Female Reproductive Anatomy - BGDA Flashcards
Where do the ovaries sit?
In the ovarian fossa on the lateral part of the pelvic wall.
What supports the ovaries?
Suspensory ligament - CT structure that contains the ovarian artery and vein.
What are the ovarian artery and vein?
These vessels are branches of the abdominal aorta and inferior vena cava respectively.
- originate high in the abdominal cavity near the kidneys
What is the free posterior surface?
This is a key hallmark of the ovaries and is an area that faces the ureter and is not lined by connective tissue. It is where ova are released.
What is mesovarium?
This is a part of the broad ligament of the uterus. It lines the rest of the ovary and connects it to the broad ligament
Outline key features of the ovarian ligament.
The ovarian ligament runs from the ovary to the lateral surface of the uterus
- lies in the broad ligament and contains smooth muscle cells
What are other names for the ovarian tubes?
- fallopian tubes
- oviducts
Where do the fallopian tubes run from?
The uterus to the region of the ovaries, along the top of the broad ligament.
What do the ovarian tubes do?
They carry spermatozoa to the ovum and carry the fertilised ovum to the cavity of the uterus.
What is the part of the broad ligament that attaches to the ovarian tubes?
Mesosalpinx.
What are the 4 regions of the uterine tube?
Infundibulum, ampulla, isthmus and intramural.
Outline key features of the infundibulum.
This is the trumpet shaped end of the ovarian tubes adjacent to the ovary
- outer rim has finger-like projections called fimbriae that attach to the tubal end of the ovary
- the longest fimbria, the ovarian fimbria, attaches to the tubal end of the ovary
- in the depths of the infundibulum lies the peritoneal ostium
Outline key features of the ampulla
- thin walled
- leads to isthmus
- fertilisation occurs here
What is the narrowest part of the uterine tube?
Isthmus.
Where does the uterus lie?
Between the bladder (anteriorly) and rectum (posteriorly).
What two pouches does the uterus form?
Vesicouterine and rectouterine.
What are the 4 parts of the uterus?
Fundus, body, isthmus and cervix.
What are key features of the cervix?
Internal os and external os on either end of the cervical canal
- in nulliparous women the external os is rounded
- in parous women is has anterior and posterior folds
- supravaginal and intravaginal parts
What is the role of folds in the cervix?
Longitudinal and palmate folds interlock for tight closure and close the cervical canal/open it during ovulation or menstruation.
What are the 3 layers to the uterine wall?
Endometrium (mucosa which undergoes changes over menstrual cycle)
- myometrium (muscular layer)
- perimetrium (serosa, peritoneum and areolar tissue)
What are the key ligaments of the uterus?
- Broad ligament
- uterosacral ligaments
- round ligament of the uterus
- transverse (lateral) cervical ligaments (of Mackenrodt)
What is the broad ligament?
The broad ligament is composed of parietal peritoneal folds which extend from the sides of the uterus to the lateral pelvic walls.
What are the 3 key components of the broad ligament?
- Mesometrium - extending from the pelvic wall to the side of the uterus - contains the uterine a and v, ovarian ligament, round ligament of uterus, uterovaginal plexus of nerves and part of the ureter
- mesosalpinx - mesentery supporting the uterine tube
- mesovarium - a fold of peritoneum which extends posteriorly from the mesometrium and mesosalpinx to the ovary
What are the uterosacral ligaments?
These are fibrous tissue and smooth muscle in the uterosacral folds, connecting the uterus with the sacrum
Where does the round ligament of the uterus cross?
It extends from the lateral aspect of the uterus, passing anteriorly between the layers of the broad ligament to leave the abdominal cavity through the inguinal canal and insert on the labia majora.
Where do the transverse (lateral) cervical ligaments of Mackenrodt extend to?
From the side of the cervix to the superior fascia of the pelvic diaphragm.
What is the vagina?
A fibromuscular tube lined by stratified squamous epithelium.
Where does it extend to?
From a vestibule to the cervix
- extends posterosuperiorly at an angle of 90 degrees to the axis of the cervix
How is the fornix formed?
The upper end of the vagina surrounds the cervix and forms a recess known as the fornix.
- there are anterior, posterior and lateral recesses (fornices)
What is the normal position of the uterus?
Anterverted and anteflexed
What does anteversion and anteflexion mean?
Anteversion - the long axis of the cervix at about 90 degrees to the long axis of the vagina
Anteflexion - the long axis of the cavity of the body of the uterus at an angle of about 150 degrees to the long axis of the cervical canal
What is retroversion?
This is when it turns backwards and weakens the pelvic floor
What is retroflexion?
This is when it bends backwards
Which structures support the uterus?
- pelvic diaphragm
- urogenital diaphragm
- perineal body
- transverse cervical ligament
- uterosacral ligament
What is the mons pubis?
Elevation over the pubic symphysis, covered by pubic hair after puberty
What is the labia majora?
Two prominent folds, pigmented and haired
- forms the boundaries of the pudendal cleft
- join at the front to form the anterior commisure
What is the skin between the labia majora posteriorly called?
Posterior commisure
What are the labia minora?
Two small folds
- hairless and pink
- form the prepuce of the clitoris and the frenulum of the clitoris anteriorly
What is the vestibule of the vagina?
Space between the labia minora
What does the vestibule of the vagina contain?
Vaginal and external urethral orifices and the openings of the greater vestibular gland ducts.
What is the clitoris?
Erectile tissue
- body of the clitoris consists of two corpora cavernosa each connected to the ischiopubic ramus by a crus of the clitoris
What is the glands clitoris?
Small, round, spongy tubercule which surrounds the corpora cavernosa
What is the bulbs of the vestibule?
Homologous to the male bulb of the penis
- joined at the front by a narrow commisura bulborum
- posteriorly overlaps the greater vestibular gland
What is the greater vestibular gland?
Homologous to the male bulbourethral glands
- secrete mucus to lubricate the vagina during sexual intercourse
What is the hymen vaginae?
Thin fold of mucosa lying inside the vaginal orifice
- when ruptured, carunculae hymenales may remain
Which arteries are most organs of the FRS supplied by?
Internal and external iliac arteries
What are the ovaries supplied by?
Ovarian branches of the abdominal aorta
Which arteries supply the bladder and ureters?
Superior vesicle arteries
Which artery supplies the uterus?
Uterine artery
Which arteries supply the vulva?
External pudendal and branches of the internal iliac artery.
Which arteries supply the anterior and posterior vaginal wall?
Anterior and posterior vaginal azygous plexus of arteries
What drains the ovaries?
Ovarian vein into the inferior vena cava (R) or left renal vein (L)
Where does the uterine vein drain into?
Internal iliac vein
Where does the vagina drain into?
The vagina drains via a vaginal plexus of veins to the internal iliac vein
Where does the vulva drain?
The vulva is drained via the external and internal pudendal veins.
In terms of lymphatic drainage, where do the ovaries, uterine fundus and body drain into?
Lumbar or paraortic nodes.
Lymphatics - where does the region around the attachment of the round ligament drain?
Along the course of the ligament to the inguinal nodes
Lymphatics - where do the lower body and cervix drain?
External, internal and sacral nodes
Lymphatics - where does the vulva drain?
Inguinal nodes
Lymphatics - where does the vagina drain?
External, internal and sacral nodes.
