Gross anatomy of the reproductive tract Flashcards
What are the parts of the female reproductive tract?
paired gonads (Ovaries (left and right) where germ cells develop)
duct system o paired uterine (fallopian) tubes o single midline uterus o single midline vagina Located in pelvis Vagina extends through pelvic floor
Describe the ovary
Produces gametes and hormones, endocrine and exocrine function
o Oestrogen and progesterone
Almond-shaped
o 3cm in younger women, often smaller in aged women (postmenopause – no longer
producing gametes)
o surface appears scarred and pitted > Ovaries go through wound healing process monthly when release an oocyte
Variable in position, esp after childbirth
o Can be higher/lower depending on the number of children a woman has had
Near lateral wall of pelvic cavity
Position stabilised by ligaments – not in direct continuity with the rest of the reproductive tract
Fimbriae extend over the ovaries
What is the blood supply to the ovary
via ovarian artery –arises from aorta at level of renal artery
Blood supply originates so high because the ovaries descend during development
What is the venous drainage of the ovary
via ovarian vein
drains to inferior vena cava on right side
left renal vein on left side
Describe the lymphatics of the oavry
o drain to aortic nodes at level of renal vessels
o Important to be aware of this because of cancer
o Drains into the abdominal cavity rapid spread of ovarian cancer
o Position of ovaries can make it very difficult to pick up on ovarian cancer at an early stage
What ligaments are associated with the ovaries?
Broad ligament
Ovarian ligament
Suspensory ligament
Describe the broad ligament
o peritoneal sheet draped over uterus and uterine tubes
o ovaries attached to the posterior layer by short mesentery, ‘the mesovarium’
Sort of like a shelf on the back of the peritoneum (broad ligament)
Fixed onto the back of the broad ligament
NB: position of the ovary is variable, especially after childbirth
Describe the ovarian ligament
o fibrous cord, links ovary to uterus
Describe the suspensory ligament of the ovary
o lateral wall of pelvis to ovary (attaches to the ovaries from above)
o carries ovarian artery and vein
What is the round ligament?
holds the uterus in place
What are the pouches in the peritoneum
o Rectouterine (pouch of Douglas) o Uterovesical
Why are the peritoneal pouches important clinically?
infection can accumulate here and be difficult to treat
o Common with back-street abortions
o Associated with endometriosis – blood and dead necrotic tissue accumulates
What are the parts of the uterine tubes/fallopian tubes/oviducts
Infundibulum
o funnel-shaped opening to peritoneal cavity
o fringed by finger like fimbriae
Ampulla
o middle section where fertilisation occurs
Isthmus
o short narrowed section
o connected to uterine wall
Interstitial/uterine part
o Continuous with the uterus
Approximately 13 cm long
NB: Not directly connected to ovary => Not a closed system => can allow infection to escape into the peritoneum (e.g. with STIs)
Describe the uterus
Pear-shaped (inverted)
In resting state (non-pregnant) 7-8cm long, 5cm wide, 2.5cm thick, but very variable in the aged
Flattened from front to back
o Slit-like space between the walls
o Necessary to keep the conceptus in place prior to implantation
What are the parts of the uterus?
Body
Cervix (Latin for ‘neck’)
o cervical canal
o internal os and external os (opening)
external faces into the vagina
difference in appearance of external os in women who have or have not borne children
o Cervix can be felt through the rectouterine pouch
Fundus
o rounded part, projects up above level of uterine tubes
Isthmus
o narrowing between body and cervix
What is a Bicornuate Uterus?
most common congenital uterine anomaly, but fairly rare overall
can impact a woman’s reproductive capabilities
o woman can carry two separate pregnancies
commonly referred to as a ‘heart-shaped’ uterus
uterus composed of two ‘horns’ separated by a septum.
In humans =
malformation, but in some other species,
incl rodents and pigs = normal.
Describe the position of the uterus
Body of uterus is bent forwards on the cervix, a position termed “anteflexion”
Whole uterus is bent forward at a right angle to the vagina, a position termed “anteversion”
NB: 20% females show retroflexion and retroversion –no symptoms
What is the blood supply to the uterus?
Uterine artery, branch of internal iliac artery
What is the venous drainage of the uterus?
Uterine vein drains to internal iliac vein
Describe the lymphatics of the uterus
o drainage of body and cervix differ
o body to para-aortic nodes
o cervix to internal iliac nodes
Give an overview of the male reproductive system
Two testes (singular = testis)
o Exocrine and endocrine glands
Duct system
o closely associated with urinary system
o share final duct - urethra
Accessory glands
o One prostate gland
o Two seminal vesicles
o Two bulbourethral glands
What is the importance of the rectovesical pouch?
less risk of infection than in females because there is no communication with the
outside
What is retrograde ejaculation
occurs when semen, which would, in most cases, beejaculatedvia the
urethra, is redirected to the urinary bladder
Describe the scrotum
o Skin
o Dartos muscle wrinkles skin of the scrotum
Smooth muscle
o External spermatic fascia
o Cremasteric fascia
o Internal spermatic fascia
These layers may be fused and hard to distinguish
They are derived from layers of the abdominal wall
Describe the testis
Has to remain outside the body at slightly cooler temperature
Cremaster muscle o skeletal muscle o Lies deep to dermis o Runs in spermatic cord o Contracts to raise testis in cold weather
Cremasteric reflex
Not to be confused with DARTOS muscle –smooth muscle in dermis, causes wrinkling of scrotal skin
Describe the covering of the testes
Tunica vaginalis of the testis
o A closed sac of peritoneum:
visceral and parietal layers
space between containing film of peritoneal fluid
What is a hydrocele?
excess fluid in the tunica vaginalis
Describe the duct system of the testes
The ends of a coiled seminiferous tubule join to form a
straight tubule (or “tubulus rectus”)
All the straight tubules join to a network “rete testis”
From this network, efferent ductules leave and join the
epididymis
What is the epididymis?
a very coiled tube – continuous with the ductus deferens
so tightly coiled that it has a gross form – head, body and tail
lined by pseudostratified columnar epithelium with
stereocilia (long microvilli)
Stereocilia increase the area for absorption from fluid
can monitor and adjust the fluid composition
Sperm mature in the epididymis, need optimum
conditions
What is the blood supply of the testis
Testicular artery
What is the venous drainage of the testis?
Pampiniform plexus (network, forms counter cooling system for testis)
o Right Drains to → testicular vein → IVC
o Left drains to renal vein
What is the lymphatic drainage of the testes?
Different lymphatic drainage of testis and scrotum:
o testis to para-aortic nodes
o scrotum to inguinal nodes
Describe the ductus deferens
Thick-walled => small lumen
Smooth muscle in the wall contracts by peristalsis at
emission
Runs in spermatic cord, through inguinal canal
Lies on side wall of pelvis, turns medially to base of
bladder
Enlarges at end –ampulla region Also attached here to seminal vesicle – outpouching of the ductus
Describe the seminal vesicles
Develops as an out-pouching of the ductus deferens
Coiled tubes
Secretes an alkaline viscous fluid which helps to neutralise the acid in the female tract.
Describe the seminal fluid
alkaline viscous fluid which helps to neutralise the acid in the female tract.
o Fructose - used for ATP production by sperm
o Prostaglandins - aid sperm mobility and viability and may also stimulate muscle contraction in
the female tract
What is the ejaculatory duct?
Duct of the seminal vesicle joins with the ductus deferens on each side to form the ejaculatory duct
Penetrates the prostate gland empties into the urethra runs through the penis => single exit point
Describe the prostate gland
Pyramidal in shape
Size and shape of a chestnut
Surrounds the beginning of the urethra
Secretes a slightly acidic fluid containing
o citrate (used by sperm for ATP production)
o acid phosphatase
o proteolytic enzymes => liquefy coagulated semen
Passes its secretion to the urethra via many prostatic ducts
What ate the bulbourethral glands
Pea-sized
Produce a mucus-like
secretion
Ducts open to spongy urethra
