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Female Internal Genital Female Perineum

• Female external
Vagina (part of the birth canal), where sperm are
deposited and from which a baby can emerge

Uterus where an embryo can develop into a fetus

Fallopian tubes (oviducts)

where a sperm can fertilize an egg

which produce and release eggs
Sperm can travel up the tract, and eggs
down the tract.
 A musculomembranous tube (7- 9 cm long)
 extends from the cervix of the uterus to the vestibule, the
cleft between the labia minora
 the upper half of the vagina lies above the pelvic
floor and the lower half lies within the perineum

■■ Anteriorly: The vagina is closely related to the bladder

above and to the urethra below

■■ Posteriorly: The upper third of the vagina is related to

the rectouterine pouch (pouch of Douglas) and its
middle third to the ampulla of the rectum. The lower
third is related to the perineal body, which separates
it from the anal canal

■■ Laterally: In its upper part, the vagina is related to the

ureter; its middle part is related to the anterior fibers
of the levator ani, as they run backward to reach the
perineal body and hook around the anorectal junction
Function :
serves as a canal for menstrual fluid
forms the inferior part of the pelvic (birth) canal
receives the penis and ejaculate during sexual intercourse
communicates superiorly with the cercical canal and inferioly with
the vestibule

Blood Supply
• The vaginal artery, a branch of the internal iliac artery,
and the vaginal branch of the uterine artery supply the vagina
Supports of the vagina

• The upper part of the vagina is supported by the levatores ani

muscles and the transverse cervical, pubocervical, and
sacrocervical ligaments

• These structures are attached to the vaginal wall by pelvic


• The middle part of the vagina is supported by the urogenital


• The lower part of the vagina, especially the posterior

wall, is supported by the perineal body
The uterus is a thick-walled, muscular, pear-shaped
organ located in the middle of the pelvis, behind the
bladder, and in front of the rectum

The uterus is approximately 7,5 cm long, 5 cm wide

and 2 cm thick and weighs approximately 90 gr

The uterus is anchored in position by several ligaments

The main function of the uterus is to sustain a

developing fetus
The uterus consists of the following:
• The cervix
• The main body (corpus)

The cervix
 is the lower part of the uterus, which protrudes
into the upper part of the vagina.
 It can be seen during a pelvic examination
 Like the vagina, the cervix is lined with a mucous
membrane, but the mucous membrane of the
cervix is smooth.
Sperm can enter and menstrual blood can exit the
uterus through a channel in the cervix (cervical canal)

The cervical canal is usually narrow, but during labor,

the canal widens to let the baby through

The cervix is usually a good barrier against bacteria,

except around the time an egg is released by the
ovaries (ovulation), during the menstrual period, or
during labor

Bacteria that cause sexually transmitted diseases can

enter the uterus through the cervix during sexual
The wall of the body of the uterus consists of
three coats or layers :

- the serous or outer serous coat
- Consist of peritoneum supported by a thin layer of
connective tissue

- the middle coat of smooth muscle
- becomes greatly distended during pregnancy
- the main branches of the blood vessels and nerves
of the uterus

- the inner mucous coat
- is firmly adhered to the underlying myometrium
- is actively involved in the menstrual cycle
if conception occurs : the blastocyst becomes implanted
 if doesn’t occur : the inner surface of this coat is shed through
Ligaments of the uterus
 The ligament of the ovary attaches to the uterus
posteroinferior to the uterotubal junction

 The round ligament of the uterus (L. ligamentum teres uteri)

attaches anteroinferiorly to this junction

 The broad ligament, is a double layer of peritoneum

(mesentery) , extends from the sides of the uterus to the lateral
walls and floor of the pelvis – keeping the uterus in position

 Suspensory ligament of the ovary (infundibulopelvic ligament) is a

fold of peritoneum that extends out from the ovary to the wall of
the pelvis and it houses the ovarian vessels.
(ovarian artery, ovarian vein,ovarian nerve plexus and lymphatic
Relation of the uterus
Anteriorly (anteroinferiorly) the vesicouterine
pouch and superior surface of the bladder

Posteriorly : the rectouterine pouch and the

anterior surface of rectum

Laterally : the peritoneal broad ligament

• Arterial supply : the uterine arteries, with
collateral from the ovarian arteries
Cervical cancer, cervical examination and
Examination of the uterus (bimanual
Disposition of the uterus and uterine prolapse
The two fallopian tubes, which are about 4 to 5 inches
(about 10 to 13 centimeters) long

Extend from the upper edges of the uterus toward the


The tubes do not directly connect with the ovaries

Instead, the end of each tube flares into a funnel shape

with fingerlike extensions (fimbriae/infundibulum)

When an egg is released from an ovary, the fimbriae guide

the egg into the relatively large opening of a fallopian tube.
• The fallopian tubes are lined with tiny hairlike
projections (cilia).

• The cilia and the muscles in the tube's wall propel

an egg downward through the tube to the uterus

• The fallopian tube is the usual site of fertilization

of the egg by the sperm
The uterine tubes are divisible into four parts, from
lateral to medial :
• Infundibulum, the funnel-shaped distal end. The finger-like
proscesses oftu the fimbriated end of the infundibulum (the
fimbriae) spread over the medial surrface of the ovary; one
ovarian fimbria is attached to the superior pole of the ovary

• Ampulla; the widest and longest part of the tube, which begins at
the medial end of the infundibulum; fertilization of the oocyte
usually occurs in the ampulla

• Isthmus; the thick- walled part of the tube, which enters the
uterine horn

• Uterine part; the short intramural segment of the tube that passes
through the wall of the uterus and opens via the uterine ostium
into the uterine cavity at the uterine horn
Patency of the uterine (salpingitis)  a
radiographic procedure  injection of water
soluble radiopaque material
Ligation of the uterine tube (tubektomy)
Ectopic tubal pregnancy
Arterial supply of the ovaries and the
uterine tubes
• The ovarian arteries arise from the abdominal
• The ovaries are almond-shaped and sized about 4 cm long

• They are attached to the uterus by the broad ligaments

• In addition to producing female sex hormones

( estrogen and progesterone) and male sex hormones, the
ovaries produce and release eggs

• The developing egg cells (oocytes) are contained in fluid-

filled cavities (follicles) in the wall of the ovaries. Each
follicle contains one oocyte.
Ovarian tissues are divided into two indistinct regions
an inner medulla and an outer cortex

The ovarian medulla is mostly composed of loose

connective tissue and contains many blood vessels,
lymphatic vessels, and nerve fibers.

The ovarian cortex consists of more compact tissue and

has a granular appearance due to tiny masses of cells
called ovarian follicles

A layer of cuboidal epithelium covers the ovary’s free

• AMENORE PRIMER : Adalah tidak terjadinya
menarche sampai usia 17 tahun.
• AMENORE SEKUNDER : Tidak terjadinya menstruasi
selama 3-6 bulan atau lebih.
• KANKER GENITALIA : Kanker yang terjadi pada
• ENDOMETRIOSIS : Jaringan endometrium yang
berada di luar uterus.
• INFEKSI VAGINA : Ditandai dengan keputihan dan