ERRNVPHGLFRVRUJ

10 Overview of the Female Reproductive System

The female reproductive system is composed of the following
structures:
• Ovaries: the paired gonads of the female reproductive system,
they produce the female germ cells called ova (oocytes, eggs)
and secrete the hormones estrogen and progesterone
• Uterine tubes (fallopian tubes or oviducts): paired tubes that
extend from the superolateral walls of the uterus and open as
fimbriated funnels into the pelvic cavity adjacent to the ovary
(to “capture” the ovulated oocyte)
• Uterus: a pear-shaped, hollow muscular (smooth muscle)
organ that protects and nourishes a developing fetus
• Vagina: a musculoelastic distensible tube (also referred to as
the birth canal) approximately 8 to 9 cm long that extends from
the uterine cervix (neck) to the vestibule
The perineum is a diamond-shaped region extending from the
pubic symphysis laterally to the two ischial tuberosities and
then posteriorly to the tip of the coccyx. The anterior half of the
diamond-shaped region is the urogenital triangle and it includes
the vulva or external female genitalia. A labia (lip) majora, cover-
ing the erectile tissue of the bulb of the vestibule, surrounds the
labia minor, which demarcates the vulva and the openings of the
urethra and vagina. The erectile tissue of the clitoris (crus, body,
and glans) demarcates the two lateral boundaries of the uro-
genital triangle that lie along the ischiopubic ramus and meet at
the pubic symphysis anteriorly. This region is innervated by the
pudendal nerve (somatic branches of S2-S4) and supplied by
branches of the internal pudendal artery (see Plate 5-15).

The female reproductive viscera are summarized in the following COLOR  the following features of the female reproductive
table. system, using a different color for each feature:
n   1. Uterine tube
FEATURE CHARACTERISTICS
n   2. Ovary
Ovary Is suspended between suspensory ligament of ovary
(contains ovarian vessels, nerves, lymphatics) and ovarian n   3. Uterus (fundus, body, and cervix)
ligament (tethered to uterus) n   4. Vagina
Uterine tube
(fallopian
Runs in mesosalpinx of broad ligament, which suspends
the tube and ovary and reflects off the uterus
n   5. Clitoris (crus, body, and glans)
tube, oviduct) n   6. Urethral opening
Uterus Consists of body (fundus and isthmus) and cervix; is
­supported by pelvic diaphragm and ligaments
n   7. Labia minora
Vagina Includes fornix—recess around protruding uterine cervix
n   8. Labia majora
n   9. Vaginal opening
The ovaries are suspended from the lateral pelvic walls by the
n 10. Bulb of the vestibule (erectile tissue)
suspensory ligament of the ovary (contains the ovarian neu-
rovascular elements) and tethered to the uterus medially by the
ovarian ligament. The uterus, uterine tubes, and ovaries also are
supported by the broad ligament, a kind of “mesentery” that
consists of peritoneum that reflects off of the pelvic walls and
sweeps up to embrace these visceral structures, not unlike the
mesenteries of the bowel. These features are summarized in the
table below.

FEATURE
Broad ligament of uterus
Ovaries
Uterine tubes
Transverse cervical
(cardinal or Mackenrodt’s)
ligaments
Uterosacral ligaments
CHARACTERISTICS
Includes mesovarium (enfolds ovary),
­ esosalpinx (enfolds uterine tube), and
m
mesometrium (remainder of ligament)
Are suspended by suspensory ligament of
ovary from lateral pelvic wall and tethered
to uterus by ovarian ligament
Consist of fimbriated end (collects ova),
infundibulum, ampulla, isthmus, and uterine
parts
Are fibromuscular condensations of pelvic
fascia that support uterus
Extend from sides of cervix to sacrum,
support uterus, and lie beneath peritoneum
(uterosacral fold)

Plate 10-1 See Netter: Atlas of Human Anatomy, 6th Edition, Plates 340, 352, and 356 Reproductive System
 booksmedicos.org

Overview of the Female Reproductive System 10

1
Suspensory ligament of ovary
2
Vesico-uterine pouch
Ligament
of ovary
Round Recto-uterine pouch
ligament (cul-de-sac of Douglas)
of uterus
(ligamentum
teres) Cervix of uterus

3
Anal canal
Urinary
bladder
Pubic External anal sphincter
symphysis
4

6
5 6
7
Anus Ischiocavernosus muscle
8 9
10
A. Pelvic cavity: median (sagittal) section Greater vestibular
(Bartholin’s)
Bulbospongiosus muscle
gland
Ischial tuberosity Bulbospongiosus
muscle
(cut away)
B. Perineum (left side shows deeper dissection)
Perineal body
9

Suspensory Levator
ligament 1 ani muscle
of ovary
2
Coccyx External anal
3 sphincter muscle

Broad ligament

Ligament
of ovary

C. Uterus: posterior view

Netter’s Anatomy Coloring Book Plate 10-1

 扯潫獭敤楣潳⹯牧

10 Uterus and Vagina

Uterus Vagina
The uterus (womb) is a pear-shaped organ suspended in the The vagina is a musculoelastic tube extending from the cervix
broad ligament (mesometrium) and tethered laterally by its to its opening in the vestibule. The lumen is lined by a strati-
connections to the uterine tubes and by the ovarian ligament fied, squamous, nonkeratinized epithelium that is lubricated by
and its attachment to the ovary. Additionally, reflecting from its mucus from cervical glands.
anterolateral aspect is the round ligament of the uterus, a dis-
tal remnant of the female gubernaculum (the proximal remnant
is the ovarian ligament attached to the ovary), which pulls the COLOR  the following features of the uterus and vagina,
ovary down from its developmental site in the posterior abdomi- using a different color for each feature:
nal wall into the pelvis. The round ligament of the uterus passes n 1. Fundus of the uterus
through the inguinal canal and ends as a fibrous fatty band in the
labia majora (homologue to the male scrotum).
n 2. Body of the uterus
The uterus has several parts: n 3. Cervix of the uterus
• Fundus: that part lying superior to the attachments of the two n 4. Vagina
uterine tubes n 5. Stratum basale (regenerates a new stratum functionale
• Body: the middle portion of the uterus that tapers inferiorly into after menstruation) of the endometrium
the cervix
• Cervix: the “neck” of the uterus, it lies subperitoneally, has a
n 6. Stratum functionale (thick surface layer that
proliferates and is sloughed off during menstruation)
narrow endocervical canal, and opens into the superior part of
of the endometrium
the vagina
n 7. Uterine glands
The uterine wall is lined internally by the endometrium, which
proliferates significantly during the first half of the menstrual
cycle in preparation for the possible implantation of a conceptus
and, if fertilization doesn’t occur, degenerates and is sloughed
off during the 3 to 5 days of menstruation that mark the begin-
ning of the next menstrual cycle. The middle layer of the uterine
wall is the myometrium, a thick smooth muscle layer, and the
outer layer is the perimetrium, a serous layer (visceral peritoneal
covering).

Plate 10-3 See Netter: Atlas of Human Anatomy, 6th Edition, Plate 352 Reproductive System
 扯潫獭敤楣潳⹯牧

Uterus and Vagina 10

1

Uterine cavity

3 Internal os (opening)

External os (opening) Vaginal fornix

A. Uterus

7 6

7
5 5

Menstruation Late proliferative phase Midsecretory phase

B. Endometrial cycle

Netter’s Anatomy Coloring Book Plate 10-3