HBF-III LEC 09 Gross Anatomy Female Reproductive Notes 2025 PDF

Female Reproductive System Page 1 of 11 Dr. Mark Ireland SESSION LEARNING OBJECTIVES 1. Describe the anatomy of the vagina: function, structural features, relationships to other structures, and innervation. 2. Describe the anatomy of the...

Female Reproductive System Page 1 of 11 Dr. Mark Ireland SESSION LEARNING OBJECTIVES 1. Describe the anatomy of the vagina: function, structural features, relationships to other structures, and innervation. 2. Describe the anatomy of the uterus: function, structural features, positioning and relationships to other structures, peritoneal coverings and support ligaments. 3. Describe the anatomy of the uterine tubes: function, structural features, parts and relationships to other structures. 4. Describe the anatomy of the ovaries: function, structural features and relationships to other structures. 5. Describe the arterial supply to the female reproductive organs. 6. Describe the venous drainage of the female reproductive organs. 7. Describe the lymphatic drainage of the female reproductive organs. Supplemental Reading: Gray’s Anatomy for Students, 4th Ed. (2020) Drake, Vogl, Mitchell (Elsevier) Chapter 5. Atlas of Human Anatomy, 7th Ed. (2019) Netter (Elsevier) Chapter 6 Female Reproductive System Page 2 of 11 Dr. Mark Ireland SESSION OUTLINE I. Vagina A. Function B. Structure C. Relationships D. Innervation II. Uterus A. Function B. Structure C. Positioning D. Relationships and Innervation E. Peritoneal Coverings and Support Ligaments III. Uterine Tubes A. Function B. Structure, Parts and Relationships IV. Ovary A. Functions B. Structure and Relationships V. Arterial Supply VI. Venous Drainage VII. Lymphatics Female Reproductive System Page 3 of 11 Dr. Mark Ireland I. VAGINA Functions →organ of copulation →birth canal →outlet for menstrual fluid produced by uterus Fig 1 Structure (Fig 1, 2 Gray’s 5.55B, 5.57B) →distensible musculomembranous tube lined with mucosa →walls have folds of mucosa called rugae →posterior wall is longer than the anterior wall; walls are normally in contact →extends from the vestibule to the cervix of the uterus →external fibrous coat formed by pelvic fascia; contains an extensive nerve plexus Fig 2 →surrounds the cervix as the vaginal fornix; anterior, posterior and lateral fornices (Fig 2) Female Reproductive System Page 4 of 11 Dr. Mark Ireland Relationships (Fig 3, 4 Gray’s 5.57A, 5.66) Fig 3 Anterior (Fig 3) – vesicouterine pouch, bladder, parts of the ureter, urethra Posterior (Fig 3)– rectouterine pouch, rectum, perineal body 5.58A Fig 4 Lateral (Fig 4) at level of the fornix –broad ligament, ureter, uterine vessels inferiorly – levator ani, greater vestibular glands, vestibular bulb, UGD Sensory Innervation – somatic sensory innervation (pain, temperature, touch, erotic stimulation) from the lower 1/3 of the vagina is supplied by the pudendal n.; the upper 2/3 is relatively insensitive to these stimuli Female Reproductive System Page 5 of 11 Dr. Mark Ireland II. UTERUS Functions →site of blastocyst implantation →environment for embryonic/fetal development →provides propulsive force during birth of fetus Structure (Fig 5 Gray’s 5.53) Fig 5 hollow with muscular walls →perimetrium – outer serous coat derived from peritoneum →myometrium – bulk of the muscular layer →endometrium – inner mucous lining which is shed and regenerated during the menstrual cycle; site of blastocyst Isthmus implantation parts →body – upper 2/3 Cervical os →fundus – upper portion above entry of uterine tubes →cornua – region of body where uterine tubes enter; uterine tube cavity →isthmus – transition zone between body and cervix; level of uterine flexion →cervix – lower 1/3 of uterus; extends into vagina →cervical canal – connects uterine cavity to vagina; usually plugged with mucus →cervical os (ostium) – opening of the cervical canal into the vagina Position (Fig 6 Gray’s 5.55A) Anteflexed: bent anteriorly between axis of cervix and axis of uterine Fig 6 body Anteverted: inclined anteriorly between axis of vagina and axis of cervix Female Reproductive System Page 6 of 11 Dr. Mark Ireland Relationships (Fig 7 Gray’s 5.59A) anterior – bladder and vesicouterine pouch posterior – rectum, Fig 7 rectouterine pouch, rectouterine fold lateral – ureters, uterine tubes/ovaries, broad ligament, transverse cervical (cardinal) lig. Innervation - The uterus and cervix have VA sympathetic innervation traveling through the pelvic plexus. These sensory (pain) pathways travel back to the spinal cord at T10-L2 levels so referred pain is felt in those dermatomes. Female Reproductive System Page 7 of 11 Dr. Mark Ireland Peritoneal Coverings and Supporting Ligaments (Fig 8, 9, Netter 346, 355) Fig 8 broad ligament – double walled sheet of peritoneum originating from the lateral pelvic wall which encloses the uterus, uterine tubes, ovarian and round ligaments, part of the uterine vessels, part of the ureter, and part of the ovary mesosalpinx – part of the broad ligament which surrounds and suspends the uterine tube (see also Fig 7) mesovarium – part of the broad ligament which suspends the ovary (see also Fig 7) round ligament – attaches near the cornua of the uterus; travels within broad ligament; enters inguinal canal; terminates in labium majus; homologue of gubernaculum ligament of the ovary - attaches near the cornua of the uterus; travels in the mesovarium; attaches to inferior pole of the ovary; also a homologue of gubernaculum Female Reproductive System Page 8 of 11 Dr. Mark Ireland suspensory ligament of the ovary – the peritoneum surrounding the ovarian vessels and nerves; originates in abdomen; attaches to superior pole of ovary Ureter and uterine vessels in cardinal (transverse cervical) ligament Fig 9 uterosacral ligament (Fig 8, 9) – fascial thickening underlying the rectouterine fold; the rectouterine fold forms as the peritoneum forming the rectouterine pouch reflects onto the rectum; contains part of the uterine vessels and ureter transverse cervical or cardinal ligament (Fig 7, 8, 9) – fascial thickening at the base of the broad ligament containing the uterine vessels and ureter; water under bridge Female Reproductive System Page 9 of 11 Dr. Mark Ireland III. UTERINE TUBES Functions – transports ova from the ovary and sperm from the uterine cavity; fertilization usually occurs within its ampulla; transports zygote to the uterine cavity for implantation Structure (Fig 10 Gray’s 5.53) – muscular tube extending laterally from the cornua of the uterus to the ovary; opens medially into the uterine cavity and laterally into the peritoneal cavity; a passageway from the exterior world to the peritoneal cavity; lies in the free edge of the broad Fig 10 ligament Parts (Fig 9 Netter 355 ) →infundibulum – funnel shaped distal end which embraces the superior pole of ovary; draws ova into its ostium with its fimbriae →ampulla – widest and longest part of the tube; usual site of fertilization →isthmus – narrow and thick walled portion between ampulla and uterine cornua →uterine part – within the uterine myometrium; contains the uterine ostium IV. OVARY Functions – produces ova and hormones Structure and Relationships (Fig 9) – oval shaped organs about 3cm in length; nearly vertically oriented; upper or tubal pole relates to the uterine tube and attaches to suspensory ligament of the ovary; lower pole attaches to ovarian ligament; anterior border attaches to mesovarium; posterior border is not covered by peritoneum Female Reproductive System Page 10 of 11 Dr. Mark Ireland V. ARTERIAL SUPPLY (Fig 11 Gray’s 5.66) Fig 11 uterine a. – reaches the lateral aspect of the cervix by traveling in the broad ligament; tortuous route along the lateral aspect of the uterus allows for expansion during pregnancy; eventually anastomoses with the ovarian a.; also contributes to blood supply of uterine tubes and upper portion of vagina ovarian a. – travels in suspensory ligament of ovary and mesovarium; supplies ovary and uterine tubes; anastomoses with uterine a. vaginal a. – may arise from internal iliac or uterine a. or common trunk with uterine a.; supplies middle and lower vagina and may also supply bladder internal pudendal a. – lower end of vagina VI. VENOUS DRAINAGE Uterovaginal Plexus – drains the uterus, vagina, proximal part of uterine tubes; empties into uterine veins; may have anastomosis with superior rectal v. to provide a portal-systemic connection Ovarian Vein – drains ovary and distal part of uterine tubes; forms a plexus in broad ligament Internal Pudendal Vein – drains lower part of vagina Female Reproductive System Page 11 of 11 Dr. Mark Ireland VII. LYMPHATIC DRAINAGE (Fig 12 Gray’s 5.68) most of vagina and Fig 12 uterus→internal, external or common iliac nodes→aortic nodes ovaries, fundus of uterus and uterine tubes→along ovarian vessels to aortic nodes lower end of vagina→superficial inguinal nodes