anatomy of Female genital organs [auto saved]
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The document describes female genital organs, including the uterus, fallopian tubes, ovaries, and associated ligaments. It notes that the uterus is pear-shaped and located in the pelvis between the rectum and bladder. It has three parts: the fundus, body, and cervix. The fallopian tubes extend from the lateral angles of the uterus to the ovaries. The ovaries are connected to the broad ligament by the mesovarium and ovarian ligament. The broad ligament divides the pelvis and contains the fallopian tubes, ovaries, and uterine vessels.
anatomy of Female genital organs [auto saved]
- 1. Female genital organs Dr. Mohamed Elfiky Professor of anatomy and embryology
- 2. Uterus Shape: Pear-shaped muscular organ. Size: 3 inches long, 2 inches wide, 1 inch thickness. Structure: It is formed of 3 parts fundus, body & cervix. (a)The fundus: is the dome-shaped part above the level of the openings of the Fallopian tubes. It is convex in all directions. (b)The body: is the part extending from the level of the openings of the Fallopian tubes to the constriction called isthmus. (c)The cervix: is the part below the level of the isthmus. It has a supra-vaginal part (outside the vagina) & a vaginal part which projects inside the vagina. Mohamed el fiky
- 3. It lies in the cavity of the pelvis between the rectum posteriorly & the urinary bladder anteriorly N.B: In the anatomical position, the uterus is anteverted anteflexed: Anteverted: The axis of the cervix with the long axis of vagina forms nearly a right angle (90 degree) . Anteflexed: the long axis of the body forms an angle 170 degree with the long axis of the cervix. Mohamed el fiky Normal position of the uterus
- 4. Parts of the uterus (A) The Fundus: • Covered with peritoneum. • Related to coils of ileum. (B) The Body: has: (1) Anterior (vesical) surface: Flattened & related to the upper surface of urinary bladder. (2) Posterior (intestinal) surface: Convex, related to pelvic colon & coils of ileum. (3) Lateral margin: Gives attachment to the broad ligament. The uterine a. ascends along this margin (between the 2 layers of the ligament.) Mohamed el fiky
- 5. (C) The Cervix: It is 1inch long & 1inch in diameter. Its upper part lies above the vagina. (supra-vaginal part) Its lower part projects through the ant. wall of the vagina (vaginal part). Cavity of the Uterus: (1) Cavity of the body: is slit-like in sagittal section, but triangular in coronal section with the apex of the triangle lying at the internal os. (2) Cavity of the cervix: Fusiform in shape. Communicates with the body through the internal os. Communicates with the vagina throughexternal os. Mohamed el fiky
- 6. Ligaments of the uterus A- Ligaments of the body. B- Ligaments of the cervix. C- Peritoneal ligaments. Mohamed el fiky
- 7. Round ligament of the uterus • It is a fibro-muscular cord extending from the superolateral aspect of the body of uterus to the labium majus. Course & Relations: • It is attached to the upper end of the lat. margin of the body of uterus in front of the fallopian tube. • It passes forwards & laterally between the 2 layers of the broad ligament below the fallopian tube. • On the lateral Wall of the lesser pelvis, it crosses over the obturator nerve , vessels, obliterated umbilical artery & external iliac ext. iliac vessels (the same relations of the vas deferens). It enters the deep inguinal ring just lateral to inferior epigastric artery , traverses the inguinal canal & emerges from the superficial inguinal ring. It ends at the subcutaneous tissue of the labium majus. In the inguinal canal, it is surrounded by the same coverings of the spermatic cord. Embryological origin: it represents the remnant of the lower part of the gubernaculum of the foetal ovary. Mohamed el fiky
- 8. Overian ligament • Extends from the uterine end of the ovary to the lat. angle of the uterus • behind the Fallopian tube (passing between the 2 layers of the broad ligament.) Embryological origin: it represents the upper part of the gubernaculum of the foetal ovary. Mohamed el fiky
- 9. Broad ligament • It is a double-layered sheet of peritoneum which stretches transversely in the pelvic cavity from the lat. margin of the uterus to the side wall of pelvis. Shape: Quadrilateral in shape having 4 borders & 2 surfaces. Relations: It divides the cavity of the lesser pelvis into 2 compartments: • (a) Ant. compartment containing the urinary bladder. (b) Post. compartment containing the rectum, coils of ileum & sigmoid colon. Mohamed el fiky
- 10. Surfaces: It has 2 surfaces: (1) Upper (intestinal) surface : • Is directed upwards & backwards. • Related to coils of ileum & sigmoid colon. • The upper layer of the ligament is pierced by the lat. end of the uterine tube. • The upper layer is evaginated by the ovary to form the mesovarium. (2) Lower (vesical) surface: Directed downwards & forwards. Borders: It has 4 borders: (1) Ant. border: is a free border which encloses the med. 4/5 of the uterine tube. (2) Post. border (root of the ligament ): is attached to the floor of the pelvis i.e. on levator ani muscle , where the 2 layers diverge from each other. (3) Medial border: attached to the lat. margin of the body of the uterus where the 2 layers separate to enclose the uterus. (4) Lateral border : attached to the side wall of the lesser pelvis where it crosses over the ext. iliac vessels, obliterated umbilical a., obturator n. & vessels (from above downwards). Broad ligament Mohamed el fiky
- 11. Parts of the broad ligament (1) Mesovarium: it is the peritoneal fold connecting the ovary to the upper layer of broad ligament it transmits the ovarian vessels & nerves to the ovary. (2) Mesosalpinx : is the part between the uterine tube & the attachment of the mesovarium & the ovarian ligament (3) suspensory lig. extending from the mesovarium to the side wall of the pelvis. It transmits the ovarian vessels & nerves to the mesovarium. (4) Mesometrium : the remaining med. & post part .of the broad ligament. Mohamed el fiky
- 12. Contents of broad ligament Between the 2 layers of the broad ligament : 2 tubes, 2 ligaments, 2 arteires, 2 embryological remnants & parametrium. (A) Tubes: (1) Uterine tube : enclosed in the ant. free border of the ligament. (2) Ureter: is not of the contents but it passes forwards & medially crossing the root of the broad ligament lat. to the cervix. (B) Ligaments: (1) Ovarian ligament : lies between the 2 layers of the broad ligament . (2) Round lig. of uterus: lies between the 2 layers of the broad ligament . (C) Arteries: (1) Ovarian a . : passes through the suspensory lig of ovary to the mesosalpinx then enters the mesovarium to reach the ovary. (2) Uterine artery: passes at first medially in the post attached border (root) of the broad ligament , crosses above the ureter lateral to the cervix) then ascends in the med. border of the ligament & finally turns laterally in the messosalpinx just below the fallopian tube. (D) Embryological remnants: (1)Epoophoron: about 15-20 rudimentary tubules present int he lateral part of the broad ligament between the ovary & the fallopian tube. (2) Paroophoron : few scattered tubules lying in the broad ligament med. to the ovary . N.B: both the epoophoron & paroophoron are the remnants of the mesonephric duct of the embryo. (E) Parametrium : dense connective tissue & extra peritoneal fatty tissue present between the 2 layers of the brood lig. Mohamed el fiky
- 13. Ligaments of the cervix (1) Mackenrodt’s ligaments (Rt & Lt ) . It is a very important factor for stability of the uterus. • Attachments: each lig extends from the side of the cervix & lat. Fornix of the vagina laterally to be attached to the side wall of pelvis . It is a strong ligament formed of condensation of fibrous tissue. (2) Utero-sacral ligaments (Rt. & Lt.): • It is a condensation of fibrous tissue & smooth muscle fibres It extends from the back of the cervix to the front of sacrum , one on each side of the rectum. Mohamed el fiky
- 14. Peritoneal ligaments (folds) Connecting the uterus to other organs (1) Anterior ligament .: it is the utero vesical fold of peritoneum extending from the front of the cervix of uterus to the upper surface of the urinary bladder. (2) Posterior ligament .: it is the recto uterine fold of peritoneum extending from the front of rectum to the past. fornix of vagina & past surface of the uterus. Mohamed el fiky
- 15. Blood Supply of the uterus (1) Uterine artery: oArises from the ant. division of internal iliac artery oRuns at 1st medially on the floor of the pelvis in the root of the broad ligament. oIt crosses above the ureter about 1inch lat. to the cervix. oAscends along the side of the body of the uterus following a wavy course oThen it turns laterally below the uterine tube to end by anastomosing with the ovarian artery . oIt supplies the uterus, uterine tube & gives off branches to the vagina. (2) Uterine vein: accompanies the uterine a & ends in the internal iliac vein . Mohamed el fiky
- 16. Uterine artery Ovarian artery Ureter Mohamed el fiky
- 17. Nerve Supply (1) Sympathetic: from T12 & L1 segments. (2) Parasympathetic : from 52, 3,4 ( via pelvic splanchnic n.) Mohamed el fiky
- 18. Lymphatic drainage (1) Cervix: its lymphatics drain into 3 groups: (a) internal iliac L.Ns. (b) external iliac L.N.s (c) Sacral L.Ns (in front of sacrum). (2) Lower part of the body : to external iliac L.Ns , fundus and the uterine tubes (3) Upper part of the body of : drain into the pre aortic & paraortic L.Ns. (4) from a limited area close to the med. end of the uterine tube: drains into the superficial inguinal L.Ns ( lymphatics pass along the round ligament of uterus). Mohamed el fiky
- 19. Fallopian tube Size: Each tube is 10 cm. long. Site: It extends laterally from the lat. angle of the uterus to the ovary on the side wall of pelvis, lying in the free ant. border of the broad ligament. Course & Relations: Each tube passes upwards, laterally and backwards from the uterus to the side wall of pelvis enclosed in the ant. border of the broad lig., then curves backwards piercing the upper layer of the broad lig. to end on the med. surface of the ovary by the infundibulum. Relations: In the whole of their course, the tubes are related to the coils of ileum & sigmoid colon. Mohamed el fiky
- 20. Parts of Fallopian tube It has 4 parts : (1) Uterine or intra-mural part: (1 cm. long) It is the most medial, narrowest & shortest part. It penetrates the supero-lateral angle of the uterus. (2) Isthmus: is the part just lat. to the uterus (forming the med. 1/3 of the tube) It is rounded & cord-like. (3) Ampulla: is the thin-walled, tortuous & most dilated part of the tube forming its lat. 1/2 & ends by the infundibulum. (4) Infundibulum: is the funnel-shaped expanded lat. end of the tube in the bottom of the abdominal opening of the tube Mohamed el fiky
- 21. Arterial supply: (1) Medial part of the tube: is supplied by the uterine a. (2) Lateral part of the tube: is supplied by the ovarian a. (3) Lymphatic drainage : into para-aortic lymph nodes. Mohamed el fiky
- 22. ovary Size: 3 cm. in length. 2 cm. in breadth. 1 cm. in thickness. Site: in the ovarian fossa on the post. part of the side wall of the lesser pelvis close to the pelvic brim. The ovarian fossa has the following boundaries: - Anteriorly ; bounded by obliterated umbilical a. & ext. iliac vessels. - Posteriorly: bounded by the ureter & internal iliac vessels. Mohamed el fiky
- 23. Shape: Almond-shaped having 2 ends, 2 surfaces & 2 borders. Ends: (1) Uterine end: Directed downwards. Attached to the lat. angle of the uterus by the ovarian ligament. (2) Tubal end: directed upwards & gives attachment to: (a) Ovarian fimbria of Fallopian tube. (b) Suspensory ligament of the ovary (Infundibulo- pelvic ligament): which is a peritoneal fold connecting the ovary to the side wall of the pelvis. It transmits ovarian vessels & nerves. Surfaces: (1) Lateral surface : lies in contact with the peritoneum of the ovarian fossa It is related to the obturator n. & vessels in the floor of the fossa. (2) Medial surface : directed medially, covered by the fimbriated end of Fallopian tube. Borders: (1) Ant. border : directed forwards towards the obliterated umbilical a. & gives attachment to mesovarium. (2) Post. border: free border, directed backwards towards the ureter. peritoneal Relations: the ovary is completely covered by peritoneum (except at the line of attachment of mesovarium). Mohamed el fiky
- 24. Ligaments of the ovary: (1) Suspensory ligament .: extends laterally from the tubal end of the ovary to the side wall of pelvis. It is a peritoneal fold which transmits the ovarian vessels & nerves to the broad lig. (2) Mesovarium: a peritoneal fold extending from the upper layer of broad lig. to the ant. border of the ovary. It transmits the ovarian vessels & nerves to the ovary. (3) Ovarian ligament ; is the remnant of the gubernaculum of foetus. It extends from the uterine end of the ovary to the lateral angle of uterus. Arterial supply of the ovary: (1) Ovarian a.: branch of abdominal aorta. (2) Uterine a.: branch of int. iliac a. It anastomoses freely with the ovarian a. Venous drainage : the veins draining the ovary form a pampiniform plexus which rapidly gives rise to ovarian v. which accompanies ovarian artery. The Rt. vein ends in the I.V.C., while the Lt. vein ends in the Lt. renal vein. Lymphatic drainage : lymphatics of the ovary accompany the ovarian vessels & end in the para-aortic lymph nodes. Mohamed el fiky
- 25. Vagina Structure: a fibromuscular tube lined by non- keratinized stratified squamous epithelium. Site: it extends upwards & backwards from the pudendal cleft (which is guarded by the 2 labia minora) to end by surrounding the cervix of the uterus. The long axis of vagina forms an angle of about 90 0 with that of the uterus. Shape: a tube with 2 walls (ant. & post. ) ant. wall is shorter 7cm . post wall longer 9cm . Mohamed el fiky
- 26. Relations: (1) Ant. wall : Upper 1/3 is pierced by the cervix. Middle 1/3 is related to the base of bladder. Lower 1/3 : intimately related to the urethra. (2) Post . Wall : - Upper 1/4 is covered by the peritoneum of the Douglas pouch & related to coils of ileum. - Middle 2/4 : related to lower 1/3 of rectum (separated from it by loose areolar tissue. - Lower 1/4 : related to the perineal body which separates the vagina from the anal canal. (3) Laterally (on each side) : (a) The upper part (lat. fornix) is related to the ureter as it runs forwards & medially. Here the ureter is crossed from lateral to med. by the uterine a. (b) Middle part : related to the sphincter vaginae part of the levator ani (c) Lower part: traverses the deep perineal pouch & is related to the greater vestibular gland Mohamed el fiky
- 27. Fornixes of the Vagina As the upper end of the vagina surrounds the vaginal part of the cervix, a circular groove is formed between the vaginal vault & that part of cervix 1. Anterior fornix : The ant. part of that groove . it is is shallow 2. The posterior fornix : between the posterior wall and cervix. it is deep 3. Lateral . Fornix : On each side of the cervix . Mohamed el fiky
- 28. Arterial Supply: the vagina is supplied by branches from : (1) Vaginal artery . (from ant. division of it. iliac a) (2) Uterine artery (from ant. division of it. iliac a) (3) Middle rectal artery(from ant. division of it. iliac a) (4) Internal pudendal artery : the branches of these arteries which supply the vagina anastomose together to form 2 longitudinal arterial chains (one in front & one behind the vagina) celled Azygos artery of the vagina Venous drainage: the veins of the vagina form plexuses at the sides of the vagina which drain into the internal iliac veins Nerve supply: most of the vagina is supplied by autonomic fibres except the lower part (supplied by pudendal nerve ) Lymphatic drainage : most of the vagina drains into the int. & external iliac L.Ns except the lower part which drains into superficial inguinal L.Ns. Mohamed el fiky
- 29. Blood supplyof the Vagina Mohamed el fiky
- 30. Female external genitalia(vulva) Formed of : 1- Elevated mons pubis : lies in front of the symphysis pubis (produced by underlying fat . 2- Labia majora with pudendal cleft in between , it is a fold of hairy skin . 3- Labia minora with vestibule in between , it is a non hairy , non fatty fold of skin . 4- Clitoris (homologue of penis in males ) lies one inch in front of urethral orifice . 5- Vestibule which contains from before back wards. o Clitoris(at its apex) o Urethral orifice . o Vaginal orifice o Ducts of vestibular glands on either side of posterior part of o vaginal orifice Nerve supply of labia majora : similar to the scrotum . Mohamed el fiky