FEMALE REPRODUCTIVE ANATOMY BY : S.ROUHOLAMIN MD

EXTERNAL GENTILIA The vulva refers to those parts that are outwardly visible The vulva includes: Mons pubis Labia majora Labia minora Clitoris Urethral opening Vaginal opening Perineum

The external genital structures of the mature female

MONS PUBIS(MONS VENERIS) 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 FUNCTION: Protect the introitus and urethral openings Are covered with hair and sebaceous glands Mass of fat, plexus of veins

LABIA MINORA (Nymphae) 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

CLITORIS Highly sensitive organ composed of nerves, blood vessels, and erectile tissue It is made up of a shaft and a glans Becomes engorged with blood during sexual stimulation (2*1) key to sexual pleasure for most women Urethral opening is located directly below clitoris

VAGINAL OPENING INTROITUS In virginal women hidden by overlapping labia minora Opening may be covered by a thin sheath called the hymen Imperforated hymen: vaginal orifice is occluded completely ,retention of menstrual discharge

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 perineum used during childbirth for widening the vaginal opening

INTERNAL GENITALIA The internal genitalia consists of the: Vagina Cervix Uterus Fallopian Tubes Ovaries

Female Internal Reproductive System (side view)

Female Internal Reproductive System (front view).

VAGINA The vagina connects the cervix to the external genitals It is located between the bladder and rectum It 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 sexual intercourse

CERVIX The cervix connects the uterus to the vagina The cervical opening to the vagina is small This acts as a safety precaution against foreign bodies entering the uterus During childbirth, the cervix dilates to accommodate the passage of the fetus This dilation is a sign that labor has begun

UTERUS A pear shaped organ Located between bladder and rectum Length: Nulliparous(6 to 8),Multiparous(9 to 10) It is made up of the endometrium, myometrium and perimetrium The powerful muscles of the uterus expand to accommodate a growing fetus and push it through the birth canal

FALLOPIAN TUBES Length:8 to 14 cm Serve as a pathway for the ovum to the uterus Are the site of fertilization by the male sperm Portions: Interstitial, isthmus, ampulla, infundibulum Fertilized egg takes approximately 6 to 10 days to travel through the fallopian tube to implant in the uterine lining

OVARIES Almond-shaped organs, development and extrusion of ova, synthesis and secretion of steroid hormones A woman is born with approximately 400,000 immature eggs called follicles During a lifetime a woman release 400 to 500 fully matured eggs for fertilization The follicles in the ovaries produce the female sex hormones, progesterone and estrogen These hormones prepare the uterus for implantation of the fertilized egg

ARTERIES Uterine and ovarian art Uterine art: Ovarian art: Internal iliac (Hypogastric) art Ovarian art: Direct branch of Aorta

VEINS Uterine veins ; Internal iliac vein ; Common iliac vein Right ovarian vein ;IVC Left ovarian vein ;Left renal vein

PELVIC Pelvic composed of four bone: sacrum , coccyx and two innominate bones Innominate bones: ilium, ischium, pubis False pelvis ;above the linea terminalis True pelvis ; below the linea terminalis

Pelvic Girdle (Hip)

Comparison of Male and Female Pelvic Structure

PLANS AND DIAMETERS OF THE PELVIS Pelvic inlet Pelvic outlet Midpelvis Greatest pelvic dimensions

PELVIC DIAMETERS Obstetrical conjugate; shortest distance between promontory of sacrum and the symphysis pubis;10 cm or more True conjugate Diagonal conjugate

PELVIC DIAMETERS

CALDWELL-MOLOY CLASSIFICATION Gynecoid pelvis Android pelvis Anthropoid pelvis Platypelloid pelvis

GYNEOID PELVIS (50%) It is the normal female type : Inlet is slightly transverse oval. Sacrum is wide with average concavity and inclination. Side walls are straight with blunt ischial spines. Sacro-sciatic notch is wide. Subpubic angle is 90-100o.

Anthropoid pelvis (25%) It is ape-like type : All anteroposterior diameters are long. All transverse diameters are short. Sacrum is long and narrow. Sacro-sciatic notch is wide. Subpubic angle is narrow.

Android pelvis (20%) It is a male type : Inlet is triangular or heart-shaped with anterior narrow apex. Side walls are converging (funnel pelvis) with projecting ischial spines. Sacro-sciatic notch is narrow. Subpubic angle is narrow <90o.

Platypelloid pelvis (5%) It is a flat female type : All anteroposterior diameters are short. All transverse diameters are long. Sacro-sciatic notch is narrow. Subpubic angle is wide.