Anatomy of the Female Genital System PDF - Lecture Notes

Here is the converted markdown format of the document: # ANATOMY OF THE FEMALE GENITAL SYSTEM Prof. Dr. Abdelhamid Attia Prof. of Obstetrics & Gynecology Cairo University The document covers the anatomy of the female genital system, including: * **The vulva**: The female external genital struc...

Here is the converted markdown format of the document: # ANATOMY OF THE FEMALE GENITAL SYSTEM Prof. Dr. Abdelhamid Attia Prof. of Obstetrics & Gynecology Cairo University The document covers the anatomy of the female genital system, including: * **The vulva**: The female external genital structures. * **The vagina**: A fibromuscular canal extending upwards. * **The uterus**: A hollow pear-shaped muscular organ. * **The fallopian tubes**: Hollow organs extending from the uterus. * **The ovaries**: Almond-shaped bodies attached to the broad ligament. ## The Vulva The female external genital structures are collectively called the vulva and consist of: 1. **Mons Pubis**: A pad of fat covered by skin and hair above the symphysis pubis. 2. **Labia Majora**: Two skin folds containing fatty tissue. The outer aspect is covered with hair, while the inner is smooth and contains sebaceous glands. 3. **Labia Minora**: Two folds of soft skin medial to the labia majora that unite posteriorly, forming the fourchette, and divide anteriorly into the frenulum and the prepuce of the clitoris. 4. **Clitoris**: A small erectile organ situated just below the S.P. It consists of a glans (erectile tissue) and a body and is extremely sensitive to erotic stimulation. 5. **Hymen**: A membrane composed of connective tissue and covered by St. Sp. Ep. on both aspects, partly closing the entrance of the vagina. 6. **The Vestibule**: The area between the labia minora and the fourchette, where the urethra and vagina open. 7. **External Urethral Meatus**: Opens in the vestibule below the clitoris. ## The Vagina The vagina is a fibromuscular canal that extends upwards and backwards from the vulva to the uterus, forming an angle of 60 degrees to the horizontal. It is closed antero-posteriorly, and the lower vaginal opening is closed by the hymen. The cervix projects into the upper blind end of the vagina (vaginal vault), dividing it into four fornices: anterior, posterior, and two lateral fornices. * The anterior vaginal wall is 8 cm long and is related to the urethra and the urinary bladder. * The posterior vaginal wall is 11 cm long and is related to the perineal body, the rectum, and the peritoneum of the Pouch of Douglas. ## The Uterus The uterus is a hollow, pear-shaped muscular organ, measuring 1x2x3 inches in a nullipara and $1\frac{1}{2} \times 2\frac{1}{2} \times 3\frac{1}{2}$ inches in a multipara. It has a triangular cavity that communicates with the cervical canal via the internal os. The Fallopian tubes enter the uterine cavity at the cornu. The uterus is inclined anteriorly to the axis of the vagina (ante-version), and the body is bent forward upon the cervix (anteflexion). The uterus is divided into three parts: 1. **Corpus (Body) Uteri**: Forming the main bulk with the part of the corpus above the insertion of the tubes, called the fundus. 2. **Isthmus Uteri**: A narrow portion of the uterus bounded superiorly by the anatomical internal os and inferiorly by the histological internal os. It measures 0.5-1 cm and expands during pregnancy, forming the lower uterine segment (10 cm). 3. **Cervix (Neck)**: The elongated lower part of the uterus that measures one inch and has a spindle-shaped canal.It communicates with the uterine cavity above at the internal Os and with the vagina below at the external Os. The cervix is divided by the attachment of the vagina into two parts: supravaginal and infravaginal portions (portio vaginalis). ## Histology of the Uterus The walls of the uterus consist of three layers: 1. **Endometrium (mucosa)**: Lined by simple cubical or columnar epithelium, contains tubular glands, and shows cyclic changes with the menstrual cycle. 2. **Myometrium (musculosa)**: Consisting of three layers: * Outer longitudinal muscle layer * Middle layer of criss-cross muscle fibers * Inner circular muscle layer 3. **Perimetrium**: The peritoneal covering or perimetrium. * Anteriorly: firmly attached to the fundus and body until the isthmus, where it becomes loose and is reflected onto the urinary bladder, forming the vesicouterine pouch. * Posteriorly: firmly attached to the fundus, body, cervix, and posterior vaginal fornix, then reflected onto the pelvic colon, forming the Douglas pouch. * Laterally: the anterior and posterior peritoneal coverings blend, forming the broad ligaments. ## The Fallopian Tubes The fallopian tube or Oviduct is a hollow organ 10 cm long, extending from the cornu of the uterus and opening into the peritoneal cavity. It is situated within the upper edge of the broad ligament and is divided into four parts: 1. **Interstitial portion (1 cm)**: Pierces the uterine wall and enters the uterus. 2. **Isthmus (2 cms)**: Narrow, straight and thick-walled portion immediately lateral to the uterus. 3. **Ampulla (5 cms)**: Wide, thin-walled and tortuous. 4. **Infundibulum (2 cms)**: The distal portion that opens in the peritoneal cavity via the tubal ostium and ends with a number of fimbriae. ### Tubal Functions * Ovum pick-up at the time of ovulation by their free fimbrial end. * Transport of the ova through the tubal lumen by their peristaltic and ciliary movements. * Production of secretions necessary for capacitation of the sperm and nutrition of the ova during their journey by their lining cells. ## The Ovaries The ovaries are two almond-shaped bodies measuring 3x2x1.5 cm. The ovary is attached to the back of the broad ligament by the mesoovarium, to the lateral pelvic wall by the infundibulopelvic ligament, and to the cornu of the uterus by the ovarian ligament. The ovaries are not covered by the peritoneum. The surface is pearly white and corrugated by the effect of monthly ovulatory activity. The ovary is divided into three regions: 1. **Cortex**: The specialized functioning part of the ovary, forming the main mass of the organ. 2. **Medulla**: A semilunar area enclosed by the cortex. 3. **Hilum**: Through which ovarian vessels, lymphatics and nerves enter and leave the ovary. ## Histology of the Ovary The cells in the ovary are: * Tunica albuginea * Cortex * Degenerating corpus luteum * Primary follicles * Germinal epithelium * Primordial follicles * Granulosa cells * Ooycte * Secondary follicle * Mesovarium and blood vessels * Vesicular (graafian) follicle * Antrum * Ooycte * Zona pellucida * Theca folliculi * Corona radiata * Ovulated ooycte * Medulla * Corpus luteum * Ovarian ligament THANK YOU