Female Reproductive tract Flashcards
vulva
external female genitalia
vulva functions
sensory tissue during sexual intercourse
assists in micturition by directing flow of urine
protects internal female reproductive tract from infection
structures of vulva
mons pubis labia majora lbia minora vestibule Bartholin's glands clitoris
mons pubis
subcutaneous fat pad located anterior to pubic symphysis
Formed by fusion of labia majora
labia majora
two hair-bearing external skin folds
extend from mons pubis posteriorly to posterior commissure
Embryologically derived from labioscrotal swellings
labia minor
hails folds of skin, lie within labia major.
fuse anteriorly to form hood of clitoris and extend posteriorly either side of vaginal opening
merge posteriorly- creating fold of skin: fourchette
embryologically derived from urethral folds
vestibule
area enclosed by labia minora
contains openings of vagina and urethra
Bartholin’s glands
secrete lubricating mucus from small ducts during sexual arousal
located either side of vaginal orifice
clitoris
located under clitoral hood
formed of erectile corpora cavernous tissue, becomes engorged with blood during sexual stimulation
embryologically derived from genital tubercle
Vascular supply of vulva
paired internal and external pudendal arteries
branches of internal iliac artery and femoral artery
Venous drainage of vulva
pudendal veins
Lymph drainage of vuvla
drains to nearby superficial inguinal lymph nodes
innervation of vulva
sensory and parasympathetic
Sensory
- Anterior: ilioinguinal nerve (branch of genitofemoral)
- Posterior: pudendal nerve
Clitoris and vestibule also receive parasympathetic innervation from cavernous nerves
vagina
distensible muscular tube which extends posterosuperiorly from external vaginal orifice to cervix
roles of vagina
Sexual intercourse
Childbirth
Menstruation
anatomical position of vagina
anterior: bladder & urethra
Posterior: rectouterine pouch, rectum and anal canal
lateral: ureters and levator ani muscle
anatomical structure of vagina
fibromuscular tube with anterior and posterior walls
Upper ending: vagina surrounds cervix, creating 2 fornices
Role of vaginal fornix
Posterior fornix acts as natural reservoir for semen after intravaginal ejaculation.
Semen retained in fornix liquefies in 20-30 minutes, allowing for easier permeation through cervical canal
histology of vagina
Stratified squamous epithelium
- provides protection and is lubricated by cervical mucus
Elastic lamina propria
- dense connective tissue layer which projects papillae into overlying epithelium
Fibromuscular layer
-comprises of 2 layers of smooth muscle; inner circular and outer longitudinal
Adventitia
- fibrous layer
- provides additional strength to vagina whilst also binding it to surround structures.
arterial supply of vagina
uterine and vaginal arteries
both branches of internal iliac artery
venous return of vagina
vaginal venous plexus
-drains into internal iliac veins via uterine vein
Lymphatic drainage of vagina
Superior: external iliac nodes
Middle: internal iliac nodes
Inferior: superficial inguinal lymph nodes
innervation of vagina
predominantly from autonomic nervous system
parasympathetic and sympathetic nerves arise from uterovaginal nerve plexus
Only inferior 1/5 of vagina receives somatic innervation via branch of pudendal nerve- deep perineal nerve
vaginal fistulae
open communication between vagina and one of the adjacent pelvic organs
main types of vaginal fistulae
vesicovaginal
- communication with bladder. urine enters vagina
urethrovaginal
- communication with urethra. urine enters vagina during urination
rectovaginal
- communication with rectum. faecal matter can enter vagina
cervix anatomical structure
ectocervix and Endocervical canal
ectocervix
portion of cervix that projects into vagina
lined by stratified squamous non-keratinised endothelium
External os
opening in ectocervix. Marks transition to Endocervical canal
endocervix
lined by mucus-secreting simple columnar epithelium
Endocervical cnal ends, and the uterine cavity begins at internal os
Functions of cervix
Facilitates passage of sperm into uterine cavity
- dilation of external and internal os
Maintains sterility of upper female repro tract
- protects uterine cavity and upper genital tract by preventing bacterial invasion
- enviornment maintained by frequent wedding of endometrium, thick cervical mucus and a narrow external os.
Arterial supply of cervix
Uterine Artery
Venous drainage of cervix
plexus in borad ligament that drains into uterine veins
Lymphatic drainage of cervix
Iliac, sacral, aortic and inguinal lymph nodes
uterus
secondary sex organ
matures during puberty under influence of sex hormones produced by ovaries
Responsible for maintenance and transportation of gametes.
Anatomical structure and location of uterus
thick-walled muscular organ capable of expansion to accommodate growing foetus
Connected distally to vagina, and laterally to uterine tubes
Anteverted with respect to vagina
histological structure of uterus
peritoneum
- double layered membrane
- continuous with abdo peritoneum
myometrium
- thick smooth muscle layer
- undergo hypertrophy and hyperplasia during pregnancy in preparation to expel foetus at birth
endometrium
- inner mucous membrane lining uterus
- deep stratum basalis
- superficial stratum functionalis: proliferates in response to oestrogen & becomes secretory in response to progesterone, Shed during menstruation
ligaments of uterus
broad ligament round ligament ovarian ligament cardinal ligament uterosacral ligament
broad ligament of uterus
double layer of peritoneum attaching sides of uterus to pelvis
acts as mesentery for uterus and contributes to maintaining it in position
round ligament of uterus
remnant of gubernaculum extending from uterine horns to labia major via inguinal canal
functions to maintain anteverted position of uterus
ovarian ligament of uterus
joins ovaries to uterus
cardinal ligament of uterus
located at base of broad ligament
extends from cervix to lateral pelvic walls
contains uterine artery and vein in addition to providing support to uterus
uterosacral ligament of uterus
extends from cervix to sacrum
provides support to uterus
Blood supply of uterus
uterine artery
venous drainage of uterus
plexus in broad ligament that drains into uterine veins
lymphatic drainage of uterus
iliac, sacral, aortic and inguinal lymph nodes
innervation of uterus
sympathetic nerve fibres: uterovaginal plexus
parasympthetic fibres: pelvic splanchnic nerve (S2-S4)
afferent fibres mostly ascend through inferior hypogastric plexus to enter spinal cord via T10-T12 and L1 nerve fibres
Fallopian tubes
lie in upper border of broad ligament, extending laterally from uterus, opening into abdo cavity, near ovaries
Functions of Fallopian tubes
assist in transfer and transport of ovum from ovary to uterus
How does fallopian structure help movement of female gamete
Inner mucosa is lined with ciliated columnar epithelial cells and peg cells (non-ciliated secretory cells). Waft ovum towards uterus and supply it with nutrients.
smooth muscle layer contracts to assist with transportation of ova nd sperm.
Muscle sensitive to sex steroid- peristalsis is greatest when oestrogen levels are high
Anatomical structure of Fallopian tubes
fimbriae
- finger-like, ciliated projection which captures ovum from surface of ovary
infundibulum
-funnel-shaped opening near ovary to which fimbriae are attached
ampulla
- widest section of uterine tubes
- fertilisation occurs here
Isthmus
- narrow section of uterine tubes connecting ampulla to uterine cavity
Arterial supply of Fallopian tubes
uterine and ovarian arteries
Venous drainage of Fallopian tubes
uterine and ovarian veins
Lymphatic drainage of Fallopian tubes
Iliac, sacral and aortic lymph nodes
Innervation of Fallopian tubes
Sympathetic and parasympathetic via nerve fibres from ovarian and uterine (pelvic) plexuses
Sensory afferent fibres run from T11-L1
ovaries
female gonads
develop within mesonephric ridge and descend through abdomen
Paired, oval organs attached to posterior surface of broad ligament of uterus by mesovarium.
main functions of ovaries
produce oocytes in preparation for fertilisation
produce sex steroid hormones oestrogen and progesterone, in response to pituitary Gonadotropins (LH and FSH)
Components of ovary
Surface
- simple cuboidal epithelium
Underlying this layer: dense connective tissue capsule
Cortex
- connective tissue stroma and numerous ovarian follicles
Each follicle contains oocyte, surrounded by single layer of follicular cells
medulla
-formed by loose connective tissue and a rich neuromuscular network- enters via hilum of ovary
ligaments of ovary
2 peritoneal ligaments
- suspensory ligament of ovary
- ligament of ovary
suspensory ligament of ovary
fold of peritoneum extending from mesovarium to pelvic wall
contains neuromuscular structures
ligament of ovary (a peritoneal ligament)
extends from ovary to fungus of uterus
continues from uterus to connective tissue of labia magus, as round ligament of uterus
Main arterial supply of ovary
paired ovarian arteries (arise from abdominal aorta)
Also contribution from uterine arteries
Venous drainage of ovary
paired ovarian veins
Left ovarian vein drains into left renal vein
Right ovarian vein drains directly into IVC
Ovary innervation
Sympathetic- ovarian plexus
Parasympathetic- uterine plexus
nerves reach ovaries via suspensory ligament of the ovary- to enter ovary at hilum
Lymphatic drainage of ovaries
drains into para-aortic nodes
