Вы находитесь на странице: 1из 36

Include :ovaries, uterine tubes, uterus, and vagina

Internal organ

Eksternal organ (VULVA/PUDENDUM)

include the mons pubis, labia majora, labia minora, clitoris, bulbs of vestibule, and greater and lesser vestibular glands

The ovaries are almond-shaped and -sized female gonads in which the oocytes (female gametes or germ cells) develop
Each ovary contains a hilum, the point of entrance and exit for blood vessels and nerves along which the mesovarium is attached

A series of ligaments holds them in position : The broad ligament of the uterus which is itself part of the parietal peritoneum, attaches to the ovaries by a double-layered fold of peritoneum called the mesovarium. T The ovarian ligament anchors the ovaries to the uterus The suspensory ligament attaches them to the pelvic wall.

The uterine tubes (formerly called oviducts or fallopian tubes) conduct the oocyte, discharged monthly from an ovary during child-bearing years, from the periovarian peritoneal cavity to the uterine cavity. They also provide the usual site of fertilization.

The uterine tubes are divisible into four parts, from lateral to medial: Infundibulum: the funnelshaped distal end of the tube that opens into the peritoneal cavity through the abdominal ostium. The finger-like processes of the fimbriated end of the infundibulum (fimbriae) spread over the medial surface of the ovary one large ovarian fimbria is attached to the superior pole of the ovary. Ampulla: the widest and longest part of the tubelongest portion, making up about the lateral two-thirds of its length; fertilization of the oocyte usually occurs in the ampulla.

Isthmus: the thick-walled part of the tube, which enters the uterine horn. Uterine part: the short intramural segment of the tube that passes through the wall of the uterus and opens via the uterine ostium into the uterine cavity at the uterine horn.

The uterus (womb) is a thickwalled, pear-shaped, hollow muscular organ.

The uterus is a very dynamic structure, the size and proportions of which change during the various changes of life

The position of the uterus changes with the degree of fullness of the bladder and rectum, and stage of pregnancy.

Although its size varies considerably, the non-gravid uterus is approximately 7.5 cm long, 5 cm wide, and 2 cm thick and weighs approximately 90 g

serves as part of the pathway for sperm deposited in the vagina to reach the uterine tubes

the site of implantation of a fertilized ovum development of the fetus during pregnancy, and labor
the source of menstrual flow

The adult uterus is usually anteverted (tipped anterosuperiorly relative to the axis of the vagina) and anteflexed (flexed or bent anteriorly relative to the cervix, creating the angle of flexion) so that its mass lies over the bladder.

Anatomical subdivisions of the uterus include: (1) a domeshaped portion superior to the uterine tubes called the fundus, (2) a tapering central portion called the body, (3) an inferior narrow portion called the cervix that opens into the vagina. Between the body of the uterus and the cervix is the isthmus, a constricted region about 1 cm (0.5 in.) long

The interior of the body of the uterus is called the uterine cavity the interior of the cervix is called the cervical canal The cervical canal opens into the uterine cavity at the internal os and into the vagina at the external os.

The wall of the body of the uterus consists of three coats, or layers:
1. Perimetriumthe serosa or outer serous coatconsists of peritoneum supported by a thin layer of connective tissue. 2. Myometriumthe middle coat of smooth musclebecomes greatly distended (more extensive but much thinner) during pregnancy. The main branches of the blood vessels and nerves of the uterus are located in this coat. 3. Endometriumthe inner mucous coatis firmly adhered to the underlying myometrium. The endometrium is actively involved in the menstrual cycle, differing in structure with each stage of the cycle. If conception occurs, the blastocyst becomes implanted in this layer; if conception does not occur, the inner surface of this coat is shed during menstruation.

Ligaments of Uterus : The paired uterosacral ligaments, alsoperitoneal extensions, lie on either side of the rectum and connectthe uterus to the sacrum The paired broad ligaments are double folds of peritoneum attaching the uterus to either side of the pelvic cavity

The cardinal (lateral cervical) ligaments are located inferior to the bases of the broad ligaments and extend from the pelvic wall to the cervix and vagina The round ligaments are bands of fibrous connective tissue between the layers of the broad ligament; they extend from a point on the uterus just inferior to the uterine tubes to a portion of the labia majora of the external genitalia

Branches of the internal iliac artery called uterine arteries supply blood to the uterus. Uterine arteries giveoff branches called arcuate These arteries branch into radial arteries that penetrate deeply into the myometrium. Just before the branches enter the endometrium, they divide into two kinds of arterioles: Straight arterioles supply the stratum basalis spiral arterioles supply the stratum functionalis and change markedly during the menstrual cycle.

The vagina, a distensible musculomembranous tube (7-9 cm long), extends from the middle cervix of the uterus to the vaginal orifice, the opening at the inferior end of the vagina The vagina lies posterior to the urinary bladder and urethra

The vaginal fornix, the recess around the cervix, has anterior, posterior, and lateral parts

The vagina: serves as a canal for menstrual fluid, forms the inferior part of the birth canal, receives the penis and ejaculate during sexual intercourse, and communicates superiorly with the cervical canal and inferiorly with the vestibule of the vagina Four muscles compress the vagina and act as sphincters: pubovaginalis, external urethral sphincter, urethrovaginal sphincter, and bulbospongiosus

The vagina is related :

anteriorly to the fundus of the urinary bladder and urethra;
posteriorly (from inferior to superior) to the anal canal, rectum, and rectouterine pouch

The vagina is related : laterally to the levator ani, visceral pelvic fascia, and ureters; and

Eksternal organ

The mons pubis is the rounded, fatty eminence anterior to the pubic symphysis, pubic tubercles, and superior pubic rami. The eminence is formed by a mass of fatty subcutaneous tissue The amount of fat increases at puberty and decreases after menopause. The surface of the mons is continuous with the anterior abdominal wall. After puberty, the mons pubis is covered with coarse pubic hairs

The labia majora are prominent folds of skin that indirectly protect the clitoris and urethral and vaginal orifices

Each labium majus is largely filled with a finger-like digital process of loose subcutaneous tissue containing smooth muscle and the termination of the round ligament of the uterus
It passes inferoposteriorly from the mons pubis toward the anus

The labia majora lie on the sides of a central depression, the pudendal cleft, within which are the labia minora and vestibule The external aspects of the labia majora in the adult are covered with pigmented skin containing many sebaceous glands and are covered with crisp pubic hair.

The internal aspects of the labia are smooth, pink, and hairless.
The labia majora are thicker anteriorly where they join to form the anterior commissure. Posteriorly, in nulliparous women (those never having borne children) they merge to form a ridge, the posterior commissure, This commissure usually disappears after the first vaginal birth.

The labia minora are rounded folds of fat-free, hairless skin. They are enclosed in the pudendal cleft and immediately surround and close over the vestibule of vagina into which both the external urethral and the vaginal orifices open. They have a core of spongy connective tissue containing erectile tissue at their base and many small blood vessels.

The clitoris is a small cylindrical mass composed of two small erectile bodies, the corpora cavernosa, and numerous nerves and blood vessels.
The clitoris is located at the anterior junction of the labia minora. A layer of skin called the prepuce of the clitoris is formed at the point where the labia minora unite and covers the body of the clitoris. The exposed portion of the clitoris is the glans clitoris. The clitoris is homologous to the glans penis. In contrast to the penis, the clitoris is not functionally related to the urethra or to urination.

The clitoris is an erectile organ located where the labia minora meet anteriorly In contrast to the penis, the clitoris is not functionally related to the urethra or to urination.

It functions solely as an organ of sexual arousal. The clitoris is highly sensitive and enlarges on tactile stimulation.

The vestibule is the space surrounded by the labia minora into which the orifices of the urethra and vagina and the ducts of the greater and lesser vestibular glands open
The external urethral orifice is located 2-3 cm posteroinferior to the glans of the clitoris and anterior to the vaginal orifice. On each side of the external urethral orifice are the openings of the ducts of the paraurethral glands The size and appearance of the vaginal orifice vary with the condition of the hymen, a thin anular fold of mucus membrane, which partially or wholly occludes the vaginal orifice. After its rupture, only remnants of the hymen, hymenal caruncles (tags), are visible

The bulbs of the vestibule are paired masses of elongated erectile tissue, approximately 3 cm in length The bulbs lie along the sides of the vaginal orifice, superior or deep to (not within) the labia minora, immediately inferior to the perineal membrane They are covered inferiorly and laterally by the bulbospongiosus muscles extending along their length. The bulbs are homologous with the bulb of the penis.

The greater vestibular glands (Bartholin glands), approximately 0.5 cm in diameter. They lie on each side of the vestibule, posterolateral to the vaginal orifice and inferior to the perineal membrane; thus they are in the superficial perineal pouch The greater vestibular glands are round or oval and are partly overlapped posteriorly by the bulbs of the vestibule.

Like the bulbs, they are partially surrounded by the bulbospongiosus muscles. These glands secrete mucus into the vestibule during sexual arousal

The lesser vestibular glands are small glands on each side of the vestibule of vagina that open into it between the urethral and the vaginal orifices. These glands secrete mucus into the vestibule, which moistens the labia and vestibule