Anatomy-of-the-female-reproductive-system

AnatomyoftheFemaleReproductiveSystemLiuWeiDepartmentofOb&GyRenJihospitalIntroductionPelvisPelvicfloorExternalgenitaliaInternalgenitaliaVesselandnerveandlymphAdjacentorgansPelvisPelvisBonypelvisosilium髂骨oscoccyx尾骨ossacrum骶骨ospubis耻骨osischium坐骨PelvisJointsSacro-iliacjoint骶髂关节Sacro-coccygealjoint骶尾关节Symphysispubica耻骨联合PelvisLigaments1.Sacrospinousligament骶棘韧带Extendfromthelateralborderofthesacrumandcoccyxtothespineoftheischium2.Sacrotuberousligament骶结节韧带Extendfromtheposterioraspectofthelower3sacralvertebraetotheischialtuberosityPelvisPelvicdivisions(iliopectinealline髂耻线)1.Falsepelvis(pelvismajor)2.Turepelvis(pelvisminor)BonybirthcanalthePelvicinlet,thepelvicoutletandthepelviccavityPelvisTypesofpelvis1.Thegynecoidtype(女型骨盆)round,slightlyovoidorellipticalinlet.adequatesacrosciaticnotch.wideinterspinousdiameters(≥10cm).52%-58.9%2.Theplatypelloidtype(扁平型骨盆)distinctovalinlet.verywidesubpubicarch.23.2%-29%Pelvis3.Theanthropoidtype(类人猿型骨盆)long,narrow,ovalinlet.extendedandnarrowanteriorandposteriorsegment.widesacrosciaticnotch.long,narrowsacrum.Straightsidewalls.4.Theandroidtype(男型骨盆)PelvicfloorThetissuesclosingdownthepelvicoutlet(musclesandfasciae)suspendandsupportthepelvicorgans,suchasuterusandbladderandrectumPosteriorpart(urogenitaltriangle)urethraandvaginapassthroughAnteriorpart(analtriangle)rectumpassthroughPelvicfloorTissues1.OuterlayerBulbocavernosusmuscle(球海绵体肌)Ischiocavernosusmuscle(坐骨海绵体肌)Superficialtransverseperinealmuscle(会阴浅横肌)Externalanalsphincter(肛门外括约肌)2.midlayerurogenitaldiaphragm泌尿生殖膈Pelvicfloor3.Innerlayer(pelvicdiaphragm盆膈)1)themainsupportofthepelvicfloor2)formedbythelevatoraniandcoccygenusmusclesandcoveringfasciae.3)Levatorani:pubococcygenus(耻尾肌),iliococcygenus(髂尾肌),puborectalis(坐尾肌)PelvicfloorPerineumgeneralconception:thetissuesclosingdownthepelvicoutletClinicalconception:thetissuesbetweenvaginaandanus.Externalgenitaliamonspubis阴阜Labiummajus大阴唇Clitotis阴蒂Labiumminus小阴唇Urethralorifice尿道口Vaginalorifice阴道口Vaginalvestibule阴道前庭Fossanavicularis舟状窝Perinealbody会阴体Anus肛门ExternalgenitaliaLabiamajoraThevenousdrainageisextensiveandformsaplexuswithnumerousanastomoses.VulvahematomaVaginalvestibuleBorderedbythelabiaminoralaterally,bythefrenulumlabiorumpudendal(阴唇系带)posteriorly,bytheurethraandclitorisanteriorly,bythehymenalringinferiorly.InternalgenitaliaInternalgenitaliaInternalgenitaliaVagina1.strongcanalofmuscle(7.5cm)extendfromtheuterustothevestibuleoftheexternalgenitalia.itslongaxisisalmostparallelwiththatofthelowerpartofthesacrum.theanteriorwallofthevaginais1.5-2cmshorterthantheposteriorwall.2.vaginalfornixthecircularcul-de-sacformedaroundthecervix4regions:theanteriorfornix,theposteriorfornixand2lateralfornices.Internalgenitalia3.Wallstructure1)mucosallayer(stratifiedsquamousepithelium)2)muscularlayer(3layer)3)submucousarea(withadenseplexusofveinsandlymphatics)InternalgenitaliaInternalgenitaliaUterus1.Pear-shaped,thick-walled,muscularorgan2.Bodyandcervix:Babyhood1:2,manhood2:13.Isthmusutericonnectthebodytocervix,1cm(non-pregnancy)Internalgenitalia4.Layersofuterinewall1)Theserouslayer(perimetrium)ThinandfirmlyadherentoverthefundousandmostofthebodyUterovesicalpouchoftheperitoneumRectouterinepouchoftheperitoneum(pouchofDouglas)2)ThemuscularlayerOuterlayer(longitudinalfibers)Innerlayer(interlacedandvariousdirections)Internalgenitalia3)Themucouslayer(endometrium)compactlayer:responsetohormoneperiodically,asinglelayerofciliatedcolumnarepitheliumspongylayer:responsetohormoneperiodically.containsmanytubularglandsfunous:non-responsetohormoneperiodicallyInternalgenitaliaCervix1.lower1/3ofuterus.connectsuterustovaginaviaendocervicalcanal2.Externalos:openingofendocervicalcanaltoectocervix3.Internalos:indistinctupperlimitofendocervicalcanalInternalgenitaliaLigaments1.Broadligament2.Roundligament3.Cardinalligament4.Utero-sacralligamentInternalgenitaliaOviduct1.Anatomy1)Interstitialportion:2)Isthmicportion:narrow3)Ampulla:wideandtortuous4)Fimbria:funnel-shapedmouthInternalgenitalia2.Layersofwall1)Serous2)Muscular:outerlongitudinalandinnercircular3)Mucous:ciliatedcolumnarepithelium,coarselongitudinalfoldsInternalgenitaliaOvary1.Anatomy1)Pairedorgan,elliptic2)Thesuspensoryligamentoftheovary3)TheovarianligamentInternalgenitalia2.Structureofovary1)Coveredbycuboidorlowcolumnarepithelium2)Consistofacortexandamedulla3)Cortex:oocytesinvariousstagesofmaturity.4)Medulla:fibers,smoothmusclecells,bloodvessel,nerves.VesselandnerveandlymphBloodvessel1.Theovarianartery1)Orginatedasbranchesoftheabdominalaorta,(left:leftrenalartery).2)Turnoverthecommoniliacarteryandureter,descendintothepelvis.EnterintoovarythroughthemesovariumVesselandnerveandlymph2.Theuterineartery1)aterminalbranchofthehypogastricartery2)Crosstheureternearthecervix(2cm)3)Ascendalongthelateralborderoftheuterus4)uterinebodybranchandcervix-vaginabranchVesselandnerveandlymph3.Vaginalartery4.InternalPudendalarteryVesselandnerveandlymphLymph1.Externalgenitalia1)superficalinguinalgland(腹股沟浅淋巴结)2)deepinguinalgland(腹股沟深淋巴结)Vesselandnerveandlymph2.Pelvicly