⁨أسئلة الثالثة أناتومي ثانية Repro - Female Genital Tract ⁩

• Female Genital Tract Anatomy

Female Genital Organs - Length

• Vagina: 3 inches anterior wall, 4 inches posterior wall.
• Uterus: 3 inches.
• Tubes: 4 inches.

Parts of Uterine Tube

• Intramural: Inside the uterine wall.
• Isthmus: The narrowest part of the tube.
• Ampulla: The widest part, the site of fertilization.
• Infundibulum: The lateral end, featuring finger-like fimbriae.

Arterial Supply

• Vagina: Uterine, vaginal, superior vesicle, and middle rectal arteries provide blood supply
• Uterus: Receives arterial blood from the uterine arteries
• Tubes: Uterine and ovarian arterial supply
• Ovary: Ovarian arteries originate from the aorta.

Ovary Arterial Supply

• It reaches the ovary using the infundibulo-pelvic part of the broad ligament

Venous Drainage

• Vagina, uterus, and tubes: drain into the internal iliac vein.

Ovary Venous Drainage

• Right ovary: drains into the inferior vena cava.
• Left ovary: drains into the left renal vein.

Lymph Drainage

• Vagina
  • Upper part: to external & internal iliac lymph nodes
  • Middle part: to internal iliac lymph nodes
  • Lower part: superficial inguinal lymph nodes
• Uterus:
  • Fundus: to para-aortic lymph nodes.
  • Cornu: to superficial inguinal lymph nodes.
  • Body and cervix: to internal & external iliac lymph nodes.
• Tubes:
  • Isthmus: to superficial inguinal lymph nodes.
  • Ampulla: to internal iliac lymph nodes.
  • Infundibulum: to para-aortic lymph nodes.
• Ovary: drains into para-aortic lymph nodes.

Nerve Supply

• Ovary: from the aortic plexus.
• Uterus & Tubes:
  • Sympathetic: T12-L1.
  • Parasympathetic: S2, 3, 4 via the inferior hypogastric plexus.
• Vagina:
  • Upper 2/3 "painless": supplied by the utero-vaginal plexus.
    • Sympathetic: LI, 2.
    • Parasympathetic: S2,3 via inferior hypogastric
  • Lower 1/3 "painful”: supplied by the pudendal nerve.
• Vulva: same as the scrotum.
• Urethra: Pudendal nerve (sensation) and pelvic plexuses (parasympathetic).

Peritoneal Cover

• Vagina: Not covered except for upper part of posterior wall.
• • Covered by Douglas pouch.
• Uterus: Completely covered
• • Except for the anterior wall of the supra-vaginal cervix.
• Uterine tubes: Completely covered by the mesosalpinx.
• Ovary: Completely covered.

Ovary Attachments

• Tubal "lateral" end: attached to infundibulo-pelvic ligament.
• Uterine "medial" end: attached to the ovarian ligament.
• Anterior border: covered by the mesovarium.

Relation of Vagina

• Anterior: urinary bladder & urethra.
• Posterior: Douglas pouch, rectum & anal canal.
• Fornices: Four spaces surround the cervix, projecting into the vaginal cavity.

Lateral Relation of Uterus

• Ureter & uterine artery.
• Broad & Round and ovarian ligaments.

Relation of Ovary "Ovarian Fossa"

• Anterior: external iliac artery.
• Posterior: ureter & internal iliac artery.
• Floor: obturator nerve.
• Inferior: uterine tube.

Uterine Support

• Pelvic Diaphragm: The levator ani & coccygeus muscles.
• Urogenital Diaphragm: External urethral sphincter & deep transverse perineal muscle.
• Perineal Body.

Uterine Position

• Ante-verted: Angle between the axis of the vagina & cervix is 90°.
• Ante-flexed: Angle between the axis of the cervix & body is 170°.

Ligaments of Uterus

• Non-peritoneal:
  • Pubo-cervical: between the cervix & pubis.
  • Sacro-cervical: between the cervix & sacrum.
  • Transverse cervical "cardinal" "Mackenrodt”: between the cervix & lateral wall.
  • Round ligament of the uterus: "from the cornu of uterus to labia majora"
  • Ovarian ligament: "from the uterine end of ovary to cornu of uterus"
• Peritoneal: broad ligament.

Broad Ligament

• Shape: Quadrangular with 4 borders & 2 surfaces.
• Anterior (upper) border: encloses the uterine tube.
• Posterior (inferior) border "root/base”: attached to the floor of the pelvis.
• Medial border: attached to the lateral margin of the uterus.
• Lateral border: related to the lateral wall of the pelvis.

Parts of Broad Ligament

• Meso-salpinx: between the uterine tube & ovarian ligament.
• Meso-metrium: between the ovarian ligament & base of the broad ligament.
• Mesovarium: between the anterior border of the ovary & the upper surface of the broad ligament.
• Infundibulo-pelvic ligament: "Suspensory ligament of the ovary": between the infundibulum & the lateral pelvic wall.

Content of Broad Ligament

• 2 Uterine tubes.
• 2 arteries: uterine & ovarian.
• 2 ligaments: round & ovarian.
• 2 Embryological remnants: epoophron & paroophron.

Uterine Prolapse

• Any defect in the factors supporting the uterus will cause a uterine prolapse.

External Genitalia

• Mons pubis:
  • Hairy, fatty area overlying the symphysis pubis.
• Labia majora:
  • Two large, hairy folds of skin that extend from the mons pubis to the front of the anus.
• Labia Minora: skin folds.
  • Two small, hairless skin folds between the labia majora.
  • They unite posteriorly to form the fourchette, but anteriorly split to enclose the clitoris.
• Vestibule: Lies between the labia majora & contains:
  • Urethra & paraurethral gland openings
  • Vagina & great vestibular gland openings
• Clitoris: Erectile tissue corresponds to the male penis.
  • Shares arterial & nerve supply & structure with the penis except it is smaller, has 2 bulbs, and doesn't enclose the urethra.
• Female urethra:
  • Length: two to four centimeters.
  • Originates at the neck of the bladder.
  • Ends opening in the vestibule just anterior to the vaginal orifice.
  • Blood supply: Branches of vaginal & internal pudendal vessels.
• Lymph drainage: Drain into the internal iliac lymph nodes.
  • Nerve supply: pudendal nerve.