Female Pelvic Visceral Organs

Gross March 30 - Female Pelvic Visceral Organs

1. Lecturer: Dante Roel Fernandez RT, M.D.

2. Hollow pear shaped
muscular organ in
which the fertilized
ovum is implanted
until the fetus is
fully developed.
3 inches in length,
2 inches in width
across its free end,
gradually
diminishing to an
inch inferiorly, with
a thickness of 1
inch

3. Parts:
LFundus- the rounded
free upper end above
the attachment of the
fallopian tubes.
fBody- main part of the
uterus.
oCervix- cylindrical
shaped organ about
one inch long that is
connected to the
vagina, separated from
the body above by a
faint groove called the
isthmus.

4. Uterine tubes.
Ligament of the
ovary.
Round ligament

5. It is located in the middle of the pelvis, posterior
at the upper surface of bladder, inferior to the
intestines.
It usually leans towards the right, with the cervix
and the upper part of the vagina being tilted
towards the left.
It is usually dextrorotated.
The myometrium is thick and firm.
Cervix has more fibrous tissue and is more firm.
Mostly covered with peritoneum.
In most women, the long axis of the uterus is
bent forward on the long axis of the vagina to an
angle of 90 degrees, a position called
anteversion, to internal os is 170 degrees a
position is called anteflexion.

7. Inferior surface: the
cervix is inserted
into the vagina
through the
uppermost part of
the anterior wall,
and nearly one half
of the cervix is
within the cavity of
the vagina.

8. Anterior surface: it is
related to the bladder,
nearly flat, with
occasional loop of
intestine.
Covered in peritoneum
Posterior surface:
distinctly convex.
Separated with the
rectum by the upper
portion of the
rectouterine pouch.
Lateral borders:
attachment to both
layers of the broad
ligaments.

9. Two and one half
inch long and is
divided into the
cavity and the body
of the cervix.
Uterine cavity
oTriangular in shape
oUterine tubes enter
via the angles of the
fundus.
oContinuous with the
canal of the cervix

10. Cervical canal
Spindle shaped, its
upper end opens into
the cavity of the
body and is referred
to as the internal os.
The lower ends open
into the vagina and
is called the external
os uteri.

11. Supplied by the
uterine arteries and
partially ovarian
arteries; drained by
similar veins.
Vessels enlarged
during pregnancy.
Uterine vessels
cross over the
ureter adjacent to
the cervix.

12. 1.Serous
(perimetrium)-
peritoneal
covering.
2.Muscular
(myometrium)-
consists of plain
muscle with
fibrous and elastic
tissue abundant in
the cervix. About
half an inch in
thickness

13. 3. Mucous
(endometrium)-
innermost lining of
the uterus.
Attached to the
muscular coat
without a
submucous layer.
Layer undergoing
cyclic changes
during
menstruation.

14. 1.Broad ligaments- dual
layered peritoneal fold
stretching transversely
from the lateral margin
of the uterus to the
lateral pelvic wall.
Extensions:
3.Mesovarium-
peritoneal fold
attaching ovary to
upper part of posterior
layer of broad
ligament.
4.Suspensory ligament
of ovary-
(infundibulopelvic
ligament.

15. Parts of broad
ligament
2.Mesosalphinx-
encloses the
fallopian tube.
3.Mesometrium- part
below attachment
of mesovarium.

16. Contents
2.Round ligament of
uterus.
3.Uterine and ovarian
vessels.
4.Uterine tubes.
5.Ovarian ligaments.
6.Epoophoron and
paraophoron.
7.Lymphatics and
nerves

17. Ligamentum teres
uteri
A long slender band
of muscle mixed
with fibrous tissue.
Represents the lower
part of the
embryonic
gubernaculum ovary.
Goes toward the
deep inguinal ring.
Traverses the
inguinal canal.

18. Utero-sacral
ligament
(sacrocervical
ligament)- markedly
thicked bands of
subserous fascia
running from the
sacral periosteum
and fascia to the
cervix.

19. Cardinal ligament
( transverse cervical,
ligament of
mackenrodt)-
thickened subserous
fascia coming from
the lateral pelvic wall
and attached on
either side of the
lower part of the
cervix and upper part
of the vagina.
Strogest ligament of
the uterus.

20. Pubocervical
ligament- pass to
the cervix from the
posterior surface of
the pubis.

21. Almond shaped
Has a smooth and pink surface in young women,
later becomes puckered due to repeated discharge
of ova.
It is atrophied in elderly women.
Position and relation:
Lies near the sidewall of the pelvis between the
broad ligament and the ureter and is attached to
the upper layer of the broad ligament.
Extremities:
7.Tubal end- immediately behind the external iliac
vein; the terminal part of the uterine tube curls
around it.
8.Uterine end- provides attachment to the ligament
of the ovary.

23. Surfaces:
2.Medial surface- is overlapped by the tube and is
related to an intestinal loop and to the tip of the
vermiform appendix.
3.Lateral surface- is separated by the peritoneum of
the side wall of the pelvis from the umbilical artery,
the obturator nerve and vessels and the obturator
internus muscle.
Borders:
5.Free border- is separated from the ureter by the
peritoneum.
6.Mesovarian- projects into the broad ligament via a
slit in its upper layer, and is held in place by the
mesovarium. The vessels and nerves enter and
leave this border, which is called the hilum of the
ovary.

25. Blood vessels:
2.Ovarian artery- arises from the aorta
proximal to the renal artery and runs
downwards over the posterior wall of the
abdomen. Crosses the external iliac artery an
inch below its origin and enters the
infundibulo-pelvic ligament, descends to the
ovary and divides into branches thaqt enter
through the hilum.
3.Ovarian veins- issue through the hilum and
form a pampiniform plexus around the
artery .

26. Lymph vessels- emerge through the hilum and,
joined by the lymph vessels from the fundus of the
uterus and from the uterine tube.
Nerves- derived from the aortic and renal plexuses.
Ligaments:
4.Ovarian ligament (round ligament of the ovary)- a
thin band of smooth muscle mixed with fibrous
tissue; but is only an inch or an inch and a half in
length; represents the upper part of the
gubernaculum ovary.
5.Suspensory ligament of the ovary- also known as
the infundibulo-pelvic ligament which runs from
the tubal end of the ovary to the lateral pelvic wall.
Contains ovarian blood vessels, lymphatics, and
nerves.

28. Reproductive organs that convey discharged ovum
from ovary to ujterus.
Length- 4 inches
Width- ¼ inch but varies in width at different parts.
It pierces the wall of the uterus medially at the
junction of fundus with the side of the body and
opens into the anterior angle of its cavity.
Divisions:
6.Intramural- part embedded in the wall of the
uterus.
7.Isthmus- proximal to the uterus, about an inch
long, almost straight, narrowest part.

29. 3. Ampulla- the longest and widest part of the
tube comprising 2/3 of the length, slightly
sacculated and convulated, and it is bound
loosely to the peritoneum, site of fertilization.
4. Infundibulum- funnel-shaped lateral end of
the tube. Broken up into a conical fringe of
finger-like processes called fimbrae. The
longest fimbria is adherent to the ovary and
is called the ovarian fimbria.
Blood vessels- branches of the uterine and
ovarian arteries.
Lymph vessels- drain to aortic nodes with the
lymph vessels from the ovary and the fundus
of the uterus.

31. Canal extending from the vulva to the cervix.
Function as organ of copulation and birth
canal.
Parts:
4.Pelvic portion- upper half lying above
urogenital diaphragm. Presents fornices
which are found around the projection of the
cervix into the vagina.
5.Perineal portion- lower half lying below
urogenital diaphragm.

33. Relationships:
1. Anteriorly- superiorly- touches the fundus of the
urinary bladder.
inferiorly- adheres to posterior wall
of the urethra.
2. Posteriorly- superiorly- related to the recto-
uterine pouch of douglas.
inferiorly- perineal body.
3. Laterally- adheres to fibers of urogenital
diaphragm.
Blood vessels: blood supply through branches of
the internal iliac artery- vaginal, uterine, internal
pudendal and middle rectal arteries.
Venous drainage- tributaries of the same name as
the arteries draining iliac veins.

34. Lymphatic drainage:
2.Upper vagina- to the external and internal
iliac nodes.
3.Middle vagaina- into the internal iliac nodes.
4.Lower vagina- to the superficial inguinal
nodes.
Nerve supply: arises from the uterovaginal
plexus.