okay we're going to talk about the female reproductive system and in this first part we're gonna talk about pelvic organs pelvic organs and answer the what questions what are the female reproductive pelvic organs and what do they do and what does the innervation blood supply of the pelvic organs hello everyone my name is dr. Morton and I'm the noted anatomist okay let's get started by getting an overview of what are the organs in the female reproductive system we have ovaries uterine tubes uterus and vagina these are the ones that we're going to be focusing on I know there are other organs in in the female pelvis such as the bladder and the rectum but we're gonna leave those for another topic we're just focusing on those in the female reproductive system so let's talk about ovaries first and talk about their topography some supportive ligaments its function and vascular supply so here in this the ovaries are located in the pelvic cavity and they're along the lateral wall within a structure called the broad ligament so in this superior view of the pelvic cavity we see the symphysis pubis anteriorly and then right behind it is the bladder and then behind that's the uterus and behind that is the rectum and in the lateral wall pelvic wall there we have an ovary and it's located within this structure called the broad ligament which is really the bottom of the proud of the peritoneum it's a mesothelioma and I'll talk about more about that in a few minutes now the ovaries are supported by something called the ovarian ligament and the MOE Varian ligament is in the medial region of each ovary and attaches to the lateral side of the uterus so there's our ovary there's the uterus and then there's the ovarian ligament attaching or connecting the ovary to the uterus now the ovarian ligament is really the superior portion of the embryonic Guber Knack ulam and i want you to hold that on pause for just a minute in your brain because i'm going to talk about that in a few minutes so here we have a coronal section of the of the female reproductive system pelvic organs and they're the ovaries are located and they have a certain function they are the primary sex organ and ovaries produce female gametes we know those as oo sites or the O and the ovaries also produce the sex hormones estrogen and progesterone and so how does that really function so here we have a picture that shows the hypothalamus part of the diencephalon and then there's the anterior pituitary that's labeled and then here we have the ovary and there we have a blood vessel or a capillary that's flowing by and what happens then is the hypothalamus releases a gonadotropic releasing hormone which then targets through the hypophyseal portal system gonadotropin the anterior pituitary that produce and secrete follicle stimulating hormone and luteinizing hormone now follicle stimulating hormone binds to specific receptors on the OU site and when that occurs it causes proliferation so some of those o sites and also these loco sites produces a result estrogen which then target not only the OU site but also flow into the bloodstream and flow throughout the body then luteinizing hormone also binds in a high surge and causes ovulation where the egg is then secreted into the peritoneal cavity and it flows throughout the uterine tube the resultant corpus luteum you see CL and that yellow part there then as a result of luteinizing hormone produces the hormone progesterone that flows throughout the blood and targets proliferation of the endometrium of the uterus okay so now what is the vascular supply of the ovaries so the ovaries are supplied by ovarian arteries and veins and the artery of ovarian arteries arise from the aortic abdominal aorta so here we have the abdominal aorta right there in that picture and then there are our paired or bilateral ovarian arteries that course down and then they go and they supply the ovaries a key thing here is that these ovarian arteries are bilaterally symmetrical the same on both sides now what about the go ona ovarian veins well the ovarian veins have a different drainage and so the right ovarian vein drains into the inferior vena cava or the left ovarian vein drains into the left renal vein which then drains into the inferior vena cava so here we have the inferior vena cava and there we have the right ovarian vein and we have the leftover in vain and there we have part of me left renal vein and there's the left ovarian vein now watch what happens blood drains from the ovaries through those paired ovarian veins but they're bilaterally asymmetrical because the right ovarian vein as it ascends drains into the IVC and the left ovarian vein is a descends drains into the left renal vein which then drains into the IVC okay so the vascular supply of the ovaries is the ovarian vessel so we just talked about as shown in this picture now the ovarian vessels course in something called the suspensory ligament of the ovaries and this is not as the classic ligament as you think of like a ligament is dense connective tissue that attaches bone to bone so this this suspensory ligament is a ligament in that it's connective tissue and it's connecting something in this case the suspensory ligament connects the ovaries to the aorta and IVC and such and so the suspensory ligaments course within two layers of tissue in the broad ligament there's one layer and there's another layer and that's what's coursing in to go to the ovaries so we called the suspensory ligament in this picture this illustration shows them more anatomically accurate where the ovarian vessels are shown there and there's what they call the suspensory ligament which is really just the peritoneum and connective tissue surrounding the ovarian vessels as they supply the ovaries all right and also that's that suspensory ligament is which they isolate and then they ligate those ovarian vessels during all four ectomy which means to to cut out the ovaries and this is to avoid severe bleeding all right so now we've just talked about the ovaries now let's go and talk about the uterine tubes and talk about the different names of the uterine tubes and the parts and the function okay so the uterine tubes are right here and uterine tubes are called the uterine tubes because it's a tube that connects the uterus to the ovary or just simply a tube off the uterus yeah that makes sense I like that name but then some people said well it's also even we called the oviduct because it's a duct the transports there's an Oh them and it transports an ovum in this duct so why don't we call it ducted transports the ovum in Ovid oh that's a good idea then Italian anatomist says you know I think you should name it after me because I identified this thing that was actually the very first name if Gabriel fallopian this list named it after me so we called it the fallopian tube and then another name boy how about a million names for the same structure as sow pinks because that's Greek for trumpet like instrument that was an ancient Greek that kind of looked like this so they called it the Sal pings now Sal pings never really stuck but the derivative or etiology continues because we call the connective tissue part we call the part of the broad ligament that surrounds the tube the mezzo Sal Pink's for tube and if you cut out the uterine tubes we call that a Sal pink ectomy which means to cut out the trumpet like structure so there's all the names but tell you the truth I'm probably just going to be using these two uterine tube and oviduct those are the two terms that I'd be most familiar with now the different parts of the YouTuber as follows there's a femme brie which is these like finger like projections that surround the ovary and then this dilated portion is called the infundibulum and then we have the ampulla and the ampulla of the uterine tube is the the most likely location that a fertilization of an egg and a sperm occurs it's going to occur here in the ampulla and then we also have the Isthmus which is this part that's leading in to the uterus there's the different parts of the uterine tube and so we've just talked about the different names its function and parts of the uterine tube now let's talk about the uterus parts and layers its functions we'll talk about the broad ligament and the round ligament of the uterus so the uterus is a hollow organ in the pelvic cavity and it's located between the bladder and the rectum so here we have a sagittal section of the female pelvis and there is the pubic symphysis and there's the sacrum front to back and then there's our urinary bladder and there's the rectum and right in between the two there's our uterus and the yellow circle over the yellow line is outlining the uterus to show that it is flexed anteriorly that's its classic location but sometimes it can even be found in a flexed posterior position in this view which is showing this coronal section of the uterus we're going to talk about its function this is an organ of gestation which means that's where fertilized egg would then implant in the endometrium to develop so the uterus receives and nourishes a fertilized oocyte until birth and so the different layers is there's the endometrium then this prefix endo means within and metrium whenever you see it think uterus okay the endometrium is epithelial lined which is flourishes and during the menstrual cycle and that's where fertilized egg implants then the myometrium mile for muscle and the muscle layer is a irregularly arranged smooth muscle within the uterus that's where that's the the power that helps contract during birth and then the epimysium which is the outside epi means upon now the different parts of the uterus is that this is the fundus the dome-shaped part is the part that's palpated in trying to ballparking how far along pregnancy is there's the Isthmus which is this narrowed portion of the bottom of the uterus and the space in between is called the body and then this part here which is the neck of the uterus and this is called the cervix think cervical vertebrae or the vertebrae in the neck this is the cervix the neck of the uterus and so this opening that communicates the Isthmus to the lumen of the uterus is called the internal Oz and then the opening that external loss communicates out into the vaginal canal there's the different parts of the uterus now what about the arterial supply to the uterus well the uterine artery which is a branch off the internal iliac artery is the prime blood supply and also there's some supply from the ovarian artery which comes from the aorta and so here we have the superior view of the pelvic cavity and a female and there we have the bladder and there's the uterus and there's the rectum okay and there's our internal iliac artery we can see they're the one that was just highlighted that's the uterine artery that comes to supply the uterus now look on the right we see a descending ovarian artery that then branches and gives a branch off into the ovary and then continues and gives a branch that goes all the way down to the uterus okay and just to show this again in this coronal section where there's our ovarian artery and there's a uterine artery and so the ovarian coming from the aorta the uterine arteries coming from the internal iliac and then here's the vaginal artery which is also branch off the internal iliac artery now watch right here we see all this very rich anastomotic connection all along the uterine tube the uterus and proximal vagina there is a strong amount of anastomosis where blood vessels connective dual supply okay here's another supportive structure called the Cardinal ligaments aport s' the cervix to the lateral walls of the pelvis and it contains the uterine vessels so but when do is in the sagittal section you see that dotted line that's the level of this cross section okay and so there's the bladder there's the uterus there's the rectum and there's our uterine tubes and there's the ovaries now that's the extra peritoneal fat or fashio in yellow and it's the it's basically between in this picture in this level it's between the transverse Allis fashio and the parietal peritoneum and I show that because that plane of fashio if we continue down oh I forgot to say and then there's the uterine vessels which we're going to talk about now that extra peritoneal fashio if we continue down below the parrot anemia that same plane is where we're going to see the Cardinal ligament so now watch in this upper right hand corner as we then bring that level down there's the level of the section right here okay and you can see the uterine vessels that are highlighted and there's the Cardinal ligament it's basically that extra peritoneal fascia because now it's now it's sub peritoneal fascia cuz it's below the peritoneum and it's a condensation and it contains the uterine vessels and there it is in yellow highlighted okay there is a Cardinal ligament it basically supports the bottom of the uterus and contains uterine vessels now there's the ureter and you're going to notice the ureter is coursing inferior to the uterine vessels so yeah so the Cardinal ligament it's a surgical relationship to talk about is that the ureter which transports urine courses under the uterine arteries so there's this water under the bridge way of remembering this where here is water there's the ureter coursing under the bridge which is the uterine artery so watch there's the ureter coursing under the uterine artery that's and we talk about that surgical relationship because in doing a hysterectomy when you're taking the uterus out you clamp the blood supply and part of clamping the blood supply is ensuring that you do not injure the ureter because if the ureter is injured scar tissue builds up then you have a problem voiding urine from the kidney and that can create a host of problems so ureters at risk of injury during ligation of the uterine vessels in a hysterectomy so remember the relationship water under the bridge now the round ligament of the uterus is it goes basically from the fundus of the uterus through the inguinal canal to the labia majora and it's the inferior portion of this embryonic Guber nak ulam so remember that again because you said hey wait I thought we already talked about something with the ovarian ligament so hold that thought I'm going to talk more about this round ligament of the uterus in a minute but basically I don't have a great picture to show other than therea surround ligament it looks like it's cut but it's just part of the picture and at the top of the picture it's where it's going through the inguinal ligament or inguinal canal now let's talk about this structure called the broad ligament so part of the peritoneum and it's a double fold of peritoneum that basically covers and connects the uterus uterine tubes and ovaries to the wall and floor of the pelvis and has three subdivisions that we'll talk about and there's an opening in it that the female has but the male does not so let's talk about each one of these first the broad ligament is a double fold of peritoneum that covers the anterior and posterior part of the uterus the uterine tubes and ovaries so here's the sagittal section through the body and in blue is the peritoneum both appear to nail lining and peritoneal fluid within the space and so what we're gonna do is zoom in a wee bit and see there's the peritoneal cavity and then there's our bladder and there's a urethra and there's the uterus and there's the vagina and there's the rectum okay to give ourselves oriented here now that dotted box is what we're going to blow up and put here and this is a lateral view of the uterus and peritoneal cavity and they're separated from each other to make a point where there's the fundus of the uterus and there's the peritoneum and there's the peritoneal cavity now I separated them for a purpose watch Shing and one more time Shing I did this because you can now see that when the uterus in which is in the sub peritoneal space below the peritoneum pushes its head up it now is covered watch and an anterior layer and a posterior layer and that's what we mean by a double fold of peritoneum that covers the anterior and posterior part of the uterus uterine tubes and ovaries but all you see in this schematic is the uterus and so we call that part of the blueline the peritoneum that's surrounding the uterus uterine tubes and ovaries the broad ligament and so here's a broad ligament in a posterior view and there's the appropriate Anatomy labeled and there's a broad ligament and it has an anterior and a posterior layer a double fold and then there's the mezzo metrium for a mesothelial lining which is the type of tissue and metrium whenever you think Meechum you think oh that's right uterus so the mesothelium that lines the metrium that lines the uterus and then there's the mezzo Sal Pink's the mesothelium that that surrounds the Sal Pink's the trumpet the tube and so if we now take and you see that yellow box surrounding we're going to take that coronal section go up here and take that little part of me a sagittal section and blow it up we can take a look at now study the three parts of the broad ligament me so Sal Pink's Musil very amusing Meacham there's our uterine tube our ovary there's the uterus and there's a few other structures to help give orientation so now watch the broad ligament in blue you can see the broad ligament surrounding in the sagittal section okay and also in the picture in the top right and then there's the anterior and the posterior layer of the broad ligament and then the part that and there's oh pardon me and here and posterior layer in the picture on the top right as well so there's the mezzo Sal Pink's the double layer that surrounds a uterine tube and the mises Sal Pink's in a in this other view and then there is the mezzo varium the double membrane that surrounds the ovary and there's a museum atrium the double an atrium post a layer of the uterus now a summary the broad ligament has three parts Musa Sal Pink's means ovarian and the largest one mezzo medium so the broad ligament also has an opening where the female peritoneum has an opening in the broad ligament where there's no homologous opening in the male peritoneum so here we have this picture where you can see the blue is the broad ligament and then there is the opening and this opening is less than one millimeter in diameter so it's quite small but there's a uterine tube the ovary in the uterus that are labeled now there's the peritoneal cavity now what do we mean by peritoneal cavity we'll take a look at the sagittal section again and that double arrow is showing you the same part of the peritoneal cavity in both pictures now watch when we zoom in okay and so there is the there's the egg and then during ovulation the egg pushes against the side of the ovary until finally an ovulation the egg is ovulated into the peritoneal cavity leaving the corpus luteum behind and then that egg is going to flow around and hopefully get by the opening this this opening and the uterine tube and then course into the uterine tube and then continue along its way to the uterus you notice that it's dotted and is a little lighter showing that it's inside is if you had x-ray vision so let's recap so what happens is the egg is ovulated from the ovary Shing and that all ovulation sends the egg through the thinline in a peritoneal into the peritoneal cavity some references talk about how the there is no broad ligament around the ovary regardless if the references there is mesothelium over the ovary or not the egg goes into the peritoneal cavity that's key to this and then the and then the egg moves back into the uterine tube via opening in the broad ligament and then it flows throughout the uterine tube now let's do a little review of some of the things we've talked about so far using some embryology so let's take a look at this female this little illustration that shows a female fetus at eight weeks and let's talk about a structure called the GU burning them which gets its name because it means it's Greek for a pilot or steer like a steering committee is sometimes called the gubernatorial committee and so the this goober nakulan this connective tissue steers or basically aids in the descent and steering of the gonads in both males and females but I'm focusing on females here and it is only present during the present and active during the formation of the urogenital system and but then when it happens in an adult female it leaves two vestigial remnants only we call the ovarian ligament and one called the round ligament of the uterus okay and so here we have the following and here we have in this picture there is showing the developing kidney and ureter and lime-green and then there's the in orange the development pyramid para mesenteric duct that's going to become the uterine tube in uterus and then there in pink is the meas and effort duct which is going to involute in females and so on the other side they're showing one of the primordial ovaries that are developing the gonads developing in the female and then there's an upper portion of the goober Nachum and there's the lower portion of the goober national now the upper goober nack you only become the ovarian ligament and the lower goober neck and we become the round ligament of the uterus now watch what happens Shing and we go to 15 weeks Shing so what happens then is we can see the kidney and ureter develop in the and more mature fetus and there's the uterine tube in the uterus and there's the inguinal canal and there's the labia majora and watch there is our ovary and there's the upper part of the goober national that is now connecting the ovary to the uterus that is going to become the ovarian ligament and then here the lower part of the goober name is attention the uterus to the labia majora that become engorgement of the uterus and so now in blue you see that what I just highlighted that is the peritoneum now it's cut it's only showing part of the peritoneum but you'll notice that the kidneys and ureters are behind that peritoneum and as a result we say oh the kidneys and the ureters are behind the peritoneum so we say they are retroperitoneal organs Retro means behind now take a look at the ovaries uterus and uterine tubes they're actually below the peritoneum so we call those sub peritoneal organs and if we then take this dotted line and highlight the very bottom part of the peritoneum that's surrounding those organs that's the broad ligament okay that's what's surrounding those structures so in an adult there we have the kidney ureter and bladder and there we have the uterus and the vagina and there is our inguinal canal and there's the labia majora and so there's our ovarian ligament there is the round ligament of the uterus and there is the suspensory ligament of the ovary that's containing the ovarian vessels so these both are derived from the GU Vernet goober nak ulam and some references even say the suspensory ligament is well okay so there's the uterus and it's part so now let's finish by talking about the vagina its functions and parts so the function of vagina is as follows it's a passageway for the endometrium during menstruation that's how the menses gets from the uterine cavity through the external of the cervix into the vaginal canal and out of the body the vagina also serves as a receptacle for the penis during sexual intercourse and it also serves as the birth canal so some of the parts of the vagina are as follows there's a uterine cavity for orientation there's the cervix and there's the vaginal canal then you're going to see highlighted right there the internal lining of the vaginal canal and notice these irregular folds or ridges are called vaginal rugae that help increase the size of the vaginal canal and then these recesses are called the lateral for nnessee so the lateral fornix and if we now take a look at this sagittal section of the female pelvis and we can see here the uterine cavity and there's our cervix and there's our vaginal canal and we highlight that vaginal canal again there are those vaginal rugae that help increase for changing the diameter of the vaginal canal and there is an anterior fornix and a posterior fornix those two different fauna sees so if we then take a look at a different view there as if a speculum view a speculum view of the cervix through the vaginal canal looks like this where there's the external a the cervix and then there we have an anterior and posterior fornix and there are the two lateral fauna sees is what it'll look like as if looking through speculum so there's the external Oz and some of the fauna sees that you can see there and so let's now take this female reproductive system pelvic organs in a nutshell we have the ovaries that are located in the lateral pelvic wall and they're supported by suspensory and ovary ovarian ligaments they function by producing an ovum and estrogen and progesterone and they're supplied by ovarian vessels the uterine tubes also called fallopian tubes or oviduct or Sal Pink's help to transport the ovum from the ovary to the uterus and it has the fimbriae all the way down to the Isthmus then we have the uterus which has a fundus isthmus body and cervix and it then also helps to receive a fertilized egg to implant in the endometrium to develop and nourish it throughout its course and the smooth muscle the myometrium to help with delivering the baby the broad ligament the bottom of the peritoneum that surrounds these structures and the round ligament which is a derivative the goober neck you l'm that helps support it and then the vagina which helps serve as a receptacle for the penis during intercourse and a passageway for menses and a baby and that my friends is the female reproductive system and pelvic organs in a nutshell sunny skies sleeps in the morning he doesn't know when to rise closes his weary eyes upon the day look at him yawning low in his morning hours away he knows that I he's down slowly and everything is fine in the end and you will be pleased to know the sunny skies as in a friend [Music]