Professional Documents
Culture Documents
FEU-NRMF
Department of Obstetrics and Gynecology
ANTERIOR ABDOMINAL WALL
confines abdominal
viscera
stretches to
accommodate the
expanding uterus
provides surgical
access to the
internal
reproductive
organs
ANTERIOR ABDOMINAL WALL
ANTERIOR ABDOMINAL WALL
Skin
LANGER LINES
describe the orientation of
dermal fibers
In the abdomen:
Transversely arranged
vertical skin incisions
more tension, wider scars
low transverse incisions
(Pfannenstiel)
follow Langer lines; superior
cosmetic results
Subcutaneous Layer
Campers fascia
Superficial
predominantly fatty layer
Scarpas fascia
Deeper
more membranous layer
PARAURETHRAL
GLANDS
CLINICAL SIGNIFICANCE:
Inflammation and
duct obstruction of
any of the
paraurethral glands
can lead to a urethral
diverticulum
formation.
Vestibular Bulbs
Male homologue: corpus Bulbocavernosus
muscle
spongiosum of the penis
almond-shaped, mainly
Vestibular bulb
composed of
aggregations of veins
3 to 4 cm long, 1 to 2 cm
wide, and 0.5 to 1 cm
thick
lie beneath the
bulbocavernosus muscle
on either side of the
vestibule.
Vestibular Bulbs
CLINICAL
SIGNIFICANCE:
During childbirth, the
vestibular bulbs may
be injured and may
even rupture to
create a vulvar
hematoma
VAGINAL OPENING AND HYMEN
Vaginal opening is
rimmed distally
by the hymen or
its remnants
VAGINAL OPENING AND HYMEN
HYMEN
Membrane
surrounding the
vaginal opening
Composed of elastic
and collagenous
connective tissue
Covered by stratified
squamous epithelium
VAGINAL OPENING AND HYMEN
The aperture of the hymen
varies.
Hymen is torn at several
sites during first coitus.
Identical tears may occur by
other penetration. The
edges of the torn hymen
soon reepithelialize
hymenal caruncle
Imperforate hymen
Rare lesion in which the
vaginal orifice is occluded
completely, causing retention
of menstrual blood
VAGINAL OPENING AND HYMEN
VAGINA
Musculo-membranous
structure
Extends from the vulva to the
uterus
interposed anteriorly and
posteriorly between the urinary
bladder and the rectum .
Lining epithelium: non-
keratinized stratified squamous
epithelium
no glands
abundant vascular supply
VAGINAL OPENING AND HYMEN
VAGINA
Embryology
upper portion - mllerian ducts
lower portion - urogenital sinus
VAGINAL OPENING AND HYMEN
VAGINA
Anteriorly, the vagina is separated
from the bladder and urethra by
connective called vesicovaginal
septum
cervicovaginal
branches of uterine Externa, internal and
Upper Third
artery and vaginal common iliac nodes
artery
Middle third inferior vesical arteries Internal iliac nodes
middle rectal and
Lower third internal pudendal Inguinal nodes
arteries
PERINEUM
The diamond area between the thighs
Boundaries are same as those of the bony pelvic outlet
Anterior: Pubic symphysis
Posterior: Ischiopubic rami
Anterolateral: Ischial tuberosities
Posterolateral: Sacrotuberous ligaments
Posterior: Coccyx
Blood supply:
Internal pudendal artery (inferior rectal artery and posterior
labial artery)
Anterior triangle, also
called the urogenital
triangle
Boundaries:
Superior: Pubic rami
Lateral: Ischial tuberosities
Posterior: Superficial transverse pernieal muscle
PERINEUM
PERINEUM
SUPERFICIAL SPACE OF THE ANTERIOR TRIANGLE
attached at the ischial tuberosity and crus
Ischiocavernosus of clitoris helps maintain clitoral erection
Overly the vestibular bulb and Bartholin
glands
Attached at the perineal body and the
clitoris
Bulbocavernosus Constrict the vaginal lumen and aid in the
release of secretions of the Bartholins
gland
Contributes to clitoral erection
Superficial transverse attach to the ischial tuberosities laterall
perineal muscles and the perineal body medially
PERINEUM
DEEPSPACE OF THE ANTERIOR
TRIANGLE
LYMPHATICS
Cervix
terminate mainly in the hypogastric nodes, which are
situated near the bifurcation of the common iliac vessels.
Body of the uterus
internal iliac nodes and periaortic lymph nodes
Blood Vessels
INTERNAL GENERATIVE ORGANS
FALLOPIAN TUBES
Also called oviducts
Vary in length from 8 to 14 cm.
lumen is lined by mucous
membrane.
PARTS
interstitial portion
isthmus
ampulla
infundibulum or fimbriated
extremity- funnel-shaped
opening at the distal
INTERNAL GENERATIVE ORGANS
FALLOPIAN TUBES
Tubal smooth muscle:
inner circular and outer
longitudinal, undergo
rhythmic contraction or
peristalsis toward the
uterine cavity
Epithelium in close
contact with muscle
layer because there is
no submucosa
Epithelium - columnar
cells (some ciliated,
others secretory)
INTERNAL GENERATIVE ORGANS
Ovaries
the ovaries vary considerably in
size.
During childbearing years, they are from
2.5 to 5 cm in length, 1.5 to 3 cm in
breadth, and 0.6 to 1.5 cm in thickness.
After menopause, ovarian size diminishes
remarkably.
BLOOD SUPPLY
The ovaries are supplied with
both sympathetic nerves from
the ovarian plexus and
parasympathetic nerves.
THANK YOU!
Quiz
12
13
14,15 Blood
supply to the
uterus
Quiz