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The Normal Female Pelvic Anatomy

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20 views7 pages

The Normal Female Pelvic Anatomy

Uploaded by

piceng ismail
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Chapter 1

The Normal Female Pelvic Anatomy

Chapter 1 : Basic Anatomy


In order to understand gynaecological diseases and
gynaecological laparoscopic surgery, it is important to
first understand the normal female pelvic anatomy.
The female reproductive system consists of 4 major parts:
the uterus, vagina, fallopian tubes and ovaries.
PART 1 : Common Gynaecological Diseases

Figure 1.1 Female body showing the


Uterus female reproductive system

The uterus, or womb, is a hollow, pear-


shaped organ with a thick muscular
wall. It is subdivided into two parts: the
corpus (body), and the cervix (neck).
• The corpus comprises the fundus, which • The cervix is the lower constricted
is the top portion of the uterus; and the segment of the uterus that joins the upper
cavity of the uterus. The cavity is where part of vagina. The small cervical opening
the embryo/foetus develops during into the vagina is called the external
pregnancy. The inner layer or the lining os while the one in the uterine cavity
of the uterus, is called the endometrium. is called the internal os. They allow the
Every month, it thickens in preparation for sperm to enter the uterus during sexual
potential pregnancy and sheds during intercourse and the menstrual fluid to flow
menstruation if pregnancy does not occur. out of the uterus during menstruation. The
The middle layer of the uterus is known as cervix can be visualised from the vagina.
the myometrium. It is mainly composed
of smooth muscle cells, which collectively
give the uterus the strength to contract
and expel the foetus during childbirth.
The outermost layer of the uterus is the
serosa, also known as the perimetrium.

34
Chapter 1: The Normal Female Pelvic Anatomy

Figure 1.2 Front section of female reproductive sysem

Vagina Ovaries
The vagina is a muscular, narrow canal The ovaries are small, oval-shaped paired
that extends from the vaginal opening glands that are attached to each side
called introitus, to the cervix. It is also of the uterus via a thin, fibrous ovarian
known as the birth canal due of the ligament. The pair is responsible for
fact that the foetus passes through it storing and nurturing immature egg cells
to be born during natural childbirth. to become mature eggs. Every month,
The inner wall of the vagina is surfaced one of the ovaries releases a mature egg
with numerous folds of soft elastic into its neighboring Fallopian tube. In
mucous membrane called vaginal addition to producing eggs, the ovaries
rugae. This allows the vagina to expand produce two main female sex hormones:
considerably during sexual intercourse the oestrogen and progesterone, which
or childbirth. During menstruation, are vital in regulating menstrual cycles.
the vagina provides a channel for the
menstrual fluid to flow out of the body.

35
PART 1 : Common Gynaecological Diseases

Fallopian tubes
The fallopian tubes, sometimes simply called tubes, are the two channels
that connect the ovaries to the uterus. They are the main structures that
facilitate fertilization. Each tube is divided into 5 main portions:

1) Fimbriae 5) Interstitium
The fringe-like structure located at the end The portion of the tube that is closest to
of the tube that captures an egg released the uterus. It is sometimes known as the
from the ovary and draws it into the tube. uterine portion of the tube for the fact
that it lies within the uterus.
2) Infundibulum
The funnel-like structure of the tube,
The inner lining of the fallopian tube is
which is margined by the fimbriae.
made up of fine finger like projections
3) Ampulla called the cilia.
The longest portion of the tube with These cilia are important in assisting
a thin wall (almost muscle-free) and the movement of the eggs towards
wide lumen (g). It is usually the portion the uterine cavity and the sperms into
where fertilization takes place. the ampulla of the fallopian tube.
4) Isthmus
The almost straight portion of the tube
with a relatively thick muscular wall
and with the narrowest lumen(g).

Figure 1.3 Anatomy of the Fallopian Tube.

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Chapter 1: The Normal Female Pelvic Anatomy

Figure 1.4 is a different view of the female


pelvis. It is how the pelvis looks when
a gynaecologist looks at the pelvis
either through a laparotomy (large
incision on the abdomen) or through
a laparoscope (key hole surgery).
The uterus is in the centre. In front
(anterior) of the uterus is the urinary
bladder. Behind (posterior) to the uterus
is the rectum. A slippery membrane
called the peritoneum(g) covers the
whole pelvis and abdomen. Beneath
the peritoneum, on either side of the
pelvis, run the ureters. The ureter is a small
tube that carries urine and runs from the
kidney to the bladder. Large blood vessels
Figure 1.4 Superior view of the pelvic organs are present on both sides of the pelvis.
These blood vessels carry blood from
the heart to both the legs and back.

Figure 1.5 Side view of the abdomen and pelvis

Figure 1.5 is a side view of the abdomen and pelvis.


The uterus is in the centre. On the side and behind
the uterus are the fallopian tubes and the ovaries. In
front of (anterior to) the uterus is the urinary bladder
and behind it (posterior to) is the rectum.

37
PART 1 : Common Gynaecological Diseases

Figure 1.6 Laparoscopic view of a normal pelvic

Figure 1.6 Laparoscopic view of a normal pelvis


(a) Uterus,
(b) Right ovary,
(c) Right fallopian tube,
(d) Right infundibulopelvic ligament,
(e) Rectum,
(f) Pouch of Douglas,
(g) Right uterosacral ligament,
(h) Left uterosacral ligament,
(i) Left fallopian tube,
(j) Left ovary,
(k) Left infundibulopelvic ligament.

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Chapter 1: The Normal Female Pelvic Anatomy

Figure 1.7 Urinary system

Figure 1.7 shows the urinary system. Ureters connect


the kidneys to the urinary bladder. Ureters are found
behind the peritoneum on the pelvic sidewalls.
They run below the ovaries and on the side of the
cervix under the uterine arteries before entering the
bladder via the ureteric tunnel. Ureters are important
structures to identify during gynaecological surgeries.

Scan Me
Watch Video 1.1
Normal female pelvic anatomy.
https://vimeo.com/149588511

Summary
It is important to understand the normal
female anatomy before proceeding to
learn about common gynaecological
diseases and laparoscopic surgery
for gynaecological diseases.

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