The female reproductive system consists of:
Some of the organs are stabilised within the pelvic cavity by ligaments and folds of the peritoneum, for example:
Broad Ligament - The ovaries, uterine tubes, and uterus are enclosed within this a mesentery (a double fold of peritoneum). This ligament attaches to lateral walls and pelvic floor of pelvic cavity and thus stabilises the organs within it and prevents their side to side movement.
Mesovarium – This is a thick fold of peritoneum which stabilises the position of the ovaries
Ovarian ligament - (Round ligament of ovary) – Attaches the ovaries to the lateral wall of uterus
Infundibulopelvic ligament – Attaches the ovary to the pelvic wall and contains the main blood vessels which enter the ovary at the hilum
Suspensory ligaments of the uterus (round ligament, uterosacral ligament and cardinal ligament) – Stabilises the uterus
Peritoneum from the abdomen descends into the pelvic cavity as far down as the superior surface of the bladder. However, it reflects back up to the abdomen and covers various organs of the reproductive system:
During this journey of the peritoneum it gives off the broad ligament (see above) and because of the way it reflects from one organ to another, various pouches are formed:
Vesicouterine pouch – between the bladder and uterus as peritoneum reflects from the bladder onto the uterus
Rectouterine pouch – between the uterus and rectum as the peritoneum reflects from the vagina onto the anterior wall of rectum
This article will briefly describe the anatomy of each component of the female reproductive system.
These are paired oval shaped organ which are 5cm long, 2cm wide, and 8mm thick. They lie against the lateral walls of the pelvic cavity in a depression called the Ovarian Fossa. They are stabilised by the mesovarium, the ovarian ligament and the infundibulopelvic ligament (see above). These organs are responsible for the process of oogenesis and release the ova into the uterine tubes.
Autonomic – via the ovarian plexus
Visceral afferents – accompany the sympathetic fibers to T10 – T12 level of the spinal cord sensory ganglia
The surface of the ovaries is covered by visceral peritoneum (germinal epithelium) which consists of columnar epithelium cells
Underneath this layer is the tunica albuginea which is a dense connective tissue layer
Internally, the ovaries are subdivided into a cortex and medulla. The cortex is where the gametes are produced.
These are the ducts that take the ovum from the ovary to the uterus when ovulation occurs. There are two uterine tubes (one for each ovary). They are hollow muscular and are about 13 cm long. Each one is divided into four parts:
The functions of the uterine tubes are:
Autonomic – via ovarian plexus and uterine plexus
Visceral afferents – follow the sympathetic fibres to T11- L1 level of the spinal cord sensory ganglia
The tubes are lined by ciliated columnar epithelium cells which help to propel ovum down the tube. There are scattered mucin secreting cells within the epithelial layer that provide nutrients for the sperm and pre-embryo. Smooth muscle lines the mucosa and provides the forces to push ovum down the tubes. Peg cells also exist and provide fluid to provide nutrition and complete the capacitation of the sperm.The outer surfaces of the tubes are lined by visceral peritoneum.
This is a small organ weighing 30-40g and its most common position is described as being anterverted – this means that it is bending forwards over the urinary bladder. In some women it may be retroverted which means that it bends backwards towards the sacrum instead. This is generally asymptomatic but may be a cause of dyspareunia.
The relations of the uterus are:
Anteriorly – vesicouterine pouch and the urinary bladder
Posteriorly – the rectouterine pouch and the anterior surface of rectum
Laterally – the broad ligament
There are three extra pairs of ligaments in addition to the broad ligament that stabilise the position of the uterus:
The uterus can be divided into the body and the cervix.
Body – the largest part and has a rounded superior portion known as the fundus and ends inferiorly at a constriction called the isthmus.
Cervix - this is the inferior portion of the uterus that extends to the vagina. The internal aspect is known as the cervical canal which is a passageway that is bounded between the Internal Os and External Os.
The wall of the uterus consists of:
These are extensively interconnected to ensure a good blood supply
Autonomic – Hypogastric plexus (sympathetic) S3-S4 (parasympathetic)
Visceral afferents – T11-T12
This is a muscular tube that extends from the cervix to the external genitalia. It opens into an area called the vestibule. The cervix extends slightly into the vaginal canal thus creating areas known as the fornix. The relations of the vagina are:
Anteriorly –the urethra open just anterior to at the urethral orifice
Posteriorly – The rectum lies parallel to it in close contact
The vaginal walls contain layers of smooth muscle and a network of blood vessels. The vagina is separated from the vestibule by a thin epithelial sheet called the hymen which breaks, often during first sexual intercourse. There are two bulbospongiosus muscles that surround the masses of erectile tissue and can constrict.
The layers of the vagina are:
Uterine arteries supplies the superior portion – a branch of the internal iliac artery
Vaginal artery and internal pudendal arteries supply the middle and inferior parts – branches of the internal iliac artery
Uterovaginal plexus – drains into internal iliac veins
Autonomic – inferior hypogastric plexus, pelvic splanchnic, pudendal nerve (all provide parasympathetic Innervation from S2-S4)
Visceral afferents – accompany parasympathetic fibers of inferior hypogastric and pelvic splanchnic nerves to S2-S4
Somatic afferents – accompany pudendal nerve to S2-S4
This area is known as the VULVA and consists of:
Fundamentals of anatomy and physiology – Martini. F.H; Nath J.L, 8th edition
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