52684484-04-dra-nur-anisah-systema-genitalia-feminina-120118191700-phpapp02.pdf

SISTEM REPRODUKSI WANITA 1

NUR ANISAH BAGIAN HISTOLOGI & BIOLOGI SEL, FAKULTASKEDOKTERAN, UNIVERSITAS GADJAH MADA, YOGYAKARTA

Blok Sistem Reproduksi, 9 Feb 2010 [04]

memiliki enam fungsi utama: Menghasilkan gamet betina, yaitu ovum, melalui proses oogenesis Menerima gamet jantan, yaitu spermatozoa Menyediakan lingkungan yang sesuai untuk pembuahan ovum oleh spermatozoa Menyediakan lingkungan yang sesuai untuk perkembangan janin

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GAMBARAN UMUM SISTEM REPRODUKSI WANITA █ KOMPONEN SISTEM ■ Ovarium (indung telur) ■ Tuba uterina (tuba Falopii/oviduct) ■ Uterus (rahim) ■ Vagina ■ Apparatus genitalia externa 3

ORGANA GENITALIA FEMININA ORGANA GENITALIA EXTERNA ORGANA GENITALIA INTERNA

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Organa genitalia feminina interna dan externa

Ø lateral organa genitalia feminina 5

Figure . Internal organs of the female reproductive system. 6

1. Ovarium 7

● Organ ini merupakan gonade ● Tersusun oleh: - folikel-folikel → perkembangan telur (ovum) - setelah folikel masak, ovum dilepaskan, sedangkan folikel yg tertinggal membentuk → corpus luteum: memproduksi hormon estrogen & progesteron

Figure 23—2. Ovary of a woman of reproductive age showing its main components: germinal epithelium, tunica albuginea, cortical region, and medullary region. 8

Figure. Photomicrograph of part of an ovary showing the cortical and medullary regions. H&E stain. Low magnification.

Ovary human, H&E 9

Folliculus ovarii Folliculus primordialis Pertumbuhan follikel: a. Folliculi primarius: i. Folliculus primarius unilaminarius ii. Folliculus multilaminarius b. Folliculus secundarius 7. Folliculus maturus = folliculus de Graaf 8. Folliculus atreticus  

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Fig. Types of ovarian follicles, from primordial to mature. The relative proportions of the follicles are not maintained in this 11 drawing.

Perkembangan folikel 12

 Folliculus ovarii  Epitel  Cortex

Figure 23—6. Cortical region of an ovary. Besides primordial follicles formed by an oocyte and flat follicular cells, a few follicles at the initial stage of growth (unilaminar primary follicles) are present. These are formed by an oocyte and one layer of cuboidal granulosa cells. Pararosaniline— toluidine blue (PT) stain. Low magnification.

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Figure 23—7. Photomicrograph of a preantral ovarian follicle formed by an oocyte and several layers of granulosa cells. The oocyte is surrounded by the zona pellucida. Picrosirius-hematoxylin (PSH) stain. Medium magnification.

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Folliculus secundarius

Folliculus de Graaf 15

Figure 23—9. Photomicrograph of part of an antral follicle. Cavities (A) that appear in the granulosa layer will fuse and form one large cavity, the antrum. The oocyte is surrounded by the zona pellucida. Granulosa cells (G) surround the oocyte and cover the wall of the follicle. A theca can be seen around the follicle. H&E. Medium magnification.

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Figure 23—10. Photomicrograph of an antral follicle showing the oocyte surrounded by the granulosa cells of the corona radiata and supported by the cells of the cumulus oophorus. The remaining granulosa cells form the wall of the follicle and surround the large antrum. A theca surrounds the whole follicle. PT stain. Medium magnification. 17

Figure 23—11. Photomicrograph of a small part of the wall of an antral follicle, showing the antrum, the layer of granulosa cells, and the thecas. The theca interna surrounds the follicle, and its cells appear lightly stained because their cytoplasm contains lipid droplets, a characteristic of steroidproducing cells. The theca interna is surrounded by the theca externa, which merges with the stroma of the ovary. A basement membrane separates the granulosa layer from the theca interna. PT stain. High magnification. 18

Figure 23—12. Photomicrograph of the atresia of a follicle characterized by: (1) the death of granulosa cells, many of which are seen loose in the antrum; (2) loss of the cells of the corona radiata; and (3) the oocyte floating free within the antrum. PT stain. Medium magnification. 19

Figure 23—13. Part of a corpus luteum. Granulosa lutein cells, which constitute the majority of the cells, derive from the granulosa layer. They are larger and stain more lightly than the theca lutein cells, which originate from the theca interna.

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Figure 23—14. Photomicrograph of a small portion of a corpus luteum. Most cells present in the figure are granulosa lutein cells. PT stain. High magnification.

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Figure 23—15. Pituitary hormones control most ovarian functions. Follicle-stimulating hormone (FSH) stimulates follicular growth and synthesis of estrogen by the granulosa cells. - Luteinizing hormone (LH) induces ovulation and transforms the granulosa layer and the theca interna into an actively secreting gland, the corpus luteum. - Estrogen and progesterone produced in the ovary act on the hypothalamus, stimulating or inhibiting the liberation of gonadotropin-releasing hormone (GnRH). 22

Figure 23—16. Corpus albicans, the scar of connective tissue that replaces a corpus luteum after its involution.

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Corpus luteum 24

Corpus albicans 25

 mrpk massa jar. fibrosa

tidak aktif  Gamb. utama ovarium manusia, jumlahnya meningkat dng usia, sering tampak menempati hampir seluruh jar. stroma ovarium

2. Tuba uterina (oviduct) Terdapat sepasang, panjang ± 12 cm Menjaring ovum yang telah lepas Sebagai tempat utama fertilisasi Membawa ovum ke uterus, baik yang sudah mengalami fertilisasi maupun yang belum mengalami fertilisasi, transportasi zygot ke uterus

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Bagian-bagian tuba uterina Pars interstitialis Isthmus Ampulla Infundibulum, lanjutan lapisan mukosanya berbentuk seperti jari-jari → fimbriae

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Figure 23—17. Photomicrograph of part of the wall of an oviduct. The highly folded mucosa indicates that this region is close to the ovary. PT stain. Low magnification.

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Figure 23—18. Photomicrograph of the epithelial lining of an oviduct. The epithelial lining is formed by ciliated and more darkly staining nonciliated secretory cells. Ciliated cells contribute to the movement of the oocyte or conceptus to the uterus. PT stain. High magnification. 29

Struktur dinding tuba uterina 1. Tunika mukosa: Epithelium simplex columnare: a. Kolumner bersilia b. “Peg cells” → berukuran rendah, diantara sel-sel bersilia, mensekresi mukus: - menolong transportasi ovum dan menghalang-halangi masuknya bakteri ke cavum peritonii

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Tuba uterina (tuba Fallopii)

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Ampula & ismus tuba uterina 32

3. Uterus Dilapisi oleh mukosa (endometrium) yg mengalami perubahanperubahan struktur berkala→ dikendalikan oleh hormon ovarium Berperan sebagai tempat implantasi dan pemberian makanan ovum yg telah mengalami fertilisasi

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Bagian-bagian uterus: Badan = body atau corpus Fundus Cervix atau leher

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Struktur dinding uterus: Fundus dan corpus disusun oleh 3 lapisan: - Myometrium: otot polos 4 lapis - Endometrium: mukosa uterus t.d.: selapis epitel kolumner, lamina propria, gld. tubuler simplex. Endometrium : - stratum fungsionale - stratum basale

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Uterus 36

 Fundus  Tumor

otot /Leiomyoma  Body  Endocervix  Cervix  Ectocervix

Tipe leiomyoma kecil

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Endoserviks

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Serviks uteri 39

Carsinoma cervix 40

 Sel epitel cervix

 Sel epitel

abnormal

 Membana basalis  Stroma

Korpus uteri fase haid 41

1. Vagina Mrpk organ serupa tabung ini membantu mendorong sperma melalui cervix Cairan di dalam lumen vagina menambah motilitas sperma Di bawah pengaruh estrogen, epitel vagina menebal dan sel-selnya menimbun glikogen,

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Vagina 43

Vagina

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5. Apparatus genitalia externa ● Terdiri atas : - Clitoris - Labium mayus - Labium minus ● Mengandung sejumlah besar ujung-ujung serabut saraf →

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Siklus menstruasi Uterus→ Lap. Mukosa: endometrium -

miometrium Perubahan siklis endometrium berlangsung melalui 2 fase: * Fase proliferasi * Fase sekresi

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Endometrium proliferatif

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Endometrium proliferatif

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Endometrium

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Endometrium

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Endometrium: permulaan menstruasi

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Permukaan endometrium

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Endometrium: pasca menopause

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Endometrium pasca menopause

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Miometrium 58

Fertilisasi dan implantasi

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Plasenta

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Desidua 63

 a. desidua → hub.

Perkembangan fetus&plasenta  b. desidua : - parietalis(DP) - capsularis (DC) - basalis (DB)  c. sel desidua: - poligonal - nukleus tercat pucat - granula sitoplasma eosinofilik

Desidua

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Plasenta tahap awal

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Bagian tepi vilus

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Plasenta muda

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Plasenta tua

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Plasenta tua 69

Membran janin

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Funikulus umbilikalis 71

Funikulus umbilikalis (tali pusat)

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GLANDULA MAMMAE

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- Schematic drawing of the female breast showing inactive and active mammary glands. - Each lactiferous duct with its accompanying smaller ducts is a gland in itself and constitutes the lobes of the gland.

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Figure 23—28. Changes in the mammary gland. A: In nonpregnant women, the gland is quiescent and undifferentiated, and its duct system is inactive. B: During pregnancy, alveoli proliferate at the ends of the ducts and prepare for the secretion of milk. C: During lactation, alveoli are fully differentiated, and milk secretion is abundant. Once lactation is completed, the gland reverts to the nonpregnant condition.

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Glandula mammae 76

STRUKTUR MAMMAE

Terdiri dari : Jaringan alveolar (kelenjar susu) : * lobus-lobus dipisahkan oleh j. ikat & j. lemak * setiap lobus bermuara ke ductus lactiferus (saluran air susu) * Saluran limfe sebagai plexus halus dalam septum interlobularis jaringan

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Photomicrograph of lactating mammary gland. Several alveoli are filled with milk, visible as granular material. The vacuoles in the lumen and in the alveolar cell cytoplasm represent the lipid portion of milk. PT stain. Medium magnification. 78

Figure 23—30. Secreting cells from the mammary gland. From left to right, note the accumulation and extrusion of lipids and proteins. The proteins are released through exocytosis. 79

Glandula mammae

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Kelenjar mamma non-aktif

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Glandula mammae selama kehamilan

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Glandula mammae dalam masa laktasi

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Kelenjar mamma dalam masa laktasi 84

ORGANA GENITALIA FEMININA ORGANA GENITALIA EXTERNA ORGANA GENITALIA INTERNA

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ORGANA GENITALIA EXTERNA CLITORIS VESTIBULUM LABIUM MINUS LABIUM MAYUS KELENJAR DEWASA (SELAMA KEHAMILAN) KELENJAR LAKTASI INVOLUSI SENILIS 86

FUNGSI : Sebagai jalan masuk sperma ke dalam tubuh wanita Sebagai pelindung organ kelamin dalam dari organisme penyebab infeksi

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Klitoris 89

Labium minus

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Labium mayus

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