FEMALE GENITAL ORGANS
Organa genitalia feminina
RNDr. Michaela Račanská, Ph.D.
spring 2017
labia majora pudendi
labia minora pudendi
clitoris
vestibulum vaginae
bulbi vestibuli
gll. vestib. maj. et min.
External genitals:
ovarium
tuba uterina
uterus
vagina
Internal female genitals:FEMALE GENITAL ORGANS
Internal female genital organs
Ovary (ovarium)
Phalopian tube (tuba
uterina)
Uterus
Vagina
Ovarium
6-10g, 3-5cm
Produces germ cells
Endocrine function
depends on functional state
Descend of the ovaries
At the beginning: abdominal cavityend
of i.u. development: fossa iliaca
- 1. year: fossa ovarica
- after giving a birth: Claudius pit
L1
Female gonads, paired, lie in shalow depressions, one on each side of the upper pelvic cavity
Nullipara – fossa ovarica (in front of a. iliaca int.)
Multipara – Claudius fossa (behind a. iliaca int.)
LOCALIZATION OF OVARY
Axis passes
longitudinaly!
Extremitas
tubaria (upper)
uterina (lower)
Facies: med., lat.
Margo
liber (post)
mesovaricus (ant,
hilus)
Ovarian cycle
Lig. suspensorium ovarii (vasa ovarica)
Lig. ovarii proprium
Hilus ovarii
Mesovarium
Lig. latum uteri
HANGING APPARATUS
Tunica albuginea
Cortex ovarii:
Folliculi ovarici - primarii
- secundarii
- vesiculosi (Graaf)
matured oocyt
Medulla ovarii
conn. tissue, blood and lymph vessels, nerves,
smooth muscle
Ovary - cortex with folicule, medulla
Ovulation
At birth 2 million follicles
Puberty 300,000-400,000
Only 400 ever mature –
one egg/month through reproductive years (from
puberty (menarche) (12-13) until menopause (45-55)
Follicular stage
(Estrogen)
Luteal stage (progesteron)
c. l. graviditatis
c. l. menstruat. > corpus
albicans
OVARIAN CYCLE
Hypophysis a) FSH b) LH = gonadotropin hormones
• Hormones levels cycle in the female on a monthly basis
• Ovarian cycle drives the uterine cycle
Ovarian cycle
Tuba uterina (salpinx)
10-15 cm
Ostium abdominale - infundibulum (fimbriae) ampulla
- isthmus - pars uterina - ostium
uterinum
Isthmus – transversally (laterally) to the wall of pelvis minor
Ampulla - dorsocranially to the upper pole of ovary
Infundibulum - dorsocaudally
Fimbriae - rotated to fac. medialis et superior ovarii
PHALOPIAN TUBE COURSE
OSTIUM ABDOMINALE TUBAE UTERINAE
1. Mucosal folds
(cylind. epithelium cilliated)
2. Circular muscular layer
3. Longitudinal muscular layer
4. tunica serosa
5. mesosalpinx
HISTOLOGY OF PHALOPIAN TUBE
CLINIC NOTE
Changes of the mucosa (inflamations!) could causes
that the tube is not passable for the egg => extrauterine
pregnancy (Ectopic tubal pregnancy)!!!!
Uterus, hystera
Corpus
- fundus
- cornua – dex. et. sin.:
lig. ovarii propr. , lig. teres uteri
- margines- dx., sin.: lig. latum,
- facies intestinalis
vesicalis
Isthmus (1 cm)
Cervix
portio supravaginalis
vaginalis (cervix)
8-10cm
Cavum uteri (3 ml)
Canalis isthmi
Ostium internum canalis cervicis
Canalis cervicis (plicae palmatae)
Ostium externum canalis cervicis
(= ostium uteri)
Cervix
portio supravaginalis
portio vaginalis
Fornix vaginae
uterus arcuatus uterus subseptus uterus septus uterus bipartitus
uterus duplex uterus duplex uterus duplex
cum vagina septa
uterus unicornis
NULLIPARA MULTIPARA
OSTIUM UTERI (OSTIUM EXTERNUM CANALIS CERVICIS)
Labium anterius et posterius
Epithel of the vagina x epithel of the uterus!!!
HISTOLOGY OF UTERUS
Endometrium
Myometrium
Perimetrium
ENDOMETRIUM
Simple cylindric epithelium
zona basalis
zona functionalis
glandulae uterinae
glandulae cervicales (mucouse closure)
menstruation cycle
menarche
menopausa (climacterium)
ostium uteri (multilayer stratified epithelium)
ISCHEMIA
1. Menstruation phase
2. Proliferation phase
3. Secretory phase
4. Ischemia
Menstruation cycle
1. stratum submucosum
2. stratum vasculosum
3. stratum supravasculosum
4. stratum subserosum
MYOMETRIUM
Lig. latum uteri
Mesosalpinx
Mesovarium
Lig. teres uteri
PERIMETRIUM (VISCERAL PERITONEUM)
PERIMETRIUM
Excavatio vesicouterina
Excavatio rectouterina
(cavum Douglasi)
PARAMETRIUM
Lig. pubouterinum
lig. pubovesicale
lig. vesicouterinum
Lig. cardinale uteri
Lig. sacrouterinum
plica sacrouterina
m. rectouterinus
Lig. teres uteri
Part of fixation apparatus
Together with the pelvic floor
Plica sacrouterina
Lig. teres uteri
Anteversion (700 – 1000)
Anteflexion (1000)
POSITION OF UTERUS
POSITION OF UTERUS
Arteria uterina – anastomosis with a. ovarica (ovarian arcade)
Uterine artery crosses ureter
(2 cm from uterine margine
1,5 cm from fornix vaginae)
A. uterina x ureter
Plexus venosus uterovaginalis
Nll. lumbales, iliaci int., iliaci ext.
nodus lymph.uterinus (Bayer),
inguinales spf., sacrales
Plexus uterovaginalis
3
4
5
6
7
8
9
10
GRAVIDITY
uterus graviditatis – 1000 g
Placenta
Funiculus umbilicalis – 50 cm
(v.umbilicalis, aa. umbilicales)
HYSTEROSALPINGOGRAPHY
VAGINA
Position of vagina
Ventrocaudal direction
Ventrally:
urinary bladder
urethra - septum urethrovaginale
Dorsally:
excavatio rectouterina
rectum - septum rectovaginale
centrum perineale
VAGINA (KOLPOS) Fornix vaginae
pars anterior et posterior
receptaculum seminis
Paries anterior
crista urethralis
area trigonalis vaginae
Paries posterior
Rugae vaginales
Columna rugarum ant. et post.
Ostium vaginae
(vestibulum vaginae)
Defloration
Carunculae hymenales
Ostium vaginae - hymen
Ostium urethrae ext.
Ostium vaginae
HISTOLOGY OF VAGINA Mucouse membrane
Multilayer squamous epithelium
No glands !!!
submucouse tissue – venous net
Muscular layer
inner - circular
outer - longitudinal
Adventicia (paracolpium)
Serosa – excavatio rectouterina
A.uterina
- a. vaginalis
A. rectalis media
A. pudenda int.
Plexus venosus uterovaginalis
Nll. iliaci int., ext, inguinales spf.
Plexus uterovaginalis, n. pudendus
Mons pubis (pubes, fatty tissue)
Labia majora pudendi
Labia minora pudendi
Vestibulum vaginae
Clitoris
Bulbi vestibuli
Gll. vestib. maj. et min.
perineum
Genitofemoralgroove
Mons pubis
Organa genitalia feminina externa
sulcus
interlabialis
commiss. lab.post.
frenulum
lab. pud.
Sulcus genitofemoralis
Rima pudendi
Commissura labiorum ant.
Perineum (raphe perinei)
Connective tissue, fat
lig. teres uteri
Labia majora pudendi
Labia minora pudendi
Sulcus interlabialis
Vestibulum vaginae
Smegma – sebaceous glands
Elastic and collagenous connective tissue,
venous plexus, nerve endings
Frenulum labiorum pudendi
Fossa navicularis
between vagina and frenulum
Praeputium clitoridis
Frenulum clitoridis
CLITORIS
Crura clitoridis
(crista phalica)
Corpus clitoridis
Glans clitoridis
Praeputium clitoridis
Frenulum clitoridis
Corpora cavernosa clitoridis
Lig. fundiforme clitoridis
Lig. suspensorium clitoridis
M. ischiocavernosus
VESTIBULUM VAGINAE
between labia minora pudendi
Glans clitoridis
(praeputium et frenulum clitoridis)
Ostium urethrae externum
(papilla urethralis, gll. vestib. minores
- between ostium urethrae et. and
vestibule of the vagina, rare in human females)
Ostium vaginae (hymen)
Fossa navicularis
Frenulum labiorum pudendi
(commisura labiorum pudendi)
BULBI VESTIBULI
Erectile bodies
(corpus spongiosum)
On (below) diaphragma
urogenitale
m. bulbospongiosus
(from centrum tendineum
perinei to the dorsum
clitoridis)
commisura bulborum
(between glans clitoridis and
ostium urethrae ext.)
GLANDULAE VESTIBULARES MAJORES (BARTHOLINI)
On the diaphragma
urogenitale
Dorsally from bulbi
vestibuli
m. bulbospongiosus
Open to the vestibulum
vaginae
PELVIC FLOOR
Diaphragma pelvis
Perineal membrane (Deep perineal pouch , diaphragma urogenitale)
Superficial perineal pouch
Pelvic outlet
m. obturatorius int.
MUSCLES OF THE PELVIC DIAPHRAGMA
Diaphragma pelvis
M. levator ani
1 pars iliaca
2 pars pubica
Hiatus urogenitalis
opening for rectum
3 M. coccygeus
Fascia diaphragmatis pelvis
sup. et inf.
Innervation: sacral plexus
1
2
3
Support the pelvic viscera, assist in the constriction of the rectum and vagina
M. levator ani
1 pars iliaca (iliococcygeus)
O: arcus tendineus m.levatoris ani
I: anoccoccygeal lig., coccyx
2 pars pubica (pubococcygeus PC)
O: ramus sup. ossis pubis
I: coccyx, ventral sacroccoccygeal lig.
Medial part of PC - M. levator prostatae, M. pubovaginalis
PERINEAL BODY – fibromuscular node between A and UG
Intermediate part of PC – M. puborectalis – blends with the
deep external anal sphincter
Innervation: sacral plexus
Anorectal angle
M. coccygeus
O: spina ischiadica
I: lateral parts of the coccyx and sacrum
(lies on the sacrospinal lig.)
Innervation: sacral plexus
PERINEUM Overlies the pelvic outlet, separated from the pelvic cavity with the pelvic diaphragm
2 triangular parts: anal region, urogenital region
Fascia diaphragmatis urogenitalis
sup. et inf. –pelvic membrane
M. transversus perinei prof.
Lig. transversum perinei in ♂ anteriorly
♀ small smooth muscles posteriorly
M. sphincter urethrae externus
(in ♀ m. sphincter urethrovaginalis)
M. compressor urethrae in ♀ only
Inn. N. pudendus
Muscles of the urogenital
region:
Urogenitale diaphragma
=deep perineal pouch
Muscles of the anal region:
M. sphincter ani externus
Sacral plexus Lig. anococcygeum
m.compressor
urethrae
m. sphincter
urethrovaginalis
m. bulbospong.
m. ischiocavernosus
m. transversus
perinei profundus
sphincter ani ext.
m. transv. perinei
superfic.
M. ischiocavernosus
M. bulbospongiosus (M. constrictor cunni)
M. transversus perinei superf.
Superficial perineal pouch
Below the perineal membrane
n. pudendus
Fascia perinei
ISCHIORECTAL – ISCHIOANAL - FOSSA
FOSSA ISCHIORECTALIS – recessus pubicus
• et v. pudenda interna, n. pudendus – canalis pudendalis
Aa., vv. et nn. rectales inf.
m. obturatorius int.
Fascia obturatoria
Fossa
ischio
rectalis
Canalis
pudendalis
(Alcock´s
canal)
Rectum
Recessus
pubicus
Spatium perinei
superficiale
N. pudendus
A. et v. pudenda interna
N. cutaneus femoris post. (rr. perineales)
A.dorsalis penis (clitoridis)
N. dorsalis penis (clitoridis)
V. dorsalis penis (clitoridis) profunda
A.,v. et n. perinealis
Gl. bulbourethralis
Fascia diaphragmatis urogenitalis sup. et inf.
Spatium perinei profundum
Fascia perinei spf.
Spatium perinei spf.
Recessus pubicus
fossae ischio-
rectalis
To review:
Thank you for your attention
RNDr. Michaela Račanská, Ph.D.
racanska@mail.muni.cz
Spring 2017
Illustrations were copied from:
Čihák R: Anatomie 2 (Splanchnologia). Avicenum,
zdravotnické nakladatelství, Praha, 1988.
Sobotta, Putz,R., und Pabst,R. Atlas der Anatomie des Menschen
20. Auflage. München: Urban & Schwarzenberg, 1993
Neil A. Campbell, Jane B. Reece, Lisa Urry, Michael L. Cain et al.:
Biology: A Global Approach (10th International Edition), 2014.
Pearson Education Limited (Verlag) 978-1-292-00865-3 (ISBN)