Overview
This lecture covers the anatomy, relationships, blood supply, functions, and clinical relevance of the internal female genital organs: ovaries, uterine (Fallopian) tubes, uterus, and vagina.
Ovaries
- Ovaries are the female gonads, located in the pelvic cavity within the ovarian fossa on each side.
- Bounded anteriorly by the obliterated umbilical artery, posteriorly by ureter and internal iliac artery.
- In nulliparous women, the ovary is vertical; in multiparous, it becomes horizontal.
- Surface is smooth pre-puberty; becomes nodular and gray after puberty.
- Covered mostly by peritoneum except at the mesovarium (anterior border).
- Connected to the broad ligament by the mesovarium; suspensory ligament attaches ovary to lateral pelvic wall.
- Upper pole relates to uterine tube, lower (uterine) pole connects to uterus via the ligament of ovary.
- Supplied by ovarian artery (from abdominal aorta), which anastomoses with uterine artery.
- Venous drainage via pampiniform plexus to ovarian vein.
- Lymph drains to lateral and pre-aortic nodes; nerve supply from sympathetic (T10-11) and parasympathetic fibers.
- Functions: oocyte/ovum production, secretion of estrogen and progesterone.
Uterine (Fallopian) Tubes
- Also called Fallopian tubes or salpinges; convey ova from ovary to uterus and are the site of fertilization.
- Each tube is ~10 cm long, opens laterally into peritoneal cavity (abdominal ostium), medially into uterus (uterine ostium).
- Four parts: infundibulum (with fimbriae), ampulla (site of fertilization), isthmus, intramural (within uterine wall).
- Located in the upper border of the broad ligament (mesosalpinx).
- Supplied by ovarian artery (lateral third) and uterine artery (medial two thirds).
- Lymph drains to lateral/pre-aortic and inguinal nodes; innervated by sympathetic (T10-L2) and parasympathetic fibers.
- Transport of ovum via peristalsis and ciliary movement.
- Common disorders: tubal blockage (causing infertility), salpingitis (inflammation), ectopic pregnancy.
Uterus
- Also called the womb; site of implantation and development of fetus.
- Pear-shaped, ~7.5 cm long, 5 cm broad, 2.5 cm thick, 30-40g in weight.
- Divided into fundus (above tube entry), body (upper 2/3), and cervix (lower 1/3).
- Normally anteverted (tilted forward) and anteflexed (bent forward).
- Communicates superiorly with uterine tubes, inferiorly with vagina.
- Supported by pelvic diaphragm muscles, perineal body, and fibromuscular ligaments (e.g., round ligament).
- Supplied mainly by uterine arteries (from internal iliac); venous drainage to internal iliac vein.
- Lymph nodes: fundus/body to aortic nodes, lower body to external iliac, cervix to internal iliac/sacral nodes.
- Innervated by sympathetic (contractions) and parasympathetic (relaxation) nerves.
- Clinical: prolapse, fibroids, carcinoma, changes with age, support mainly by musculature.
Vagina
- Fibromuscular canal, female copulatory organ, connects cervix to vulva.
- Lies behind bladder/urethra and in front of rectum/anal canal.
- Directed upwards and backwards, ~8 cm anterior wall, 10 cm posterior wall.
- Upper end surrounds cervix; lower end partially closed by hymen (may be absent).
- Highly distensible, allows passage of fetal head at delivery.
- Supplied by vaginal, uterine, middle rectal, and internal pudendal arteries.
- Lymph drainage: upper third to external iliac, middle to internal iliac, lower to superficial inguinal nodes.
- Lower one third is pain sensitive (pudendal nerve); upper two-thirds is pain insensitive (autonomic).
- Clinical: inspection and palpation (bimanual), lacerations (trauma/childbirth), infections (vaginitis), prolapse.
Key Terms & Definitions
- Ovary — female gonad producing ova and hormones.
- Mesovarium — peritoneal fold attaching ovary to broad ligament.
- Suspensory ligament of ovary — contains ovarian vessels, attaches ovary to pelvic wall.
- Uterine (Fallopian) tube — duct conveying ovum from ovary to uterus.
- Ampulla — widest part of tube, site of fertilization.
- Infundibulum — funnel-shaped lateral end of tube with fimbriae.
- Uterus — muscular organ for fetal development.
- Fundus — part of uterus above Fallopian tube entry.
- Cervix — lower narrow part of uterus projecting into vagina.
- Anteversion/Anteflexion — forward tilt/bend of uterus relative to vagina.
- Vagina — muscular canal for copulation and childbirth.
- Fornix — recess around cervix in upper vagina.
- Hymen — thin mucosal membrane at vaginal entrance (often absent).
Action Items / Next Steps
- Review anatomical diagrams of female internal genitalia.
- Memorize blood supply, lymphatic drainage, and innervation of each organ.
- Study clinical conditions: prolapse, ectopic pregnancy, fibroids, and infections.
- Prepare for next lecture on external genitalia.