Female anatomy Flashcards
Female urethra
4cm
opens at vestibule
distal end marked by skene’s glands
A: internal pudendal arteries, vaginal arteries and inferior vesical branches of the vaginal arteries.
N: vesical plexus and the pudendal nerve. Visceral afferents from the urethra run in the pelvic splanchnic nerves.
L: proximal internal iliac nodes, distal superficial inguinal.
Ligament that anchors the uterus anteriorly
round ligament
Ligament that anchors the uterus posteriorly
utero-sacral ligament
Ligament that anchors the uterus laterally
Broad ligament (mesovarium and suspensory ligaments)
pudendal cleft
The cleft between the labia majora is called the pudendal cleft. It contains the labia minora and the vestibule.
clitoris
three parts: root, body and glans.
The body consists of two corpora cavernosa and two attachment points (crura).
Vestibular glands
The greater vestibular (Bartholin’s) glands are found on each side of the vestibule. They are homologous to the bulbourethral glands in the male and serve to lubricate the vulva during sexual intercourse
Paraurerthral glands / Skene’s glands
The lesser vestibular glands are located between the urethral and vaginal orifices. These glands are homologous to the male prostate.
Vulva
arteries
veins
lymph
nerves
Internal pudendal artery supplies majority (from internal iliac artery)
Dorsal artery of the clitoris is a branch from internal pudendal artery
External pudendal artery supplies the perineal and labial skin (from femoral artery)
Venous drainage via pudendal veins
Lymphatic drainage via femoral - superficial inguinal lymph nodes
Receives sensory and autonomic innervation
Anteriorly via ilioinguinal nerve and genital branch of the genitofemoral nerve
Posteriorly via the pudendal nerve and posterior cutaneous nerve of the thigh
Clit innervation
Sensory supply from dorsal nerve of the clitoris (à pudendal nerve branch)
Autonomic supply to smooth muscle and corpora cavernosa of the clitoris from the cavernous nerves (à uterovaginal plexus, a subsidiary of inferior hypogastric plexus)
Vagina 4 layer lining histologically (internal to external)
Stratified squamous epithelium –protective; lubricated by cervical mucus and external Bartholin’s glands (vaginal epithelium itself is not glandular/ secretory)
Elastic lamina propria – dense connective tissue layer, projects papillae into the overlying epithelium with capillary loops ++ (vascular supply for epithelium)
Fibromuscular layer – 2 layers of smooth muscle; inner circular and an outer longitudinal layer
Adventitia – fibrous layer, provides additional strength to the vagina whilst bridging it to the surrounding structures
Vagina
arteries
veins
lymph
nerves
Arterial supply via uterine and vaginal arteries; branches of internal iliac artery
Venous drainage via venous plexus -> uterine vein -> internal iliac veins
Lymphatic drainage in 3 sections:
Upper 1/3: external iliac
Middle 1/3: common and internal iliac nodes
Lower 1/3: superficial inguinal and peri-rectal lymph nodes
Innervation mainly via autonomic nervous system (except very inferior/ outermost 1/5th of the vagina)
Parasympathetic and sympathetic supply to smooth muscle/vessels from utero-genital nerve plexus
Subsidiary of the hypogastric plexus
The inferior 1/5th of the vagina receives somatic (voluntary/ skeletal muscle fibres) innervation via the deep perineal nerve - Branch of the pudendal nerve
Ecto and endo cervix epithelium
Ectocervix
Stratified squamous non-keratinized epithelium
Endocervical canal
Lined by mucous secreting simple columnar epithelium
Cervix blood supply, lymph and what ligament attaches
Cervix receives arterial supply via the uterine artery
Venous drainage is via venous plexus in the broad ligament of the uterus à uterine veins
Lymphatic drainage via iliac, inguinal, sacral and aortic lymph nodes (varied drainage)
Pubocervical ligament attaches cervix to posterior aspect of pubic symphysis; aiding uterine support
Cardinal ligament
specific, thickened part of the broad ligament located at its base
cervix to lateral pelvic wall at the level of the ischial spines
Contains the uterine artery and vein
Located at the inferior border of the broad ligament
Uterus
Vasc
Nerve
Lymph
Vasculature of the uterus:
Uterine artery supply
Venous plexus within broad ligament - uterine veins
Lymphatic drainage via varied nodes (as with cervix); iliac, sacral, aortic and inguinal
Innervation of the uterus:
- Parasympathetic from the pelvic splanchnic nerves
- Sympathetic from the uterovaginal plexus (originates from the hypogastric plexus)
- Cervix via inferior fibres of uterovaginal plexus (from the hypogastric plexus)
Parts of fallopian tube
(lateral to medial): fimbriae, infundibulum, ampulla, isthmus
Epithelium fallopian tube
Lined with ciliated columnar epithelial cells and peg cells (non-ciliated secretory cells)
Ovaries derived from?
Develop from the paramesonephric duct within the abdominal cavity
Descend through the abdomen (inverse to the kidneys)
Ovaries histological features
Surface – simple cuboidal epithelium with underlying dense connective tissue capsule
Cortex – connective tissue stroma containing numerous ovarian follicles
Medulla – loose connective tissue with rich neurovascular network, enters via the ovarian hilum
Suspensory ligament of the ovary
(sometimes called the infundibulo-pelvic ligaments)
Extends outwards from the ovary - lateral abdominal wall
Contains the ovarian vessels and nerves
Neurovascular supply of the ovaries:
Arterial supply from paired ovarian arteries -
Arise directly from the abdominal aorta, inferior to the renal arteries
(Smaller contribution from the uterine arteries)
Venous drainage via paired ovarian veins
Left ovarian vein - left renal vein
Right ovarian vein - inferior vena cava directly
Nervous supply reaches the ovaries via the suspensory ligament of the ovary, entering at the hilum
Both sympathetic and parasympathetic innervation from the ovarian and uterine plexuses
Lymph from the ovaries - para-aortic nodes
fallopian tube
10-12 cm long
1-4 mm in diameter
5 from lat to med
(1) fimbriae: ~25
(2) infundibulum: funnel-shaped, opens into the peritoneal cavity
(3)ampulla: the widest and longest section, location of fertilisation and ectopic
(4) isthmus:narrowest segment
(5) interstitial or intramural segment: the section within the myometrium
Arterial
» terminal branch of the ovarian artery (lateral one-third)
»terminal branch of the uterine artery (medial two-thirds)
Venous
» pampiniform plexus to the ovarian veins (lateral one-third)
» uterine plexus to the internal iliac vein (medial two-thirds)
Lymph
via ovarian vessels to the para-aortic nodes and uterine vessels to the internal iliac chain
pelvic outlet
Anterior: Pubic arch
Lateral: Ischial tuberosity and sacrotuberous ligament
Posterior: Coccyx (tip)
