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ANATOMYOF
FEMALEGENIT
AL
TRACT
By
Dr. Md Razi Ahmad MD
Assist. Prof. GTCH Patna
• External genitalia
• Internal genitalia
• Accessory reproductive
organs
Female external genitalia
Mons
veneris
Labia
majora
• Post commisure
Labia
minora
• prepuce
• Frenulum
• Fourchette
• Fossa
navicularis
clitoris
• Glans
• Body
• 2 crura
vestibule • 6 openings
• bartholin’s abscess
• Hymen
External
genitalia
(vulva,
pudendum)
MONS PUBIS
The triangular mound of fatty tissue that
covers the pubic bone
It protects the pubic symphysis
During adolescence sex hormones trigger
the growth of pubic hair on the mons
pubis
Hair varies in coarseness curliness,
amount, color and thickness
LABIA MAJORA
Referred to as the outer lips
They have a darker pigmentation
The Labia Majora:
Protect the introitus and urethral openings
Are covered with hair and sebaceous
glands
Tend to be smooth, moist, and hairless
Become flaccid with age and after
childbirth
LABIA MINORA
Referred to as the “inner lips”
Made up of erectile, connective tissue that
darkens and swells during sexual arousal
Located inside the labia majora
They are more sensitive and responsive to
touch than the labia majora
The labia minora tightens during
intercourse
CLITORIS
• Highly sensitive organ composed of
nerves, blood vessels, and erectile tissue
• Located under the prepuce
• It is made up of a shaft and a glans
• Becomes engorged with blood during
sexual stimulation
• Key to sexual pleasure for most women
• Urethral opening is located directly
below clitoris
Clitoris
VAGINAL OPENING INTROITUS
Opening may be covered by a thin
sheath called the hymen
Using the presence of an intact hymen
for determining virginity is erroneous
Some women are born without hymens
The hymen can be perforated by many
different events
UNIT 3: FEMALE
REPRODUCTIVE SYSTEM 11
• Blood supply
– Arteries
• Br. of internal pudendal artery
– Labial A.,
– Transverse perineal A.,
– A to vestibular bulb,
– deep & dorsal arteries to clitoris
• Br. of Femoral A
– Superficial & deep external
pudendal A
– Veins
• Internal pudendal vein
• Vesical/ vaginal venous plexuses
• Long saphenous vein
Nerve supply
– Ant-sup part
• Ilio inguinal & genital br. of genitofemoral N
(L1,L2)
– Post-inf part
• Pudendal br. of post.cut. N of thigh (S123)
– In between
• Labial & perineal br.of Pudendal N (S234)
• Lymphatics
– Superf. Inguinal nodes
– Gland of Cloquet
– Ext. & Int. Iliac nodes
PERINEUM
• The muscle and tissue located
between the vaginal opening and
anal canal
• It supports and surrounds the lower
parts of the urinary and digestive
tracts
• The perinium contains an abundance of
nerve endings that make it sensitive to
touch
• An episiotomy is an incision of the
perinium used during childbirth for
widening the vaginal opening
18
Vagina
ovaries
Uterus
Internal
genital
organs
Fallopian
tubes
VagIna
• Fibromuscular membranous sheath
• Excretory channel
• Organ of copulation
• Birth canal of parturition
• 45° horizontal
• 2.5cm diameter
• distensibility
VAGINA
• The vagina connects the cervix to the external genitals
• It is located between the bladder and rectum
Functions :
• As a passageway for the menstrual flow
• For uterine secretions to pass down through the
introitus
• As the birth canal during labor
• With the help of two Bartholin’s glands becomes
lubricated during SI
• Walls
– Ant : 7.5 cm
– Post : 9cm
– 2 lateral walls
• Fornices :
– Ant : shallow
– 2 lateral
– Post : deep
Normal vaginal mucosa
Pelvic floor superior view
Pelvic floor inferior view
Pelvic floor side view
levator ani muscle is largest and
strongest muscle in the pelvis
Pubococcygeus
(Master sphincter)
(weight bearing)
Ischiococcygeus
(weight bearing)
Iliococcygeus
Urogenital diaphragm
•Braces the vagina and
urethra (PUL)
•Provides the stage for
sexual quartet
•Stabilizes the perineal
body
The fetal head can damage
the pelvic floor
Sexual quartet
1 Clitoris
(Krause corpuscles)
2 Vestibular bulb
(Erectile tissue)
3 Bartholin gland
(Alkaline mucous)
4 Vagina
(Copulatory canal)
• Structure
– mucous coat
– Submucous layer of loose areolar vascular
tissues
– Muscular layer
– Fibrous coat (from endopelvic fascia)
:highly vascular
• Vaginal secretion
– Doderlein’s bacilli : lactic acid from
glycogen
• Blood Supply
– Arteries
• Cervicovaginal br. Of uterine A
• Vaginal A
• Middle rectal A
• Internal pudendal
• Anastomose---form 2 azygos arteries
– Veins drain into:
• Internal iliac V
• Internal pudendal V
• Lymphatics drain into
• Upper 1/3rd : internal iliac nodes
• Middle 1/3rd: external iliac nodes
• Lower 1/3rd (below hymen) : superficial inguinal
gp.
• Nerve supply
• Parasympathetic : S234
• Sympathetic: hypogastric plexus
• Lower end : pudendal N (sensory )
Uterus
• Hollow, pyriform muscular organ
• Position: anteversion & anteflexion
uterus dextrorotated
• Measurements
– 7.5cm long
– 5cm wide
– 3cm thick
– Weight : 50-80gm
Partsof uterus
• Structure
– Perimetrium : serous coat
– Myometrium: thick bundles of sm.
M
• During pregnancy:
– Outer long.
– Middle interlacing
– Inner circular
– Endometrium
• Surface epithelium
• Lamina propria
– Stromal cells
– Endometrial glands
– Vessels & nerves
• Decidua in pregnancy
• Secretion: scanty & watery
• Relation
–Anterior
• Aboveint.os:uterovesical pouch
• Belowint.os:separatedfromUBbylooseareolar
tissue
–Posterior
• PouchofDouglaswithcoilsonintestine
–Lateral
• Broadligament
• Mackenrodt’
sligament
• UterineA&ureter
• Ligaments of uterus
– Uterosacral ligament
– Transverse cervical/ Mackenrodt’s lig
– Pubovesicocervical lig
– Round ligament
– Broad ligament
• Mesovarium
• Mesosalpinx
• mesometrium
• Suspensory lig of ovary
/ infundibulopelvic ligament
• Blood supply
– Arteries:
• Uterine A
• Ovarian & Vaginal As.
– Veins drain into
• Internal iliac veins
• Lymphatics
• Nerves
– Sympathetic
• Motor : T5 & T6
• Sensory : T10 – L1
– Parasympathetic
•Pelvic N ( S2,3,4) : both motor
& sensory : ends in
•ganglia of Frankenhauser
1
2
2
3
3
4
4
5 5
6
Figure: internal organs in female pelvis. 1. uterus, 2. ovaries, 3.
fallopian tubes, 4. round ligaments, 5. utersacral ligaments, 6.
rectouterine pouch (pouch of Douglas) , 7.broad ligaments.
7
Arterial system
1. Ovarian artery: the chief
source
of the blood for ovaries.
2. Uterine artery:
corpus branch
cervical-vaginal branch
3. Vaginal artery: main source
of the blood for the middle
part of vagina
4. Internal pudendal artery:
supply for superficial
perineum, labia majora,
labia minora, lower part of
the vagina, clitoris
Blood supply for female genitalia
Fallopian tube
• (uterine tube,oviduct)
• 10-14 cm
•Lies within the
superior border of
broad ligament
• 2 openings
– Medially into cornua
– Laterally into abdominal cavity
Parts of fallopian tube
Structure:-3 layers
• Blood Supply
– Arteries
• Uterine A
• Ovarian A
– Veins
• Through pampiniforn plexus into ovarian
veins
• Lymphatics
• Para-aortic nodes
• Nerve supply
– Uterine & ovarian nerves
T
h
eOva ry
• Paired, situated on either side of uterus
• Close to lateral pelvic wall
• In ovarian fossa of Waldeyer
• Size: 4*3*2 cm
• Only intra-abdominal structure not
covered by peritoneum
• Medial pole: attached to uterine cornua
by ovarian ligament
• Laterally to the pelvic wall by
infundibulopelvic ligament
• Fimbrial end of oviduct close to ovary &
attached to it via fimbria ovarica
• Structure : 2
parts
• Lined single layer of germinal
epithelium of Waldeyer (cuboidal epi.)
• Tunica albuginea : stromal cells
thickened
beneath germinal epithelium
• Contain primordial follicles
• Corpus albicans/ atretic follicles
Cortex
• Loose connective tissues, blood vessels,
nerves, muscles
• Hilus cells : homologous to interstitial
cells of testes
Medulla
ovarian
V. IV
C
• Blood Supply
– Arterial : Ovarian A
– Veins :
• Through pampiniform plexus
Lt. Renal Vein
• Lymphatics
• Para-aortic nodes
• Nerve supply
• Sympathetic supply from T10 along
ovarian A.
• Lymphatic drainage:
– External genital organ lymph group:
1. superficial inguinal lymph nodes.
2. deep inguinal lymph nodes
– Pelvic lymph group:
1. iliac lymph group.
2. presacral lymph group.
3. lumbar lymph group.
The nerve of external genitalia
• Pudendal nerve
– Obstetric local anesthesia
• Divided into 3 branches beside
tuberosity
– Inferior hemorrhoid nerve
– Dorsal nerve
– Perineal nerve
The nerve of internal genitalia
• Sympathetic and parasympathetic nerves
from lumbar and sacral spinal cord
• Sympathetic nerve are derived from Plexus
– Sacral plexus
– Ovarian plexus
Pelvic innervation
Frankenhauser’s plexus
Pudendal nerve
Hypogastric nerve (s)
Celiac plexus
Inferior mesentric plexus
Superior hypogastric plexus
Inferior hypogastric plexus
PSN
LUNA
BREASTS
• Organs of sexual arousal
• Contain mammary glands
• Consist of connective
tissue that serves as
support
• Each breast contain 15-
25 clusters called
lobes
• Each lobule is connected
by ducts that open into
the nipples
• The nipples are made up
of erectile tissue
• The pigmented around
the nipples are called the
areola
• Breast size is
determined primarily
by heredity
• Size also depends on
the existing fat and
glandular tissue
• Breasts may exhibit
cyclical changes,
including increased
swelling and tenderness
prior to menstruation
• Benign breast changes
refer to fibrocystic
disease
• Lumps or masses that
are noncancerous
UNIT 3: FEMALE REPRODUCTIVE
SYSTEM
67
Basics of female genital organ