ANATOMY- FEMALE REPRODUCTIVE SYSTEM, Lecture notes of Anatomy

Download ANATOMY- FEMALE REPRODUCTIVE SYSTEM and more Lecture notes Anatomy in PDF only on Docsity! FEMALE REPRODUCTIVE SYSTEM A. External Genitalia – Organs outside the true pelvis B. Internal Genitalia – Organs within the true pelvis External Genitalia 1. Mons pubis 2. Labia majora and minora 3. Clitoris 4. Vestibule 5. Vestibular glands Internal Genitalia 1. Vagina 2. Uterus 3. Ovaries 4. Uterine tubes THE FEMALE UROGENITAL TRIANGLE A. Vulva – Term applied to the female external genitalia 1. Mons Pubis – Rounded hair-bearing elevation of skin anterior to the pubis 2. Labia Majora – Prominent, hair bearing folds of skin extending posteriorly from the mons pubis to unite posteriorly in the midline Mons Pubis Labia Majora 3. Labia Minora – Two smaller hairless folds of soft skin that lie between the labia majora. Their posterior ends are united to form a sharp fold, the fourchette. Anteriorly, they split to enclose the clitoris, forming an anterior prepuce and a posterior frenulum. 4. Vestibule – Smooth triangular area bounded laterally by the labia minora, with the clitoris at its apex and the fourchette at its base. SNELL 437, 449 External genitalia and the orifices of the urethra and vagina Labia Minora Vestibule 5. Vaginal Orifice – In virgins, this is protected by a thin mucosal fold, the hymen which is perforated at the center. 6. Orifices of the ducts of Greater Vestibular Glands – Small orifices one on each side, are found in the groove between the hymen and the posterior part of the labium minus 7. Clitoris – Situated at the apex of the vestibule anteriorly. The glans of the clitoris is partly hidden by the prepuce. Vaginal Orifice Clitoris Opening of the Bartholin’s Gland UTERUS Hollow, thick walled pear shaped muscular organ normally located in the lesser pelvis between the urinary bladder in front and the rectum behind. It measures about 7.5 cms in length, 5 cms in its widest diameter and nearly 2.5 cms in thickness. It weighs 30-40 gms. The lesser pelvis (or true pelvis) is that part of the pelvic cavity which is situated below and behind the pelvic brim. Relations of the Uterus A. Anteriorly – The body of the uterus is related anteriorly to the uterovesical pouch and the superior surface of the bladder. The supravaginal cervix is related to the superior surface of the bladder. The vaginal cervix is related to the anterior fornix of the vagina B. Posteriorly – Related posteriorly to the rectouterine pouch (Pouch of Douglas) with coils of the ileum or sigmoid colon C. Laterally – The body of the uterus is related laterally to the broad ligament and the uterine artery and vein . The supravaginal cervix is related to the ureter as it passes forward to enter the bladder. The vaginal cervix is related to the lateral fornix of the vagina. The uterine tubes enter the superolateral angles of the uterus, and the round ligaments of the ovary and of the uterus are attached to the uterine wall just below this level. Position of the Uterus A. Anteversion – In most women, the long axis of the uterus is bent forward on the long axis of the vagina B. Anteflexion – Long axis of the body of the uterus is bent forward at the level of the internal os with the long axis of the cervix C. Retroverted – The fundus and the body of the uterus are bent backward on the vagina so that they lie in the rectouterine pouch (Pouch of Douglas) D. Retroflexed – Body of the uterus is in addition bent backward on the cervix E. In the erect position, with the bladder empty, the uterus lies in an almost horizontal position ANTEVERSION ANTEFLEXION cms long, 1.5 cms wide and 1 cm thick. The position of the ovary is subject to a wide variation in women who have borne children because it is displaced in the first pregnancy and probably never returns to its original position. Relations of the Ovary A. Anteriorly – Obliterated umbilical artery B. Posteriorly – Ureter and internal iliac artery C. Superiorly – External iliac vessels Ligaments of the Ovary A. Mesovarium – Ovary is attached to the back of the broad ligament B. Round ligament of the ovary – Represents the remains of the upper part of the gubernaculum connects the lateral margins of the uterus to the ovary C. Suspensory ligament of the ovary – Part of the broad ligament extending between the attachment of the mesovarium and the lateral wall of the pelvis MESOVARIUM Blood Supply of the Ovary The ovarian artery from the abdominal aorta Venous Drainage of the Ovary Ovarian veins drains into the IVC on the right and left renal vein on the left Lymphatic Drainage of the Ovary Lymph vessels follow the ovarian artery and drain into the para-aortic nodes at L1 vertebra Innervation of the Ovary Aortic plexus at L1 vertebra The blood supply, lymph and nerve supply of the ovary pass the lateral end of broad ligament, part known as the suspensory ligament of the ovary FALLOPIAN TUBE The Fallopian tubes also known as oviducts, uterine tubes, and salpinges (singular salpinx) are two very fine tubes lined with ciliated epithelia, leading from the ovaries into the uterus, via the utero-tubal junction. Transmits ova from the ovaries to the cavity of the uterus and are situated in the upper margins of the broad ligaments. Communications of the Fallopian Tube A. Abdominal ostium – Opening into the peritoneal cavity B. Opening to the uterus – Uterine part of the tube or intramural Parts of the Fallopian Tube A. Infundibulum – Funnel shaped lateral end that projects beyond the broad ligament and overlies the ovary. The free edge of the funnel has several fingerlike processes known as fimbriae B. Ampulla – Widest part of the tube; Most common site of fertilization C. Isthmus – Narrowest part of the tube and lies just lateral to the uterus D. Intramural part – Segment that pierces the uterine wall Blood Supply of the Fallopian Tube The uterine artery from the internal iliac artery and the ovarian artery from the abdominal aorta Venous Drainage of Fallopian Tube Corresponds to the artery Lymphatic Drainage of the Fallopian Tube The lymph vessels follow the corresponding arteries and drain into the internal and para-aortic nodes Innervation of the Fallopian Tube Inferior Hypogastric plexus TUBAL LIGATION Tubal ligation is a permanent voluntary form of birth control (contraception) in which a woman's fallopian tubes are surgically cut or blocked off to prevent pregnancy. Tubal ligation is performed in women who want to prevent future pregnancies. It is frequently chosen by women who do not want more children, but who are still sexually active and potentially fertile, and want to be free of the limitations of other types of birth control. VAGINA Description: It measures about 3 inches; Muscular tube which extends upward and backward between the vulva and the uterus; Female genital canal, excretory duct for the menstrual flow and forms part of the birth canal. Relations: The upper half of the vagina lies above the pelvic floor within the pelvis between the bladder anteriorly and the rectum posteriorly; the lower half lies within the perineum between the urethra anteriorly and the anal canal posteriorly Communications: Vulva and uterus Blood Supply: The vaginal artery, branch of the internal iliac artery, and the vaginal branch of the uterine artery Venous Drainage: Vaginal veins drain into the internal iliac veins Lymphatic Drainage: The upper third of the vagina is drained by internal and external iliac nodes, the middle third by the internal iliac nodes, and the lower third by the superficial inguinal nodes Nerve Supply: Nerves from the inferior hypogastric plexuses CULDOCENTESIS The closeness of the peritoneal cavity to the posterior vaginal fornix enables the physician to drain a pelvic abscess through the vagina without performing a major operation. It is also possible to identify blood or pus in the peritoneal cavity by the passage of a needle through the posterior fornix. The needle will pass through the mucous membrane of the vagina, muscular coat of the vagina, connective tissue coat of the vagina, visceral layer of pelvic fascia and the visceral layer of peritoneum. Complications: 1. Loops of ileum and sigmoid colon are normally present in the pouch of Douglas could be impaled by the needle 2. When the uterus is retroflexed, the needle may enter the posterior wall of the body of the uterus