Transcript Anatomy of the female reproductive system

Anatomy of the Female
Reproductive System
Liu Wei
Department of Ob & Gy
Ren Ji hospital
Introduction
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Pelvis
Pelvic floor
External genitalia
Internal genitalia
Vessel and nerve and lymph
Adjacent organs
Pelvis
Pelvis
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Bony pelvis
os ilium
髂骨
os sacrum
os coccyx
骶骨
尾骨
os ischium
坐骨
os pubis
耻骨
Pelvis
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Joints
Sacro-iliac joint
骶髂关节
Sacrococcygeal joint
骶尾关节
Symphysis
pubica
耻骨联合
Pelvis
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Ligaments
1.
Sacrospinous ligament 骶棘韧带
Extend from the lateral border of the
sacrum and coccyx to the spine of the
ischium
Sacrotuberous ligament 骶结节韧带
Extend from the posterior aspect of the
lower 3 sacral vertebrae to the ischial
tuberosity
2.
Pelvis
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Pelvic divisions (iliopectineal line 髂
耻线)
1.
False pelvis (pelvis major)
Ture pelvis (pelvis minor)
Bony birth canal
the Pelvic inlet, the pelvic out let and the pelvic
cavity
2.
Pelvis
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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%58.9%
The platypelloid type (扁平型骨盆)
distinct oval inlet. very wide subpubic
arch. 23.2%-29%
2.
Pelvis
3.
4.
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.
The android type (男型骨盆)
Pelvic floor
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The tissues closing down the pelvic
outlet (muscles and fasciae)
suspend and support the pelvic organs,
such as uterus and bladder and rectum
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Posterior part (urogenital triangle)
urethra and vagina pass through
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Anterior part (anal triangle)
rectum pass through
Pelvic floor
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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)
mid layer
urogenital diaphragm 泌尿生殖膈
2.
Pelvic floor
3.
1)
2)
3)
Inner layer (pelvic diaphragm 盆膈)
the main support of the pelvic floor
formed by the levator ani and
coccygenus muscles and covering
fasciae.
Levator ani: pubococcygenus (耻尾肌),
iliococcygenus (髂尾肌), puborectalis (坐
尾肌)
Pelvic floor
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Perineum
general conception: the tissues closing down
the pelvic outlet
Clinical conception: the tissues between
vagina and anus.
External genitalia
mons pubis
阴阜
Clitotis
Labium majus
阴蒂
大阴唇
Labium minus
Urethral orifice
小阴唇
尿道口
Vaginal orifice
Vaginal vestibule
阴道口
阴道前庭
Fossa navicularis
Perineal body
舟状窝
会阴体
Anus
肛门
External genitalia
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Labia majora
The venous drainage is extensive and forms
a plexus with numerous anastomoses.
Vulva hematoma
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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
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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.
vaginal fornix
the circular cul-de-sac formed around the cervix
4 regions: the anterior fornix, the posterior fornix and 2
lateral fornices.
2.
Internal genitalia
3.
1)
2)
3)
Wall structure
mucosal layer (stratified squamous epithelium)
muscular layer (3 layer)
submucous area ( with a dense plexus of veins
and lymphatics)
Internal genitalia
Internal genitalia
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Uterus
1.
Pear-shaped,thick-walled, muscular
organ
Body and cervix:
Babyhood 1:2, manhood 2:1
Isthmus uteri
connect the body to cervix, 1cm (nonpregnancy)
2.
3.
Internal genitalia
4.
1)
2)
Layers of uterine wall
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
Douglas)
The muscular layer
Outer layer (longitudinal fibers)
Inner layer (interlaced and various directions)
Internal genitalia
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
glands
funous: non-response to hormone periodically
3)
Internal genitalia
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Cervix
1.
lower 1/3 of uterus. connects uterus
to vagina via endocervical canal
External os: opening of
endocervical canal to ectocervix
Internal os: indistinct upper limit of
endocervical canal
2.
3.
Internal genitalia
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Ligaments
1.
Broad ligament
Round ligament
Cardinal ligament
Utero-sacral ligament
2.
3.
4.
Internal genitalia
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1.
1)
2)
3)
4)
Oviduct
Anatomy
Interstitial portion:
Isthmic portion: narrow
Ampulla: wide and tortuous
Fimbria: funnel-shaped mouth
Internal genitalia
2.
1)
2)
3)
Layers of wall
Serous
Muscular: outer longitudinal and
inner circular
Mucous: ciliated columnar
epithelium, coarse longitudinal folds
Internal genitalia
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1.
1)
2)
3)
Ovary
Anatomy
Paired organ, elliptic
The suspensory ligament of the
ovary
The ovarian ligament
Internal genitalia
2.
Structure of ovary
1)
Covered by cuboid or low columnar
epithelium
Consist of a cortex and a medulla
Cortex: oocytes in various stages of
maturity.
Medulla: fibers, smooth muscle cells,
blood vessel, nerves.
2)
3)
4)
Vessel and nerve and lymph
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Blood vessel
1.
The ovarian artery
Orginated as branches of the
abdominal aorta, (left: left renal
artery).
Turn over the common iliac artery
and ureter,descend into the pelvis.
Enter into ovary through the
mesovarium
1)
2)
Vessel and nerve and lymph
2.
The uterine artery
1)
a terminal branch of the hypogastric
artery
Cross the ureter near the cervix (2cm)
Ascend along the lateral border of the
uterus
uterine body branch and cervix-vagina
branch
2)
3)
4)
Vessel and nerve and lymph
3.
4.
Vaginal artery
Internal Pudendal artery
Vessel and nerve and lymph
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Lymph
1.
External genitalia
superfical inguinal gland (腹股沟浅淋巴结)
deep inguinal gland (腹股沟深淋巴结)
1)
2)
Vessel and nerve and lymph
2.
1)
2)
3)
Pelvic lymph
iliac lymph
common iliac, internal iliac and external
iliac
Anterior Sacral lymph
Lumbar lymph: abdominal aorta
Adjacent organs
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Urethra
Urinary bladder
Ureter
Rectum
Vermiform appendix
Adjacent organs
Answer the questions
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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?
END