Anatomy of Female Anatomy of Female reproductive systemreproductive system

Teng YinchengTeng Yincheng M.D., Ph.D., Professor M.D., Ph.D., Professor

Department Of Obstetrics & GynecologyDepartment Of Obstetrics & Gynecology

Renji Hospital Affiliated to SJTU School of Medicine Renji Hospital Affiliated to SJTU School of Medicine

• bony pelvis

• female genital organs

• blood supply of female genital organs

Bony pelvisBony pelvis1. The bony pelvis is made up of 4

bones:

ilium

ischium

pubis

sacrum

1) 2 os coxae or innominate bones the iliumcoxae the ischium the pubis

2) 1 sacrum: Formed from 5 sacral vertebrae which fuse.

3)1 coccyx: Formed from 4 fused vertebrae.

2.Joint and ligament2.Joint and ligament

Sacro-iliac joint

Sacro-coccygeal

joint

腹股沟韧带骶棘韧带骶结节韧带

3.True pelvis and false pelvis3.True pelvis and false pelvis

The pelvis is divided into

the pelvis major (false pelvis) is bounded by the lumbar vertebrae

posteriorly,an iliac fossa bilaterally,and the abdominal wall anteriorly

the pelvis minor (true pelvis)

is formed by sacrum and coccyx posteriorly and by the ischium and pubis laterally and anteriorly

4.Pelvic planes4.Pelvic planes

• The pelvic inlet( pelvic brim): the promontory, and alae of the

sacrum ,linea terminalis the superior border of the

symphysis pubis • The plane of greatest diameter

is bounded by the junction of the second and third sacral vertebrae posteriorly,the upper part of the obturator foramina laterally,and the midpoint of the pubis anteriorly

• The plane of least diameter: extends from the lower border of the pubis anteriorly to lower sacrum at the level of the ischial spines

• The plane of the outlet is irregular

consisting of two intersecting triangles

5.The types of female pelvis5.The types of female pelvis

Gynecoid pelvis Occurs 40%--50% the inlet is rounded the side walls are

straight the sacrum is well

curved, and the sacrosciatic notch is adequate

Platypelloid pelvisoccurs in approximately 30% , 10% to

15% of African-american women There is an oval inlet the sacrum is normal the side walls are straight the sacrosciatic notch is narrower

Android pelvis occurs in only 2% to 5% of women wedge-shaped inlet the side walls converge the sacrum is inclined forward the sacrosciatic notch is narrow

Anthropoid pelvisoccurs in approximately

20% ;approximately 40% of black womenthe inlet is oval, long, and narrow the side walls are straight(do not

converge)the sacrum is long and narrowthe sacrosciatic notch is wide.Both the interspinous and intertuberous

diameter are somewhat smaller

6.Length of pelvic plane diameters6.Length of pelvic plane diametersPelvic plane diameter Average length(cm)

Inlet

Greatest diameter

Midplane

outlet

True conjugate

Obstetric conjugate

Diagonal conjugate

Transverse diameter

Oblique diameter

Anterior-posterior

Transverse

Anterior-posterior

Bispinous(interspinous)

Anterior-posterior

bituberous

10.5-11.5

10.0-11.0

12.5

13.5

12.5

12.75

12.5

11.5-12.0

10.0

11.5

8.0—11.0

7.Pelvic floor7.Pelvic floor

female genital organsfemale genital organs

mons pubis: fatty tissue

labia majora labia minora which lie

inside the labia majora clitoris: is located

anterior to the labia minora

1.External genitalia1.External genitalia

vestibuleLies between the labia minora Is

bounded Anteriorly by clitoris Posteriorly by perineum

Urethra and vaginal orifice open to the midline of the vestibule

Bartholin’s glands also empty into the vestibule

2.Internal genitalia2.Internal genitalia 1)VaginaMuscular tube from vestibule extends

to uterusThe anterior vaginal wall is 2cm

shorter than the posterior wallThe area around the cervix---the

fornix the posterior fornix is important

pouch which allows access to the peritoneal cavity from vagina

The vaginal wall consists of a mucous membrane , Beneath this is a submucosal layer of connective tissue which contains a rich of veins and lymphatics

The muscular wall has three layers of smooth muscle.

2)uterus2)uterusCervix

cylindrical shape, 2-3cm long vaginal portion external os

cervix tube

stratified squamous epithelium

simple columnar epithelium

2) Isthmus separate cervix and body

3) Corpus cornu fundus

long 7-8cm; wide 4-5cm; thick 2-3cm

The ratio of the body to the cervix

Before puberty 1:2; after puberty 2:1

The uterus is surported by the following ligaments

Round ligamentBroad ligamentCardinal ligamentUtero-sacral ligament

Histology of uterusHistology of uterusThere are three layers of the bodyThe inner is endometrium which is

consisted of the simple columnar epithelium

Beneath the mucosa is the muscular layer,covered by peritoneal serosa

3)Fallopian tubes3)Fallopian tubesLength: 8-14cmThe tube is divided four portions Interstitial isthmus Ampulla:the centre portion Infundibulum:surround the ovary

and help to collect the oocyte at the time of ovulation

The innner layer is covered by ciliate columnar epitheliun

The cilia beat toward the uterus assisting in oocyte transport

4. ovaries4. ovaries• Be located on either

side of the uterus• Volume:4*3*1cm• Weight:5-6g• be almond-shaped• Is divided two portion: cortex(outer portion): contains amount of

follicles medulla(central portion): blood vessels,

nerve fibres, lymphatics

blood supplyblood supply

Arterial systemOvarian artery:

from abdominal aorta (left may be from kedney artery)

Uterine arteryVaginal arteryInternal pudendal

artery from internal iliac artery

Lymphatic drainageLymphatic drainage

外生殖器淋巴　　腹股沟浅　　　上组　下组　　腹股沟深盆腔淋巴　　髂淋巴组　　骶前淋巴组　　腰淋巴组

The organ in the neighborhoodThe organ in the neighborhood

Urethera

Urinary bladder

Ureter

Rectum

Vermiform appendix

Teng YinchengTeng Yincheng M.D., Ph.D., ProfessorM.D., Ph.D., Professor

Department of Obstetrics & GynecologyDepartment of Obstetrics & Gynecology

Renji Hospital Affiliated to SJTU School of MedicineRenji Hospital Affiliated to SJTU School of Medicine

Thanks for Your AttentionThanks for Your Attention