Post on 21-May-2015
ANATOMY OF FEMALE GENITAL TRACT
• External genitalia• Internal genitalia• Accessory reproductive organs
Mons veneri
sLabia
majora
•Post commisure
Labia minora
•prepuce•Frenulum•Fourchette•Fossa navicularis
clitoris
•Glans•Body•2 crura
vestibule
•6 openings• bartholin’s abscess•Hymen
External genitalia (vulva, pudendum)
• Blood supply– Arteries • Br. of internal pudendal artery
– Labial A., – Transverse perineal A., – A to vestibular bulb,– deep & dorsal arteries to clitoris
• Br. of Femoral A– Superficial & deep external pudendal A
– Veins• Internal pudendal vein• Vesical/ vaginal venous plexuses• Long saphenous vein
• Nerve supply– Ant-sup part• Ilio inguinal & genital br. of genitofemoral N (L1,L2)
– Post-inf part• Pudendal br. of post.cut. N of thigh (S123)
– In between• Labial & perineal br.of Pudendal N (S234)
• Lymphatics– Superf. Inguinal nodes– Gland of Cloquet– Ext. & Int. Iliac nodes
Vagina
Uterus
Fallopian
tubes
ovaries
Internal genital organs
Vagina
• Fibromuscular membranous sheath• Excretory channel• Organ of copulation• Birth canal of parturition• 45° horizontal• 2.5cm diameter• distensibility
• Walls – Ant : 7.5 cm– Post : 9cm– 2 lateral walls
• Fornices :– Ant : shallow – 2 lateral– Post : deep
• Structure –mucous coat– Submucous layer of loose areolar
vascular tissues–Muscular layer– Fibrous coat (from endopelvic
fascia) :highly vascular
• Vaginal secretion– Doderlein’s bacilli : lactic acid from
glycogen– Acidic pH (4-5)
• Blood Supply– Arteries
• Cervicovaginal br. Of uterine A• Vaginal A• Middle rectal A• Internal pudendal • Anastomose---form 2 azygos arteries
– Veins drain into:• Internal iliac V• Internal pudendal V
• Lymphatics drain into• Upper 1/3rd : internal iliac nodes• Middle 1/3rd: external iliac nodes• Lower 1/3rd (below hymen) : superficial inguinal gp.
• Nerve supply• Parasympathetic : S234• Sympathetic: hypogastric plexus• Lower end : pudendal N (sensory )
Uterus• Hollow, pyriform muscular organ in
pelvis• Position: anteversion & anteflexion
uterus dextrorotatedcervix levorotated
• Measurements – 7.5cm long– 5cm wide– 3cm thick– Weight : 50-80gm
Body/ corpus• Fundus : 1.5 cm• Body proper: 3.5 cm• cornua
isthmus • 0.5 cm• Between anatomical & histological
internal os (of Aschoff)
cervix •2.5cm•Supravaginal & infravaginal(portio vaginalis) parts•Cervical canal •External os opening shape•Secretion: alkaline & thick, rich in fructose, NaCl, & mucoprotein
Parts of uterus
• Structure – Perimetrium : serous coat– Myometrium: thick bundles of sm. M
• During pregnancy:– Outer long.– Middle interlacing– Inner circular
– Endometrium • Surface epithelium • Lamina propria
– Stromal cells– Endometrial glands– Vessels & nerves
• Decidua in pregnancy• Secretion: scanty & watery
• Relation
–Anterior• Above int.os : uterovesical pouch• Below int.os: separated from UB by loose areolar tissue
–Posterior• Pouch of Douglas with coils on intestine
–Lateral • Broad ligament•Mackenrodt’s ligament • Uterine A & ureter
• Ligaments of uterus– Uterosacral ligament– Transverse cervical/ Mackenrodt’s lig– Pubovesicocervical lig– Round ligament– Broad ligament • Mesovarium• Mesosalpinx • mesometrium • Suspensory lig of ovary/ infundibulopelvic ligament
• Blood supply – Arteries:
• Uterine A • Ovarian & Vaginal As.
– Veins drain into• Internal iliac veins
• Lymphatics • Nerves– Sympathetic
• Motor : T5 & T6• Sensory : T10 – L1
– Parasympathetic • Pelvic N ( S2,3,4) : both motor & sensory : ends in ganglia of Frankenhauser
Fallopian tube (uterine tube, oviduct)
• 10-14 cm • Lies within the superior border of broad ligament• 2 openings– Medially into cornua– Laterally into abdominal cavity
Parts of fallopian tube
•Within uterine myometrium•1.25 cm
Intramural/ interstitial
•Straight & narrowest•2.5 cm Isthmus •Tortuous & widest•Site of fertilisation •5cm
Ampulla
•1.25 cm long•Abdominal ostium surrounded by fimbriae•Ovarian fimbria
Infundibulum
Serous coat
• Covered with peritoneum on all sides except attachment of mesosalpinx
Muscular layer
•Outer longitudinal •inner circular
Mucous membrane• ciliated columnar epithelium•Thrown into folds
Structure : -3 layers
• Blood Supply– Arteries
• Uterine A• Ovarian A
– Veins • Through pampiniforn plexus into ovarian veins
• Lymphatics • Para-aortic nodes
• Nerve supply– Uterine & ovarian nerves
The Ovary• Paired, situated on either side of uterus• Close to lateral pelvic wall• In ovarian fossa of Waldeyer• Size: 4*3*2 cm• Only intra-abdominal structure not covered by
peritoneum• Medial pole: attached to uterine cornua by ovarian
ligament• Laterally to the pelvic wall by infundibulopelvic
ligament• Fimbrial end of oviduct close to ovary & attached to it
via fimbria ovarica
• Structure : 2 parts
•Lined single layer of germinal epithelium of Waldeyer (cuboidal epi.)•Tunica albuginea : stromal cells thickened beneath germinal epithelium•Contain primordial follicles•Corpus albicans/ atretic follicles
Cortex
•Loose connective tissues, blood vessels, nerves, muscles•Hilus cells : homologous to interstitial cells of testes
Medulla
• Blood Supply– Arterial : Ovarian A– Veins : • Through pampiniform plexus ovarian V. Lt. Renal Vein IVC
• Lymphatics • Para-aortic nodes
• Nerve supply • Sympathetic supply from T10 along ovarian A.