Female Internal Reproductive Organs Flashcards
What are the female internal reproductive organs?
- ovary
- uterine tube
- uterus
- vagina
What are the ovaries?
paired organs which produce oocytes after puberty and which also have an endocrine function
What hormones are secreted by the ovaries?
- estrogen
- progesterone
- relaxin
Where is the ovary located?
- on the posterior aspect of the broad ligament on the lateral wall of the true pelvis
- lies within the ovarian fossa
- ovary comes out of the fossa during pregnancy
What is the ovarian fossa bounded by?
- obliterated umbilical artery (anteriorly)
- ureter and internal iliac vessels (posteriorly)
Is the ovary covered by peritoneum?
no
How does the oocyte leave the ovary?
it is expelled into the peritoneal cavity before entering the uterine tube
What is the ligament of ovary?
attaches the ovary to the body of the uterus
What is the suspensory ligament of ovary?
extends from the ovary to the pelvic brim and contains the ovarian vessels
What is the blood supply to the ovaries?
- ovarian artery (from the abdominal aorta)
- ovarian branch of the uterine artery (from internal iliac artery)
What is the general blood supply to female internal reproductive organs?
In general, every structure gets two sources of blood:
- from abdomen
- from pelvic region
What is the innervation of the ovary?
ovarian plexus
Where are the uterine tubes?
extend from the peritoneal cavity near the ovary to the cavity of the uterus
What do the uterine tubes do?
- transport oocytes from the ovary to the uterus through ciliary action and muscular contraction
- the passage of the oocyte takes 3-4 days
- they transport sperm in the opposite direction
What are the four parts of the uterine tube?
- uterine part: the portion of the tube which lies inside the uterus
- isthmus: the narrowest external part, nearest the uterus
- ampulla: the longest and widest part of the uterine tube
- infundibulum: the funnel-shaped portion nearest the ovary
What is the abdominal ostium?
the opening of the uterine tube near the ovary
Is the abdominal ostium connected to the ovary?
no; there is a gap between them
What are fimbriae?
- fingerlike projections around the margin of the infundibulum
- when an oocyte is discharged from the ovary, it is caught by the fimbriae and passes through the abdominal ostium
- contain smooth muscle
What is the ovarian fimbria?
a long fimbria which is attached to the ovary
Where is the most common site of fertilization?
ampulla
Where is the second most common site of fertilization? What problems may result?
- infundibulum
- could lead to an ectopic pregnancy
What is the blood supply to the uterine tube?
- tubal branches of the uterine artery
- tubal branches of the ovarian artery
What is the innervation to the uterine tube?
- ovarian plexus
- inferior hypogastric plexus
What is ectopic pregnancy?
- the development of the fetus at some site other than the uterine cavity
- the most common type is tubal ectopic pregnancy: development of the fetus in the uterine tube
- usually results in rupture of the uterine tube with severe hemorrhage
- tubal pregnancy usually results from inflammation or blockage of the uterine tube
- risk factors:
1. sexually transmitted diseases
2. reversal of tubal ligation
3. endometriosus - abdominal ectopic pregnancy: implantation in the rectouterine pouch
- other types: mesenteric and cervical ectopic pregnancy
What is the uterus?
the organ in which the fertilized oocyte normally becomes embedded and in which fetal development takes place
What forms the birth canal?
the cavites of the uterus and vagina
What is the appearance of the uterus?
variable in shape, size, location, and structure depending on age and the number of pregnancies
What is the uterus like in the nulliparous woman (one with no children)?
the walls of the uterus are thick and muscular and the organ is shaped like an inverted pear
How does the uterus change after menopause?
increase in fibrous tissue and cysts
What is the normal position of the uterus?
both anteverted and anteflexed
What is anteversion?
the lower end of the uterus forms approximately a right angle with the vagina
What is retroversion?
- opposite of anteversion
- associated with:
1. severe menstrual cramps
2. painful parturition
3. increased risk for uterine prolapse
What is anteflexion?
the uterus is bent downward at the junction between its body and cervix
What can change the position of the uterus?
fullness of the bladder
What is the fundus of the uterus?
the rounded part of the uterus located superior to the entrance of the uterine tubes
What is the body of uterus?
the main part of the uterus located inferior to the fundus and superior to the isthmus
What is the isthmus of uterus?
- the narrow constricted portion between the body and cervix
- it is also called the internal os
What is the cervix of uterus?
- the inferior part of the uterus which extends from the isthmus to the opening in the vagina
- consists of two parts:
1. supravaginal part: the portion above the vagina
2. vaginal part: the portion within the vagina
What is the external os?
the opening of the cervical canal into the vagina
What is the uterine cavity?
- lies within the body of the uterus
- it is wide above and narrow below
What is the cervical canal?
lies within the cervix and extends from the internal os to the external os
Where does implantation usually occur in the uterus?
high on the posterior wall of the uterine cavity
What is the vesicouterine pouch?
- between the bladder and uterus
- relatively shallow
What is the rectouterine pouch?
- between rectum and uterus
- deep
What is the broad ligament?
- a double layer of peritoneum which extends from the uterus to the lateral walls of the pelvis
- encloses the uterine tubes
- has three parts:
1. mesosalpinx
2. mesovarium
3. mesometrium
What is the mesosalpinx?
the part of the broad ligament between the uterine tube and mesovarium
What is the mesovarium?
the part of the broad ligament which extends posteriorly to attach to the ovary and ligament of the ovary
What is the mesometrium?
the part of the broad ligament below the mesovarium
What is the round ligament?
- attaches to the uterus below and anterior to the entrance of the uterine tubes
- it passes through the inguinal canal and terminates in the labia majora
- analog of the spermatic cord; remnant of the gubernaculum of the ovary along with the ligament of the ovary
What is the transverse cervical (cardinal) ligament?
a thickening of pelvic fascia which passes laterally from the cervix to merge with the upper fascia of the pelvic diaphragm
What is the uterosacral ligament?
passes backward from the cervix in the rectouterine fold to attach to the sacrum
What is the pubocervical ligament?
passes forward from the cervix lateral to the urethra to attach to the pubis
What is important regarding the ureter in a hysterectomy?
- the ureter is endangered
- if nicked, urine leaks out and produces inflammation of the pelvis
Which structures give support to the uterus?
- pelvic diaphragm
- broad ligament
- pelvic viscera (bladder)
- pubocervical, transverse cervical, and uterosacral ligaments
What is the blood supply to the uterus?
- uterine artery
- ovarian artery
What is the lymph drainage of the uterus?
- lumbar nodes (fundus and upper part of body)
- external iliac nodes (lower part of body)
- internal iliac nodes (cervix): important in the spread of cervical cancer
What is the innervation to the uterus?
uterovaginal plexus - primarily to the blood vessels
What are the functions of the vagina?
- female organ of copulation
- lower portion of the birth canal
- excretory duct for the products of menstruation
How does the vagina communicate with the cervical canal?
through the external os
How does the vagina communicate with the vestibule?
through the vaginal orifice
What is the position of the vagina?
- the fundus of the bladder and urethra lie anterior to it
- the rectum lies posterior to it
What is a fornix?
the recess between the cervix and the walls of the vagina
What are the parts of the fornix?
- anterior fornix
- two lateral fornices
- posterior fornix
What is the vaginal vault?
the superior, expanded portion of the vagina below the cervix
What structures support the vagina?
- levator ani
- perineal body
- perineal membrane
- pubocervical, transverse cervical, and uterosacral ligaments
What is the blood supply to the vagina?
- uterine artery (to upper part)
- vaginal artery (to lower part)
What is the lymphatic drainage of the vagina?
- internal iliac nodes (upper 3/4 of vagina)
- superficial inguinal nodes (lower 1/4)
What is the innervation of the vagina?
- pudendal nerve (lowermost part)
- uterovaginal plexus - autonomic
- there is little sensation in the vagina except in the lowermost part
What complications may result from damage to the vaginal walls, pelvic diaphragm, and ligaments during parturition?
- rectocele
- cystocele
- uterine prolapse
What is rectocele?
- bulging of the rectum into the posterior wall of the vagina
- may cause difficulty in defecation
What is cystocele?
- bulging of the bladder into the anterior wall of the vagina
- may cause difficulty in micturition
What is uterine prolapse?
- the uterus slips down into the vagina and descends to and abnormally low level in the pelvis
- the cervix may protrude externally through the vaginal orifice
- risk factors:
1. multiple births
2. retroverted uterus
What is the chiropractic note regarding the uterus?
- pain from a retroverted uterus, inflammation of the uterine lining, or traction of a large uterus on the uterosacral ligament may cause sacral pain
- severe menstrual cramps may be related to L1 or L2 subluxations
