Ovary

Anatomy of the ovary

1. Topic :- Ovary Anatomy ▪︎ Presented by :- DASHRATH PARIHAR SHETH J.P. GAC, BHAVNAGAR --------☆--------

2. ☆ Ovary :- The ovaries are the female gonads. Size : 4×2 × 3 cm Situation :- Each ovary lies in the ovarian fossa on the lateral pelvic wall. The ovarian fossa is bounded:
1. Anteriorly by the obliterated umbilical artery.
2. Posteriorly by the ureter and the internal iliac artery. Coverings :- Extension of mesovarium forming germinal epithelium, overlying tunica albuginea Parts :- Cortex & Medulla DJ

3. Cortex : outer part consists of: Stroma: connective tissue & stromal cells
Paranchyma: different phases of ovarian follicles. Medulla : Most internal part of the ovary, consists of loose connective tissue and blood vessels entering through hilum from mesenteries.

4. # Position :- The position of the ovary is variable. In nulliparous women, its long axis is nearly vertical, So that the ovary is usually described as having an upper pole and a lower pole. However, in multiparous women, the long axis becomes horizontal; so that the upper pole points laterally and the lower pole medially. DJ

5. # External Features :- Before puberty, the ovaries have smooth surfaces which are greyish – pink in colour. After puberty, the surface becomes uneven and the colour turns to grey from pink. Each ovary have :- Two poles or extremities :- (i) the upper or tubal pole (ii) the lower or uterine pole Two borders :- (i) the anterior or mesovarian border (ii) the posterior or free border Two surfaces :- (i) lateral (ii) medial

6. # Relations :- ☆ Peritoneal Relations : The ovary is almost entirely covered with peritoneum except along the mesovarian or anterior border where the two layers of the covering peritoneum are reflected onto the posterior layer of the broad ligament of the uterus. The ovary is connected to the posterior layer of the broad ligament by a short fold of peritoneum, called the mesovarium . The squamous epithelium of the mesovarium is continuous with the cubical epithelium of the ovary. The mesovarium transmits the vessels and nerves to and from the ovary .

7. ☆ Visceral Relations :- Upper Or tubal pole: It is broader than the lower pole, and is related to the uterine tube and the external iliac vein. The ovarian fimbria and the suspensory ligament of the ovary are attached to the upper pole of the ovary. Lower or uterine pole: It is related to the pelvic floor. It is connected, by the ligament of the ovary, to the lateral angle of the uterus, posteroinferior to the attachment of the uterine tube. The ligament lies between the two layers two layers of the broad ligament of the uterus and contains some smooth muscle fibres. Anterior or mesovarian border: It is straight and is related to the uterine tube and the obliterated umbilical artery. It is attached to the back of the broad ligament of the uterus by the mesovarium, and forms the hilus of the ovary. Posterior or free border: It is convex and is related to the uterine tube and the ureter. Lateral surface: It is related to the ovarian fossa which is lined by parietal peritoneum. This peritoneum separates the ovary from the obturator vessels and nerve. Medial surface: It is largely covered by the uterine tube The peritoneal recess between the mesosalpinx and this surface is known as the ovarian bursa. Only the lower pole and lateral surfaces are not related to uterine tube, remaining two borders, upper pole and medial surface are related to the tube.

8. # Functions :- ○ Production of oocytes: During reproductive life of about 30 years (from puberty to menopause), the ovaries produce alternately one secondary oocyte per month (per ovarian cycle of 28 days). Liberation of oocyte from the ovary is called ovulation. It occurs on or about the 14 th day of the 28-day menstrual cycle. Variations in the length of menstrual cycle are due to variations in the preovulatory phase; the postovulatory phase is constant. An oocyte is viable (capable of being fertilized) for about 12-24 hours ○ Production of hormones: A. Oestrogen is secreted by the follicular and paraluteal cells.
B. Progesterone is secreted by the luteal cells.

9. ◇ Ovarian artery: It arises from the abdominal aorta just below the renal artery. It descends over the posterior abdominal wall and enters the suspensory ligament of the ovary. It sends branches to the ovary through the mesovarium, and continues medially through the broad ligament of the uterus to anastomose with the uterine artery. In addition to ovary, the ovarian artery also supplies the uterine tube, the side of uterus and the ureter ◇ Uterine artery: It gives some branches which reach the ovary through the mesovarium. ☆ Arterial Supply :- DJ

10. ♧ Venous Drainage :- The veins emerge at the hilus and form a pampiniform plexus around the artery. The plexus condenses into a single ovarian vein near the pelvic inlet. This vein ascends on the posterior abdominal wall and drains into the inferior vena cava on the right side and into the left renal vein on the left side. ♧ Lymphatic Drainage :- The lymphatics from the ovary communicate with the lymphatics from the uterine tube and fundus of the uterus. They ascend along the ovarian vessels to drain into the lateral aortic and preaortic nodes. ♧ Nerve Supply :- The ovarian plexus, derived from the renal, aortic and hypogastric plexuses, accompanies the ovarian artery It contains both sympathetic and parasympathetic nerves. Sympathetic nerves (T10, T11) are afferent for pain as well as efferent or vasomotor. Parasympathetic nerves (S2-S4) are vasodilator DJ

11. ¤ Histology :- Histologically, the ovary is made-up of the following parts from without inwards.
1 Germinal epithelium of cubical cells, derived from peritoneum.
2 Tunica albuginea is a thin layer of connective tissue
3 The cortex contains ovarian follicles at various stages of development. Each follicle contains one oocyte One follicle matures every month and sheds an oocyte. Total of 400 oocytes are ovulated in the reproductive life. After the oocyte is liberated, the Graafian follicle is converted into a structure called the corpus luteum. Changes involving formation of ovarian follicles till the degeneration of corpus luteum constitute the ovarian cycle.
4 The hormone, oestrogen, is secreted by follicular cells
of ovarian follicles. Another hormone, progesterone, is produced by the corpus luteum.
5 Medulla has rich vascular connective tissue, containing vessels, nerves and lymphatics. DJ

12. # Clinical Anatomy # • Determination of ovulation: In cases of sterility, the ovulation can be determined by repeated ultra- sonography. • Prolapse of ovaries: Ovaries are frequently displaced to the pouch of Douglas where they can be palpated by a PV or per vaginal examination. • Ovarian cysts: The developmental arrest of the ovarian follicles may result in the formation of one or more small ovarian cysts. Multiple small theca lutein cysts involve both the Ovaries in cases with Stein-Leventhal syndrome. The syndrome is characterised by mild hirsutism, deep voice, secondary amenorrhoea, and cystic enlargement of both the ovaries • Carcinoma of ovary is common, and accounts for 15% of all cancers and 20% of gynaecological cancers. • Ovaries are the commonest site in the abdomen for endometriosis. The endometrial cysts in the ovary are called the chocolate cysts. DJ

13. ☆ THANK YOU ☆ DJ