Female Reproductive Organs Flashcards
Describe the location of the ovary and some of its features
- Suspended by mesentery (mesovarium),
- Supported by the suspensory ligament of the ovary and ovarian ligament.
- Lies in the ovarian fossa with obturator nerve laterally (referred pain through medial thigh),
- Site of oogenesis and endocrine gland
What are the anatomical relations of the ovary
Superiorly - External iliac vessels,
Inferiorly - Obturator nerve,
- Anteriorly - broad ligament,
- Posteriorly is the ureter and internal iliac vessels
Describe features of the uterine tubes
- 10cm long that begins lateral to the ovaries and attaches to the body of the uterus at the uterine cornua. It is enclosed within mesosalpinx. Function is to convey ovum from ovary to uterine cavity (peristaltic movement and cilia)
Name the different sections of the uterine tubes
- Infundibulum with fimbriae,
- Ampulla,
- Isthmus,
- Intra-mural
Describe the functions and parts of the uterus
- Function is for development of embryo and expulsion of foetus during childbirth.
- It has 3 parts; body, isthmus and cervix
Describe the feature of the body of the uterus
- Fundus sits superior to orifices of uterine tubes.
- The cavity is the site of implantation of a normal pregnancy.
- Wall has three layers; perimetrium, myometrium and endometrium
Describe the relationships of the uterus
- Lies in the midline between bladder and rectum,
- Uterine artery crosses over ureter,
- Covered in peritoneum
- Separated from surrounding structures by vesicouterine pouch and the rectouterine pouch
Describe features of the cervix
- Mostly fibrous with a small amount of elastin.
- Inferior aspect is dome-shaped and bulges into the vagina, forming fornices.
- Endocervix (endocervical canal) lines by columnar epithelium,
- Ectocervix (extends into vagina) lined by non-keratinising, stratified squamous epithelium.
- Transformation zone - area where there is transition from columnar to stratified squamous epithelium
Describe the angles of the uterus
axis of cervix = 90 degrees (anteversion),
Adult uterus bent forward on itself = 170 degrees (anteflexion)
What is retroflexion?
If the angle of the uterus is over 180 degrees. it can cause backache and difficulty conceiving.
Describe features and functions of the vagina
- 7-9cm long fibromuscular tube that extends from cervix to vestibule.
- The internal end is enlarged,
- Contains lactobacilli (important for maintaining acidity),
- Functions include; for insertion of the penis and receives ejaculate, canal for menstrual fluid and part of birth canal.
What is the vagina anatomical relations?
Anterior is the bladder and urethra, posterior is the rectum, lateral is the ureter passing laterally to lateral fornix, levator ani and pelvic fasica.
What is the function of the peritoneum of the pelvis?
Draps over pelvic viscera forming pouches (vesicouterine and rectouterine). It creates folds and ligaments between viscera and pelvic wall.
What is the function of the broad ligament? Name the three parts
It keeps the uterus in position but allows movement. It encloses the uterine tube in the superior margin, the suspensory ligament of the ovary and the round ligament of the uterus. It consists of 3 parts; Mesometrium, mesosalpinx and mesovarium.
Describe features of the round ligament of the uterus
- It is from the cornua of uterus to labia majora.
- Remnant of the lower part of gubernaculum.
Describe features of the round ligament of the ovary
From cornua of uterus to ovary.
- Remnants of upper part of gubernaculum
What is the suspensory ligament of the ovary?
Ovarian vessels covered in peritoneum.
What are the muscles and ligaments that support the uterus?
- Uterus supported by pelvic muscles (especally levator ani)
- COnsensations of fascia extend from cervix to pelvic wall; Pubocervical ligament anteriorly, transverse cervical (cardinal) ligament laterally and uterosacral ligament posteriorly
What separates the posterior vagina from the rectum?
Rectovaginal septum
Describe features of the urethra
lies anterior to vaginal wall and opens in vestibule immediately anterior to vagina. Paraurethral glands open into vestibule (one on each side of lateral margin to urethra)
What is the mons pubis?
Pad of fatty subcutaneous tissue overlying pubic symphysis for protection
What is the labia majora
Skin folds from mons pubis to perineum. They do not unite posteriorly instead there is a depression (posterior commisure). They enclose the pudendal cleft. Contain sebaceous glands and covered in pubic hair
What is the labia minora
Thin skin folds medial to labia majora. They surround the vaginal vestibule. Anteriorly they bifurcate and form the frenulum. Posteriorly unite to form the fourchette
What is the clitoris?
Cavernpus tissue at anterior junction of labia minora. Consists of 2 crura, body and glands. Contains vascular erectile tissue.
What is the vestibule?
Between the labia minora, contains the urethral and vaginal openings.
What is the hymen?
Thin mucosal fold surrounding opening of vagina (introitus)
What are the bulbs of vestibule?
Paired masses of elongated erectile tissue that lie lateral to vaginal orifice. Covered by bulbospongiosus muscle
What are the greater vestibular glands (bartholin’s glands)?
They open adjacent to posterolateral margin of vaginal opening. Drain into vestibule and secrete mucus for lubrication.
What is the blood supply of the ovaries
Arterial - Ovarian artery from aorta (L2),
Venous drainage - Pampinform plexus to ovarian vein to IVC on right, or left renal vein on left.
What is the blood supply of the uterine tubes?
Arterial - Tubal branches from ovarian and uterine arteries.
Venous drainage - Tubal veins to ovarian veins and uterovaginal venous plexus.
What is the blood supply of the uterus
Arterial - Uterine artery which is a branch of the internal iliac.
Venous drainage - Uterovaginal venous plexus to uterine veins to internal iliac.
What is the blood supply of the Vagina
Arterial - Vaginal artery which is a branch of the internal iliac artery.
Venous drainage - Uterovaginal venous plexus and internal iliac veins
What is the blood supply of the external genitalia
Arterial - Internal pudendal (from internal iliac) and external pudendal (from femoral).
Venous - Internal pudendal to internal iliac. External pudendal to femoral veins. The clitoris is drained by deep dorsal veins (then to vesicle plexus
What is the blood supply of the urethra
Arterial - Internal pudendal and vaginal arteries.
Venous - Internal pudendal and vaginal veins
What is the lymph drainage of the ovaries?
Para-aortic lymph nodes
What is the lymph drainage of the uterine tubes?
Para-aortic +/- superficial inguinal nodes
What is the lymph drainage of the uterus and proximal vagina?
Internal iliac nodes
What is the lymph drainage of the distal vagina?
Deep and superficial inguinal nodes
What is the lymph drainage of the external genitalia?
Superficial inguinal nodes (little to deep inguinal and internal iliac)
What is the lymph drainage of the urethra
External and internal nodes (deep and superficial inguinal)
What is the nerve supply of the ovary and distal uterine tube?
Sympathetics from T10-11 so referred pain to periumbilical region.
What is the nerve supply of the proximal uterine tube and uterine body?
Sympathetics from T12-L2 so reffered pain to suprapubic area
What is the nerve supply of the uterine cervix and proximal vagina
(below pelvic line) so PSNS from S-4 so pain is felt deeply in pelvis
What is the nerve supply of the distal vagina
Somatic pudendal nerve (S2-4) and sympathetics (no psns) Sensitive to touch and temp, pain is localised.
What is the nerve supply of the urethra
From vesicle plexus and pudendal nerve
What is the nerve supply of the external genitalia
Pudendal, ilioinguinal and genital branch of genitofemoral nerve
