Unit 4: Lecture 8 (Female External & Internal Genital Organs & ANS of Much of Abdominopelvic Viscera)

Uterine (fallopian) tubes

What are the paired muscular tubes that provide the passage for oocytes (egg cells) from the ovaries to the uterus? They play a central role in reproduction, serving both as a conduit and as the site of fertilization.

Infundibulum, fimbriae, ampulla, isthmus, and uterine part

What are the 5 main regions of the uterine (fallopian) tubes?

Infundibulum

What part of the uterine (fallopian) tubes are the funnel-shaped distal end adjacent to the ovary? It contains the ostium (opening) through which the oocyte enters.

Fimbriae

What part of the uterine (fallopian) tubes are fingerlike projections of the infundibulum that help sweep the oocyte into the tube?

Ampulla

What part of the uterine (fallopian) tubes is The longest and widest section of the uterine tube? This is the typical site of fertilization.

Isthmus

What part of the uterine (fallopian) tubes is the narrow, medial third of the tube that connects to the uterus?

Uterine part

What part of the uterine (fallopian) tubes is the segment that traverses the uterine wall and opens into the uterine cavity?

Ampulla

What part of the uterine (fallopian) tubes is the typical site of fertilization?

Ampulla

What is the most common site of ectopic pregnancy, which occurs when a fertilized egg implants outside the uterine cavity? This can result in tube rupture if undiagnosed and is a surgical emergency.

Visceral peritoneum

What is the serosa (outer layer) of the uterine tubes derived from?

Tubal scarring

What can occur from infections like pelvic inflammatory disease (PID) is a major cause of infertility? These infections often damage the ciliated epithelium, impairing oocyte transport.

Ciliated simple columnar epithelium

What type of epithelium are the uterine tubes lined with?

Inner circular and an outer longitudinal smooth muscle layer, which generates peristaltic movements.

What layers does the muscularis layers of the uterine tubes contain?

Serve as the conduit for the oocyte after ovulation, provide the anatomical and physiological environment for fertilization (typically in the ampulla), and transport the fertilized oocyte (zygote) toward the uterus via ciliary movement and peristalsis.

What are the functions of the uterine (fallopian) tubes?

Eptopic tubal pregnancy

What is implantation of a fertilized ovum outside the uterine cavity?

2%

Ectopic pregnancies overall occur in about __% of all pregnancies.

True

(T/F) If undetected, tubal pregnancies can lead to rupture of the uterine tube, resulting in intra-abdominal hemorrhage—a life-threatening emergency. Embryonic survival is not possible.

Mechanical obstruction of the tube (e.g., scarring from pelvic inflammatory disease), tubal ligation failure (rare), and idiopathic (no identifiable cause)

What are the causes of eptopic pregnancy?

True

(T/F) Eptopic pragnancy can mimic appendicitis, especially with right-sided tubal pregnancy due to shared innervation patterns and peritoneal irritation.

Pelvic ultrasound, often with Doppler, is the first-line imaging modality. Beta-hCG levels are also used for diagnostic correlation.

What is the typical imaging modality to diagnose eptopic pregnancy?

Eptopic tubal pregnancy

What is the most common form of ectopic gestation?

Ovaries

What are paired female gonads that serve both reproductive and endocrine functions? They produce oocytes for fertilization and secrete hormones that regulate the menstrual cycle, reproductive physiology, and secondary sexual characteristics.

What happens to ovaries post-menopause

They shrink significantly and are largely composed of fibrous scar tissue.

Intraperitoneal

Are the ovaries intraperitoneal or retroperitoneal?

Mesovarium, suspensory ligament, and ovarian ligament

What 3 ligaments stabilize the ovaries?

Mesovarium

What ligament attaches the anterior border of the ovary to the broad ligament, carrying vessels and lymphatics?

Suspensory ligament

What ligament extends from the ovary to the lateral pelvic wall, containing the ovarian vessels, lymphatics, and nerves?

Ovarian ligament

What ligament connects the ovary to the uterus, anchoring it medially?

Gametogenesis and hormone production

What are the two main functions of the ovaries?

Oocytes

What do the ovaries prduce?

Estrogen and progesterone

What hormones do the ovaries synthesize?

True

(T/F) Ovaries are paired endocrine and reproductive organs.

Ovarian cycle

What is a hormonally regulated sequence of events within the ovaries that prepares an oocyte for potential fertilization? This cyclical process is closely tied to the menstrual cycle and includes follicular development, ovulation, and corpus luteum function. Each stage reflects significant hormonal and structural changes that support reproductive capacity.

400,000

At birth, the ovaries contain approximately 1.5 to 2 million primary oocytes enclosed in primordial follicles. By puberty, how many remain?

46 chromosomes (23 pairs)

Primary oocytes contain __ chromosomes (__ pairs) and are diploid

Corpus luteum

What do the remnants of of the follicle in the ovarian cycle become, which functions for 10-

13 days, producing high levels of progesterone and some estrogen?

Degenerates into the corpus albicans

What happens to the corpus luteum within the ovarian cycle if fertilization does not occur?

Posterior wall of the uterine body near the fundus or on the posterior fundus, within the functional layer of the endometrium

Where does the fertilized egg (blastocyst) typically implant?

Corpus luteum

What is a key endocrine structure that can be

mistaken for a cyst on imaging? It is essential for early pregnancy maintenance before placental hormone production begins.

Eptopic pregnancy

What is the leading cause of 1st trimester death?

True

(T/F) Primary oocytes are diploid and immature; secondary oocytes are haploid and capable of fertilization.

Ovarian cysts

What are fluid-filled sacs that form within or on the surface of an ovary? They are common and frequently benign, particularly during the reproductive years. They may be physiological (related to normal ovarian function) or pathological.

Follicular and corpus luteum cysts

What are the two types of ovarian cysts?

Follicular cysts

What type of ovarian cystsdevelop when a dominant follicle fails to rupture and release the oocyte? Instead, the follicle continues to grow, forming a fluid-filled cyst.

Corpus luteum cysts

What type of ovarian cysts occur when the corpus luteum seals and fluid accumulates inside? These may persist after ovulation.

False

(T/F) Both types of ovarian cysts are typically symptomatic.

True

(T/F) Functional cysts (follicular, corpus luteum) are common and usually benign.

Vaginal venous plexus

What does venous blood from the vagina drain into?

True

(T/F) Vaginal venous plexuses are interconnected with uterine and vesical venous

plexuses.

Internal iliac veins

What do the vaginal venous plexuses drain into?

Uterine venous plexus, primarily within the broad ligament

What drains venous blood from the uterus?

Internal iliac vein

What does the uterine plexus drain into?

Pampiniform plexus

What drains venous blood from the ovaries?

Directly into inferior vena cava

What does the right ovarian vein drain into?

Left renal vein

What does the left ovarian vein drain into?

Internal iliac veins

In males, what vein does the rectal, vesicle, and prostatic venous plexuses drain into?

True

(T/F) Vagina, uterus, and ovaries have distinct but interconnected venous drainage systems.

Perineum

What is the diamond-shaped region located between the pubic symphysis and the coccyx?

True

(T/F) The female external genitalia lie entirely within the urogenital triangle.

Anterior urogenital triangle and posterior anal triangle

What is the perineum divided into?

Progesterone

What does the corpus luteum mainly secrete?

Vestibule

What is the space between the labia minora into which the urethral and vaginal orifices open? It also contains the openings of the greater vestibular glands and paraurethral glands.

Grows the endometrial lining

What does progesterone do?

Clitoris

What is composed of paired corpora cavernosa (crura), a glans, and a body? It is highly innervated and homologous to the male penis. It functions primarily as a sensory organ important in sexual arousal.

Vestibular bulbs

What are paired masses of erectile tissue located deep to the labia minora and lateral to the vaginal orifice? They narrow the vaginal vestibule during arousal and are homologous to the bulb of the penis.

Greater vestibular glands (Bartholin glands)

What lies posterior to the bulbs and secrete mucus to lubricate the vestibule? They are homologous to the male bulbourethral glands.

Half-way (14 days)

In what point of the menstruation cycle does ovulation occur?

Paraurethral Glands (Skene's Glands)

What small glands open near the urethral orifice and may contribute to female ejaculation? They are homologous to the male prostate gland.

True

(T/F) The clitoris, vestibular bulbs, and glands are important for reproductive and sensory functions.

Obstruction of the Bartholin gland duct prevents normal mucus drainage, leading to gland swelling, if bacteria colonize the retained secretions, infection (bartholinitis) may occur and common pathogens include E. coli, Staphylococcus aureus, and sexually transmitted organisms like Neisseria gonorrhoeae and Chlamydia trachomatis.

What can cause an infection of the greater vestibular (Bartholin) glands?

Unilateral, tender swelling near the posterior aspect of the vaginal vestibule.

What is the typical presentation of an infection of greater vestibular (bartholin) glands?

Initial management may include warm compresses and sitz baths, abscesses often require incision and drainage, and recurrent cases may need marsupialization (surgical creation of a permanent drainage tract).

What are the typical treatments for infection of the greater vestibular (Bartholin) glands?

True

(T/F) Male and female external genitalia develop from the same embryologic precursors.

True

(T/F) The clitoris contains paired corpora cavernosa, the same erectile tissue found in the dorsal aspect of the penis.

Genital tubercle

What does the (clitoris) corpora cavernosa arise from?What

True

(T/F) Venous plexuses around the genitals are a prominent site of cancer spread.

Vestibular bulbs

What are homologous to the male bulb of the penis and corpus spongiosum?

Clitoris (corpora cavernosa) and vestibular bulbs (corpus spongiosum)

What two female structures are homologous to male penile erectile tissues?

Labia minora

What are derived from the urogenital folds and are homologous to the shaft (body) of the penis?

True

(T/F) While the male counterpart develops into an elongated erectile structure, the labia minora remain as paired folds that flank the vestibule in females.

Labia majora

What develops from the labioscrotal swellings and are homologous to the male scrotum?

Glans clitoris

What is homologous to the glans penis?

True

(T/F) The autonomic innervation of the gastrointestinal tract is divided into sympathetic and parasympathetic components.

Up-regulates (stimulates) digestion: increases peristalsis, glandular secretion, and relaxes sphincters.

What is the function of the parasympathetic nerve supply to foregut, midgut, & hindgut?

Vagus nerve (CN X)

What nerve passes through the celiac and superior mesenteric plexuses (does not synapse here) to supply parasympathetic innervation to the foregut and midgut?

Pelvic splanchnic nerves (S2-S4)

What nerves through the inferior mesenteric plexus (but do not synapse here) supply parasympathetic innervation to the hindgut?

Down-regulates digestion: inhibits peristalsis and secretion, and contracts sphincters.

What is the function of the sympathetic nerve supply to foregut, midgut, & hindgut?

T5-L2

Sympathetic fibers innervating the foregut, midgut, and hindgut originate from ____-____ and synapse in celiac, superior, or inferior mesenteric ganglia.

Excitatory

Is parasympathetic innervation of the digestive system excitatory or inhibitory?

Inhibitory

Is sympathetic innervation of the digestive system excitatory or inhibitory?

T1-L2

From what nerve roots is the entire sympathetic nervous system from?