1. Anatomy of the Female Reproductive System
Liu Wei
Department of Ob & Gy
Ren Ji hospital

2. Introduction Pelvis Pelvic floor External genitalia Internal genitalia
Vessel and nerve and lymph
Adjacent organs

3. Pelvis

4. Pelvis Bony pelvis os ilium 髂骨 os sacrum 骶骨 os coccyx 尾骨 os pubis 耻骨
os ischium 坐骨

5. Sacro-coccygeal joint
Pelvis
Joints
Sacro-iliac joint
骶髂关节
Sacro-coccygeal joint
骶尾关节
Symphysis pubica
耻骨联合

6. Pelvis Ligaments Sacrospinous ligament 骶棘韧带
Extend from the lateral border of the sacrum and coccyx to the spine of the ischium
Sacrotuberous ligament 骶结节韧带
Extend from the posterior aspect of the lower 3 sacral vertebrae to the ischial tuberosity

8. Pelvis Pelvic divisions (iliopectineal line 髂耻线)
False pelvis (pelvis major)
Ture pelvis (pelvis minor)
Bony birth canal
the Pelvic inlet, the pelvic out let and the pelvic cavity
Ture pelvis is located below the iliopectineal line, bounded anteriorly by the pubic bones, posteriorly by the sacrum and coccyx, laterally by the ischium and a small segment of the ilium.

10. Pelvis Types of pelvis The gynecoid type (女型骨盆)
round, slightly ovoid or elliptical inlet. adequate sacrosciatic notch. wide interspinous diameters(≥10cm). 52%-58.9%
The platypelloid type (扁平型骨盆)
distinct oval inlet. very wide subpubic arch. 23.2%-29%

12. Pelvis The anthropoid type (类人猿型骨盆)
long, narrow, oval inlet. extended and narrow anterior and posterior segment. wide sacrosciatic notch. long , narrow sacrum. Straight side walls.
The android type (男型骨盆)

13. Pelvic floor
The tissues closing down the pelvic outlet (muscles and fasciae)
suspend and support the pelvic organs, such as uterus and bladder and rectum
Posterior part (urogenital triangle)
urethra and vagina pass through
Anterior part (anal triangle)
rectum pass through

15. Pelvic floor Tissues Outer layer mid layer urogenital diaphragm 泌尿生殖膈
Bulbocavernosus muscle (球海绵体肌)
Ischiocavernosus muscle (坐骨海绵体肌)
Superficial transverse perineal muscle (会阴浅横肌)
External anal sphincter (肛门外括约肌)
mid layer
urogenital diaphragm 泌尿生殖膈

16. Pelvic floor Inner layer (pelvic diaphragm 盆膈)
the main support of the pelvic floor
formed by the levator ani and coccygenus muscles and covering fasciae.
Levator ani: pubococcygenus (耻尾肌), iliococcygenus (髂尾肌), puborectalis (坐尾肌)

17. Pelvic floor
Perineum
general conception: the tissues closing down the pelvic outlet
Clinical conception: the tissues between vagina and anus.

18. External genitalia mons pubis 阴阜 Labium majus Clitotis 大阴唇 阴蒂
Labium minus
小阴唇
Urethral orifice
尿道口
Vaginal orifice
阴道口
Vaginal vestibule
阴道前庭
Fossa navicularis
舟状窝
Perineal body
会阴体
Anus 肛门

19. External genitalia Labia majora
The venous drainage is extensive and forms a plexus with numerous anastomoses. Vulva hematoma
Vaginal vestibule
Bordered by the labia minora laterally, by the frenulum labiorum pudendal (阴唇系带) posteriorly, by the urethra and clitoris anteriorly, by the hymenal ring inferiorly.

20. Internal genitalia

21. Internal genitalia

22. Internal genitalia Vagina strong canal of muscle (7.5cm)
extend from the uterus to the vestibule of the external genitalia. its long axis is almost parallel with that of the lower part of the sacrum. the anterior wall of the vagina is 1.5-2cm shorter than the posterior wall.
vaginal fornix
the circular cul-de-sac formed around the cervix
4 regions: the anterior fornix, the posterior fornix and 2 lateral fornices.

23. Internal genitalia Wall structure
mucosal layer (stratified squamous epithelium)
muscular layer (3 layer)
submucous area ( with a dense plexus of veins and lymphatics)

24. Internal genitalia

25. Internal genitalia Uterus Pear-shaped,thick-walled, muscular organ
Body and cervix:
Babyhood 1:2, manhood 2:1
Isthmus uteri
connect the body to cervix, 1cm (non-pregnancy)

26. Internal genitalia Layers of uterine wall
The serous layer (perimetrium)
Thin and firmly adherent over the fundous and most of the body
Uterovesical pouch of the peritoneum
Rectouterine pouch of the peritoneum (pouch of Douglas)
The muscular layer
Outer layer (longitudinal fibers)
Inner layer (interlaced and various directions)

27. Internal genitalia The mucous layer (endometrium)
compact layer: response to hormone periodically, a single layer of ciliated columnar epithelium
spongy layer: response to hormone periodically. contains many tubular glands
funous: non-response to hormone periodically

28. Internal genitalia Cervix
lower 1/3 of uterus. connects uterus to vagina via endocervical canal
External os: opening of endocervical canal to ectocervix
Internal os: indistinct upper limit of endocervical canal

29. Internal genitalia Ligaments Broad ligament Round ligament
Cardinal ligament
Utero-sacral ligament

31. Internal genitalia Oviduct Anatomy Interstitial portion:
Isthmic portion: narrow
Ampulla: wide and tortuous
Fimbria: funnel-shaped mouth

33. Internal genitalia Layers of wall Serous
Muscular: outer longitudinal and inner circular
Mucous: ciliated columnar epithelium, coarse longitudinal folds

34. Internal genitalia Ovary Anatomy Paired organ, elliptic
The suspensory ligament of the ovary
The ovarian ligament

36. Internal genitalia Structure of ovary
Covered by cuboid or low columnar epithelium
Consist of a cortex and a medulla
Cortex: oocytes in various stages of maturity.
Medulla: fibers, smooth muscle cells, blood vessel, nerves.

37. Vessel and nerve and lymph
Blood vessel
The ovarian artery
Orginated as branches of the abdominal aorta, (left: left renal artery).
Turn over the common iliac artery and ureter,descend into the pelvis. Enter into ovary through the mesovarium

39. Vessel and nerve and lymph
The uterine artery
a terminal branch of the hypogastric artery
Cross the ureter near the cervix (2cm)
Ascend along the lateral border of the uterus
uterine body branch and cervix-vagina branch

40. Vessel and nerve and lymph
Vaginal artery
Internal Pudendal artery

41. Vessel and nerve and lymph
External genitalia
superfical inguinal gland (腹股沟浅淋巴结)
deep inguinal gland (腹股沟深淋巴结)

42. Vessel and nerve and lymph
Pelvic lymph
iliac lymph
common iliac, internal iliac and external iliac
Anterior Sacral lymph
Lumbar lymph: abdominal aorta

43. Adjacent organs Urethra Urinary bladder Ureter Rectum
Vermiform appendix

44. Adjacent organs

45. Answer the questions
How many types of pelvis are there? What are they?
What is perineum?
What is vaginal vestibule?
How many ligaments of uterus are there? What are they?
How many ligaments of ovary are there? What are they?
What is uterine isthmus?

46. END