Porth's Essentials of Pathophysiology, 4e

isorders of the female reproductive system have widespread effects on physical and psychological function, including general health status, sexuality, and reproductive potential. This chapter provides a review of the structure and function of the female reproductive system and a discussion of disorders of the external and internal female reproductive organs, menstrual disor- ders, and disorders of the breast. Structure and Function of the Female Reproductive System The female reproductive system consists of the external and internal genital structures. 1,2 The external struc- tures, or genitalia, are situated in the anterior part of the perineum, and the internal structures (vagina, uterus, fallopian tubes, and ovaries) are located in the pelvic cavity (Fig. 40-1). External Genitalia The external genitalia, which are collectively referred to as the vulva , include the mons pubis, labia majora, labia minora, clitoris, and perineal body (Fig. 40-2). Because of their location, the urethra and anus usually are con- sidered in a discussion of the external genitalia. The mons pubis is a rounded, skin-covered fat pad located anterior to the symphysis pubis. Running pos- teriorly from the mons pubis are two elongated, hair- covered, fatty folds, the labia majora . The labia majora enclose the labia minora , which may be smaller than the labia majora and are composed of skin, fat, and some erectile tissue. The clitoris is located below the clitoral hood, which is formed by the joining of the two labia minora to form the prepuce . The clitoris is an erectile organ, rich in vascular and nervous supply. Analogous to the male penis, it is a highly sensitive organ that becomes engorged during sexual stimulation. Disorders of the Female Genitourinary System 40 C h a p t e r D

Structure and Function of the Female Reproductive System

External Genitalia Internal Genitalia Vagina

Uterus and Cervix Fallopian (Uterine) Tubes Ovaries

The Menstrual Cycle The Hypothalamic-Pituitary Axis Ovarian Hormones Ovarian Follicle Development and Ovulation Endometrial Changes Disorders of the Female Reproductive Organs Disorders of the External Genitalia Bartholin Gland Cyst and Abscess Benign and Malignant Disorders of the Vulva Vulvodynia Disorders of the Vagina Vaginitis Cancer of the Vagina Disorders of the Uterine Cervix Cervicitis Premalignant Lesions and Cancer of the Cervix Disorders of the Uterus Infectious Disorders of the Uterus and Pelvic Structures

Endometriosis Adenomyosis

Endometrial Cancer Uterine Leiomyomas Disorders of Uterine Support

Disorders of the Ovaries

Cystic Lesions of the Ovaries Polycystic Ovary Syndrome

Ovarian Cancer Menstrual Disorders Dysfunctional Menstrual Cycles Amenorrhea Dysmenorrhea Premenstrual Syndrome Disorders Menopause and Aging Changes Disorders of the Breast

Breast Structures Benign Disorders

Inflammatory Disorders Benign Epithelial Disorders

Breast Cancer Detection

Diagnosis and Classification Treatment Paget Disease

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