Anatomy of the female reproductive system by jfm16066

VIEWS: 501 PAGES: 46

									Anatomy of the Female
 Reproductive System

         Liu Wei
  Department of Ob & Gy
     Ren Ji hospital
   Pelvis
   Pelvic floor
   External genitalia
   Internal genitalia
   Vessel and nerve and lymph
   Adjacent organs
    Bony pelvis

    os ilium

                            os sacrum
    os coccyx

                            os pubis
    os ischium
   Joints

Sacro-iliac joint

                             coccygeal joint

    Ligaments
1.   Sacrospinous ligament 骶棘韧带
     Extend from the lateral border of the
     sacrum and coccyx to the spine of the
2.   Sacrotuberous ligament 骶结节韧带
     Extend from the posterior aspect of the
     lower 3 sacral vertebrae to the ischial
    Pelvic divisions (iliopectineal line 髂
1.   False pelvis (pelvis major)
2.   Ture pelvis (pelvis minor)
     Bony birth canal
     the Pelvic inlet, the pelvic out let and the pelvic
    Types of pelvis
1.   The gynecoid type (女型骨盆)
     round, slightly ovoid or elliptical inlet.
     adequate sacrosciatic notch. wide
     interspinous diameters(≥10cm). 52%-
2.   The platypelloid type (扁平型骨盆)
      distinct oval inlet. very wide subpubic
     arch. 23.2%-29%
3.   The anthropoid type (类人猿型骨盆)
      long, narrow, oval inlet. extended and
     narrow anterior and posterior segment.
     wide sacrosciatic notch. long , narrow
     sacrum. Straight side walls.
4.   The android type (男型骨盆)
                Pelvic floor
   The tissues closing down the pelvic
    outlet (muscles and fasciae)
    suspend and support the pelvic organs,
    such as uterus and bladder and rectum
   Posterior part (urogenital triangle)
    urethra and vagina pass through
   Anterior part (anal triangle)
    rectum pass through
               Pelvic floor
    Tissues
1.   Outer layer
Bulbocavernosus muscle (球海绵体肌)
Ischiocavernosus muscle (坐骨海绵体肌)
Superficial transverse perineal muscle (会阴浅横肌)
External anal sphincter (肛门外括约肌)
2.  mid layer
urogenital diaphragm 泌尿生殖膈
              Pelvic floor
3.   Inner layer (pelvic diaphragm 盆膈)
1)   the main support of the pelvic floor
2)   formed by the levator ani and
     coccygenus muscles and covering
3)   Levator ani: pubococcygenus (耻尾肌),
     iliococcygenus (髂尾肌), puborectalis (坐
               Pelvic floor
   Perineum
general conception: the tissues closing down
  the pelvic outlet
Clinical conception: the tissues between
  vagina and anus.
                    External genitalia

    mons pubis
      Clitotis                           Labium majus

        阴蒂                                   大阴唇
                                         Labium minus
 Urethral orifice
     尿道口                                   Vaginal orifice
Vaginal vestibule
   阴道前庭                                  Fossa navicularis

 Perineal body                                舟状窝

    会阴体                                       Anus
            External genitalia
   Labia majora
    The venous drainage is extensive and forms
     a plexus with numerous anastomoses.
     Vulva hematoma
   Vaginal vestibule
    Bordered by the labia minora laterally, by
    the frenulum labiorum pudendal (阴唇系带)
    posteriorly, by the urethra and clitoris
    anteriorly, by the hymenal ring inferiorly.
Internal genitalia
Internal genitalia
              Internal genitalia
    Vagina
1.   strong canal of muscle (7.5cm)
     extend from the uterus to the vestibule of the external
     genitalia. its long axis is almost parallel with that of the
     lower part of the sacrum. the anterior wall of the vagina is
     1.5-2cm shorter than the posterior wall.
2.   vaginal fornix
     the circular cul-de-sac formed around the cervix
     4 regions: the anterior fornix, the posterior fornix and 2
     lateral fornices.
            Internal genitalia
3.   Wall structure
1)   mucosal layer (stratified squamous epithelium)
2)   muscular layer (3 layer)
3)   submucous area ( with a dense plexus of veins
     and lymphatics)
Internal genitalia
           Internal genitalia
    Uterus
1.   Pear-shaped,thick-walled, muscular
2.   Body and cervix:
     Babyhood 1:2, manhood 2:1
3.   Isthmus uteri
     connect the body to cervix, 1cm (non-
            Internal genitalia
4.   Layers of uterine wall
1)   The serous layer (perimetrium)
     Thin and firmly adherent over the fundous and
     most of the body
     Uterovesical pouch of the peritoneum
     Rectouterine pouch of the peritoneum (pouch of
2)   The muscular layer
     Outer layer (longitudinal fibers)
     Inner layer (interlaced and various directions)
          Internal genitalia
3)  The mucous layer (endometrium)
compact layer: response to hormone
    periodically, a single layer of ciliated
    columnar epithelium
spongy layer: response to hormone
    periodically. contains many tubular
funous: non-response to hormone periodically
          Internal genitalia
    Cervix
1.   lower 1/3 of uterus. connects uterus
     to vagina via endocervical canal
2.   External os: opening of
     endocervical canal to ectocervix
3.   Internal os: indistinct upper limit of
     endocervical canal
           Internal genitalia
    Ligaments
1.   Broad ligament
2.   Round ligament
3.   Cardinal ligament
4.   Utero-sacral ligament
          Internal genitalia
    Oviduct
1.   Anatomy
1)   Interstitial portion:
2)   Isthmic portion: narrow
3)   Ampulla: wide and tortuous
4)   Fimbria: funnel-shaped mouth
          Internal genitalia
2.   Layers of wall
1)   Serous
2)   Muscular: outer longitudinal and
     inner circular
3)   Mucous: ciliated columnar
     epithelium, coarse longitudinal folds
          Internal genitalia
    Ovary
1.   Anatomy
1)   Paired organ, elliptic
2)   The suspensory ligament of the
3)   The ovarian ligament
           Internal genitalia
2.   Structure of ovary
1)   Covered by cuboid or low columnar
2)   Consist of a cortex and a medulla
3)   Cortex: oocytes in various stages of
4)   Medulla: fibers, smooth muscle cells,
     blood vessel, nerves.
     Vessel and nerve and lymph
    Blood vessel
1.   The ovarian artery
1)   Orginated as branches of the
     abdominal aorta, (left: left renal
2)   Turn over the common iliac artery
     and ureter,descend into the pelvis.
     Enter into ovary through the
     Vessel and nerve and lymph
2.   The uterine artery
1)   a terminal branch of the hypogastric
2)   Cross the ureter near the cervix (2cm)
3)   Ascend along the lateral border of the
4)   uterine body branch and cervix-vagina
     Vessel and nerve and lymph
3.   Vaginal artery
4.   Internal Pudendal artery
     Vessel and nerve and lymph
    Lymph
1.   External genitalia
1)   superfical inguinal gland (腹股沟浅淋巴结)
2)   deep inguinal gland (腹股沟深淋巴结)
     Vessel and nerve and lymph
2.   Pelvic lymph
1)    iliac lymph
     common iliac, internal iliac and external
2)    Anterior Sacral lymph
3)    Lumbar lymph: abdominal aorta
            Adjacent organs
   Urethra
   Urinary bladder
   Ureter
   Rectum
   Vermiform appendix
Adjacent organs
        Answer the questions
   How many types of pelvis are there?
    What are they?
   What is perineum?
   What is vaginal vestibule?
   How many ligaments of uterus are there?
    What are they?
   How many ligaments of ovary are there?
    What are they?
   What is uterine isthmus?

To top