ANATOMY OF FEMAL

REPRODUCTIVE ORGANS
IT INCLUDES :-
A.EXTERNAL GENITALIA (VULVA)
B.INTERNAL GENITAL ORGANS

A.EXTERNAL GENITALIA INCLUDES – MONS VENERIS,LABIA

MAJORA,LABIA MINORA,CLITORIS,VESTIBULE,PERINEUM
 1.MONS PUBIS
• IT IS THE PAD OF SUBCUTANEOUS ADIPOSE
CONNECTIVE TISSUE LYING IN FRONT OF THE
PUBIS
• IN ADULT COVERED WITH HAIR
 2.LABIA MAJORA
• VULVA IS BOUNDED ON EACH SIDE BY THE ELEVATION OF
SKIN AND SUBCUTANEOUS TISSUE, WHICH FORM THE
LABIA MAJORA
• THEY JOIN POSTERIORLY TO FORM POST. COMMISSURE
• OUTER SURFACE COVERED WITH HAIR AND INNER
SURFACE IS HAIRLESS.
• CONTAIN SEBACEOUS GLANDS,SWEAT GLANDS,HAIR
FOLLICLES
• THEY ARE HOMOLOGUS WITH THE SCROTUM OF MALE.
 3.LABIA MINORA
• L. MINORA ARE THICK FOLDS OF SKIN ,DEVOID OF FAT ,
ON EITHER SIDE JUST WITHIN THE LABIA MAJORA
• ANTERIORLY THEY DIVIDED TO ENCLOSE THE CLITORIS
AND UNITE WITH EACH OTHER IN FRONT AND BEHIND
THE CLITORIS TO FORM PREPUCE AND FRENULUM
RESPECTIVELY. POSTERIOLY THEY UNITE TO FORM
FOURCHETTE.
• BETWEEN FOURCHETTE AND VAGINAL ORIFICIE IS THE
FOSSA NAVICULARIS
• IT IS HOMOLOGOUS TO THE VENTRAL ASPECT OF PENIS.
 4.CLITORIS
• IT IS A SMALL CYLINDRICAL ERECTILE BODY,
MEASURING 2.5 CM SITUATED IN THE MOST
ANTERIOR PART OF THE VULVA
• IT CONSISTS OF GLANS,BODY AND TWO
CRURA. IT IS ATTACHED TO UNDERSURFACE
OF SYMPHYSIS PUBIS BY SUSPENSORY
LIGAMENT
• IT IS HOMOLOGOUS TO PENIS IN MALE.
 5.VESTIBULE
• IT IS A TRIANGULAR SPACE BOUNDED ANTERIORLY BY CLITORIS, POSTERIORLY BY
FOURCHETTE AND LATERLLY BY LABIA MINUS
• FOUR OPENNING AT VESTIBULE- URETHRAL OPENING,VAGINAL ORIFICE AND
HYMEN,TWO BARTHOLIN’S GLAND DUCT.
• BARTHOLIN’S GLANDS ARE SITUATED IN THE SUPERFICIAL PERINEAL POUCH CLOSE
TO THE POSTERIOR END OF VESTIBULAR BULB. PEA-SIZED ABOUT0.5 CM AND
YELLOWISH WHITE COLOR,SECRETS ALKALINE MUCUS DURING SEXUAL
EXCITEMENT. EACH GLAND HAS A DUCT OF 2 CM LENGTH, OPEN INTO VESTIBULE
OUT SIDE THE HYMEN AT A JUNCTION BETWEEN ANTERIOR 2/3RD AND
POSTERIOR 1/3RD
• BARTHOLIN’S GLAND CORRESPONDS TO BULBOURETHRAL GLAND IN MALE
• VESTIBULAR BULBS ARE BILATERAL ELONGATED MASSES OF ERECTILE TISSUES LIES
UNDER THE MUCOUS MEMBRANE OF VESTIBULE AND INFRONT OF BARTHOLIN’S
GLANDS AND INCORPORATED WITHIN THE BULBOCAVERNOSUS MUSCLES. THEY
ARE HOMOLOGOUS TO SINGLE BULBE OF PENIS AND SPONGIOSUM IN THE MALE
• IT IS DEVLOPED FROM SEPERATED VENTRAL PART OF UROGENITAL SINUS
 6.PERINEUM
• PYRAMIDAL SHAPED TISSUE WHERE THE PELVIC FLOOR AND THE PERINEAL
MUSCLES AND FASCIA MEET IN BETWEEN VAGINAL AND ANAL CANAL IS
CALLED OBSTETRICAL PERINEUM. MEASURES 4 CM X 4 CM BASE COVERED
BY PERINEAL SKIN AND APEX TOWARDS RECTO-VAGINAL SEPTUM
• THIS MUSCULO-FASCIAL STRUCTURE :- A) FASCIA -1) TWO LAYERS OF
SUPERFICIAL PERINEAL FASCIA-SUPERFICIAL FATTY LAYER AND DEEPER
LAYER CALLED COLLES FASCIA. 2) INFERIOR AND SUPERIOR LAYER OF
UROGENITAL DIAPHRAGM,TOGETHER CALLED TRIANGULAR LIG. B)
MUSCLES- 1)SUPERFICIAL AND DEEP TRANSEVERSE
PERINEI(PAIRED),2)BULBOSPONGIOSUS,3)LEVATOR ANI-PUBOCOCCCYGEUS
PART(PAIRED) 4) SPHINCTER ANI EXTERNUS
• IMPORTANCE –1) HELPS IN SUPPORT LEVATOR ANI AND INDIRECTLY
SUPPORTS VAGINA,BLADDER, UTERUS, 2)EPISIOTOMY DONE HERE, 3)IT IS
VULNERABLE TO INJURY DURING CHILD BIRTH.
 BLOOD AND NERVE SUPPLY OF VULVA
• ARTERIES- 1)BRANCHES OF INTERNAL PUDENDAL ARTERIES-
LABIAL,TR. PERINEAL DEEP AND DORSAL ARTERY TO CLITORIS,
2)BR. OF FEMORAL ARTERY-SUPERFICIAL AND DEEP PUDENDAL BR.
• VEINS- THEY FORM PLEXUS AND DRAIN INTO-1)INTERNAL
PUDENDAL VEIN,2)VESICAL AND VAGINAL VENOUS PLEXUS ,
3)LONG SAPHENOUS VEIN
• NERVE SUPPLY -1) ANTEROSUPERIOR PART IS SUPPLIED BY
CUTANEOUS BR. FROM ILLIOINGUINAL AND GENITAL BR. FROM
GENITOFEMORAL NERVE(L1,L2), 2) POSTEROINFERIOR PART –
PUDENDAL BR. FROM POST. CUTANEOUS NERVE OF THIGH(S2,3,4),
3) BETWEEN TWO GROUPS-LABIAL AND PERINEAL BRANCHES OF
PUDENDAL NERVE(S2,3,4)
 B.INTERNAL GENITAL ORGANS
• IT INCLUDES –
1)VAGINA,2)UTERUS,3)FALLOPIAN TUBE AND
4)OVARIES
 1.VAGINA
• IT IS A FIBROMUSCULOMEMBRANOUS STRUCTURE COMMUNICATING THE UTERINE CAVITY WITH THE
EXTERIOR AT VULVA
• IT IS THE ORGAN OF COPULATION AND FORMS BIRTHCANAL FOR PARTURATION
• CANAL IS DIRECTED UPWARDS AND BACKWARDS FORMING AN ANGLE OF 45*
• LENGTH OF ANTERIOR VAGINAL WALL IS 7 CM AND POSTERIOR WALL LENGTH 9 CM. FOUR FORNICES DUE
TO PROJECTION OF CX THROUGH THE ANTERIOR VAGINAL WALL.
• LAYERS OF VAGINA FROM WITHIN OUTWARDS – 1) MUCOUS COAT LINED BY STRATIFIED SQ.
EPI.,2)SUBMUCOUS LAYERS OF LOOSE AREOLAR TISSUE,3)MUSCULAR LAYER-INNER CIRCULAR AND OUTER
LONGITUDINAL, 4)FIBROUS COAT DERIVED FROM ENDOPELVIC FASCIA
• EPITHELIUM- UNDER THE ACTION OF SEX HORMONES FROM BIRTH TO 10-14 DAYS UNDER MATERNAL
ESTROGEN,PRE-PUBERTY AND POST-MENOPAUSAL EPI. THIN AND FEW LAYERS, FROM PUBERTY TO TILL
MENOPAUSE STRATIFIED SQ. EPI. DEVOID OF GLANDS. THREE DISTINCT LAYERS-BASAL
CELLS,INTERMEDIATE CELLS, AND SUPERFICIAL CORNIFIED CELLS.
• INTERMEDIATE CELLS, AND SUPERFICIAL CORNIFIED CELLS CONTAIN GLYCOGEN.
• CONVERSION OF GLYCOGEN OF EXFOLIATED SQ.EPI. CELLS TO LACTIC ACID BY DODERLEIN’S BACILLI. PH
AVERAGE 4.5
• BLOOD SUPPLY FROM-1)CERVICO VAGINAL BRANCH OF UTERINE ARTEY,2) VAGINAL ARTERY, 3) MIDDLE
RECTAL , 4) INTERNAL PUDENDAL. VEINS DRAINS INTO INTERNAL ILLIAC AND INTERNAL PUDENDAL VEIN
• NERVE SUPPLY SYMPATHETIC AND PARASYMPATHETIC FROM PELVIC PLEXUS.LOWER PART IS SUPPLIED BY
PUDENDAL NV.
• VAGINA DEVELOPED FROM DISTAL PART OF MULLERIAN DUCT AND VAGINAL PLATE OF URO-GENITAL
SINUS
 2.THE UTERUS
• UTERUS NORMAL POSITION ANTEVERTED AND ANTEFLEXED,UT. DEXTROROTATION AND CX
LEVOROTATION.
• UT MEASURES ABOUT 8CM X 5CM X 2.5CM. WT.50-80 GM
• THREE PARTS- BODY,ISTHMUS,CERVIX
• IN NULLIPAROUS CX IS CONICAL WITH EXT OS IS LOOKING CIRCULAR AND IN PAROUS CX IS
CYLINDRICAL EXT.OS HAVING BILATERAL SLIT
• NORMAL LENGTH OF UT. CAVITY FROM FUNDUS TO CX IS 6-7 CM
• STRUCTURES OF BODY 3 LAYERS PERIMETRIUM,MYOMETRIUM,ENDOMETRIUM, MYOMETRIUM-3
LAYERS-OUTER LONGITUDINAL,MIDDLE INTERLACING AND INNER CIRCULAR.
• EMNDOMETRIUM-LAMINA PROPRIA AND SURFACE ENDOMETRIUM SINGLE LAYER OF CILLIATED
COLUMNAR EPI.
• CX- IT CONSISTS OF FIBROUS CONNECTIVE TISSUE AND 15% MUSCLE FIBRE
• TRANSITIONAL ZONE -1-10 MM WIDTH WITH VARIABLE HISTOLOGICALFEATURES . THE ZONE CONSISTS
OF ENDOCERVICAL STROMA AND GLANDS COVERED BY SQ. EPI.. THIS ZONE IS NOT STATIC BUT
CHANGES WITH HORMONE LEVEL.THIS ZONE IS CONSTANTLY IRRITATED NOT ONLY BY HORMONES BUT
ALSO BY INFECTION (HPV) AND TRAUMA. MORE CHANCE OF DYSPLASIA AND CIS AND INVASIVE
CANCER.
• UT. DEVELOPED FROM FUSION OF DISTAL PART OF TWO MULLERIAN DUCTS
 2.THE UTERUS
• BLOOD SUPPLY – ARTERIAL SUPPLY-.1.-UTERINE ARTERY, 2.
OVARIAN ARTERY 3.VAGINAL ARTERY. VEINS ALONG THE
COURSE OF ARTERIES
• NERVE SUPPLY- SYMPATHETIC SENSORY (T10-L1) AND
MOTOR (T5 ,T6) ,PARASYMPATHETIC BY PELVIC NERVE
BOTH MOTOR AND SENSORY(S2,3,4)→GANGLIA OF
FRANKENHAUSER LIES ON BOTH SIDE OF CX. CX IS
INSENSITIVE TO TOUCH.
• IN CHILDHOOD CX:BODY 2:1, PUBERTY
CX:BODY1:2,FOLLOWING CHILDBIRTH CX:BODY 1:3, AFTER
MENOPAUSE UT. ATROPHIC.
 3.FALLOPIAN TUBE(UT)
• UT ARE PAIRED STRUCTURE, LENGTH 10 CM,TWO END- UTERINE
END(1 MM) AND ABDOMINAL OSTIUM(2 MM)
• FOUR PARTS -1)INTRAMURAL -1.25CM,2)ISTHMUS -2.5
CM,3)AMPULLA- 5CM,4)INFUNDIBULUM-1.25 CM
• IT HAS 3 LAYERS- SEROUS,MUSCULAR AND MUCOUS LAYER LINED BY
COLUMNAR EPI. PARTLY CILIATED
• FUNCTIONS – TRANSPORT OF GAMETS,FACILITATE FERTILIZATION,
SURVIVAL OF ZYGOTE THROUGH ITS SECRETION
• IT DEVELOPED FROM PROXIMAL PART OF MULLERIAN DUCT
• BLOOD SUPPLY FROM UTERINE AND OVARIAN ANASTOMOSIS.
VENOUS RETURN BY PAMPINIFORM PLEXUS
• NERVE SUPPLY FROM UTERINE AND OVARIAN NERVES
 4.OVARY
• OVARIES ARE PAIRED SEX GLANDS , INTRAPERITONEAL ,NULLIPARA OVARIES LIE IN
OVARIAN FOSSA ON LATERAL PELVIC WALL.
• OVARY(3CMX2CMX1CM) IS ATTACHED TO POSTERIOR LAYER OF BROAD LIG. BY
MESOVARIUM, LATERAL PELVIC WALL BY INFUNDIBULO-PELVIC LIG. AND UTERUS
WITH BY OVARIAN LIG.
• OVARIAN FOSSA SUPERIORLY TO THE EXTERNAL ILLIAC VEIN,POSTERIORLY URETER
AND INTERNAL ILIAC VESSELS,LATERALLY PERITONEUM SEPARATING THE OBTURATOR
VESSELS AND NERVE.
• OVARY-1)COVERED WITH SINGLE LAYERS OF CUBICAL EPI. KNOWN AS GERMINAL EPI.
2) CORTEX-STROMAL CELLS ARE THICKENEDBENEATH THE GERMINAL EPI. TO FORM
TUNICA ALBUGINIA. DURING REPRODUCTIVE PERIOD UNDER SEX HORMONES
DIFFERENT STAGES OF FOLLICLES ARE –PRIMORDIAL FOLLICLES,MATURING
FOLLICLES,GRAFIAN FOLLICLES ,CORPUS LUTEUM AND CORPUS ALBICANS ARE
PRESENT IN CORTEX, 3) MEDULLA-FEW MUSCLE FIBRES,LOOSE CONNECTIVE
TISSUE,BLOOD VESSELS AND NERVES AND HILUS CELL( LIKE INTERSTITIAL CELL OF
TESTES).
 OVARY
• OVARY DEVELOPED FROM MESOTHELIAL LAYERS
OF PERITONEUM GENITAL RIDGE. IMMATURE OVA
ORIGINATE FROM CELLS FROM THE DORSAL
ENDODERM OF YOLK SAC.
• BLOOD SUPPLY BY OVARIAN ARTERY, VENOUS
DRAINAGE IS THROUGH PAMPINIFORM
PLEXUS→OVARIAN VEIN→I V C(ON RT. SIDE) AND
LT SIDE TO LT. RENAL VEIN
• NV. SUPPLY - T10 SEGMENT SYMPATHETIC SUPPLY.
OVARY
 FEMALE URETHRA
• IT EXTEND FROM BLADDER NECK TO EXTERNAL URETHRAL MEATUS. LENGTH 4 CM, DIAMETER
6MM , MUCOUS LINED BY TRANSITIONAL EPI. EXCEPT AT EXTERNAL MEATUS STRATIFIED SQ. EPI.
• OPEN 2.5 CM BELOW THE CLITORIS AT VESTIBULE.
• NUMEROUS TUBULAR GLANDS CALLED PARAURETHRAL GLANDS OPEN INTO THE LUMEN
THROUGH THE DUCTS OF WHICH TWO ARE LONGER CALLED SKENCTE’S DUCT -OPEN ON POST
URETHRAL WALL (SKENE’S GLANDS ARE HOMOLOGUS TO PROSTATE IN MALE)
• SPHINCTERS OF URETHRA-1) SPHINCTER URETHRA IN THE UROGENITAL
DIAPHRAGM→VOLUNTARY ARREST OF URINE, 2) AT URETHROVESICLE-JUNCTION THERE IS
INTRICATE DECUSSATION OF INVOLUNTARY MUSCLE→FORMING ANTERIOR AND POSTERIOR
SLINGS→INVOLUNTARY INTERNAL SPHINCTER(LISSOSPHINCTER)→DETRUSSOR
CONTRACTS,SLING RELAX→FUNNELING OF BLADDER NECK→URINE FLOWS INTO URETHRA.
• BLOOD SUPPLY- PROXIMAL PART BY INFERIOR VESICLE AND DISTAL PART BY INTERNAL
PUDENDAL ARTERY.
• NV.-PUDENDAL NV.
• DEVELOPED FROM VESICOURETHRAL PART OF CLOACA.
• SHORT URETHRA LEADS TO FREQUENT CYSTITIS, INJURY DURING CHILD BIRTH AND INFECTION
OF PARA-URETHRAL GLANDS.
 URINARY BLADDER
• BLADDER IS A HOLLOW MUSCULAR ORGAN WITH CONSIDERABLE POWER OF DISTENSION.
• CAPACITY 450 ML BUT MAY UPTO 3-4 L
• DISTENDED BLADDER HAS AN APEX,SUPERIOR SURFACE, BASE, TWO INFEROLATERAL
SURFACE, AND NECK.
• IN THE INTERIOR OF BLADDER AN TRIANGULAR AREA MARMED BY TWO URETERIC OPENING
ON TWO SIDES AND URETHRAL OPENING BELOW-CALLED TRIGONE OF UB.
• NECK RESTS ON SUPERIOR LAYER OF UROGENITAL DIAPHRAGM.
• LAYERS ARE – OUTER VICERAL LAYER OF PELVIC FASCIA,MUSCLE LAYER AND MUCOUS COAT
LINED BY TRANSITIONAL EPI. NO GLAND AND SUBMUCOUS COAT.
• BLOOD SUPPLY THROUGH SUPERIOR AND INFERIOR VESICLE ARTERIES.THE VEINS DRAIN
INTO VESICLE AND VAGINAL VENOUS PLEXUS. LYMPHATICS DRAINS INTO EXTERNAL AND
INTERNAL ILIAC LN
• NV. SUPPLY FROM PELVIC PLEXUS AND PARASYMPATHETIC VIA NERVI
ERIGENTES(S2,3,4).PARASYMPATHETIC PRODUCES DETRUSOR MUSCLE CONTRACTION
AND RELAXATION OF INTERNAL SPHINCTER. SYMPATHTIC CONVEYS AFFERENT PAINFUL
STIMULI UB DEVELOPED FROM UROGENITAL SINUS.
 PELVIC URETER
• IT EXTENDS FROM ITS CROSSING OVER THE PELVIC BRIM TO OPENING INTO UB. 13 CM LENGTH
AND 5 MM DIAMETER
• IT CROSSES THE PELVIC BRIM INFRONT THE BIFURCATION OF COMMON ILIAC ARTERY BEHIND
THE ROOT OF MESENTRY ON RT. SIDE AND BEHIND THE APEX OF MESOSIGMOID ON LT. SIDE.IT
FORMS THE POSTERIOR BOUNDARY OF OVARIAN FOSSA
• IT CROSSED BY UTERINE ARTERY ANTERIORLY 1.5 CM LATERAL TO CX AT THE BASE OF BROAD LIG.
• 3 LAYERS AS UB
• BLOOD SUPPLY – SEGMENTAL SUPPLY VISCERAL BANCHES FROM ANT. DIVISION OF INTERNAL
ILIAC ARTERY. VEINS – UTERINE,VAGINAL,MIDDLE RECTAL, SUPERIOR GLUTEAL.
• LYMPHATICS- EXTERNAL AND INTERNAL ILIAC LN
• NV. SUPPLY- SYMPHATIC-FROM HYPOGASTRIC AND PELVIC PLEXUS, PARASYMPHATIC FROM
SACRAL PLEXUS
• DEVELOPED FROM URETERIC BUD FROM CAUDAL END OF MESONEPHRIC DUCT.
• COMMON SITES OF URETERIC INJURY DURING HYSTERECTOMY ARE -1)INFUNDIBULOPELVIC
LIGAMENT, 2)BY THE SIDE OF THE CX DURING CLAMPING OF CARDINAL LIG. 3)VAGINAL ANGLE
AS THE URETER TRVERSES ALONG THE ANTERIOR FORNIX, 4) DURING PELVIC
PERITONIZATION
 RECTUM AND ANAL CANAL
• IT COMMENCES AT THE LEVEL S3 VERTEBRA AS CONTINUATION OF PELVIC COLON AND ENDS IN ANAL CANAL.
LENGTH 12-15 CM
• RECTUM IS SURROUNDED BY RECTAL FASCIA,MUSCLE COAT CONSISTS OF OUTER LONGITUDINAL AND INNER
CIRCULAR,SUBMUCOUS LAYER IS LOOSE AND CONTAINS VENOUS PLEXUSES, MUCOUS MEMBRANE LINED BY
COLUMNAR EPI.
• ANAL CANAL MEASURES 2.5 CM. AT THE JUNCTION OF UPPER2/3RD AND LOWER 1/3RD IS THE WHITE
LINE(HILTON’S LINE). ANTERIORLY IT IS RELATED TO PERINEAL BODY AND POSTERIORLY TO THE ANOCOCCYGEAL
BODY
• ANAL SPHINCTERS- 1) INVOLUNTARY INTERNAL SPHINCTER IS FORMED BY CIRCULAR MUSCLE LAYER AT UPPER
2/3RD ,2) VOLUNTARY SPHINCTER ANI EXTERNUS WHICH SURROUNDS THE ENTIRE LENGTH HAS THREE PARTS-
SUBCUTANEOUS PART,SUPERFICIAL PART,DEEP PART.
• LINING EPI.- UPPER 2/3RD COLUMNAR EPI. AND LOWER 1/3RD BY STRATIFIED SQ. EPI.
• BLOOD SUPPLY – 1) SUPERIOR RECTAL-BRANCH OF INFERIOR MESENTERIC,2) MIDDLE AND INFERIOR RECTAL-
BRANCH OF INTERNAL ILIAC ARTERY
• VENOUS DRAINAGE – RECTUM AND UPPER 2/3RD OF ANAL CANAL DRAIN VIA SUPERIOR RECTAL VEIN→PORTAL
SYSTEM, LOWER 1/3RD OF ANAL CANAL →INFERIOR RECTAL VEIN →SYSTEMIC CIRCULATION
• NV. SUPPLY- RECTUM AND UPPER 2/3RD OF ANAL CANAL AUTONOMIC NV OF PELVIC PLEXUSES, LOWER 1/3RD BY
INFERIOR HAEMORHOIDAL NV.
• RECTUM AND UPPER 2/3RD OF ANAL CANAL DEVELOPED FROM DORSAL PART OF CLOACA(ENDODERM), LOWER
1/3RD OF ANAL CANAL DEVELOPED FROM ANAL PIT(ECTODERM)
 PELVIC FLOOR (PELVIC DIAPHRAGM)
• IT IS A MUSCULAR PARTITION WHICH SEPARATES THE PELVIC CAVITY FROM
THE ANATOMICAL PERINEUM.
• IT CONSISTS OF THREE SETS MUSCLES ON EITHER SIDE-
PUBOCOCCYGEUS,ISCHIOCOCCYGEUS AND ILIOCOCCYGEUS. THEY ARE
COLLECTIVELY CALLED LEVATOR ANI. IT’S UPPER SURFACE IS COVERED WITH
PARIETAL LAYER OF PELVIC FASCIA AND INFERIOR SURFACE IS COVERED WITH
ANAL FASCIA. MUSCLE WITH COVERING FASCIA IS CALLED PELVIC
DIAPHRAGM. STRACTURE PASSING THROUGH PELVIC DIAPHRAGM ARE
HIATUS UROGENITALIS(URETHRA,VAGINA), HIATUS RECTALIS (ANAL CANAL)
• MUSCLES ARE ORIGINATE FROM PUBIC RAMI,CONDENSED FASCIA COVERING
THE OBTURATOR INTERNUS(WHITE LINE) AND INNER SURFACE OF ISCHIAL
SPINE.
• NV. SUPPLY-S3,S4 SACRAL NV.,INFERIOR RECTAL NV.AND PERINEAL BRANCH
OF PUDENDAL NV(S2,3,4)
PELVIC DIAPHRAGM
 FUNCTIONS OF PELVIC DIAPHRAGM
• SUPPORTS THE PELVIC ORGANS
• COUNTERACTS THE DOWNWARD THRUST OF INCREASED
INTRAABDOMINAL PRESSURE AND GUARDS THE HIATUS
UROGENITALIS
• FACILITATES THE ANTERIOR INTERNAL ROTATION OF
PRESENTING PART
• PUBORECTALIS PLAYS AN ANCILLARY ROLE TO THE ACTION OF
EXTERNAL ANAL SPHINCTER.
• ISCHIOCOCCYGEUS HELPS TO STABILIZE THE SACRO-ILIAC AND
SACRO-COCCYGEUS JOINTS
• TO STEADY THE PERINEAL BODY
 ANATOMICAL PERINEUM
• PERINEUM IS BOUNDED ABOVE BY THE INFERIOR
SURFACE OF THE PELVIC FLOOR , BELOW BY THE
SKIN BETWEEN THE BUTTOCKS AND
THIGH.LATERALLY IT IS BOUNDED BY ISCHIOPUBIC
RAMI,ISCHIAL TUBEROSITIES AND SACROTUBROUS
LIG. AND POSTERIORLY BY COCCYX.
• DIAMOND SHAPED SPACE IS DIVIDED INTO TWO
TRIANGULAR SPACE-ANTERIOR TRIANGL IS CALLED
UROGENITAL TRIANGLE AND POSTERIOR ONE IS
CALLED ANAL TRIANGLE
 UROGENITAL TRIANGLE
• IT IS PIERCED BY THE TERMINAL PART OF VAGINA AND URETHRA
• TWO POUCH- SUPERFICIAL POUCH AND DEEP PERINEAL POUCH
• SUPERFICIAL POUCH – IS FORMED BY DEEP LAYER OF PERINEAL SUPERFICIAL
PERINEAL FASCIA(COLLES FASCIA)AND INFERIOR LAYER OF UROGENITAL
DIAPHRAGM(PERINEAL MEMBRANE). CONTENTS ARE- SUPERFICIAL TRANSEVERSE
PERINEI(PAIRED),BULBOCAVERNOSUS COVERING THE BULBE OF THE
VESTIBULE,ISCHIOCAVERNOSUS(PAIRED)COVERING THE CRURA OF CLITORIS AND
BARTHOLIN GLANDS
• DEEP PERINEAL POUCH- IS FORMED BY THE INFERIOR SUPERIOR LAYERS OF
UROGENITAL DIAPHRAGM.BETWEEN TWO LAYERS ONE SPACE IS 2.5 CM CONTENTS
ARE DEEP TRANSVERSE PERINE(PAIRED),SPHINCTER URETHRAE MEMBRANCAE.
BOTH THE POUCHES CONTAIN VESSELS AND NERVE
• ANAL TRIANGLE –IT CONTAINS TERMINAL PART OF ANAL CANAL SPHINCTER ANI
EXTERNUS,ANOCOCCYGEAL BODY ISCHIORECTAL FOSSA,BLOOD VESSELS NV,
LYMPHATICS.
 BROAD LIGAMENTS
• THE DOUBLE FOLD OF PERITONEUM WHICH EXTENDS FROM THE LATERAL
BORDER OF UTERUS TO THE LATERAL PELVIC WALL OF PELVIS IS CALLED BROAD
LIG. THESE ARE TWO,ONE IN EACH SIDE. TWO LAYERS ANTERIOR AND POSTERIOR
LAYERS.
• ANTERIOR LAYER REFLECTED FORWARDS AT THE LEVEL OF INTERNAL OS AS
UTEROVESICLE POUCH.
• POSTERIOR LAYER DESCENDS A LITTLE DOWN TO COVER THE UPPER 1/3 RD OF
VAGINAL WALL TO FORM POST. LAYER OF POD.
• PARTS OF BROAD LIG. – 1)INFUNDIBULO-PELVIC LIG- FROM INFUNDIBULUM OF
UT. TUBE TO LATERAL PELVIC WALL,CONTAINS OVARIAN
VESSELS,NVS,LYMPHATICS, 2) MESOVARIUM – FOLD OF PERITONEUM FROM
OVARY TO POST. LAYER OF BROAD LIG., VESSELS,LYMPHATICS AND NV. PASSING
TO HILUM OF OVARY, 3) MESOSALPINX- PART BETWEEN UT. TUBE AND OVARY.
CONTAINS TUBO-OVARIN ANASTOMOTIC VESSELS AND VESTIGEAL
REMNANTS.4)MESOMETRIUM- PART BELOW THE MESOSALPINX.
 CONTENTS OF BROAD LIG.
• UT.TUBE
• UTERINE AND OVARIAN VESSELS
• NV., LYMPHATICS
• PROXIMAL PART OF ROUND LIG.
• OVARIAN LIG.
• PARAMETRIUM CONTAINING LOOSE AREOLAR TISSUE AND
FAT,TERMINAL PART OF URETER, UTERINE ARTERYPARACERVICAL NV.
LYMPHATICS PLEXUS
• VESTIGEAL STRUCTURE SUCH AS DUCT OF
GURTNER.EPOOPHORON,PAROOPHORON
• DEVELOPED FROM BROAD TR. FOLD OF TWO MULLERIAN DUCTS
• ACT AS SUPPORT OF UT.