 Each ovary is oval shaped, measuring 4×2 cm

 It usually lies against the lateral wall of pelvis in a depression (ovarian fossa), bounded by
external iliac vessels above & internal iliac vessels behind.
 Function: production of female ova & female sex hormones (estrogen and progesterone) in
the sexually mature female.
 Blood Supply
 Arteries: ovarian artery arises from abdominal aorta at the level of L1
 Veins: ovarian vein drains into IVC on right side & into the left renal vein on left side

 Lymph Drainage: follow the ovarian artery & drain into the para-aortic nodes at the level of L1.
 Nerve Supply: derived from the aortic plexus & accompanies the ovarian artery.
 Ovarian ligament (Round ligament of the ovary): connects the lateral margin of uterus to ovary
 Attached to the back of the broad ligament by the mesovarium

 Each tube is ~10 cm long & lies in the upper border of broad ligament
 Infundibulum:
 Funnel-shaped lateral end that projects beyond the broad ligament & overlies the ovary.
 The free edge of the funnel has several fingerlike processes, known as
fimbriae, which are draped over the ovary.

 Ampulla: is the widest part of the tube.

 Isthmus: is the narrowest part of the tube & lies just lateral to the uterus.
 Intramural part: is the segment that pierces the uterine wall.
 Functions:
 Receives the ovum from the ovary
 Provides a site of fertilization of the ovum (usually in the ampulla).
 Provides nourishment for the fertilized ovum & transports it to the cavity
of uterus.

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 Blood Supply:
 Arteries: The uterine artery from internal iliac artery & the ovarian artery from abdominal aorta.
 Veins: correspond to the arteries.

 Lymph Drainage: internal iliac & para-aortic nodes.

 Nerve Supply: sympathetic & parasympathetic nerves from the inferior
hypogastric plexuses.

 The uterus is a hollow, pear-shaped organ with thick muscular walls, (8 cm)
long, (5 cm) wide & (2.5 cm) thick.
 It is divided into the fundus, body, and cervix
 The fundus lies above the entrance of the uterine tubes.
 The body lies below the entrance of the uterine tubes.
 The cervix is the narrow part of the uterus. It pierces the anterior wall of
vagina & is divided into supravaginal & vaginal parts.
 The cavity of the cervix (cervical canal) communicates with the cavity of
the body through internal os & with that of vagina through external os.

 The uterus is covered with peritoneum except anteriorly, below the level of the
internal os, where the peritoneum passes forward onto the bladder.
 Function: it serves as a site for the reception, retention, and nutrition of the
fertilized ovum.
 Relations:
 Anteriorly:
o The body of the uterus is related anteriorly to the uterovesical pouch and
the superior surface of the bladder
o The supravaginal cervix is related to the superior surface of the bladder
o The vaginal cervix is related to the anterior fornix of the vagina.

 Posteriorly:
o The body of the uterus is related posteriorly to the rectouterine pouch
(pouch of Douglas) with coils of ileum or sigmoid colon within it

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  Laterally:
o The body: broad ligament & uterine artery and vein
o Supravaginal cervix: ureter as it passes forward to enter the bladder.
o Vaginal cervix: lateral fornix of the vagina.
o The uterine tubes enter the superolateral angles of the uterus & the round
ligaments of the ovary & uterus are attached to the uterine wall just below
this level.

 Blood Supply
 Arteries: uterine artery, a branch of the internal iliac artery which
anastomose with the ovarian artery, which also assists in supplying uterus.
 Veins: uterine vein follows the artery & drains into the internal iliac vein.

 Lymph Drainage:
 The lymph vessels from the fundus: accompany the ovarian artery & drain
into para-aortic nodes at L1.
 From the body & cervix: drain into internal & external iliac lymph nodes.
 A few lymph vessels follow the round ligament of uterus through the
inguinal canal and drain into the superficial inguinal lymph nodes.

 Nerve Supply: sympathetic & parasympathetic nerves from branches of inferior

hypogastric plexuses
 The uterus is supported mainly by the tone of the levatores ani muscles & three
important ligaments (transverse cervical, pubocervical & sacrocervical)

 Round ligament of uterus:

 It extends between the superolateral angle of the uterus, through deep inguinal ring
& inguinal canal to the subcutaneous tissue of labium majora.
 It helps keep the uterus anteverted (tilted forward) & anteflexed (bent forward) but
is considerably stretched during pregnancy.

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 Anteversion: In most women, the long axis of the uterus is bent forward
on the long axis of the vagina.
 Anteflexion: the long axis of the body of uterus is bent forward at the
level of internal os with the long axis of the cervix
 Retroversion: in some women, the fundus & body are bent backward on
the vagina so that they lie in the rectouterine pouch (pouch of Douglas).
 Retroflexion: if the body of the uterus is, in addition, bent backward on
the cervix.

 It is a muscular tube that extends upward & backward from the vulva to
the uterus. ~ 8 cm long and has anterior and posterior walls
 At its upper end, the anterior wall is pierced by the cervix.
 The vaginal orifice in a virgin possesses a thin mucosal fold called the hymen
 The upper half of the vagina lies above the pelvic floor & the lower half lies within
the perineum.
 The area of the vaginal lumen, which surrounds the cervix, is divided into four
regions, or fornices: anterior, posterior, right lateral & left lateral.
 Function: it is the female genital canal which serves as the excretory duct for the
menstrual flow & forms part of the birth canal.
 Relations:
 Anteriorly: bladder above & urethra below
 Posteriorly:
o Upper 1/3 of the vagina > rectouterine pouch (pouch of Douglas).
o Middle 1/3> rectum.
o Lower 1/3> perineal body, which separates it from the anal canal.

 Laterally:
o Upper part: ureter
o Middle part: anterior fibers of levator ani. Contraction of fibers of levator ani
compresses the walls of vagina.
o Lower part: urogenital diaphragm & the bulb of the vestibule.

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 Blood Supply
 Arteries: vaginal artery, a branch of internal iliac A & the vaginal branch of uterine artery.
 Veins: vaginal veins form a plexus around the vagina that drains into internal iliac vein

 Lymph Drainage:
 Upper 1/3 of the vagina drains to the external & internal iliac nodes
 Middle 1/3 drains to the internal iliac nodes
 Lower 1/3 drains to the superficial inguinal nodes.

 Nerve Supply: inferior hypogastric plexuses.

 Supports of the Vagina:
 Upper part: by levatores ani & transverse cervical, pubocervical & sacrocervical ligaments.
 Middle part: by urogenital diaphragm.
 Lower part, especially the posterior wall: by the perineal body.

 The visceral pelvic fascia is a layer of connective tissue which covers &
supports the pelvic viscera.
 Subperitoneal condensations of pelvic fascia on the upper surface of the
levatores ani form the pubocervical, transverse cervical & sacrocervical
ligaments of the uterus.
 They are attached to the cervix & the vault of vagina and play an important
role in supporting the uterus & keeping the cervix in its correct position.
 Transverse Cervical (Cardinal) Ligaments: fibromuscular condensations
of pelvic fascia that pass from the lateral walls of pelvis to the cervix &
upper end of vagina.
 Pubocervical Ligaments: 2 firm bands of CT that pass from the posterior
surface of pubis to the cervix. They are positioned on either side of the
neck of bladder & give some support (pubovesical ligaments).
 Sacrocervical Ligaments: 2 firm fibromuscular bands of pelvic fascia that pass from the
lower end of sacrum to the cervix & upper end of vagina. They form two ridges, one on
either side of the rectouterine pouch (pouch of Douglas).

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 The peritoneum passes down from anterior abdominal wall onto the upper surface of urinary
bladder.
 It then runs directly onto the anterior surface of uterus, at the level of the internal os & then
over the posterior surface.
 It continues downward and covers the upper part of posterior vagina, where it forms the
anterior wall of the rectouterine pouch (pouch of Douglas).
 In female, the lowest part of abdominopelvic peritoneal cavity in the erect position is the
rectouterine pouch.

 Two-layered folds of peritoneum that extend across the pelvic cavity from the lateral margins
of uterus to the lateral pelvic walls.
 Superiorly, the two layers are continuous & form the upper free edge.
 Inferiorly, at the base of the ligament, the layers separate to cover the pelvic floor.
 The ovary is attached to the posterior layer by the mesovarium.
 The part of the broad ligament that lies lateral to the attachment of the mesovarium forms
the suspensory ligament of the ovary.
 The part of the broad ligament between uterine tube & mesovarium is called the
mesosalpinx.
 At the base of it, the uterine artery crosses the ureter
 Each broad ligament contains the following:
 Uterine tube in its upper free border
 Round ligament of the ovary & uterus.
 Uterine & ovarian blood vessels, lymph vessels, and nerves
 Epoophoron: a vestigial structure that lies in the broad ligament above the attachment of
mesovarium. It represents the remains of mesonephros.
 Paroöphoron: a vestigial structure that lies in the broad ligament just lateral to uterus. It
is a mesonephric remnant.

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 Root of the Clitoris: 3 masses of erectile tissue, bulb of the vestibule & right and left crura.
 The bulb of the vestibule: divided into 2 halves because of the presence of vagina.
Attached to the undersurface of urogenital diaphragm & covered by bulbospongiosus.
 The crura of the clitoris: become the corpora cavernosa anteriorly. Each remains separate
and is covered by an ischiocavernosus muscle

 Body of the Clitoris

 Consists of the two corpora cavernosa covered by their ischiocavernosus muscles.
 The corpus spongiosum of the male is represented by a small amount of erectile tissue
from the vestibular bulbs to the glans.

 Glans of the Clitoris

 Small mass of erectile tissue that caps the body of the clitoris, provided with numerous
sensory endings.
 Glans is partly hidden by the prepuce.

 The term vulva, or pudendum, refers to the external genitalia of the female.
 It includes the mons pubis, labia majora & minora, clitoris, vestibule of the vagina, vestibular bulb,
greater vestibular glands, external urethral orifice & paraurethral (Skene’s) glands
 Blood Supply: Branches of external & internal pudendal arteries on each side.
 Lymph Drainage: Medial group of superficial inguinal nodes.
 Nerve Supply:
 The anterior parts: are supplied by ilioinguinal nerves & genital branch of genitofemoral nerves.
 The posterior parts: are supplied by branches of perineal N & posterior cutaneous nerves of thigh

 It is about 3.8 cm long that extends from the neck of bladder to external meatus
 Opens into the vestibule 2.5 cm below the clitoris.
 At the sides of external urethral meatus are the small openings of the ducts of paraurethral glands
which correspond to the prostate in the male (open into the vestibule).