952 



MENSTRUATION. 



The essential characteristic internal phenomena of menstruation 

 concern: (i) The alterations in the uterine mucosa and (2) the rupture 

 of the ovarian follicle. 



The uterine mucosa is the actual source of the hemorrhage. The 

 ciliated epithelium of the reddened, greatly swollen, spongy and soft 

 endometrium, from 3 to 6 mm. thick, is exfoliated. The openings of 

 the numerous convoluted uterine glands are distinct, but their cells 

 are in a state of fatty degeneration, as is also the interglandular tissue 

 of the cells and the blood-vessels. This fatty degeneration and the 

 desquamation of the degenerated tissue after disintegration take place 

 only in the superficial layers of the mucosa, whose lacerated vessels 

 give rise to the hemorrhage. The deeper layers of the mucosa remain 

 intact and from them reconstruction of the entire mucosa takes place at 

 the close of menstruation. 



^-- Ampulla of the tube. 

 ^__-- Fallopian tube. 



Isthmus of the tube. 



Infundibulum of the tube 



Fimbriated 

 extremity of 

 the tube. 



Fimbria ovarica. 



Uterus. 



Infundibulo-pelvic ligament. ; 



T ,.,.,. ,. ' Ovarian ligament. 



Infundibulo-ovanan ligament. 



Ovary. Broad ligament. 



FIG. 362. The Ovary and the Fallopian Tube (after Henle). 



* Blood-vessel following the margin of the ovary. Eo. Epoophoron exposed by removal of a portion of the 



broad ligament. 



The second important internal process, ovulation, takes place in 

 the ovary. The latter receives a greatly increased supply of blood, and 

 the most mature follicle becomes more fully distended, projects above 

 the surface, and finally ruptures its wall and the ovarian capsule, with 

 hemorrhage from the laceration. At the same time the fimbriated ex- 

 tremity of the tube, in a state of erection from the engorgement of the 

 vessels, lies in close apposition to the ovary in such a manner that the 

 ovum, carried out with the liquor of the follicle and the surrounding 

 granulosa-cells, passes along the ovarian fimbriae and falls into the tube. 

 The ciliated cells of the tube and the fimbriae, moving toward the uterus, 

 cause a movement of the fluid moistening the ovary that carries the 

 ovum into the funnel of the tube. Ducalliez and Kiiss were able by 

 tense injection of the vessels to bring about artificial erection and ap- 

 plication of the abdominal orifice of the tube to the ovary. Rouget 

 calls attention to the unstriated muscle-fibers of the broad ligament, 

 which it is thought may by constriction cause the necessary injection of 

 the tubal vessels. 



