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.