Transcript Anatomy of the Female Reproductive System

Anatomy of the Female
Reproductive System
Ob & Gy Department, First hospital,
Xi’an Jiao Tong University
WANG SHU
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Anatomy of the Bony Pelvis
• Bones
• Joints
• False pelvis and true pelvis
• Three planes of the true pelvis
• Types of the female pelvis
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bone
joints
F&T
3 plane
I. BONES
ilium
Two coxae
Pelvi
pubis
Sacrum
Coccyx
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Ischium
5 fused vertebrae
5 fused cartilaginous
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II. JOINTS
Two sacro-iliac joints
joints
Sacro-coccygeal joint
Symphysis pubis
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III. False Pelvis & True Pelvis
• The lines of demarcation between false
pelvis and true pelvis
------ border line
. posterior : upper border of sacral promontory
. lateral: ilio-pectineal boundary
. anterior: upper border of pubis
• False pelvis
• True pelvis
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IV. Three Planes of True Pelvis
• Inlet: the pelvic inlet to the pelvis minor is bounded
by
. posteriorly: the promontory of the sacrum;
. laterally:the linea terminal;
. anteriorly:the upper border of the pubis, ending at the
symphysis.
• Mid-cavity
• Outlet: very irregular ,it is bounded by
. anteriorly: the arcuate ligament of the pubis ,
. laterally: the ischiopubic arch, the ischial tuberosity,
. Posteriorly: the sacrotuberous ligament, the coccyx.
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V. Types of the Female Pelvis
• Gynaecoid
• Anthrocoid
• Platypelloid
• Android
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a
b
c
d
A. Gynecoid Pelvic
Inlet:
The gynecoid pelvis provides a rounded ,slightly
oviod , or elliptical inlet with a well-rounded
forepelvis.
Posterior segment:
This type of pelvis has a well-rounded, spacious
posterior segment, an adequate sacrosciatic notch,
a hollow sacrum with a somewhat backward sacral
inclination,and a Norman-type arch of the pubic rami.
Side walls:
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This type of pelvis has straight side walls and
wide interspinous and intertuberous diameters.the
bones are primarily of medium weight and structure.
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B. Anthropoid Pelvic
Inlet:
This type of pelvis is characterized by a long,
narrow, oval inlet with an extended and narrow
anterior.
Posterior segment:
This type of pelvis has a posterior segment, a wide
sacrosciatic notch, and a long, narrow sacrum.
Side walls:
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Straight side walls are characteristic of the
anthropoid pelvis, whose interspinous and
intertuberous diameters are less than those of the
average gynecoid pelvis. A medium bone structure is
usual.
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C. Platypelloid Pelvic
Inlet:
This type of pelvis has a distinct oval inlet with a
very wide, rounded retro pubic angle
Posterior segment:
This type of pelvis has a a wider, flat posterior
segment. The sacrosciatic notch is narrow and
has a normal sacral inclination, although it is often
short. The subpubic arch is very wide and
Side walls:
The side walls are straight,with wide
interspinous and intertuberous diameters.
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D. Android Pelvic
Inlet:
The android pelvis has a wedge-shaped inlet, a
narrow forepelvis.
Posterior segment:
This type of pelvis has a flat posterior segment,
and a narrow sacrosciatic notch,with the sacrum
inclining forward. .
Side walls:
The side walls converge and the bones are
medium to heavy in structure..
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Pelvic floor
Outer layers: bulbocavernosus muscle
ischiocavernosus muscle
superficial transverse perineal
muscle
external sphincter muscle of anus
Mid-layers: urogenital diaphragm
Inter layers: pelvic diaphragm
Perineum:
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perineal body
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External genital organs
•
•
•
•
•
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Mons pubis
Labia majus
Labia minus
Clitoris
Vaginal vestibule
Urethral orifice
Major vestibular gland
Vestibular bulb
Vaginal orifice and hymen
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Internal genital organs
I. VAGINA
• Fornices
Because the cervix of the uterus projects into the upper
portion,the anterior wall of the vagina is shorter than the
posterior wall.the circular cul-de-sac formed around the cervix
is known as the fornix and is divided into 4 regions;the
anterior fornix,the posterior fornix,and 2 lateral fornices.
• Mucous membrane
The mucous of the vagina is lined throughout by stratified
squamous epithelium.Even though the vagina has no true
glands,there is a secretion present.it consists of cervical
mucus, desquamated epithelium,and a direct transudate.
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II. UTERUS
• Bulk of uterus
The uterus is a pear-shaped,thick-walled,muscular
organ.it is approximately 7~8cm long and 4~5cm at its
widest point.In the prepubertal period,it is considerably
smaller.In women who have borne children, it is larger.
•
Isthmus of uterus
The communi-cation of the cavity below with the
cavity of the cervix corresponds in position to the
isthmus and forms the internal orifice(internal osuteri).
At the extremty of the vaginal portion is the opening
leading to the vagina, the external orifice (external os
uteri), which is round or oval before parturition but
takes the form of a transverse slit in women who have
borne children.
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II. UTERUS
• The normal position of the uterus:
Normally ,the uterus forms a sharp angle with the vagina,so
that its anterior surface lies on the upper surface of the bladder
and the body is in a horizontal plane when the woman is
standing erect.there is a bend in the area of the isthmus, at
which the cervix then faces downward.this position is the
normal anteversion, it may be placed backward (retroversion).
• Tissue structure
. Endometrium: it is soft and spongy,composed of tissue
resembling embryonic connective tissue.
. Myometrium: the muscular layer is extremely thick.
. Perimetrium: it is simply the peritoneal covering.it is thin
and firmly adherent over the fundus and most of the body.
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II. UTERUS
• Cervix
. supra-vaginal portion
. vaginal portion
• Ligaments
. round ligaments
. broad ligaments
. utro-sacral ligaments
. transverse cervical ligaments
• Arteries:
The blood supply to the uterus is from the uterine
and ovarian arteries.
The uterine artery runs downward and medially to
cross the ureter near the cervix.
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III. Fallopian Tube
• Position:
the fallopian tubes serve to convey the ova to the
uterus. They extend from the superior angles of the
uterus to the region of the ovaries,running in the
superior border of the broad ligament.Each tube is 714cm long.
• Four portions:
. Interstitial: it has a rather long intramural course,
and its opening into the uterus.
. Isthmus: it is very narrow ,1mm in diameter.
. Ampulla: it is wider,more tortuous,it terminates
in the infundibulum.
. Infundibulum: it is attached to the ovary.
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IV. Ovaries
• Tissue structure:
The ovary is covered by low columnar epithelium and consists
of a cortex and a medulla. The medulla is made up of connective
tissue fibers and supporting tissue;the definitive ova (oocytes)
lies in the cortex.
• Position:
The ovaries are paired organs situated close to the wall on
either side of the pelvis minor. It is suspended by means of the
mesovarium,the suspensory ligament of the ovary,and the
ovarian ligament.
• Arteries:
The ovarian arteries may originate as branches of the
abdominal aorta,the left frequently originates from the left renal
artery;the right less frequently.
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