Anatomy of Female reproductive system

1. Anatomy of Female reproductive system Teng YinchengM.D., Ph.D., Professor Department Of Obstetrics & Gynecology Renji Hospital Affiliated to SJTU School of Medicine

2. bony pelvis • female genital organs • blood supply of female genital organs

3. Bony pelvis • The bony pelvis is made up of 4 bones: ilium sacrum pubis ischium

4. 1) 2 os coxae or innominate bones • the ilium • coxae the ischium • the pubis

5. 2) 1 sacrum: Formed from 5 sacral vertebrae which fuse. 3)1 coccyx: Formed from 4 fused vertebrae.

6. 2.Joint and ligament Sacro-iliac joint Sacro-coccygeal joint 腹股沟韧带 骶棘韧带 骶结节韧带

7. 3.True pelvis and false pelvis The pelvis is divided into the pelvis major (false pelvis) is bounded by the lumbar vertebrae posteriorly,an iliac fossa bilaterally,and the abdominal wall anteriorly the pelvis minor (true pelvis) is formed by sacrum and coccyx posteriorly and by the ischium and pubis laterally and anteriorly

8. 4.Pelvic planes • The pelvic inlet( pelvic brim): the promontory, and alae of the sacrum ,linea terminalis the superior border of the symphysis pubis • The plane of greatest diameter is bounded by the junction of the second and third sacral vertebrae posteriorly,the upper part of the obturator foramina laterally,and the midpoint of the pubis anteriorly

9. The plane of least diameter: extends from the lower border of the pubis anteriorly to lower sacrum at the level of the ischial spines • The plane of the outlet is irregular consisting of two intersecting triangles

10. 5.The types of female pelvis Gynecoid pelvis • Occurs 40%--50% • the inlet is rounded • the side walls are straight • the sacrum is well curved, and the sacrosciatic notch is adequate

11. Platypelloid pelvis • occurs in approximately 30% , 10% to 15% of African-american women • There is an oval inlet • the sacrum is normal • the side walls are straight • the sacrosciatic notch is narrower

12. Android pelvis • occurs in only 2% to 5% of women • wedge-shaped inlet • the side walls converge • the sacrum is inclined forward • the sacrosciatic notch is narrow

13. Anthropoid pelvis • occurs in approximately 20% ;approximately 40% of black women • the inlet is oval, long, and narrow • the side walls are straight(do not converge) • the sacrum is long and narrow • the sacrosciatic notch is wide. • Both the interspinous and intertuberous diameter are somewhat smaller

14. 6.Length of pelvic plane diameters

15. 7.Pelvic floor

17. female genital organs

18. 1.External genitalia • mons pubis: fatty tissue • labia majora • labia minora which lie inside the labia majora • clitoris: is located anterior to the labia minora

19. vestibule • Lies between the labia minora Is bounded Anteriorly by clitoris Posteriorly by perineum • Urethra and vaginal orifice open to the midline of the vestibule • Bartholin’s glands also empty into the vestibule

20. 2.Internal genitalia 1)Vagina Muscular tube from vestibule extends to uterus The anterior vaginal wall is 2cm shorter than the posterior wall The area around the cervix---the fornix the posterior fornix is important pouch which allows access to the peritoneal cavity from vagina The vaginal wall consists of a mucous membrane , Beneath this is a submucosal layer of connective tissue which contains a rich of veins and lymphatics The muscular wall has three layers of smooth muscle.

21. 2)uterus Cervix cylindrical shape, 2-3cm long vaginal portion external os cervix tube stratified squamous epithelium simple columnar epithelium

22. 2) Isthmus separate cervix and body 3) Corpus cornu fundus long 7-8cm; wide 4-5cm; thick 2-3cm The ratio of the body to the cervix Before puberty 1:2; after puberty 2:1

24. The uterus is surported by the following ligaments Round ligament Broad ligament Cardinal ligament Utero-sacral ligament

25. Histology of uterus • There are three layers of the body • The inner is endometrium which is consisted of the simple columnar epithelium • Beneath the mucosa is the muscular layer,covered by peritoneal serosa

26. 3)Fallopian tubes Length: 8-14cm The tube is divided four portions • Interstitial • isthmus • Ampulla:the centre portion • Infundibulum:surround the ovary and help to collect the oocyte at the time of ovulation The innner layer is covered by ciliate columnar epitheliun The cilia beat toward the uterus assisting in oocyte transport

27. 4. ovaries • Be located on either side of the uterus • Volume:4*3*1cm • Weight:5-6g • be almond-shaped • Is divided two portion: cortex(outer portion): contains amount of follicles medulla(central portion): blood vessels, nerve fibres, lymphatics

28. blood supply Arterial system • Ovarian artery:from abdominal aorta (left may be from kedney artery) • Uterine artery • Vaginal artery • Internal pudendal artery from internal iliac artery

30. Lymphatic drainage 外生殖器淋巴 　　腹股沟浅 　　　上组　下组 　　腹股沟深 盆腔淋巴 　　髂淋巴组 　　骶前淋巴组 　　腰淋巴组

31. The organ in the neighborhood Urethera Urinary bladder Ureter Rectum Vermiform appendix

32. Thanks for Your Attention Teng YinchengM.D., Ph.D., Professor Department of Obstetrics & Gynecology Renji Hospital Affiliated to SJTU School of Medicine