8/18/2019 Repro Duk Siwan It A
1/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Human Anatomy & Physiology, Sixth Edition
Elaine . !arieb
PowerPoint® Lecture Slides prepared by Vince Austin, University of Kentucky
Sistem Reproduksi
Wanita
8/18/2019 Repro Duk Siwan It A
2/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
2
Anatomi Reproduksi Wanita
"#arium adl organ reprodu$si utama %anita
!&buat gamet 'o#a(
!&se$resi$an hormone $elamin 'estrogen )
progesterone(
"rgan a$sesoris* du$tus t&ms$ tuba uterin, uterus,
dan #agina +enitalia internal o#arium ) du$tus internal
+enitalia e$sternal organ2 $elamin e-ternal
8/18/2019 Repro Duk Siwan It A
3/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Anatomi Reproduksi Wanita
/igure 2.11
8/18/2019 Repro Duk Siwan It A
4/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
4
Ovarium
Pasangan organ yg ada di tiap sisi uterus ygdipegang oleh bbrp ligaments
"#arian jang$ar o#ary leta$nya medial thd uterus
uspensory jang$ar o#ary leta$nya lateral thd
dinding pel#is 'panggul(
!eso#arium m&gantung$an o#arium di tengahnya 3igament luas tda ligament suspensory dan
meso#arium
8/18/2019 Repro Duk Siwan It A
5/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Ovarium
/igure 2.14a
8/18/2019 Repro Duk Siwan It A
6/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
5
Ovarium
uplai darah arteri o#arian ) cabang o#arian dari arteri
uterine
!ere$a di$elilingi oleh tunica albuginea 6ibrous, yg ditutup
oleh selapis sel epithel yang disebut epitel germinal
!enempel dlm $orte$s o#ary adl 6oli$el o#arian
7iap 6ollicle tdd satu telur yg blm masa$ 'immature( yg
disebut oocyte
el2 di se$itar oocyte disebut*
el2 6ollicle 'satu sel b&lapis tebal(
el2 granulosa 'di mana t&dpt lbh dr 1 lapis(
8/18/2019 Repro Duk Siwan It A
7/56Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Ovarium
6oli$el primordial satu lapis sel 6oli$el mirip
s$uamos yg mengelilingi oocyte
6oli$el primer dua 8 lebih lapis sel2 granulosacuboid menutupi oocyte
6oli$el se$under mempunyai ruang yang berisi
cairan antara sel2 granulosa yang menyatu untu$membentu$ central antrum
8/18/2019 Repro Duk Siwan It A
8/56Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
9
Ovarium
/ollicle +raa6ian 6oli$el se$under pd $ebanya$an
tahap matur yg m&beng$a$ dari permu$aan o#arium
"#ulasi pengeluaran oocyte dari pematangan
6oli$el
Corpus luteum 6oli$el yg ruptur setelah o#ulasi
8/18/2019 Repro Duk Siwan It A
9/56Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
:
Ovarium
/igure 2.12
8/18/2019 Repro Duk Siwan It A
10/56Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
10
Tube Uterina (Tuba allopii! dan Ovidu"ts
!enerima oocyte yg telah mengalami o#ulasi danmemberi$an tempat untu$ 6ertilisasi 'pembuahan(
Berjalan $e regio superolateral uterus #ia isthmus
!elebar secara distal di se$itar o#arium membentu$
ampulla
;mpulla bera$hir dg bentu$ corong. In6undibulum*ujung dari tuba dg umbai
8/18/2019 Repro Duk Siwan It A
11/56Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
11
Tube Uterina
7uba uterina td$ punya $onta$ dg o#arium dan
oocyte yg telah o#ulasi dilempar di rongga peritoneum
=enyut cilia pada 6imbriae mencipta$an arus untu$
memba%a oocyte $e dalam tuba uterine "ocyte diba%a $e arah uterus oleh peristalti$ dan
$erja ciliary
el2 noncilia menjaga oocyte dan sperma cu$up gi>idan lembab
!esosalpin- peritoneum #isceral yg menopang
tuba uterina
8/18/2019 Repro Duk Siwan It A
12/56Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
12
Uterus
"rgan berongga dg dinding tebal t&leta$ dlm pel#is
anterior thd rectum ) posterosuperior thd $andung
$emih
Body porsi besar dari uterus
/undus regio yg m&bulat superior thd pintu masu$
tuba uterine
Isthmus regio yg menyempit antara body ) cer#i-
8/18/2019 Repro Duk Siwan It A
13/56Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
1
Uterus
Cer#i- 'leher rahim( leher sempit yg tdpt dlm
in6erior #agina
Cer#ical canal rongga cer#i- yg menghubung$an
dengan*
?agina #ia os e-ternal
Badan uterus #ia os internal
@elenjar ser#i$s mense$resi mucus yg menutupi os
e-ternal dan menghalangi sperma masu$ $ecuali
selama pertengahan si$lus
8/18/2019 Repro Duk Siwan It A
14/56Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
14
#upports o$ the Uterus
!esometrium portion o6 the broad ligament that
supports the uterus laterally
3ateral cer#ical ligaments e-tend 6rom the cer#i-
and superior part o6 the #agina to the lateral %alls o6the pel#is
Aterosacral ligaments paired ligaments that secure
the uterus to the sacrum
ound ligaments bind the anterior %all to the labia
majora
8/18/2019 Repro Duk Siwan It A
15/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings1
Peritoneal Pou"hes
e#eral cul
8/18/2019 Repro Duk Siwan It A
16/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings15
%inding uterus
7erdiri dari lapisan
Perimetrium outermost serous layer the #isceral
peritoneum
!yometrium middle layer interlacing layers o6
smooth muscle
Endometrium mucosal lining o6 the uterine ca#ity
8/18/2019 Repro Duk Siwan It A
17/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings1
Uterine Wall
/igure 2.1b
8/18/2019 Repro Duk Siwan It A
18/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings19
ndometrium
!empunyai sejumlah $elenjar uterus yg berubah
panjangnya seperti berubahnya $etebalan endometrial
tratum 6ungsionalis*
!engalami perubahan si$lus dlm merespon thd hormon2
o#arium
=itumpah$an selama menstruasi
tratum basalis*
!embentu$ 6ungsionalis baru setelah menstruasi bera$hir
7ida$ merespon thd hormon2 o#arium
8/18/2019 Repro Duk Siwan It A
19/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings1:
#upply Pembuluh %arah Uterus
;rteries uterine arise 6rom the internal iliacs,
ascend the sides o6 the uterus and send branches intothe uterine %all
;rcuate arteries branches o6 the uterine arteries in
the myometrium that gi#e rise to radial branches
adial branches descend into the endometrium and
gi#e o66*
piral arteries to the stratum 6unctionalis
traight arteries to the stratum basalis
8/18/2019 Repro Duk Siwan It A
20/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings20
#uplai Pembuluh %arah Uterine
=egeneration and regeneration arteri spiral
menyebab$an 6ungsionalis ditumpah$an selamamenstruasi
?ena endometrium berdinding tipis dengan
pelebaran sinusoid
8/18/2019 Repro Duk Siwan It A
21/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings21
'agina
aluran berdinding tipis yg terleta$ antara $andung$emih dan re$tum, memanjang dari cer#i- bagian
luar tubuh
Arethra dile$at$an pd dinding anterior
!emberi$an jalan untu$ persalinan, aliran
menstruasi, dan merupa$an organ senggama
!u$osa de$at ori6isium #agina membentu$ suatu
se$at yg tida$ sempurna yg disebut hymen
8/18/2019 Repro Duk Siwan It A
22/56
8/18/2019 Repro Duk Siwan It A
23/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings2
ternal )enitalia* 'ulva (Pudendum!
7erleta$ di bag luar #agina, termasu$ mons pubis,labia, clitoris, dan #estibular
!ons pubis bundar, area berlema$ di atas sim6isis
pubis
3abia majora memanjang, ditutupi rambut, lipatan
$ulit berlema$ homologous thd s$rotum la$i
8/18/2019 Repro Duk Siwan It A
24/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings24
ternal )enitalia* 'ulva (Pudendum!
@elenjar #estibular yg lebih besar
@elenjar sebesar $acang polong yg mengapit#agina
Domologous to thd $elenjar bulbourethral 'pria(
!enjaga #estibule lembab dan melumasi
8/18/2019 Repro Duk Siwan It A
25/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings2
ternal )enitalia* 'ulva (Pudendum!
Clitoris 'homologous to the penis(
Erectile tissue hooded by the prepuce
7he e-posed portion is called the glans
Perineum
=iamond
8/18/2019 Repro Duk Siwan It A
26/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings25
+ammary )lands
!odi6i$asi dari $elenjar $eringat yang terdiri dari 1<
2 lobus yang menyebar di se$itar dan membu$a pada puting
;reola pigmentasi $ulit di se$itar puting
uspensory ligaments attach the breast to underlying
muscle 6ascia
3obus2 berisi glandular al#eoli yg m&produ$si susu
pada %anita menyusui
Campuran $elenjar al#eolar menyalur$an susu $e
du$tus lacti6erous, yg membu$a $e bag luar
8/18/2019 Repro Duk Siwan It A
27/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings2
#tru"ture o$ a"tating +ammary )lands
/igure 2.1
8/18/2019 Repro Duk Siwan It A
28/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings29
-reast .an"er
Asually arises 6rom the epithelial cells o6 the ducts
is$ 6actors include*
Early onset o6 menses or late menopause
o pregnancies or the 6irst pregnancy late in li6e Pre#ious history o6 breast cancer or 6amily history o6 breast
cancer
Dereditary 6actors including mutations to the genes BC;1and BC;2
0 o6 %omen %ith breast cancer ha#e no $no%n ris$6actors
.
8/18/2019 Repro Duk Siwan It A
29/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings2:
-reast .an"er* %ete"tion and Treatment
Early detection is by sel6
8/18/2019 Repro Duk Siwan It A
30/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings0
Oogenesis
O i P b t
8/18/2019 Repro Duk Siwan It A
31/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings1
Oogenesis* Puberty
;t puberty, one acti#ated primary oocyte produces t%ohaploid cells
7he 6irst polar body
7he secondary oocyte
7he secondary oocyte arrests in metaphase II and is o#ulated
I6 penetrated by sperm the second oocyte completes meiosisII, yielding*
"ne large o#um 'the 6unctional gamete(
; tiny second polar body
t $ O i
8/18/2019 Repro Duk Siwan It A
32/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings2
vents o$ Oogenesis
/igure 2.1:
8/18/2019 Repro Duk Siwan It A
33/56
$ lik l
8/18/2019 Repro Duk Siwan It A
34/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings4
ase $olikuler
/oli$el primordial, diarah$an oleh oocyte, menjadi a6oli$el primer
/oli$el primer menjadi 6oli$el se$under
7e$a 6olliculi dan sel
8/18/2019 Repro Duk Siwan It A
35/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
ase $olikuler
/oli$el se$under menjadi 6oli$el #esicular
;ntrum melebar dan m&isolasi oosit dan corona
radiata /oli$el #esicular membeng$a$ dari permu$aan luar
o#arium
"osit primer meleng$api meiosis I, dan tahap yang
diatur untu$ o#ulasi
O i . l
8/18/2019 Repro Duk Siwan It A
36/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings5
Ovarian .y"le
/igure 2.20
O lasi
8/18/2019 Repro Duk Siwan It A
37/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Ovulasi
"#ulasi terjadi $eti$a dinding o#arium ruptur dan
mengeluar$an oosit se$under
!ittelschmer> nyeri tusu$ $adang terasa saat
o#ulasi
1
8/18/2019 Repro Duk Siwan It A
38/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings9
ase uteal
etelah o#ulasi, 6oli$el yg ruptur collaps '$empes(,
sel2 granulosa cells membesar, dan bersama sel2the$a internal, membentu$ corpus luteum
@orpus luteum mense$resi$an progesterone and
estrogen Hi$a $ehamilan tida$ terjadi, corpus luteum
mengalami degenerasi dlm 10 hari, meninggal$ans$ar 'corpus albicans(
Hi$a $ehamilan terjadi, corpus luteum m&produ$sihormon sampai plasenta mengambil alih peran tsb'pad se$itar bulan(
+enetapkan #iklus Ovarium
8/18/2019 Repro Duk Siwan It A
39/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings:
+enetapkan #iklus Ovarium
elama masa $ana$ 2, o#arium tumbuh dan
mense$resi$an sejumlah $ecil estrogen yg
menghambat lepasnya +nD hypothalami$
!enjelang pubertas, +nD dilepas$an /D dan 3D
dilepas$an oleh pituitary, yg be$erja pd o#arium
Peristi%a ini berlanjut sampai suatu pola si$lusde%asa dicapai dan menarche terjadi
/nteraksi Hormonal #elama #iklus Ovarium
8/18/2019 Repro Duk Siwan It A
40/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings40
/nteraksi Hormonal #elama #iklus Ovarium
Dari 1 +nD merangsang lepasnya /D dan 3D
/D dan 3D merangsang pertumbuhan ) pematangan 6oli$el,dan estrogen $adar rendah dilepas$an
!ening$atnya $adar estrogen*
!enghambat lepasnya /D dan 3D
!emacu pituitary untu$ mensintesa dan mengumpul$an
gonadotropin2 ini
@adar estrogen mening$at dan tingginya $adar estrogen
memili$i e6e$ umpan bali$ positi6 pituitary, menyebab$anhenta$an mendada$ dari 3D
/nteraksi Hormonal #elama #iklus Ovarium
8/18/2019 Repro Duk Siwan It A
41/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings41
/nteraksi Hormonal #elama #iklus Ovarium
3D merangsang oocyte primer untu$
menyempurna$an meiosis I, dan oocyte se$under
melanjut$an $e metaphase II
Dari $e 14 3D mencetus$an o#ulation
3D mentrans6ormasi 'm&ubah bentu$( 6oli$el yg
telah ruptur menjadi corpus luteum, yg m&produ$siinhibin, progesterone, dan estrogen
/nteraksi Hormonal #elama #iklus Ovarium
8/18/2019 Repro Duk Siwan It A
42/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings42
/nteraksi Hormonal #elama #iklus Ovarium
Dormon2 ini menutup /D dan 3D lepas dan
menurun$an 3D di a$hir a$ti#itas luteal
Dari $e 25
8/18/2019 Repro Duk Siwan It A
43/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings4
eedba"k +e"hanisms in Ovarian un"tion
/igure 2.21
#iklus Uterina (+enstrual!
8/18/2019 Repro Duk Siwan It A
44/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings44
#iklus Uterina (+enstrual!
ang$aian si$lus perubahan yang dialami
endometrium tiap bulan dalam merespon hormon
o#arian dalam darah
Dari 1
8/18/2019 Repro Duk Siwan It A
45/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings4
+enses
Hi$a 6ertilisasi td$ tjd, $adar progesterone turun,
menghilang$an du$ungan hormonal endometrium
;rteri spiral $a$u dan spasme dan sel2 endometrial
mulai mati
3apisan 6ungsional mulai mencerna dirinya sendiri
;rteri spiral mengerut pd satu %a$tu $emudian tiba2
rile$s ) membu$a lebar
=erasnya 6ragmen2 darah melemah$an bantalan
$apiler dan lapisan 6ungsional mengelupas
)onadotropins Hormones and the Ovarian and
8/18/2019 Repro Duk Siwan It A
46/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
45/igure 2.22a, b
)onadotropins, Hormones, and the Ovarian and
Uterine .y"les
)onadotropins Hormones and the Ovarian and
8/18/2019 Repro Duk Siwan It A
47/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
4/igure 2.22c, d
)onadotropins, Hormones, and the Ovarian and
Uterine .y"les
$ek0 trauterine strogens dan Progesterone
8/18/2019 Repro Duk Siwan It A
48/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
49
@adar estrogen mening$at selama pubertas
!ening$at$an oogenesis dan pertumbuhan 6ollicle dalam
o#arium
!engguna$an e6e$ anaboli$ pd saluran reprodu$si %anita
Aterine tubes, uterus, and #agina tumbuh membesar dan
menjadi ber6ungsi
7uba 6allopii dan uterus menunju$$an pening$atan motilitas
!u$osa #agina menebal dan genetalia e$sternal matang
$ek0 trauterine strogens dan Progesterone
Tanda1tanda 2elamin #ekunder 3ang %isebab
8/18/2019 Repro Duk Siwan It A
49/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
4:
Pertumbuhan payudara
!ening$atnya deposisi lema$ sub$utan, $hususnya
pinggul dan payudara
Panggul melebar dan menjadi ringan
Pertumbuhan bulu pubis dan a-ila
Tanda1tanda 2elamin #ekunder 3ang %isebab
kan strogen
8/18/2019 Repro Duk Siwan It A
50/56
#eually Transmitted %iseases* )onorrhea
8/18/2019 Repro Duk Siwan It A
51/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
1
#eually Transmitted %iseases* )onorrhea
Bacterial in6ection spread by contact %ith genital,anal, and pharyngeal mucosal sur6aces
igns and symptoms
In males pain6ul urination, discharge o6 pus 6rom
the penis In 6emales none '20(, abdominal discom6ort,
#aginal discharge, abnormal uterine bleeding
3e6t untreated, can result in pel#ic in6lammatorydisease
7reatment* antibiotics, but resistant strains are becoming more pre#alent
#eually Transmitted %iseases* #yphilis
8/18/2019 Repro Duk Siwan It A
52/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
2
#eually Transmitted %iseases* #yphilis
Bacterial in6ection transmitted se-ually or
contracted congenitally
In6ected 6etuses are stillborn or die shortly a6ter birth
; painless chancre appears at the site o6 in6ection
and disappears in a 6e% %ee$s
#eually Transmitted %iseases* #yphilis
8/18/2019 Repro Duk Siwan It A
53/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
#eually Transmitted %iseases* #yphilis
econdary syphilis sho%s signs o6 pin$ s$in rash,
6e#er, and joint pain
; latent period 6ollo%s, %hich may progress to
tertiary syphilis characteri>ed by gummas 'lesions o6
the C, blood #essels, bones, and s$in(
7reatment* penicillin
#eually Transmitted %iseases* .hlamydia
8/18/2019 Repro Duk Siwan It A
54/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
4
#eually Transmitted %iseases* .hlamydia
!ost common 7= in the A..
esponsible 6or 20 o6 all diagnosed cases o6
pel#ic in6lammatory disease
ymptoms include urethritis penile and #aginaldischarges abdominal, rectal, or testicular pain
pain6ul intercourse and irregular menses
Can cause arthritis and urinary tract in6ections inmen, and sterility in %omen
7reatment is %ith tetracycline
%evelopment Aspe"ts* Puberty
8/18/2019 Repro Duk Siwan It A
55/56
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
%evelopment Aspe"ts* Puberty
eproducti#e organs gro% to adult si>e and become
6unctional
econdary se- characteristics appear
Characteristics o6 puberty
!ales enlargement o6 the testes and scrotum,
appearance o6 a-illary and 6acial hair, and gro%th
o6 the penis
/emales enlarging o6 the breasts, menarche, and
dependable o#ulation
+enopause
8/18/2019 Repro Duk Siwan It A
56/56
5
+enopause
"#ulasi dan menses berhenti seluruhnya
7anpa estrogen yang cu$up, organ reprodu$si dan
payudara menjadi atrophy
!enga$ibat$an sensiti6 dan depresi
Pembuluh darah $ulitb mengalami #asodilatasi yg
intense 'terjadi hot 6lashes(
7erdi $ehilangan tulang dan menipisnya $ulit
berangsur