Reproductive Organs and Associated Pelvic Structures - BPK 326

pelvic diaphragm (pelvic floor)

muscles create a muscular trampoline (supporting organs of pelvis)

- voluntarily controlled and exercised (kegal exercise)

- crucial to continence (bladder and bowel control) and sexual function

3 groups of pelvic diaphragm

pelvic diaphragm

urogenital diaphragm

sphincter and erectile muscles of urogenital tract

levator ani group

puborectalis

pubococcygeus

iliococcygeus

pelvic floor injury

common consequence of vaginal delivery

- puborectalis and pubococcygeus are most common muscles damaged

- causes incontinence and sexual dysfunction

compared to cesarean section

- vaginal devilry is associated with 2 fold increase risk of pelvic floor dysfunction

- combo of aging and birth

uterus

- fundus and cervix

womb

- contains the developing fetus during gestation

- 50-200g non-pregnant, expands a lot and weighs 1kg at birth

- fundus = top part connects to ovaries through fallopian tubes

- cervix is connected to vagina

- uterus changes size dramatically during pregnancy (10 months baby loses weight)

complications of pregnancy

rapidly expanding uterus compresses adjacent organs compromising function and creating complications

- shortness of breath

- heart burn (kicking stomach, pushing acid into esophagus)

- reduced stomach capacity

- impaired intestinal transit and constipation

broad ligament

sheet like fold of peritoneum

- extends from the sides of the uterus to the lateral wall and floor of the pelvis

- holds uterus in position

round ligament

true ligament

- extends from lateral aspects (horns) of the uterus to the labium majorum

- extend anteriorly

- pain in pelvis / labia due to baby growing (tugging on them)

uterine prolapse

due to damage in pelvic floor muscles and or ligaments

- uterus collapses into vagina (outside of vagina)

fallopian tubes

aka uterine tubes

- transport the fertilized ovum from the ovaries to the body of the uterus

- 10cm long

- bilateral

4 divisions prox to dis

- infundibulum

- ampulla

- isthmus

- intramural

ectopic pregnancy

aka tubal pregnancy

- egg implants on the wall of fallopian tube

- results in death of embryo

- life threatening for mother (tubes can burst)

- appendix lies very close to right ovary and uterine tube

- tubal pregnancy can be misdiagnosed as appendicitis

tubal ligation

aka tubes tied

- surgical method of birth control

- ovas that are released simply degenerate and are absorbed

abdominal - part is cut or removed

laparoscopic - cauterized or cut

vagina

fibromuscular tube

- 7-10 cm in length

- facilitates childbirth, menstruation, sexual intercourse, sexual pleasure

cervix

separates uterus and vagina

- dilates during labour to admit the passage of the baby into the birth canal

- check routinely for cervical cancer (Pap smear)

normal - smooth, glistening surface, small and round = never been pregnant

HPV infection - large and bloody opening (for non-invasive cancer)

vulva

external female genitalia

- mons pubis

- clitoris

- labia minor

- labia majora

- vaginal orifice

female genital mutilation

remove clit

remove vaginal tissue and clit

sewing shut, small hole for excretion

stretched labia

- common in immigrant countries. (African, Middle East and Asia)

penis

contains erectile bodies - tissues containing vascular space that can be engorged with blood (tumescence - erection)

- corpora cavernosa

transverse section of penis

corpus cavernosa

corpus spongiosum

corpus cavernosa - dorsal, lateral enlargement (one on each side)

- contain large vascular sinuses (allows penis to fill with blood)

- largest portion of the penis

corpus spongiosum - ventral

- contains urethra

- continuous with glans, both have less tunic covering relative to the corpus cavernosum

root of penis

contains two crura

one bulb

slide 16

prepuce / foreskin

covers majority of the glans

- uncircumcised, foreskin attaches to fascia overlying the body of the penis

- arose from religious and social convention

benefits - reduced risk of urinary tract infection, penile cancer, sexual transmitted diseases (HIV)

risks - infection, permanent disfiguration, impaired sexual pleasure or function

urethra

extends from internal urethral office of bladder to external urethral orifice of the glans

4 parts

- preprostatic (intramural) urethra (surrounded by internal urethral sphincter)

- prostatic urethra

- membranous urethra (surrounded by external urethral sphincter)

- spongy (penile) urethra

prostatic urethra

contains urethral crest - where prostatic ducts open bilaterally

- contains seminal colliculus, where ejaculatory ducts open

affected by benign prostatic hyperplasia

- non cancerous increases in prostate size

- results in waking up in the middle of the night to urinate, urinary hesitancy (hard to stop/start pee), intermittent urine flow

ejaculatory duct

formed by the merger of seminal vesicle duct with vas deferens

spongy urethra

Cowper's glands (bulbourethral glands)

- eject lubricating fluid into urethra

- two openings increase the size of the urethra, ampulla (proximally) and navicular fossa (distally in glans)

sperm track

testis - produce sperm

epididymis - matures sperm

vas deferens - moves sperm

ampulla

seminal vesicle - add secretion

ejaculatory duct

urethra

vas deferens ligation

vasectomy

- surgical form of birth control

- easy non-invasive

- can be reversible

egg track

ovary

fallopian tube - fertilization

uterus