anatomy of the female reproductive system liu wei department of ob & gy ren ji hospital

Anatomy of the Female Reproductive System

Liu WeiDepartment of Ob & Gy

Ren Ji hospital

Introduction Pelvis Pelvic floor External genitalia Internal genitalia Vessel and nerve and lymph Adjacent organs

Pelvis

Pelvis Bony pelvis

os ilium

髂骨

os coccyx

尾骨

os sacrum

骶骨

os pubis

耻骨os ischium

坐骨

Pelvis Joints

Sacro-iliac joint

骶髂关节

Sacro-coccygeal joint

骶尾关节

Symphysis pubica

耻骨联合

Pelvis

Ligaments1. Sacrospinous ligament 骶棘韧带 Extend from the lateral border of the sacr

um and coccyx to the spine of the ischium

2. Sacrotuberous ligament 骶结节韧带 Extend from the posterior aspect of the l

ower 3 sacral vertebrae to the ischial tuberosity

Pelvis Pelvic divisions (iliopectineal line

髂耻线 )1. False pelvis (pelvis major)2. Ture pelvis (pelvis minor) Bony birth canal the Pelvic inlet, the pelvic out let and the pelvic

cavity

Pelvis

Types of pelvis1. The gynecoid type ( 女型骨盆 ) round, slightly ovoid or elliptical inlet. ad

equate sacrosciatic notch. wide interspinous diameters(≥10cm). 52%-58.9%

2. The platypelloid type ( 扁平型骨盆 ) distinct oval inlet. very wide subpubic ar

ch. 23.2%-29%

Pelvis

3. The anthropoid type ( 类人猿型骨盆 ) long, narrow, oval inlet. extended and n

arrow anterior and posterior segment. wide sacrosciatic notch. long , narrow sacrum. Straight side walls.

4. The android type ( 男型骨盆 )

Pelvic floor The tissues closing down the pelvic o

utlet (muscles and fasciae) suspend and support the pelvic organs, suc

h as uterus and bladder and rectum Posterior part (urogenital triangle) urethra and vagina pass through Anterior part (anal triangle) rectum pass through

Pelvic floor Tissues1. Outer layerBulbocavernosus 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 )2. mid layer urogenital diaphragm 泌尿生殖膈

Pelvic floor

3. Inner layer (pelvic diaphragm 盆膈 )1) the main support of the pelvic floor2) formed by the levator ani and coccygen

us muscles and covering fasciae.3) Levator ani: pubococcygenus ( 耻尾肌 ), i

liococcygenus ( 髂尾肌 ), puborectalis ( 坐尾肌 )

Pelvic floor Perineumgeneral conception: the tissues closing

down the pelvic outlet

Clinical conception: the tissues

between vagina and anus.

External genitalia

mons pubis

阴阜Labium majus

大阴唇Clitotis

阴蒂Labium minus

小阴唇Urethral orifice

尿道口 Vaginal orifice

阴道口Vaginal vestibule

阴道前庭 Fossa navicularis

舟状窝Perineal body

会阴体 Anus

肛门

External genitalia Labia majora The venous drainage is extensive and forms

a plexus with numerous anastomoses. Vulva hematoma

Vaginal vestibule Bordered by the labia minora laterally, by t

he 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 Vagina1. strong canal of muscle (7.5cm) extend from the uterus to the vestibule of the external ge

nitalia. 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.

2. vaginal fornix the circular cul-de-sac formed around the cervix 4 regions: the anterior fornix, the posterior fornix and 2 l

ateral fornices.

Internal genitalia3. Wall structure1) mucosal layer (stratified squamous epitheliu

m) 2) muscular layer (3 layer)3) submucous area ( with a dense plexus of veins

and lymphatics)

Internal genitalia

Internal genitalia Uterus1. Pear-shaped,thick-walled,

muscular organ2. Body and cervix: Babyhood 1:2, manhood 2:13. Isthmus uteri connect the body to cervix, 1cm

(non-pregnancy)

Internal genitalia4. Layers of uterine wall1) 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 o

f Douglas)2) The muscular layer Outer layer (longitudinal fibers) Inner layer (interlaced and various directions)

Internal genitalia

3) The mucous layer (endometrium)compact layer: response to hormone periodi

cally, a single layer of ciliated columnar epithelium

spongy layer: response to hormone periodically. contains many tubular glands

funous: non-response to hormone periodically

Internal genitalia

Cervix1. lower 1/3 of uterus. connects uterus

to vagina via endocervical canal

2. External os: opening of endocervical canal to ectocervix

3. Internal os: indistinct upper limit of endocervical canal

Internal genitalia Ligaments1. Broad ligament2. Round ligament3. Cardinal ligament4. Utero-sacral ligament

Internal genitalia Oviduct1. Anatomy1) Interstitial portion:2) Isthmic portion: narrow3) Ampulla: wide and tortuous4) Fimbria: funnel-shaped mouth

Internal genitalia

2. Layers of wall1) Serous2) Muscular: outer longitudinal

and inner circular 3) Mucous: ciliated columnar

epithelium, coarse longitudinal folds

Internal genitalia Ovary1. Anatomy1) Paired organ, elliptic2) The suspensory ligament of the ov

ary3) The ovarian ligament

Internal genitalia

2. Structure of ovary1) Covered by cuboid or low columnar epit

helium2) Consist of a cortex and a medulla3) Cortex: oocytes in various stages of mat

urity.4) Medulla: fibers, smooth muscle cells, bl

ood vessel, nerves.

Vessel and nerve and lymph

Blood vessel1. The ovarian artery1) Orginated as branches of the abdo

minal aorta, (left: left renal artery).2) Turn over the common iliac artery

and ureter,descend into the pelvis. Enter into ovary through the mesovarium

Vessel and nerve and lymph

2. The uterine artery1) a terminal branch of the hypogastric art

ery2) Cross the ureter near the cervix (2cm)3) Ascend along the lateral border of the ut

erus4) uterine body branch and cervix-vagina

branch

Vessel and nerve and lymph

3. Vaginal artery4. Internal Pudendal artery

Vessel and nerve and lymph

Lymph1. External genitalia1) superfical inguinal gland ( 腹股沟浅淋巴

结 )2) deep inguinal gland ( 腹股沟深淋巴结 )

Vessel and nerve and lymph

2. Pelvic lymph1) iliac lymph common iliac, internal iliac and

external iliac 2) Anterior Sacral lymph3) Lumbar lymph: abdominal aorta

Adjacent organs

Urethra Urinary bladder Ureter Rectum Vermiform appendix

Adjacent organs

Answer the questions

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