Female Reproductive System

Label the following diagram

What is the role of the pelvic inlet

Separates the true pelvis from the false pelvis

• True pelvis: structures below the pelvic inlet, including the reproductive organs within this area, bladder & r3ctum

• False pelvis: anything above the pelvic inlet to the iliac bone

Name the 4 main pelvic shape variations

• Gynaecoid: Wider, more round

  • most common type in females

• Android: narrower, more tapered pelvis

• Anthropoid: oval-shaped pelvis

• Platypelloid: wider side-to-side, flatter front-to-back

Label the following diagram

What are the 2 peritoneal pouches & why are they clinically relevant?

• Peritoneal pouches: where the peritoneum reflects over pelvic organs, forming pouches

  • Vesicouterine pouch: the pouch between the bladder & uterus

  • Rectouterine pouch (pouch of Douglas); the pouch between the uterus & r3ctum

• Clinically relevant due to fluid accumulation sites (more common in rectouterine poch - deeper)

How can fluid be drained from the rectouterine pouch?

By puncturing the back of the vag!na with a probe to drain fluid

What are the ovaries?

Paired almond-shaped gonads located in the lateral pelvis, which are the site of oocyte production & hormone (oestrogen & progesterone) secretion

• Positioned near lateral pelvic wall

• Connected to uterus via ligaments (mesentery) → mobility

Describe the 2 attachments of the ovaries

• Ovarian ligament: connects ovary to uterus

• Suspensory ligament: connects ovary to lateral pelvic wall

  • Contains ovarian vessels = major blood supply

*Structures help maintain ovarian position

Label the following diagram

For the uterine tubes, state:

• What they are

• What they are also known as

• Where they are located

• What they open into

• Uterine ligaments = paired muscular tubes extending from uterus → ovary

• AKA Fallopian tubes (though this term is not used anymore)

• Located in superior aspect of broad ligament

• Open into peritoneal cavity near ovary

  • Not actually connected to ovary; ‘waft’ the egg from the ovary into the tube

Name & describe the 5 regions of the uterine tube

1. Fimbriae: finger-like projections near the ovary

2. Infundibulum: funnel-shaped lateral end

3. Ampulla: widest & longest segment (site of fertilisation)

4. Isthmus: narrow medial segment

5. Intramural part: passes through uterine wall

Label the following diagram of the regions of the uterine tube

Where can ectopic pregnancies occur?

Anywhere outside the uterus;

• Abdominal cavity b/w ovary & uterine tube

• Anywhere along uterine tube

  • Fimbriae

  • Infundibulum

  • Ampulla

  • Isthmus

  • Intramural part

For the uterus, state:

• What it is & where it is located

• What it is divided into

• Key role

• Hollow muscular organ in midline pelvis

• Divided into:

  • Fundus: superior region

    • Can be felt after third month; measure height of foetus

  • Body: main portion

  • Cervix: inferior portion

    • Directly connected to uterus

    • Premature births if placenta (highly vascular) grows over base cervix (if implantation occurs to low)

• Key role: site of implantation

Label the following diagram of the key regions of the uterus

Label the following diagram of the axes & angles of the uterus

Describe the typical position of the uterus, in terms of:

• Relation to vag!na

• Relation to bladder

• What it is position in between

• What the cervix opens into

• Normally anterverted (tilted forward relative to vag!na)

• Normally anteflexed (flexed forward over bladder)

• Positioned b/w bladder (anterior) & r3ctum (posterior)

• Cervix opens into anterior wall of vag!na

Label the following diagram of the uterine wall layers

Name & describe the uterine wall layers

• Endometrium: inner mucosal layer

  • Site of implantation

  • Undergoes cyclical changes (menstruation)

• Myometrium: thick, smooth muscle layer

  • Dominant layer

  • Leads to uterine contractions

• Perimetrium: outer serosal layer (i.e. visceral peritoneum)

Label the following diagram of the cervix & surrounding structures

For the cervix, state:

• What it is

• What it contains

• What it is divided into

• What is opens into

• Inferior, narrow portion of uterus

• Contains cervical canal

• Divided into supravaginal & vaginal parts

• Opens into vag!na via external os

Label the following diagram of the vag!na

For the vag!na, state:

• Its structure

• Where it extends

• Where it is positioned

• What it surrounds & what this forms

• Fibromuscular tubular structures

• Extends from cervix → external genitalia

• Posterior to bladder & urethra

• Surrounds cervix → vaginal fornices

What are the vaginal fornices?

Depressions around the vaginal part of the cervix

Label the following diagram

For the broad ligament, state:

• What it is

• Where it extends

• Its role

• What it contains

• Double-layer of peritoneum

• Extends from lateral uterus to pelvic walls

• Provides supportive mesentery-like structure → keeps uterus in the right location while allowing for some movement during pregnancy

• Contains vessels & uterine tube

Aside from the broad ligament, what are the other 3 main ligaments in the female reproductive anatomy & what are their roles?

• Round ligament OF THE UTERUS: maintains uterus anteversion

  • Closed tube, doesn’t carry anything (= to spermatic cord in males)

  • Goes through inguinal canal towards external genitalia

  • Runs within the broad ligament

• Ovarian ligament: connects ovary to uterus

• Suspensory ligament: carries ovarian vessels

Label the following diagram

Label the following diagram

For the pelvic floor, state:

• What it forms

• What it is composed of

• What it does

• Key muscle group

• Forms inferior boundary of pelvic cavity

• Composed of muscles & connective tissue (seals off bottom of pelvis)

• Supports pelvic organs & keeps abdominal organs in place

• Key muscle group = levator ani (3 subgroups of muscles)

Name the 3 levator ani muscles & where they come from

• Puborectalis: pubic bone

  • Concentric contraction → functional sphincter → close rectum

• Pubococcygeus: moves towards bone @ back (doesn’t form a sling)

• Iliococcygeus: raphe of iliac area → coccyx bone

*All attach to pubic bone

Label the following diagram of the levator ani muscles

Describe the key function of the pelvic floor

• Supports pelvic organs

• Maintains continence (urine & faeces)

• Puborectalis acting as functional ‘sling’ around r3ctum → maintain anorectal angle & contribute to continence

What is the perineum & what does it do?

Diamond-shaped region inferior to the pelvic floor

• Supports continuity b/w pelvic cavity & the exterior

• Important route for vessels

State what the ischial tuberosities of the pelvis separates the perineum into, & what each of these features contain

Divided into:

• Urogenital triangle: contains external openings of urethra & vag!na

• An@l triangle: contains external openings of @nus

What is the perineal body, & what is a major clinical implication of this area during birth?

The major anchorage point for levator ani

• Birth → becomes stretched → tears → loss of support → involuntary defection & urination

• Might have to be manually cut during pregnancy so that the baby’s head has enough space to pass, & then be easily stitched back

Label the following diagram

Label the following diagram of the vulv@

Name & describe the 4 key regions of the vulv@ (external genitalia)

• Lab!a majora: outer skin folds

  • Where the round ligament of the uterus inserts within

  • Protects deeper genitalia

• Lab!a minora: inner mucosal folds

  • Glands → lubricant

  • Do not grow hair

• Cl!toris: anterior erectile structure

  • Similar to male pen!s

• Vestibule: area b/w lab!a minora, containing urethra + vag!nal opening

Label the following diagram of the vascular supply of the female reproductive system

Label the following diagram of the venous drainage of the female reproductive system

For the vascular supply of the female reproductive system, state:

• the 2 main arteries and where they arise from

• Where vessels run

• Where the arteries supply

• Main arteries:

  • Uterine artery arising from internal iliac artery

    • Gives rise to vag!nal artery

  • Ovarian artery arising from gonadal paired vessels of abdominal aorta

    • Runs over common iliac vessels & pelvic brim

• Vessels run within supporting ligaments

• Supply corresponds to the organ location

For the venous drainage of the female reproductive system, state:

• Where veins follow

• Where the right ovarian vein drains to

• Where the left ovarian vein drains to

• What the uterine drainage follows

• Veins follow arterial pathways

• Right ovarian vein → inferior vena cava

• Left ovarian vein → left renal vein

• Uterine drainage follows internal iliac system

State the anatomical pathway of the female reproductive tract

Ovary → uterine tube → uterus → cervix → vag!na