Anatomy of the Female

reproductive system
Introduction
 Pelvis
 Pelvic floor
 External genitalia
 Internal genitalia
 Vessel and nerve and lymph
 Adjacent organs
Pelvis
Bony Pelvis
 The bony pelvis is formed by:
 the hip bones in front and at the sides
 by the sacrum and coccyx behind
 When a subject is in the anatomical position, the
anterior superior iliac spines and the pubic tubercles
are in the same coronal plane.
 The pelvic surface of the body of the pubis, on which
the bladder rests, faces more upward than backward.
The pelvic surface of the sacrum faces more
downward than forward
Pelvic inlet
 The pelvic inlet, or brim (upper pelvic
aperture)
 indicated by the lineae terminales, the
iliac parts of which are the arcuate
lines.
 The inlet is at about half a right angle
to the horizontal.
Conjugate
 The anteroposterior (or true) conjugate
diameter:
 extends from the upper margin of the pubic
symphysis to the middle of the sacral
promontory.
 The obstetrical conjugate diameter:
 which is measured from the back of the pubic
symphysis , is the shortest diameter through
which the fetal head must pass in its course
through the inlet.
Conjugates
 The diagonal conjugate diameter :between
the lower margin of the pubic symphysis and
the sacral promontory , is measured per
vagina .
 Inability to palpate the sacral promontory
suggests that the conjugate diameter of the
inlet is adequate for parturition, whereas
palpation indicates a contracted pelvis.
 Measurement of the diagonal conjugate
diameter by the middle finger. The indicated
length on the index finger gives the true
conjugate, because the index is about 1.5 cm
shorter than the middle finger.
 Pelvis
 Bony pelvis
ilium

sacrum

coccyx

ischium pubis
Pelvic outlet
 The pelvic outlet (lower pelvic aperture)
extends from the pubic symphysis to
the tip of the coccyx and, from side to
side, between the ischial tuberosities;
hence it is diamond shaped.
 The outlet is at a slight angle (10 to 15
degrees) to the horizontal.
 The subpubic angle is nearly a right
angle in the female and about 60
degrees in the male.
Pelvic outlet
 The path taken through the pelvic cavity by the fetal
head is known as the axis of the birth canal.
 The axis intersects the inlet at a right angle, turns
forward at the uterovaginal angle (level of ischial
spines), and follows the axis of the vagina.
 During parturition, the fetal head (usually the
suboccipitobregmatic diameter) occupies successively
the inlet (transverse diameter), cavity (oblique
diameter, and outlet (anteroposterior diameter)
 The bony pelvis and fetal head. Note
how the head turns as it occupies first
the inlet, then the cavity, and finally the
outlet.
 Pelvis
 Joints

Sacro-iliac joint

Sacrococcygeal
joint

Symphysis pubis
Pelvis
 Ligaments
1. Sacrospinous ligament
Extend from the lateral border of the
sacrum and coccyx to the spine of the
ischium
2. Sacrotuberous ligament
Extend from the posterior aspect of
the lower 3 sacral vertebrae to the
ischial tuberosity
Pelvis
 Pelvic divisions
(iliopectineal line )
1. False pelvis (pelvis major)
2. Ture pelvis (pelvis minor)

Bony birth canal

the Pelvic inlet, the pelvic out
let and the pelvic cavity
 PELVIS
False pelvis True pelvis
(major) (minor)

To support the pregnancy Sacrum and coccyx

Bounded by lumbar posteriorly
vertebrae posteriorly,
Ischium and pubis
iliac fossa bilaterally
abdominal wall anteriorly bilaterally
and anteriorly
Pelvis
 Types of pelvis
1. The gynecoid type
round, slightly ovoid or elliptical inlet.
adequate sacrosciatic notch. wide
interspinous diameters(≥10cm). 52%-
58.9%
2. The platypelloid type
distinct oval inlet. very wide
subpubic arch. 23.2%-29%
s
Pelvis
3. The anthropoid type
long, narrow, oval inlet.
extended and narrow anterior
and posterior segment. wide
sacrosciatic notch. long , narrow
sacrum. Straight side walls.
4. The android type
Pelvic floor
 The tissues closing down the pelvic
outlet (muscles and fasciae)
suspend and support the pelvic organs,
such as uterus and bladder and rectum
 Posterior part (urogenital triangle)
urethra and vagina pass through
 Anterior part (anal triangle)
rectum pass through
Pelvic floor
 Tissues
1. Outer layer
Bulbocavernosus muscle
Ischiocavernosus muscle
Superficial transverse perineal muscle
External anal sphincter
mid layer
2.

urogenital diaphragm
Pelvic floor
3. Inner layer (pelvic diaphragm)
1) the main support of the pelvic
floor
2) formed by the levator ani and
coccygenus muscles and covering
fasciae.
3) Levator ani: pubococcygenus ,
iliococcygenus , puborectalis
Pelvic floor
 Perineum
general conception: the tissues
closing down the pelvic outlet
Clinical conception: the tissues
between vagina and anus.
 External genitalia

Mons pubis

Labia majora
clitoris
Labis minora
Urethral orifice
Vaginal orifice
Vaginal vestibule Fossa navicularis

Perineal body
anus
External genitalia
 Labia majora
The venous drainage is extensive and
forms a plexus with numerous
anastomoses. Vulva hematoma
 Vaginal vestibule
Bordered by the labia minora laterally,
by the frenulum labiorum pudendal
posteriorly, by the urethra and clitoris
anteriorly, by the hymenal ring
inferiorly.
Internal genitalia
Internal genitalia
 Vagina
1. strong canal of muscle (7.5cm)
extend from the uterus to the vestibule of
the external genitalia. its long axis is almost
parallel with that of the lower part of the
sacrum. the anterior wall of the vagina is 1.5-
2cm shorter than the posterior wall.
2. vaginal fornix
the circular cul-de-sac formed around the
cervix
4 regions: the anterior fornix, the
posterior fornix and 2 lateral fornices.
Internal genitalia
3. Wall structure
1) mucosal layer (stratified
squamous epithelium)
2) muscular layer (3 layer)
3) submucous area ( with a dense
plexus of veins and lymphatics)
Internal genitalia
 Uterus
1. Pear-shaped,thick-walled, muscular
organ
2. Body and cervix:
Babyhood 1:2, manhood 2:1
3. Isthmus uteri
connect the body to cervix, 1cm
(non-pregnancy)
Internal genitalia
4. Layers of uterine wall
1) The serous layer (perimetrium)
Thin and firmly adherent over the fundous
and most of the body
Uterovesical pouch of the peritoneum
Rectouterine pouch of the peritoneum
(pouch of Douglas)
2) The muscular layer
Outer layer (longitudinal fibers)
Inner layer (interlaced and various
directions)
Internal genitalia
3) The mucous layer (endometrium)
compact layer: response to hormone
periodically, a single layer of ciliated
columnar epithelium
spongy layer: response to hormone
periodically. contains many tubular
glands
funous: non-response to hormone
periodically
Internal genitalia
 Cervix
1. lower 1/3 of uterus. connects uterus
to vagina via endocervical canal
2. External os: opening of endocervical
canal to ectocervix
3. Internal os: indistinct upper limit of
endocervical canal
Cervix
Internal genitalia
 Ligaments
1. Broad ligament
2. Round ligament

3. Cardinal ligament

4. Utero-sacral ligament
Ligaments
 Round Ligament:

 Fibrous and muscle tissue

 Anterior to the fallopian tubes
 Correlate with the male gubernaculums
 They extend laterally, cross the external iliac
vessels, and enter the internal inguinal ring, and
insert in the labia majora.
 Sampson’s artery, a branch of the uterine artery,
runs along the length of the round ligament.
Ligaments
 Broad Ligament:
 Double reflection of the peritoneum, draped over
the round ligaments.

 Cardinal Ligament:
 Found at the base of the broad ligament.
 Provides the main support for the uterus and
cervix.
 It attaches to the cervix and extends laterally,
connecting to the endopelvic fascia.
Ligaments
 Uterosacral Ligaments:

 Provide minor cervical support.

 Originate from the upper posterior cervix,
travel around the rectum bilaterally, and
fan out to attach to the 1st - 5th sacral
vertebrae.
Internal genitalia
 Oviduct
1. Anatomy

1) Interstitial portion:

2) Isthmic portion: narrow

3) Ampulla: wide and tortuous

4) Fimbria: funnel-shaped mouth

Internal genitalia
2. Layers of wall
1) Serous
2) Muscular: outer longitudinal and
inner circular
3) Mucous: ciliated columnar
epithelium, coarse longitudinal
folds
Internal genitalia
 Ovary
1. Anatomy

1) Paired organ, elliptic

2) The suspensory ligament of the

ovary
3) The ovarian ligament
Internal genitalia
2. Structure of ovary
1) Covered by cuboid or low
columnar epithelium
2) Consist of a cortex and a medulla
3) Cortex: oocytes in various stages
of maturity.
4) Medulla: fibers, smooth muscle
cells, blood vessel, nerves.
Vessel and nerve and lymph
 Blood vessel
1. The ovarian artery
1) Originated as branches of the abdominal
aorta, (left: left renal artery).
2) Turn over the common iliac artery and
ureter, descend into the pelvis. Enter
into ovary through the mesovarium
Vessel and nerve and lymph

2. The uterine artery

1) a terminal branch of the hypogastric
artery
2) Cross the ureter near the cervix (2cm)
3) Ascend along the lateral border of the
uterus
4) uterine body branch and cervix-vagina
branch
Vessel and nerve and lymph

3. Vaginal artery
4. Internal Pudendal artery
Vessel and nerve and lymph
 Lymph
1. External genitalia
1) superfical inguinal gland

2) deep inguinal gland

Vessel and nerve and lymph

2. Pelvic lymph
1) iliac lymph
common iliac, internal iliac and
external iliac
2) Anterior Sacral lymph
3) Lumbar lymph: abdominal aorta
Adjacent organs
 Urethra
 Urinary bladder
 Ureter
 Rectum
 Vermiform appendix