B8.003 Female Reproductive Organs Flashcards
function of ligaments in the female repro system
support organs in pelvis and provide a conduit for vessels and nerves
all of the ligaments of the female repro system
- broad
- medometrium
- mesosalpinx
- mesovarium - ovarian
- suspensory ligaments of ovary
- round ligaments of uterus
- cardinal ligaments
- pubocervical ligaments
- uterosacral ligaments
composition of broad ligament
double layer of peritoneum
layout of croad ligament
extends from the sides of the uterus to the lateral walls and floor of the pelvis, where it becomes continuous with the parietal peritoneum
sections of broad ligament
mesometrium
mesosalpinx
mesovarium
mesometrium
below ovary to uterine body
mesovarium
attaches ovary to broad ligament
mesosalpinx
between ovary and fallopian tube
uterovesical fold
anterior peritoneal fold which reflects from the junction of the uterine body and cervix onto the bladder
uterovesical pouch
created from uterovesicular fold
anteriorly between bladder and uterus
rectovaginal fold
posterior peritoneal fold which reflects from the posterior vaginal fornix onto the rectum
rectouterine pouch
created from rectovaginal fold
between vagina and rectum
most inferior aspect of the peritoneal cavity, and therefore is the first location where free fluid accumulates
ovarian ligament
within/part of the broad ligament
round, cord shaped thickening
attaches the ovary to the uterus
suspensory ligament
within/part of the broad ligament
attaches the ovary to the pelvic wall
contains ovarian vessels and nerve
round ligament
originates at uterine horn, passes through the broad ligament, enters the inguinal canal through the deep inguinal ring and ends in the connective tissue of the labium majus in the perineum
remnant of gubernaculum
uterine horn
area where fallopian tubes enter uterus
cardinal ligament
arise from the side of the cervix and the lateral fornix of the vagina
attaches on lateral pelvic wall
contains uterine artery and vein
provides primary support in maintaining uterine position and preventing prolapse
significance of position of cardinal ligament in hysterectomy
have to be careful not to severe ureter; runs closely with uterine artery which is within the cardinal ligament
pubocervical ligament
attaches cervix to posterior surface of pubic symphysis
uteerosacral ligament
attaches cervix to sacrum
clinical relevance of uterine ligaments
weak or damaged uterine ligaments and/or pelvic muscles can lead to prolapse
uterus falls through the vagina :(
description of ovaries
paired, oval organs
thumb sized
primary functions of ovaries
produce oocytes (female gametes) in preparation for fertilization produce steroids (estrogen and progesterone)
3 histo sections of ovary
germinal epithelium
cortex
medulla
germinal epithelium of ovary
simple cuboidal epithelium covering the ovary
ovary cortex
outer portion
connective tissue stroma
contains maturing follicles, corpora lutea
ovary medulla
inner portion
connective tissue
neruovascular network
enters hilum from mesovarium
ovarian tumors
any cell type in the ovary can be the origin of an ovarian tumor
polycystic ovaries
hormone dysfunction and multiple (>10) ovarian cysts
associated with infertility (excessive androgens and abnormal follicle development)
ovarian cyts
fluid filled masses
can be physiological and regress on their own
location of fallopian tubes
paired, muscular J shaped tubes
upper border of the broad ligament
extend laterally from uterus
open into abdominal cavity, near the ovaries
primary function of fallopian tubes
assist in the transport of the ovum, transport of sperm to the egg, provide environment for fertilization, and then transport the egg/embryo to the uterus
external structure of fallopian tubes
10-14 cm long less than 1 cm in external diameter 4 sections: infundibulum ampulla isthmus intramural
infundibulum
1-2 cm
funnel shaped, contains opening to peritoneal cavity and fimbria
fimbria extend over the ovary’s surface during ovulation to guide free egg into the fallopian tube
ampulla
7-8 cm long
crescent shaped around the ovary, fertilization usually occurs here
isthmus
3-6 cm long
constriction at the transition to the uterus
intramural
enters the uterus
internal structure of fallopian tubes
- adventitial layer on surface contains blood vessels and nerves
- muscular wall: inner circular layer and outer longitudinal layer
- mucosa: folds of epithelium in the inner portion
on fimbriated end: less muscle, more mucosa
on isthmus end: signifcant musculature, less mucosal folding
fallopian tube epithelium
ciliated columnar and non-ciliated secretory epithelial cells
smooth muscle layers in fallopian tube
contract to assist with transportation of the ova and sperm
ciliated cells of fallopian tube
responsive to estrogen
help propel the ovum/embryo toward the uterus
tubal ligation
surgical cutting of the uterine tubes for sterilization
oocyte unable to pass into uterus
salpingitis
inflammation of tubes usually due to bacterial infection
can cause adhesions of the mucosa, may block lumen
may result in infertility or an ectopic pregnancy
ectopic pregnancy
medical emergency
implanted blastocyst can cause rupture and hemorrhage of the affected tube
fallopian tube carcinoma
majority of high grade serous ovarian carcinoma is thought to arise from serous tubal intraepithelial carcinomas
torsion of tube
allowed due to wide mesosalpinx of the ampullary segment of the tube
can result in ischemic atrophy of ampullary segment
description of uterus
thick walled muscular organ
posterosuperior to bladder
anterior to rectum
connected distally to vagina and laterally to fallopian tubes
function of uterus
site for implantation and nourishment of the fetus
play a role in labor and delivery
parts of the uterus
fundus
body
cervix
fundus
convex upper segment of the uterus
above entry point of fallopian tubes
body of uterus
usual site for implantation of blastocyst
cervix
lower part of uterus linking it with the vagina
structurally and functionally different to the rest of the uterus
tissue layers of fundus and body of uterus
perimetrium myometrium endometrium -deep stratum basalis -superficial stratum functionalis
perimetrium
double layered membrane
continuous with abdominal peritoneum
myometrium
thick smooth muscle layer
undergo hypertrophy and hyperplasia during pregnancy in preparation to expel the fetus at birth
endometrium
inner mucous membrane lining the uterus
- deep stratum basalis
- superficial stratum functionalis
deep stratum basalis
outer portion of endometrium
changes little throughout the menstrual cycle
not shed at menstruation
regenerates the functionalis
superficial stratum functionalis
inner portion of endometrium overlying epithelium invaginating glands supportive, vascular stroma sheds during menstruation and regenerates from cells in the basalis layer
endometrial phases of cycle
proliferative secretory menstrual postmenopausal **changes in response to E2 and P4 to provide and optimal environment supporting implantation and fetal development**
endometrial carcioma
most common malignancy of female repro tract
found around menopause
abnormal uterine bleeding
fibroids
most common benign tumors in women
myometrium tumor
often asymptomatic, but if large enough the mass can cause symptoms including heavy bleeding, pelvic pain, and infertility
endometriosis
endometrial tissue at sites outside of the uterus, commonly ovaries and ligaments of uterus
ectopic tissue is still responsive to E2, thus cyclic proliferation and bleeding will occur
associated with dysmenorrhea and/or infertility
hysterectomy
surgical removal of uterus
usually as a result of cervical or uterine cancer
cervix
lower portion of the uterus that connects the vagina with the main body of the uterus
distinct from uterus
function of cervix
control of movement into and out of uterus
- facilitates passage of sperm into the uterine cavity via dilation of the external and internal os
- maintains sterility of the upper female repro tract via frequent shedding of the endometrium, thick cervical mucous, and a narrow external os
- plays a role in delivery of fetus
regions of the cervix
cervical canal
external os
internal os
cervical canal
hollow orifice through the cervix that connects the uterine cavity to the hollow lumen of the vagina
external os
connecting cervical canal to the lumen of the vagina
small circular opening surrounded by external tissue of the cervix
rounded and convex
internal os
connecting the cervical canal to the uterine cavity
small circular opening where the cervical canal narrows before opening into the uterus
endocervical canal epithelium
single layer of mucin secreting columnar epithelium
deep cleft infoldings or “glands”
ectocervical epithelium
nonkeratinized stratified squamous epithelium
junction between 2 epithelial types in cervix
squamocolumnar junction and transformation zone
site of origin of cervical cancer
2 types of cervical cancer
- squamous cell carcinoma (ectocervical)
2. adenocarcinoma (glandular lining)
cause of cervical cancers
HPV infection of the female genitalia
vaccinations exist
pap smear
lightly scrape cells from cervix to assess for dysplasia suggestive of precancerous changes
cervicitis
chronic inflammation and infection of the cervix
most commonly by chlamydia or neisseria gonorrheoae
usually asymptomatic
complications: pain, discharge, bleeding, PID, infertility
vagina
strong, hollow, fibromuscular canal approximately 7-9 cm long
extends from uterus to the vestibule of the external genitalia where it opens to the exterior
roles of vagina in the female
sexual intercourse
childbirth
menstruation
histo layers of vagina
inner to outer
- stratified squamous
- elastic lamina propria
- fibromuscular layer
- adventitia
vaginal stratified squamous epithelium
provides protection
lubricated by cervical mucus
low vaginal pH of 4.5 prevent infection by other organisms
vaginal elastic lamina propria
dense connective tissue layer which projects papillae into the overlying epithelium
fibromuscular layer of vagina
smooth muscle fibers indistinctly arranged in 3 layers: outer longitudinal layer, circumferential layer, poorly differentiated inner longitudinal layer
adventitia of vagina
fibrous layer
provides additional strength to vagina while binding it to surrounding structures
vaginal neoplasms
squamous intraepithelial lesions: atypical premalignant squamous epithelial lesion of the vagina related to HPV
vaginal fistula
open communication between vagina and one of the adjacent pelvic organs
result of prolonged labor: fetus exerts pressure on vaginal wall limiting blood supply and results in necrosis
primarily occure between vagina and the bladder, urethra, and rectum
vaginal candidiasis
yeast infection
candida albicans (90%)
natural flora disrupted: abx therapy, douching
treated with antifungals
ovarian artery
branch from the aorta
carried in suspensory ligament
enters ovary at hilum
branches supply fallopian tube
uterine artery
branch from internal iliac, carried in cardinal ligament
supplies uterus, branches to supply ovary and fallopian tube
branches to supply vagina
uterine veins
drain to hypogastric
ovarian veins
R drains to IVC
L drains to L renal vein
vaginal artery
branch from internal iliac
supplies uterus, vagina
vaginal veins
drain to internal iliac vein
innervation of ovary/tubes
superior mesenteric and renal plexus
ovarian plexus
pelvic splanchnic nerves
innervation of uterus/vagina
superior hypogastric plexus
sensory impulses enter T11-L1
uterovaginal pelvic plexus
pelvic splanchnic nerves
innervation of inferior portion of vagina
SOMATIC pudendal nerve (S2-4)
lymphatic drainage of the female repro organs
honestly nobody has ever made us learn lymphatics so lets hope that continues to ring true bc i dont want to do this one
