The Female Reproductive System - RMC

Perineum

Diamond-shaped area between the medial thighs

o Anteriorly (really superiorly) by the pubic symphysis
o Laterally by the ischial tuberosities
o Posteriorly (inferior) by the coccyx.

2 distinct triangle bases

o
Imaginary horizontal line extending b/w the ischial tuberosities

Anterior triangle, or Urogenital triangle

o Contains the urethral and vaginal orifices in females
o Contains the base of the penis and the scrotum in males.

Posterior triangle, or Anal triangle

o Location of the anus in both sexes.
Boundaries of Female Perineum External Genitalia = Vulva

Mons pubis Hair covered Fat Pad

Medial aspects (insides) of the thighs

Gluteal folds

The superior end of the Intergluteal Cleft

the cleft b/w the buttocks (tip of the coccyx is palpable)
Up until 6 wk of lifethere is no differentiation of sex
-clitoris and glans penis have the same precursor
Pelvic Diaphragm (in the pelvic triagles)
Levator Ani and Coccygeus muscles make up Pelvic Floor Muscles Diaphragm

Levator Ani made up of 3-Muscles:

Puborectalis Pubis & Rectus

Pubococcygeus

Iliococcygeus
o The anal aperture goes through it

Supports pelvic organs

Seals inferior opening of bony pelvis (muscular floor)

Lifts to help release (or not release) feces during defecation

Anatomy of Female Reproductive System
Peritoneum = The peritoneum is the serous membrane that forms the lining of the abdominal cavity or the coelom

Peritoneum Folds around the various pelvic organs and creates two major dead-end recesses, or pouches.
o Anterior vesicouterine pouch forms the space b/w the uterus and the urinary bladder
o Posterior rectouterine pouch forms the space b/w the uterus anteriorly and the rectum posteriorly

More commonly known as Pouch of Douglas Cul-de-sac of Peritoneum b/w Uterus &
Cervix

Primary sex organs of the female are the OVARIES.

Accessory sex organs include

o Uterine tubes
o Uterus,
o Vagina,
o Clitoris
o Mammary glands.
Peritoneal Folds/ Ligaments

Mesovarium:
o Double folds of Peritoneum
o Attaches Ovaries to broad ligament

Broad ligament
o Peritoneum that Drapes over the uterus
o Extends from lateral uterine fold to wall of pelvis
o Holds Ovaries and Uterine Tubes
o Mesosalpinx Peritoneum covering over Uterine Tubes
(which are part of the uterus)

Round Ligament
o From uterus through the inguinal canal Labia Majora of ext. genitalia

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Ovarian ligament
o Ovary to superior margin of uterus
Suspensory ligament
o Ovary to pelvic wall

Superficial Pouch (Didnt Discuss)

B/w inferior fascia of UG diaphragm and membranous layer of superficial fascia (Colles Fascia)

Contains:
o Superficial transverse perineal muscle & Ischiocavernosus and bulbospongiosus muscles
o Cura of penis or clitoris
o Perineal Nerve
o Internal pudenal artery and vein
Deep Perineal Space (Pouch) (Didnt Discuss)

B/w superior and inferior fascia of UG Diaphragm

Contents:
o Deep transverse perineal muscle
o Sphincter & Membraneous part of urethra
o Bulbourethral glands
o Branches of internal pudenal vessels
o Pudenal nerve
OVARY

Production of Gametes and Hormones

Posterior to broad ligament (Mesovarium)
o Broad: a fold of peritoneum; Drapes over reproductive organs

Suspensory & ovarian ligaments anchor

o Suspensory- to lateral wall of pelvis
o Ovarian- to uterus

Blood supply by Ovarian Artery

***Venous drainage
o Right Gonadal Vein empties into Inferior Vena Cava!
o Left Gonadal Vein empties into Left RENAL Vein! empties into IVC

Composed of Ovarian Follicles (sac-like)

Structures of ovarian follicle:

o Oocyte Stimulated by FSH
o Follicular cells Forming Ovarian Follicles

Homologous to testes

Vasculature of Ovaries
o Ovarian artery from ab. Aorta enters suspensory ligaments and branches through mesovarium
o Veins drain via pampiniform plexi

The Female Reproductive System - RMC

Lymphatics of Ovaries
o Follow ovarian blood vessels, ascend to lumbar lymph nodes
Innervation of Ovaries Both Sympathetic & Parasympathetic
o Parasympathetic from pelvic splanchnic nerves
o Afferent fibers enter spinal cord through T10 and T11 nerves

UTERUS (includes cervix, fallopian tube)

Located b/w Urinary Bladder and Rectum

Organ of gestation

Intraperiotneal (broad ligament)

Anteverted (leans forward) at junction of cervix and vagina

Anteflexed (bends) at cervix and body

Hollow organ
Support of the Uterus

Pelvis floor muscles: Pelvic & Urogenital Diaphragm

Round Ligaments: Lateral Uterus through Inguinal canal to Labia Majora

o Maintain Anteverted position

Transverse Cervical Ligaments (Cardinal): Lateral Cervix and Vagina to pelvic wall

Uterosacral Ligaments: Inferior/Lateral Uterus to Sacrum

o Cardinal and Uterosacral Ligaments are thickenings of subserous fascia and smooth muscle
Functions:

Implantation (pre-embryo), Nourishment (embryo/fetus), Ejects fetus, & Menstruation (Actually Uterine
Bleeding!)
o Organogenesis First 56 days after fertilization; After that, all organs have developed, and
growth continues.
o Site for Implantation: pre-embryo implants to inner uterine wall and connects to its lining
o Supports, protects, and nourishes the developing embryo/fetus

Forms vascular connection with uterine wall develops into placenta

o Ejects fetus at birth after maternal oxytocin levels increase contractions of labor
o Site of Menstruation

If oocyte not fertilized or after birth muscular wall contracts and sheds inner lining
Regions of the Uterus
Fundus: (dome shaped) Rounded portion superior & anterior to uterine tube entrance
o A non-impregnated Uterus is a Pelvic Organ!
o During pregnancy, Fundus becomes Abdominal Organ!
Body: Main portion; cavity is triangular
Isthmus: Constricted region b/w body and cervix
Cervix: Narrow portion which joins to vagina
o Cervical canal
o Internal Os opening to Isthmus
o External Os opening to Vagina

Uterine Layers/ Wall of the Uterus

The Female Reproductive System - RMC

Perimetrium: Serosa Outer Layer; Peritoneum and thin connective tissue; Continuous with broad ligament
(because its part of the peritoneum)

Myometrium: Smooth Muscle; Middle Layer; becomes distended during pregnancy (muscle cells increase in
size and number)

Endometrium: Hormone sensitive (Estrogen & Progesterone); Growth cycles b/w puberty and menopause
(this is the layer that will shed during menstration)
o Two layers: Stratum Basalis & Stratum Functionalis

S. Functionalis builds up each month (ovarian hormones)

o Uterine glands secret glycoproteins into uterine cavity (nutrients for potential zygote)
o At Menstruation: func. layers self digest; Spiral Arteries kink and constrict so cells die
o Just before menstrual flow, Spiral Arteries open wide, capillaries burst and func. layer sloughs off.
Oxitocin = only hormone with a positive feedback that creates uterine contraction

Blood Supply: Uterine (from internal iliac), Vaginal, and Ovarian (from abdominal aorta) arteries ***HIGHLY
VASCULARIZED FOR REPRODUCTION!!! KNOW ARTERIES!!!

Arcuate, the straight arteries, then squiggly arteries into the endometrium
UTERINE TUBES (Fallopian tubes/oviductspart of the uterus)

Extend laterally from both sides of uterus toward ovaries

o Does NOT physically attach to Ovaries

W/in and Suspended by Broad Ligament

Homologous to Vas Deferens Tubular Structure

Receives Ovulated Oocyte
o ~3 to 5 days for Pre-Embryo to reach lumen of Uterus!!!

PARTS: Inside Lined with Mucosa (Simple Ciliated Columnar)

Muscularis Serosa (Made up of MESOSALPINX)
o Infundibulum Flared end of tube

Fimbriae = finger like projections at distal end

o **Ampulla Long, Wide portion

Where Secondary Oocyte is FERTILIZED

o Isthmus Narrow, attach to uterus
o Cilia line walls of tubes (move oocyte towards uterus)
o Interstitial Segment

Blood supply via Ovarian and Uterine Arteries

Drainage to Lumbar Lymph Nodes

Nerve supply from Ovarian and Uterine Plexi

Cilia and Non-Ciliated Simple Columnar Epithelium
o Ciliary movement and periodic peristaltic contractions move ova
o Secretion of nutrient substances

VAGINA

The Female Reproductive System - RMC

Muscles related to the vagina:

o Pubovaginalis (part of levator ani)
o External Urethral Sphincter Muscle
o Urethrovaginal Sphincter Muscle
o Bulbospongiosus Muscle

Lymphatic Drainage of the Vagina (important in this location because its an

opening to the outside)
o Superior: internal and external iliac nodes
o Middle: internal iliac nodes
o Inferior: sacral and common iliac nodes; superficial inguinal nodes
**Parasym and Sym both innervate the vagina
External Genitalia

***Collectively called the VULVA (or Pudendum)

Mons pubis Fatty Hair Covered Area overlying pubic symphysis

Labia Majora Homologous to Scrotum

o Outer skin pigmented

Sweat, sebaceous glands

Hairs present after puberty

o Inner Skin Pink (no pubic hair)

Thick-walled, Fibromuscular Tube The Organ of Copulation

Forms the inferior-most region of female reproductive tract
~10cm in length in an adult female
Connects uterus w/ outside of the body anteroventrally (functions as Birth Canal)
Passageway for Menstruation
HIGHLY VASCULARIZED (Uterine, Vaginal, Pudendal Arteries) & invested w/ Lymphatic Vessels
Its relatively thin, distensible wall consists of 3 tunics:
o Inner Mucosa (Thrown into RUGAE) Middle Muscularis & Outer Adventitia (NOT Serosa!...bc its not
an intra-abdominal organ (like the esophagus))
From Cervix (~ 90 degree angle) to Exterior of Body (Vestibule)
o Vestibule is region b/w labia minora
Posterior to Urethra & Anterior to Rectum
Hymen Mucous Membrane over entry (Embryonic Remnant)
Fornices Pocket surrounding Uterine Cervix (surgical access to pelvic cavity; location of birth control
device)

Labia minora
o No hair, no fat
o Core of spongy connective tissue containing erectile tissue and many blood vessels
o Contains Vestibule Potential space b/w Labia; Enclosed by Labia Majora

Contains Openings: Urethral & Vaginal Orifices, & Vestibular Glands (Bartholin's Glands)
o Posterior forms frenulum of clitoris
Clitoris located where Labia Minora meets Anteriorly
o Prepuce External/Anterior fold of the Labia Minora that forms a hood like Covering over the Clitoris

Glans clitoris

Two Crura (each is a crus)

Two Corpora Cavernosa (Just like the Penis, the Clitoris has Two Corpora)
o Frenulum of clitoris
o Contains erectile tissue, homologous to penis
Four purposes include:
o Sensory & Erectile tissue
o Directs the flow of urine
o Prevents entry of foreign material
o Padding
Greater vestibular gland
o Under or behind bulb of vestibule
o Homologous to bulbourethral gland

The Female Reproductive System - RMC

o
o

Secretes mucus
Drained by duct into vestibule (b/w labia minora and hymen)