Repro3 - Anatomy of the Female Reproductive System

Question 1

What are the 4 ligaments of the female reproductive tract?

Answer 1

1. ) Broad Ligament - flat sheet of peritoneum which folds over the internal female genitalia anteriorly and posteriorly
2. ) Ovarian Ligament - connects the ovary to the side of the uterus
   - it lies within the broad ligament
3. ) Suspensory Ligament of Ovary - attaches the ovary to the lateral abdominal wall
   - also lies within the broad ligament
   - contains the ovarian neurovasculature
4. ) Round Ligament - remnant of the embryonic gubernaculum, also lies within the broad ligament
   - originates at the uterine horns and attaches to the labia majora, passing through the inguinal canal

Question 2

5 features of the broad ligament

3 Divisions and Attachments

Answer 2

1. ) Divisions - mesometrium, mesosalpinx, mesovarium
2. ) Mesometrium - surrounds the uterus and covers the external iliac vessels
3. ) Mesovarium - surrounds the ovaries, attaching them to the posterior surface of the broad ligament
   - it encloses the the neurovascular supply of the ovaries
4. ) Mesosalpinx - encloses the Fallopian tubes
   - originates superiorly to the mesovarium
5. ) Attachments - uterus, fallopian tubes, and ovaries
   - also contains the ovarian and uterine arteries

Question 3

4 features of neurovasculature of the ovaries

Blood Supply
Venous Drainage
Innervation
Lymphatic Drainage

Answer 3

1. ) Blood Supply - ovarian artery (abdominal aorta) and uterine artery (internal iliac artery)
2. ) Venous Drainage - left ovarian vein drains into the left renal vein whilst right drains into the IVC
3. ) Innervation - ovarian and uterine plexus (suspensory ligament of the ovaries)
4. ) Lymphatic Drainage - para-aortic lymph nodes

Question 4

What are the 2 pouches present in females their significance?

Answer 4

1. ) Rectouterine Pouch (Pouch of Douglas) - space between the rectum and the uterus
2. ) Uterovesicle Pouch - space between the uterus and the bladder
3. ) Significance - can be a site of fluid collection e.g. in an haemorrhage or infection

Question 5

4 features of the vagina

Function
Blood Supply
Lymph Drainage and Innervation
Clinical Condition

Answer 5

1.) Functions - sexual intercourse, childbirth, menstruation

2. ) Blood Supply- uterine and vaginal arteries (internal iliac artery)
   - vaginal venous plexus –> uterine vein –> internal iliac vein
3. ) Lymph Drainage and Innervation - lymph drains to
   - external iliac nodes (superior region), internal iliac nodes (middle), superficial inguinal nodes (inferior)
   - innervated by the uterovaginal nerve plexus

4.) Thrush - vagina contains lactobacilli (flora) to keep environment acidic to prevent Candida

Question 6

4 features of the cervix

Function
Structure
Neurovasculature
Clinical Condition

Answer 6

1.) Function - facilitates passage of sperm and maintains sterility by frequent shedding and thick cervical mucus

2. ) Structure - ectocervix and endocervial canal
   - external os marks transition of ecto –> endo
   - internal os marks transition of endo –> uterus
   - lined w/ simple columnar epithelium producing mucus
3. Neurovasculature - uterine artery and vein
   - lymph drainage into iliac, sacral, aortic, and inguinal nodes

4.) Cervical Cancer - often occurs in the transitional zone which is close to the external os and where the epithelium changed from cervical to vaginal

Question 7

5 features of the uterus

Function
Structure 
Anatomical Position
Blood Supply
Clinical Condition

Answer 7

1.) Function - maintaining and transporting gametes

2. ) Structure - the fundus (top), body, and cervix
   - comprised of myometrium, endometrium and lined with simple columnar epithelium

3.) Anatomical Position - antiverted between vagina and cervix and antiflexed between cervix and uterus

4. ) Blood Supply - uterine artery (internal iliac artery)
   - ureter runs underneath the uterine artery
5. ) Endometriosis - ectopic endometrial tissue is dispersed along the peritoneal cavity and beyond
   - associated with severe period pain and infertility

Question 8

4 features of the ovaries

Function
Structure
Clinical Condition x2

Answer 8

1. ) Function - where oogenesis occurs
2. ) Structure - has tunica albuginea (fibrous outer structure) and fully enclosed in parietal peritoneum
3. ) Ovarian Cysts - cysts derived from follicles
   - can be asymptomatic or lead to torsion or rupture
   - polycystic ovaries (>10) is a common cause of infertility

4.) Tumours - arise mainly from epithelial components or germ cells

Question 9

4 features of the fallopian (uterine) tubes

Function
Structure
Clinical Condition x2

Answer 9

1.) Function - allows passage of the ovum to the uterus and is where fertilisation occurs

2. ) Structure - has fimbriae to allow a large SA to ‘catch’ the ovum in the peritoneal cavity and channel it to the infundibulum and then continues to the ampulla
   - tubes are also lined with cilia
3. ) Ectopic Pregnancy - abnormal implantation at the ampulla which can lead so a severe haemorrhage
4. ) Blocked Fallopian Tubes - occurs due to scarring in chronic infection leading to infertility

Question 10

3 features of the histology and structure of the vagina

Epithelium
Layers
Fornices

Answer 10

1.) Epithelium - lined w/ stratified squamous epithelium

2. ) Layers - elastic lamina propria (DCT layer)
   - 2 layers of smooth muscle, an inner circular and outer longitudinal layer
   - adventitia, fibrous layer providing additional strength
3. ) Fornices - where the vagina surround the cervix
   - 2 domes, the anterior and posterior fornices
   - posterior fornix acts as a natural reservoir for semen

Question 11

3 features of the vulva

Answer 11

1. ) This is the external genitalia
2. ) Comprised of the labia majora and labia minora
3. ) It is where vulval tumours occur and a site of female genital mutilation