Anatomy of the Female Reproductive System

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Anatomy of the Female Reproductive System

• Liu Wei
• Department of Ob Gy
• Ren Ji hospital

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Introduction

• Pelvis
• Pelvic floor
• External genitalia
• Internal genitalia
• Vessel and nerve and lymph
• Adjacent organs

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Pelvis
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Pelvis

• Bony pelvis

os ilium ??
os sacrum ??
os coccyx ??
os pubis ??
os ischium ??
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Pelvis

• Joints

Sacro-iliac joint ????
Sacro-coccygeal joint ????
Symphysis pubica ????
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Pelvis

• Ligaments
• Sacrospinous ligament ????
• Extend from the lateral border of the
  sacrum and coccyx to the spine of the ischium
• Sacrotuberous ligament ?????
• Extend from the posterior aspect of the
  lower 3 sacral vertebrae to the ischial tuberosity

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Pelvis

• Pelvic divisions (iliopectineal line ???)
• False pelvis (pelvis major)
• Ture pelvis (pelvis minor)
• Bony birth canal
• the Pelvic inlet, the pelvic out let
  and the pelvic cavity

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Pelvis

• Types of pelvis
• The gynecoid type (????)
• round, slightly ovoid or elliptical
  inlet. adequate sacrosciatic notch. wide
  interspinous diameters(10cm). 52-58.9
• The platypelloid type (?????)
• distinct oval inlet. very wide subpubic
  arch. 23.2-29

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Pelvis

• The anthropoid type (??????)
• long, narrow, oval inlet. extended and
  narrow anterior and posterior segment. wide
  sacrosciatic notch. long , narrow sacrum.
  Straight side walls.
• The android type (????)

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Pelvic floor

• The tissues closing down the pelvic outlet
  (muscles and fasciae)
• suspend and support the pelvic organs, such as
  uterus and bladder and rectum
• Posterior part (urogenital triangle)
• urethra and vagina pass through
• Anterior part (anal triangle)
• rectum pass through

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Pelvic floor

• Tissues
• Outer layer
• Bulbocavernosus muscle (?????)
• Ischiocavernosus muscle (??????)
• Superficial transverse perineal muscle (?????)
• External anal sphincter (??????)
• mid layer
• urogenital diaphragm ?????

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Pelvic floor

• Inner layer (pelvic diaphragm ??)
• the main support of the pelvic floor
• formed by the levator ani and coccygenus muscles
  and covering fasciae.
• Levator ani pubococcygenus (???), iliococcygenus
  (???), puborectalis (???)

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Pelvic floor

• Perineum
• general conception the tissues closing down the
  pelvic outlet
• Clinical conception the tissues between vagina
  and anus.

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External genitalia
mons pubis ??
Labium majus ???
Clitotis ??
Labium minus ???
Urethral orifice ???
Vaginal orifice ???
Vaginal vestibule ????
Fossa navicularis ???
Perineal body ???
Anus ??
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External genitalia

• Labia majora
• The venous drainage is extensive and forms a
  plexus with numerous anastomoses. Vulva hematoma
• Vaginal vestibule
• Bordered by the labia minora laterally, by the
  frenulum labiorum pudendal (????) posteriorly,
  by the urethra and clitoris anteriorly, by the
  hymenal ring inferiorly.

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Internal genitalia
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Internal genitalia
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Internal genitalia

• Vagina
• strong canal of muscle (7.5cm)
• extend from the uterus to the
  vestibule of the external genitalia. its long
  axis is almost parallel with that of the lower
  part of the sacrum. the anterior wall of the
  vagina is 1.5-2cm shorter than the posterior
  wall.
• vaginal fornix
• the circular cul-de-sac formed around
  the cervix
• 4 regions the anterior fornix, the
  posterior fornix and 2 lateral fornices.

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Internal genitalia

• Wall structure
• mucosal layer (stratified squamous epithelium)
• muscular layer (3 layer)
• submucous area ( with a dense plexus of veins and
  lymphatics)

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Internal genitalia
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Internal genitalia

• Uterus
• Pear-shaped,thick-walled, muscular organ
• Body and cervix
• Babyhood 12, manhood 21
• Isthmus uteri
• connect the body to cervix, 1cm
  (non-pregnancy)

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Internal genitalia

• Layers of uterine wall
• The serous layer (perimetrium)
• Thin and firmly adherent over the
  fundous and most of the body
• Uterovesical pouch of the peritoneum
• Rectouterine pouch of the peritoneum
  (pouch of Douglas)
• The muscular layer
• Outer layer (longitudinal fibers)
• Inner layer (interlaced and various
  directions)

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Internal genitalia

• The mucous layer (endometrium)
• compact layer response to hormone periodically,
  a single layer of ciliated columnar epithelium
• spongy layer response to hormone periodically.
  contains many tubular glands
• funous non-response to hormone periodically

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Internal genitalia

• Cervix
• lower 1/3 of uterus. connects uterus to vagina
  via endocervical canal
• External os opening of endocervical canal to
  ectocervix
• Internal os indistinct upper limit of
  endocervical canal

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Internal genitalia

• Ligaments
• Broad ligament
• Round ligament
• Cardinal ligament
• Utero-sacral ligament

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Internal genitalia

• Oviduct
• Anatomy
• Interstitial portion
• Isthmic portion narrow
• Ampulla wide and tortuous
• Fimbria funnel-shaped mouth

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Internal genitalia

• Layers of wall
• Serous
• Muscular outer longitudinal and inner circular
• Mucous ciliated columnar epithelium, coarse
  longitudinal folds

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Internal genitalia

• Ovary
• Anatomy
• Paired organ, elliptic
• The suspensory ligament of the ovary
• The ovarian ligament

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Internal genitalia

• Structure of ovary
• Covered by cuboid or low columnar epithelium
• Consist of a cortex and a medulla
• Cortex oocytes in various stages of maturity.
• Medulla fibers, smooth muscle cells, blood
  vessel, nerves.

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Vessel and nerve and lymph

• Blood vessel
• The ovarian artery
• Orginated as branches of the abdominal aorta,
  (left left renal artery).
• Turn over the common iliac artery and
  ureter,descend into the pelvis. Enter into ovary
  through the mesovarium

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Vessel and nerve and lymph

• The uterine artery
• a terminal branch of the hypogastric artery
• Cross the ureter near the cervix (2cm)
• Ascend along the lateral border of the uterus
• uterine body branch and cervix-vagina branch

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Vessel and nerve and lymph

• Vaginal artery
• Internal Pudendal artery

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Vessel and nerve and lymph

• Lymph
• External genitalia
• superfical inguinal gland (???????)
• deep inguinal gland (???????)

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Vessel and nerve and lymph

• Pelvic lymph
• iliac lymph
• common iliac, internal iliac and external
  iliac
• Anterior Sacral lymph
• Lumbar lymph abdominal aorta

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Adjacent organs

• Urethra
• Urinary bladder
• Ureter
• Rectum
• Vermiform appendix

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Adjacent organs
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Answer the questions

• How many types of pelvis are there? What are
  they?
• What is perineum?
• What is vaginal vestibule?
• How many ligaments of uterus are there? What are
  they?
• How many ligaments of ovary are there? What are
  they?
• What is uterine isthmus?

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