ANATOMY OF THE FEMALE

REPRODUCTIVE SYSTEM

Ma. Sisa Balagosa- Fernandez, M.D., FPOGS

 Embryology
Urogenital System
: urinary and reproductive organs both developed from
the intermediate mesoderm

urogenital ridge

nephrogenic ridge genital ridge

(Mullerian/Wolffian) (primordial gonads)
 Embryology
First 6 weeks AOG
• Embryo is bisexual due the presence of two pairs of genital
ducts:
a. Wolffian duct
b. Mullerian duct
7 Weeks AOG
• Urorectal septum divides and seperates the cloaca creating
the rectum & urogenital sinus
 Embryology

3 Parts of the Urogenital sinus:

1. vesicle – urinary bladder
2. pelvic – female uerthra
3. phallic – distal vagina, Bartholin’s gland &
skene’s gland
7th – 8th Weeks of gestation:
1. Testis Determining Factor
2. Y chromosomes
a. differentiation of a male embryo
b. development of the mesonephric duct into a male
genital tract
c. degeneration of the paramesonephric duct
d. formation of other male organs epididymis, vas
deferens & interstitial cells of Leydig
2. Absence of Y chromosomes, testes and Anti
Mullerian hormone result:

a. differentiation into a female embryo

b. paramesonephric duct develops into a female
genital tract
c. fusion of the transverse portion of the
paramesonephric ducts at the mdline forms the
uterus
d. unfused cranial ducts become the oviducts
e. fused caudal longitudinal segments forms uterovaginal
canal which becomes the epithelium and glands
of the uterus and upper vagina
 Female External Genital Tract
1. Mons Pubis -subcutaneous fat anterior to the
symphysis pubis forming a round eminence and
covered with hairs
2. Labia Majora – two elongated swellings that forms
the lateral boundaries of the vulva.
- covered by skin with scattered hairs laterally.
- richly supplied with plexus of veins
- scrotum in males
3. Labia Minora - two thin folds of skin devoid
of hairs and subcutaneous fat, but richly
supplied with nerve endings
- homologous to penile urethra and part of
the skin of penis in males
4. Clitoris – erectile organ composed of a body,
two crura and a glans
- homologous to penis in males
5. Bulbs of the vestibule – paired of erectile
tissues at the sides of the vaginal orifice and
attached to the superficial layer of the
urogenital diaphragm
- in males, homologue to bulb of the penis and
posterior part of the corpus spongiosum
6. Vestibule of the vagina – space enclosed by the
labia minora with several openings
a. external urethral orifice
b. opening of the skene’s gland
c. vaginal opening
d. opening of the bartholin’s gland
7. Perineum – diamond shaped area at the lower
end of the trunk between the thigh and buttocks
Boundaries:
a. Anterior – symphysis pubis and arcuate
pubic ligament
b. anterolateral - ischiopubic rami
c. lateral – ischial tuberosities
d. posterolateral – sacrotuberous ligament
e. posterior - coccyx
 Urogenital Triangle
Two spaces within the urogenital triangle:
1. Superficial pouch
a. crura of the clitoris
b. greater vestibular gland
c. 3 pairs of the superficial perineal muscles
d. superficial muscles and nerves
2. Deep pouch
a. sphincter of the membranous urethra
b. deep transverse perineal muscles
c. nerves of the clitoris
d. internal pudendal vessels and nerves
 Anal Triangle
- Located posteriorly and pierced by the anal
opening
- Its superficial fascia is web-like that contained
fat pads which serves as a flexible support for
the lower part of the rectum
- Alcock’s canal- passageway of the pudendal
nerve and internal pudendal vessel as the
enter the perineum
9. Perineal body
- fibrous mass located between the anus
posteriorly and the vestibule anteriorly
- provides support to the perineum but can
be damaged during parturition
- composed of fibers from:
a.levator ani
b. superficial perineal muscles
c. bublbocavernosus muscles
d. anal sphincter muscles
 FEMALE INTERNAL GENITALIA
1. Vagina – distensible musculomembranous
structure that extends from the vestibule to
the uterus
- Boundaries:
a. Anterior : urinary bladder
b. Posterior : rectum
 Vagina
- Vaginal wall is consist of tunica muscularis
(smooth muscle, dense connective tissue)
- Lining epithelium is stratified squamous
epithelium
FUNCTIONS OF THE VAGINA:
1. organ of copulation
2. excretory canal
3. birth canal
 UTERUS

- Thick walled hollow pear shaped muscular organ

- Measures: 8cms long, 5 cms wide, 2.5 cms thick
- site of implantation of the fertilized embryo
- Boundaries:
a. anterior: urinary bladder
b. posterior: coils of small and large intestine
c. lateral: broad ligament, round ligament,
ureter, oviducts, uterine vessels
 UTERUS
Parts of the Uterus:
1. Corpus / body of the uterus
2. Isthmus -
3. Cervix – long cylindrical portion that projects
into the vagina
Uterus
Layers of the Uterus:
1. Endometrium- inner mucous membrane,
lined with columnar epithelium and contains
glands that secrete an alkaline fluid to keep
the cavity moist
a. Zona Functionalis
b. Zona Basalis
2. Myometrium – consist of interlacing
bundles of smooth muscle fibers forming the
bulk of the uterus
3. Serosa
 Ligaments of the Uterus
1. Broad Ligament – derived from the peritoneal
fold w/c has bothe the anterior and posterior
layer
2. Infundibulopelvic Ligament – a continuation of
the broad ligament
3. Transverse Cervical Ligament ( Cardinal
Ligament of Makenrodt)- located at the lateral
side of the cervix
4. Round Ligament
5. Uterosacral Ligament
Ligaments of the Uterus
 Cervix
- Barrel shaped structure measuring 3cms. long
- Extends from the isthmus of the uterus to the
upper portion of the vagina
- Lined by ciliated columnar epithelium in its
upper 2/3 ( supravaginal) while the lower 1/3
is lined with squamous epithelium ( pars
vaginalis)
Papsmear
 FALLOPIAN TUBES
- Oviducts, uterine tubes
- Are musculotubular sturctures measuring 10-
12 cm long , located between the layers of the
upper borders of the broad ligament
- Functions:
a. site of implantation
b. conduit for the sperm and the ovum
Fallopian Tube
Layers of the Fallopian Tube:
1. Mucosa – lined with ciliated columnar
epithelium containing connective tissues
with blood vessels and nerve endings
2. Muscularis – inner circular and outer
longitudinal fibers
3. Serosa – includes the peritoneum and
adjacent organs
 OVARIES
- Almond shaped structures located in a
depression in the lateral pelvic wall between the
ureter and external iliac vein
- Each structure has 2 surfaces, 2 boarders, and
two poles
- Upper pole ( tubal ) is attached to the lateral
pelvic wall by the infundibulopelvic ligament
while lower pole ( uterine) is attached to the
lateral margin of the uterus by the ovarian
ligament
 Ovary
- Lined with low cuboidal epitheliem,
2 layers of the ovary:
1. Cortex - contains the primordial and
graffian follicles at various stages of
development
2. Medulla – contains the arteries and veins
 Blood Supply
Common Iliac Artery

External Iliac Artery Internal Iliac Artery

ANTERIOR POSTERIOR

1. Obturator artery 1. Lateral Sacral artery 2.

Internal Pudendal artery 2. Superior Gluteal artery
3. Inferior GlutealArtery
4. Umbilical Artery
5. Inferior Vesical Artery
6. Uterine Artery
7. Middle hemorrhoidal Artery
 Internal Pudendal Artery
Branches:
1. Inferior rectal artery
2. Perineal artery
3. Artery of the clitoris
Supplies the following structures:
1. External Anal Sphincter
2. Levator Ani muscles
3. Urogenital Diaphrgam
4. Clitoris and lower vagina
5. Skin and fat of the anal region
 Uterine Artery
- Main arterial supply of the uterus
- Courses downward and medially and crosses
the ureter near the cervix at about 1.5 cm
from the lateral fornix
- Therefore, caution must be done when
clamping the uterine arteries , this may injure
the ureter.
 UTERINE ARTERY

Anterior Arcuate Posterior Arcuate

Radial artery ( myometrium )

Spiral artery Straight artery

( coiled artery)

Functional layer Basal layer

( endometrium ) ( endometrium)
 Lymphatic Drainage
Pelvic Lymph Nodes:
1. Internal Iliac Nodes
2. Vesical and rectal nodes
3. Perirectal nodes
Abdominal Nodes:
1. Inferior mesenteric and preortic nodes
Inguinal Nodes:
1. Deep inguinal nodes
2. Superficial inguinal nodes
Congenital Anomalies of the Female
Reproductive Organs
A. Ambiguous Genitalia
1. Female Pseudohermaphroditism
: Gonadal sex 46, XX
: virilized external genitalia, (+) ovaries, cervix &
vagina, potentially fertile
2. Male Pseudohermaprhoditism
: Gonadal sex 46, XY
: (+) testis, (-) uterus, with testis within the abdomen
3. True Hermaphroditism
: Genetic sex: 46,XX ( most common) ,or 46,
XX/46,XY
 Mullerian Anomalies
1. Vagina Agenesis/ atresia
2. Mullerian Agenesis ( Mayer-Rokitansky –
Kuster-hauser Syndrome)
3. Unicornuate Uterus
4. Uterine Didelphys
5. Bicornuate Uterus
6. Septate Uterus
7. Arcuate Uterus