and outer longitudinal)
Adventitia – Connective tissue rich in blood vessels, lymphatics, and nerves
✅ 4. Functions of the Vagina:
Passage for menstrual flow
Receives the penis during sexual intercourse
Serves as the birth canal during labor
Protective barrier – acidic pH prevents infection
Allows passage for uterine secretions
✅ 5. Vaginal pH and Flora:
Acidic pH (around 4.0–4.5) in reproductive years
Maintained by Lactobacillus species (Döderlein’s bacilli)
Acidic environment prevents microbial growth
✅ 6. Blood Supply:
Arteries: Vaginal artery (branch of internal iliac artery)
Vaginal prolapse – Weak support leads to protrusion
Examinations – Pap smear collected from cervix via vagina
Route for procedures – e.g., vaginal hysterectomy, ultrasound, pessary insertion
✅ 10. Golden One-Liners for Quick Revision:
Vagina = birth canal + copulatory organ + menstrual outlet
Lined by stratified squamous epithelium
Maintains acidic pH via Lactobacilli
Length = 7–10 cm
Posterior to bladder, anterior to rectum
✅ 11. MCQs for Practice:
Q1. The epithelium of the vaginal mucosa is: a) Simple cuboidal b) Stratified squamous non-keratinized c) Pseudostratified columnar d) Simple columnar Correct Answer: b) Stratified squamous non-keratinized Rationale: Provides protection against friction and pathogens.
Q2. Which organism maintains the acidic pH of the vagina? a) Staphylococcus b) E. coli c) Lactobacillus d) Candida Correct Answer: c) Lactobacillus Rationale: Produces lactic acid to prevent infections.
Q3. What is the average vaginal length in adult females? a) 3–4 cm b) 5–6 cm c) 7–10 cm d) 12–15 cm Correct Answer: c) 7–10 cm Rationale: Normal range depending on parity and age.
Q4. The anterior relation of the vagina is: a) Rectum b) Ureter c) Urinary bladder and urethra d) Sigmoid colon Correct Answer: c) Urinary bladder and urethra Rationale: Vagina lies posterior to bladder and anterior to rectum.
Q5. The lower 1/3 of the vagina drains into which lymph nodes? a) Para-aortic b) Deep inguinal c) Superficial inguinal d) External iliac Correct Answer: c) Superficial inguinal Rationale: Important in spread of lower genital tract malignancies.
Supplied by autonomic nerves from the inferior hypogastric plexus
Insensitive to pain, but stretching during labor causes discomfort
✅ 9. Lymphatic Drainage:
Internal iliac lymph nodes
External iliac lymph nodes
Sacral lymph nodes
✅ 10. Applied Clinical Points:
Cervical Erosion (Ectropion) – eversion of endocervical epithelium onto ectocervix
Cervicitis – inflammation due to infection (Chlamydia, HPV)
Cervical Incompetence – leads to mid-trimester abortion or preterm labor
Cervical Cancer – most common malignancy in developing countries
Pap Smear Test – screening for cervical dysplasia/cancer
✅ 11. Golden One-Liners for Quick Revision:
Cervix = neck of uterus, connects uterus and vagina
Lined by two types of epithelium – squamous (outside) and columnar (inside)
Transformation zone = common site for cervical cancer
Pap smear is taken from the squamocolumnar junction
Opens (dilates) during labor to allow fetal passage
✅ 12. MCQs for Practice:
Q1. The cervix connects the uterus with the: a) Fallopian tubes b) Perineum c) Ovaries d) Vagina Correct Answer: d) Vagina Rationale: The cervix is the canal that links the uterus to the vagina.
Q2. The transformation zone of the cervix is the site for: a) Fertilization b) Cancer screening c) Menstrual bleeding d) Ovulation Correct Answer: b) Cancer screening Rationale: This is where precancerous lesions and cervical cancer usually arise.
Q3. What type of epithelium lines the ectocervix? a) Simple columnar b) Stratified squamous c) Transitional d) Pseudostratified Correct Answer: b) Stratified squamous Rationale: The outer cervix facing the vagina is covered by squamous epithelium.
Q4. Which hormone causes thinning of cervical mucus at ovulation? a) Progesterone b) LH c) Estrogen d) FSH Correct Answer: c) Estrogen Rationale: Estrogen promotes sperm-friendly cervical mucus during ovulation.
Q5. During labor, the cervix must dilate up to: a) 3 cm b) 5 cm c) 7 cm d) 10 cm Correct Answer: d) 10 cm Rationale: Full cervical dilation is 10 cm to allow fetal head to pass.
The fallopian tubes are paired, slender, muscular tubes that extend from the uterus to the ovaries, functioning to transport the ovum from the ovary to the uterus, and are the site of fertilization.
They are also known as:
Uterine tubes
Oviducts
✅ 2. Location:
Located in the upper border of the broad ligament of the uterus (mesosalpinx).
One tube on each side of the uterus, connecting the uterine cavity with the peritoneal cavity near the ovaries.
✅ 3. Structure and Parts:
Each fallopian tube is about 10–12 cm long and has four parts:
Infundibulum:
Funnel-shaped lateral end
Has finger-like projections called fimbriae
Function: Collect the ovum from the ovary after ovulation
Ampulla:
Widest and longest part
Site of fertilization
Isthmus:
Narrow, straight part near the uterus
Muscular and less distensible
Interstitial (Intramural) Part:
Passes through the uterine wall
Opens into uterine cavity via the tubal ostium
✅ 4. Layers of Fallopian Tube Wall:
Mucosa – Ciliated columnar epithelium to help move ovum
Muscularis – Inner circular and outer longitudinal smooth muscle
Serosa – Outer peritoneal covering
✅ 5. Functions of Fallopian Tube:
Transport of ovum from ovary to uterus
Site of fertilization (ampulla)
Nourishment of gametes and zygote
Transport of sperm toward the ovum (via ciliary action and peristalsis)
✅ 6. Blood Supply:
Arterial:
Uterine artery (branch of internal iliac)
Ovarian artery (from abdominal aorta)
Venous:
Drains into ovarian and uterine veins
✅ 7. Nerve Supply:
From ovarian plexus and uterine (pelvic) plexus
✅ 8. Lymphatic Drainage:
Drains into lumbar (para-aortic) lymph nodes
✅ 9. Clinical Significance:
Ectopic pregnancy – Implantation of fertilized ovum in fallopian tube (most commonly ampulla)
Tubal blockage – Common cause of infertility
Salpingitis – Inflammation due to PID (Pelvic Inflammatory Disease)
Tubectomy – Surgical method of female sterilization (permanent contraception)
Hydrosalpinx – Fluid-filled tube due to chronic inflammation
✅ 10. Golden One-Liners for Quick Revision:
Fallopian tube = site of fertilization
Has four parts: infundibulum, ampulla, isthmus, interstitial
Fimbriae help in collecting the ovum
Ampulla = commonest site of ectopic pregnancy
Transport by cilia + peristalsis
✅ 11. MCQs for Practice:
Q1. What is the function of the fimbriae of the fallopian tube? a) Nourish the fetus b) Support the uterus c) Collect the ovum d) Secrete hormones Correct Answer: c) Collect the ovum Rationale: Fimbriae sweep the released egg from the ovary into the tube.
Q2. The most common site of fertilization is the: a) Isthmus b) Infundibulum c) Ampulla d) Cervix Correct Answer: c) Ampulla Rationale: Fertilization usually occurs in the wide, spacious ampulla.
Q3. The total length of a fallopian tube is approximately: a) 5 cm b) 8 cm c) 10–12 cm d) 20 cm Correct Answer: c) 10–12 cm Rationale: Normal anatomical length of each tube is about 10–12 cm.
Q4. Which part of the fallopian tube passes through the uterine wall? a) Ampulla b) Infundibulum c) Isthmus d) Interstitial Correct Answer: d) Interstitial Rationale: It is the narrowest part and enters the uterine cavity.
Q5. Tubectomy is done by ligating which structure? a) Round ligament b) Broad ligament c) Fallopian tube d) Uterine artery Correct Answer: c) Fallopian tube Rationale: Tubectomy is surgical sterilization by blocking the fallopian tubes.
The ovaries are paired, almond-shaped female reproductive glands that produce ova (eggs) and secrete female sex hormones such as estrogen and progesterone.
They are the primary sex organs of the female reproductive system.
✅ 2. Location:
Located in the pelvic cavity, on either side of the uterus
Positioned in the ovarian fossa on the lateral pelvic wall
Attached to:
Uterus by the ovarian ligament
Lateral pelvic wall by the suspensory ligament of the ovary
✅ 3. Structure:
Size: Approximately 3 cm (length) × 2 cm (width) × 1 cm (thickness)
Covered by germinal epithelium
Each ovary has:
Cortex – Contains ovarian follicles, corpus luteum, corpus albicans
Medulla – Contains blood vessels, lymphatics, and nerves
✅ 4. Functions of the Ovaries:
🔹 1. Reproductive Function:
Oogenesis – Production and maturation of ova (female gametes)
Each ovary releases one ovum per menstrual cycle (approximately)
🔹 2. Endocrine Function:
Secretion of female hormones:
Estrogen – For development of secondary sexual characteristics, endometrial proliferation
Progesterone – Maintains endometrium for implantation
Also secrete inhibin and relaxin
✅ 5. Blood Supply:
Arterial:
Ovarian artery (direct branch of abdominal aorta)
Venous:
Right ovarian vein → Inferior vena cava
Left ovarian vein → Left renal vein
✅ 6. Nerve Supply:
Derived from ovarian plexus (autonomic nerves)
✅ 7. Lymphatic Drainage:
Para-aortic (lumbar) lymph nodes
✅ 8. Hormonal Regulation:
Controlled by the hypothalamic-pituitary-ovarian axis:
Ovarian cysts – Functional or pathological fluid-filled sacs
Ovarian cancer – Silent killer, often diagnosed late
Oophorectomy – Surgical removal of one or both ovaries
Menopause – Decline in ovarian function, leading to cessation of menstruation
✅ 10. Golden One-Liners for Quick Revision:
Ovaries = female gonads
Produce ova + estrogen + progesterone
Located in ovarian fossa of pelvic cavity
Each ovary releases 1 ovum per cycle
Blood supply from ovarian artery (from aorta)
✅ 11. MCQs for Practice:
Q1. The female gonads are called: a) Uterus b) Ovaries c) Fallopian tubes d) Vagina Correct Answer: b) Ovaries Rationale: Ovaries are the primary reproductive organs in females.
Q2. Ovary secretes which hormones? a) FSH and LH b) Estrogen and Progesterone c) Oxytocin and Estrogen d) Relaxin and Prolactin Correct Answer: b) Estrogen and Progesterone Rationale: These hormones regulate menstrual cycle and pregnancy.
Q3. The blood supply to the ovary comes from: a) Uterine artery b) Internal iliac artery c) Ovarian artery d) Renal artery Correct Answer: c) Ovarian artery Rationale: Directly arises from the abdominal aorta.
Q4. Which part of the ovary contains developing follicles? a) Medulla b) Cortex c) Hilum d) Peritoneum Correct Answer: b) Cortex Rationale: Ovarian follicles are located in the cortical region.
Q5. Ovarian hormones are regulated by: a) Prolactin b) TSH c) FSH and LH d) ACTH Correct Answer: c) FSH and LH Rationale: Follicle Stimulating Hormone and Luteinizing Hormone regulate ovulation and hormone production.
The uterus is a hollow, muscular, pear-shaped organ of the female reproductive system. It plays a central role in menstruation, implantation of fertilized ovum, fetal development, and childbirth.
✅ 2. Location:
Located in the pelvic cavity, between the urinary bladder (anteriorly) and rectum (posteriorly).
Held in position by ligaments: broad ligament, round ligament, uterosacral ligament, and cardinal ligament.
✅ 3. Structure and Parts:
The uterus is about 7.5 cm long, 5 cm wide, and 2.5 cm thick in a non-pregnant adult female.
🔹 Anatomical Parts:
Fundus – Dome-shaped top portion above the openings of fallopian tubes
Body (Corpus) – Main central part
Isthmus – Narrow part between body and cervix
Cervix – Lower narrow part, opens into the vagina
🔹 Cervical Openings:
Internal os – Opens into the uterine cavity
External os – Opens into the vagina
✅ 4. Uterine Wall Layers:
Perimetrium – Outer serous covering (part of peritoneum)
Menstruation – Endometrial shedding if fertilization doesn’t occur
Reception of fertilized ovum – Implantation site
Nourishment of embryo/fetus through placenta
Protection and growth of fetus
Expulsion of fetus during labor (parturition)
✅ 6. Blood Supply:
Arteries:
Uterine artery (branch of internal iliac artery)
Anastomoses with ovarian artery
Veins:
Uterine veins → internal iliac vein
✅ 7. Nerve Supply:
Autonomic nerves via inferior hypogastric plexus
Sympathetic (T10–L2): motor to uterine muscles
Parasympathetic (S2–S4): vasodilation and sensory
✅ 8. Lymphatic Drainage:
Fundus → Para-aortic lymph nodes
Body → External iliac nodes
Cervix → Internal iliac and sacral nodes
✅ 9. Hormonal Regulation:
Estrogen and progesterone (from ovaries) regulate:
Endometrial growth
Maintenance of pregnancy
Uterine tone
✅ 10. Clinical Significance:
Fibroids (leiomyoma) – Benign tumors of myometrium
Endometriosis – Endometrial tissue outside uterus
Uterine prolapse – Descent of uterus into the vagina
Adenomyosis – Endometrial tissue within myometrium
Carcinoma of the endometrium or cervix
Dysmenorrhea, menorrhagia – Painful/heavy periods
✅ 11. Golden One-Liners for Quick Revision:
Uterus = site of implantation, gestation, and labor
Fundus is the dome-shaped top
Myometrium = contracts during labor
Endometrium = sheds in menstruation, site of implantation
Blood supply = uterine artery from internal iliac
✅ 12. MCQs for Practice:
Q1. The uterus is located between the: a) Ovary and fallopian tube b) Bladder and rectum c) Kidney and ureter d) Liver and spleen Correct Answer: b) Bladder and rectum Rationale: Uterus lies in the midline of the pelvic cavity, anterior to rectum, posterior to bladder.
Q2. The inner lining of the uterus is called: a) Perimetrium b) Endometrium c) Myometrium d) Epimetrium Correct Answer: b) Endometrium Rationale: It undergoes cyclic changes and is shed during menstruation.
Q3. The layer responsible for uterine contractions is: a) Endometrium b) Myometrium c) Perimetrium d) Epithelium Correct Answer: b) Myometrium Rationale: Made of smooth muscle; contracts during labor and menstruation.
Q4. Which hormone maintains the endometrium for implantation? a) Estrogen b) FSH c) Progesterone d) LH Correct Answer: c) Progesterone Rationale: Secreted by corpus luteum, prepares uterus for pregnancy.
Q5. The part of the uterus that opens into the vagina is the: a) Fundus b) Body c) Isthmus d) Cervix Correct Answer: d) Cervix Rationale: Cervix is the lower narrow part connecting to the vagina.
The breasts (mammary glands) are modified sweat glands located in the anterior chest wall, functioning as accessory reproductive organs responsible for milk production (lactation) after childbirth.
✅ 2. Location:
Situated in the superficial fascia of the anterior thoracic wall.
Extend from the 2nd to the 6th rib, and from the sternum to the mid-axillary line.
Rest on the pectoralis major muscle and partly on serratus anterior.
✅ 3. Structure of the Breast:
The breast is composed of:
🔹 A. Skin:
Contains the nipple and areola
Nipple: Contains lactiferous duct openings
Areola: Pigmented area surrounding nipple; has Montgomery’s glands (sebaceous glands)
🔹 B. Glandular Tissue (Parenchyma):
Contains 15–20 lobes → Each lobe is made up of lobules
Lobules consist of alveoli/acini that secrete milk
Lactiferous ducts carry milk → open at nipple
🔹 C. Fibrous Tissue (Stroma):
Suspensory ligaments of Cooper: Support the breast; stretch with age or disease (e.g., cancer)
🔹 D. Adipose Tissue:
Fills the spaces between lobes and gives breast its size and shape
✅ 4. Blood Supply:
Arterial:
Internal thoracic (mammary) artery
Lateral thoracic artery
Thoracoacromial artery
Intercostal arteries
Venous drainage:
Into axillary, internal thoracic, and intercostal veins
✅ 5. Lymphatic Drainage:
Very important clinically (esp. in breast cancer):
Rest → Internal thoracic (parasternal), supraclavicular, and abdominal nodes
✅ 6. Nerve Supply:
Derived from 4th to 6th intercostal nerves
Provide sensory supply to the skin and autonomic to blood vessels and smooth muscle
✅ 7. Hormonal Influence:
Estrogen → Growth of ducts (puberty)
Progesterone → Growth of alveoli/lobules (luteal phase & pregnancy)
Prolactin → Stimulates milk production
Oxytocin → Milk ejection during breastfeeding
✅ 8. Functions of the Breast:
Milk production (lactation) for nourishment of the newborn
Sexual arousal and secondary sexual characteristics
Important role in maternal-infant bonding
✅ 9. Clinical Significance:
Breast cancer – commonly arises from upper outer quadrant
Mastitis – Infection of the breast during lactation
Fibrocystic changes – Benign lumps with cyclical pain
Gynecomastia – Breast enlargement in males
Mammography – Screening tool for breast cancer
Sentinel lymph node biopsy – Determines spread of breast cancer
✅ 10. Golden One-Liners for Quick Revision:
Modified sweat gland → Breast
15–20 lobes with lactiferous ducts
Cooper’s ligaments → Suspensory support
Milk production → Stimulated by Prolactin
Milk ejection → Stimulated by Oxytocin
Upper outer quadrant → Most common site of breast cancer
75% lymph drains → To axillary nodes
✅ 11. MCQs for Practice:
Q1. The breast is a modified form of which gland? a) Sebaceous gland b) Salivary gland c) Sweat gland d) Endocrine gland Correct Answer: c) Sweat gland Rationale: Breast is a modified apocrine sweat gland.
Q2. The number of lobes in each breast is approximately: a) 5–10 b) 10–15 c) 15–20 d) 20–25 Correct Answer: c) 15–20 Rationale: Each lobe drains into a lactiferous duct.
Q3. The hormone responsible for milk ejection is: a) Estrogen b) Progesterone c) Prolactin d) Oxytocin Correct Answer: d) Oxytocin Rationale: Oxytocin causes contraction of myoepithelial cells for milk let-down.
Q4. The upper outer quadrant of the breast is clinically significant because: a) It is the site of most infections b) It contains more lymph nodes c) It is the most common site of breast cancer d) It has no ducts Correct Answer: c) It is the most common site of breast cancer Rationale: Majority of breast cancers arise in this region.
Q5. The suspensory ligaments of the breast are called: a) Montgomery glands b) Cooper’s ligaments c) Gartner’s ducts d) Bartholin’s ligaments Correct Answer: b) Cooper’s ligaments Rationale: These ligaments provide structural support to the breast.
The menstrual cycle is a cyclical series of physiological changes in a woman’s reproductive system, primarily the ovaries and uterus, occurring approximately every 28 days from puberty to menopause (except during pregnancy or lactation).
It prepares the female body for fertilization and pregnancy.
✅ 2. Normal Duration:
Cycle length: 21–35 days (average 28 days)
Duration of menstruation: 3–7 days
Average blood loss: 30–80 mL
✅ 3. Phases of Menstrual Cycle:
The cycle is regulated by the hypothalamic–pituitary–ovarian axis and divided into:
🔹 A. Ovarian Cycle (Occurs in Ovaries)
1. Follicular Phase (Day 1–14):
FSH stimulates the growth of ovarian follicles.
Dominant follicle matures (Graafian follicle).
Estrogen is secreted → stimulates endometrial growth.
Ends with LH surge triggering ovulation.
2. Ovulation (Day 14):
Sudden LH surge causes release of ovum from Graafian follicle.
Ovum enters fallopian tube – fertile period.
3. Luteal Phase (Day 15–28):
Corpus luteum forms from ruptured follicle.
Secretes progesterone (main hormone) and estrogen.
If no fertilization → corpus luteum degenerates → hormone levels fall.
🔹 B. Uterine Cycle (Occurs in Endometrium of Uterus)
1. Menstrual Phase (Day 1–5):
Shedding of functional endometrium due to drop in progesterone and estrogen.
Bleeding occurs (menstruation).
2. Proliferative Phase (Day 6–14):
Under estrogen influence, endometrium regenerates and thickens.
Glands and blood vessels grow.
3. Secretory Phase (Day 15–28):
Under progesterone influence, endometrium becomes secretory.
Prepares for implantation of fertilized ovum.
If no implantation → hormones fall → menstruation restarts.
Q1. The hormone responsible for ovulation is: a) FSH b) LH c) Estrogen d) Progesterone Correct Answer: b) LH Rationale: A surge in LH around Day 14 triggers ovulation.
Q2. The hormone that prepares the endometrium for implantation is: a) Estrogen b) LH c) Progesterone d) Oxytocin Correct Answer: c) Progesterone Rationale: Progesterone from corpus luteum maintains the endometrium.
Q3. Menstrual bleeding occurs due to: a) Ovulation b) Estrogen peak c) Corpus luteum activity d) Drop in estrogen and progesterone Correct Answer: d) Drop in estrogen and progesterone Rationale: Hormonal withdrawal leads to endometrial shedding.
Q4. The average menstrual cycle length is: a) 14 days b) 21 days c) 28 days d) 35 days Correct Answer: c) 28 days Rationale: Standard cycle length used for calculations.
Q5. Fertilization most likely occurs in which phase? a) Menstrual b) Follicular c) Ovulation d) Luteal Correct Answer: c) Ovulation Rationale: Ovum is released during ovulation; fertilization happens here.