Anatomy of Reproductive System

Zamroni, M.D

Introduction

Pelvis Pelvic floor External genitalia Internal genitalia Vessel and nerve and lymph Adjacent organs

Pelvis

Pelvis

Bony pelvis
os ilium

os sacrum os coccyx

os ischium

os pubis

Pelvis

Joints

Sacro-iliac joint

Sacrococcygeal joint

Symphysis pubica

Pelvis

1.

Ligaments
Sacrospinous ligament Extend from the lateral border of the sacrum and coccyx to the spine of the ischium Sacrotuberous ligament Extend from the posterior aspect of the lower 3 sacral vertebrae to the ischial tuberosity

2.

Pelvis

1. 2.

Pelvic divisions (iliopectineal line)

False pelvis (pelvis major) Ture pelvis (pelvis minor) Bony birth canal the Pelvic inlet, the pelvic out let and the pelvic cavity

Pelvis

1.

Types of pelvis
The gynecoid type (female) round, slightly ovoid or elliptical inlet. adequate sacrosciatic notch. wide interspinous diameters(10cm). 52%58.9% The platypelloid type distinct oval inlet. very wide subpubic arch. 23.2%-29%

2.

Pelvis
3.

4.

The anthropoid type long, narrow, oval inlet. extended and narrow anterior and posterior segment. wide sacrosciatic notch. long , narrow sacrum. Straight side walls. The android type (male)

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

1.

Tissues
Outer layer

Bulbocavernosus muscle Ischiocavernosus muscle Superficial transverse perineal muscle External anal sphincter

mid layer urogenital diaphragm

2.

Pelvic floor
3. 1) 2)

3)

Inner layer (pelvic diaphragm) the main support of the pelvic floor formed by the levator ani and coccygenus muscles and covering fasciae. 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 Clitotis Labium majus Labium minus 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

Internal genitalia

1.

Vagina
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. vaginal fornix the circular cul-de-sac formed around the cervix 4 regions: the anterior fornix, the posterior fornix and 2 lateral fornices.

2.

Internal genitalia
3.

1)
2) 3)

Wall structure mucosal layer (stratified squamous epithelium) muscular layer (3 layer) submucous area ( with a dense plexus of veins and lymphatics)

Internal genitalia

Internal genitalia

1. 2.

Uterus
Pear-shaped,thick-walled, muscular organ Body and cervix: Babyhood 1:2, manhood 2:1 Isthmus uteri connect the body to cervix, 1cm (nonpregnancy)

3.

Internal genitalia
4.

1)

2)

Layers of uterine wall 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) The muscular layer Outer layer (longitudinal fibers) Inner layer (interlaced and various directions)

Internal genitalia
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
3)

Internal genitalia

1.

Cervix
lower 1/3 of uterus. connects uterus to vagina via endocervical canal External os: opening of endocervical canal to ectocervix Internal os: indistinct upper limit of endocervical canal

2.
3.

Internal genitalia

1. 2. 3. 4.

Ligaments
Ovarii proprium ligament Mesoshalping ligament Cardinal ligament Utero-sacral ligament

Internal genitalia
1. 1)

2)
3) 4)

Oviduct Anatomy Interstitial portion: Isthmic portion: narrow Ampulla: wide and tortuous Fimbria: funnel-shaped mouth

Internal genitalia
2. 1) 2) 3)

Layers of wall Serous Muscular: outer longitudinal and inner circular Mucous: ciliated columnar epithelium, coarse longitudinal folds

Internal genitalia
1. 1)

2)
3)

Ovary Anatomy Paired organ, elliptic The suspensory ligament of the ovary The ovarian ligament

Internal genitalia
2.
1) 2) 3) 4)

Structure of ovary
Covered by cuboid or low columnar epithelium Consist of a cortex and a medulla Cortex: oocytes in various stages of maturity. Medulla: fibers, smooth muscle cells, blood vessel, nerves.

Vessel and nerve and lymph

1. 1)

Blood vessel
The ovarian artery Orginated as branches of the abdominal aorta, (left: left renal artery). Turn over the common iliac artery and ureter,descend into the pelvis. Enter into ovary through the mesovarium

2)

Vessel and nerve and lymph

2.
1) 2) 3) 4)

The uterine artery

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

Vessel and nerve and lymph

3. 4.

Vaginal artery Internal Pudendal artery

Vessel and nerve and lymph

1. 1) 2)

Lymph
External genitalia superfical inguinal gland profundal inguinal gland

Vessel and nerve and lymph

2.
1)

Pelvic lymph
iliac lymph common iliac, internal iliac and external iliac Anterior Sacral lymph Lumbar lymph: abdominal aorta

2) 3)

Adjacent organs

Urethra Urinary bladder Ureter Rectum Vermiform appendix

Adjacent organs

Answer the questions

How many types of pelvis are there? What are they? What is perineum? What is vaginal vestibule? How many ligaments of uterus are there? What are they? How many ligaments of ovary are there? What are they? What is uterine isthmus?

Roabbana zidna ilman warzuqna fahman