anatomy of the female reproductive system liu wei department of ob & gy ren ji hospital
TRANSCRIPT
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Anatomy of the Female Reproductive System
Liu WeiDepartment of Ob & Gy
Ren Ji hospital
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Introduction Pelvis Pelvic floor External genitalia Internal genitalia Vessel and nerve and lymph Adjacent organs
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Pelvis
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Pelvis Bony pelvis
os ilium
髂骨
os coccyx
尾骨
os sacrum
骶骨
os pubis
耻骨os ischium
坐骨
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Pelvis Joints
Sacro-iliac joint
骶髂关节
Sacro-coccygeal joint
骶尾关节
Symphysis pubica
耻骨联合
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Pelvis
Ligaments1. Sacrospinous ligament 骶棘韧带 Extend from the lateral border of the sacr
um and coccyx to the spine of the ischium
2. Sacrotuberous ligament 骶结节韧带 Extend from the posterior aspect of the l
ower 3 sacral vertebrae to the ischial tuberosity
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Pelvis Pelvic divisions (iliopectineal line
髂耻线 )1. False pelvis (pelvis major)2. Ture pelvis (pelvis minor) Bony birth canal the Pelvic inlet, the pelvic out let and the pelvic
cavity
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Pelvis
Types of pelvis1. The gynecoid type ( 女型骨盆 ) round, slightly ovoid or elliptical inlet. ad
equate sacrosciatic notch. wide interspinous diameters(≥10cm). 52%-58.9%
2. The platypelloid type ( 扁平型骨盆 ) distinct oval inlet. very wide subpubic ar
ch. 23.2%-29%
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Pelvis
3. The anthropoid type ( 类人猿型骨盆 ) long, narrow, oval inlet. extended and n
arrow anterior and posterior segment. wide sacrosciatic notch. long , narrow sacrum. Straight side walls.
4. The android type ( 男型骨盆 )
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Pelvic floor The tissues closing down the pelvic o
utlet (muscles and fasciae) suspend and support the pelvic organs, suc
h as uterus and bladder and rectum Posterior part (urogenital triangle) urethra and vagina pass through Anterior part (anal triangle) rectum pass through
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Pelvic floor Tissues1. Outer layerBulbocavernosus 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 )2. mid layer urogenital diaphragm 泌尿生殖膈
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Pelvic floor
3. Inner layer (pelvic diaphragm 盆膈 )1) the main support of the pelvic floor2) formed by the levator ani and coccygen
us muscles and covering fasciae.3) Levator ani: pubococcygenus ( 耻尾肌 ), i
liococcygenus ( 髂尾肌 ), puborectalis ( 坐尾肌 )
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Pelvic floor Perineumgeneral conception: the tissues closing
down the pelvic outlet
Clinical conception: the tissues
between vagina and anus.
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External genitalia
mons pubis
阴阜Labium majus
大阴唇Clitotis
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
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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 t
he frenulum labiorum pudendal ( 阴唇系带 ) posteriorly, by the urethra and clitoris anteriorly, by the hymenal ring inferiorly.
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Internal genitalia
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Internal genitalia
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Internal genitalia Vagina1. strong canal of muscle (7.5cm) extend from the uterus to the vestibule of the external ge
nitalia. 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.
2. vaginal fornix the circular cul-de-sac formed around the cervix 4 regions: the anterior fornix, the posterior fornix and 2 l
ateral fornices.
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Internal genitalia3. Wall structure1) mucosal layer (stratified squamous epitheliu
m) 2) muscular layer (3 layer)3) submucous area ( with a dense plexus of veins
and lymphatics)
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Internal genitalia
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Internal genitalia Uterus1. Pear-shaped,thick-walled,
muscular organ2. Body and cervix: Babyhood 1:2, manhood 2:13. Isthmus uteri connect the body to cervix, 1cm
(non-pregnancy)
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Internal genitalia4. Layers of uterine wall1) 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 o
f Douglas)2) The muscular layer Outer layer (longitudinal fibers) Inner layer (interlaced and various directions)
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Internal genitalia
3) The mucous layer (endometrium)compact layer: response to hormone periodi
cally, a single layer of ciliated columnar epithelium
spongy layer: response to hormone periodically. contains many tubular glands
funous: non-response to hormone periodically
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Internal genitalia
Cervix1. lower 1/3 of uterus. connects uterus
to vagina via endocervical canal
2. External os: opening of endocervical canal to ectocervix
3. Internal os: indistinct upper limit of endocervical canal
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Internal genitalia Ligaments1. Broad ligament2. Round ligament3. Cardinal ligament4. Utero-sacral ligament
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Internal genitalia Oviduct1. Anatomy1) Interstitial portion:2) Isthmic portion: narrow3) Ampulla: wide and tortuous4) Fimbria: funnel-shaped mouth
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Internal genitalia
2. Layers of wall1) Serous2) Muscular: outer longitudinal
and inner circular 3) Mucous: ciliated columnar
epithelium, coarse longitudinal folds
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Internal genitalia Ovary1. Anatomy1) Paired organ, elliptic2) The suspensory ligament of the ov
ary3) The ovarian ligament
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Internal genitalia
2. Structure of ovary1) Covered by cuboid or low columnar epit
helium2) Consist of a cortex and a medulla3) Cortex: oocytes in various stages of mat
urity.4) Medulla: fibers, smooth muscle cells, bl
ood vessel, nerves.
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Vessel and nerve and lymph
Blood vessel1. The ovarian artery1) Orginated as branches of the abdo
minal aorta, (left: left renal artery).2) Turn over the common iliac artery
and ureter,descend into the pelvis. Enter into ovary through the mesovarium
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Vessel and nerve and lymph
2. The uterine artery1) a terminal branch of the hypogastric art
ery2) Cross the ureter near the cervix (2cm)3) Ascend along the lateral border of the ut
erus4) uterine body branch and cervix-vagina
branch
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Vessel and nerve and lymph
3. Vaginal artery4. Internal Pudendal artery
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Vessel and nerve and lymph
Lymph1. External genitalia1) superfical inguinal gland ( 腹股沟浅淋巴
结 )2) deep inguinal gland ( 腹股沟深淋巴结 )
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Vessel and nerve and lymph
2. Pelvic lymph1) iliac lymph common iliac, internal iliac and
external iliac 2) Anterior Sacral lymph3) Lumbar lymph: abdominal aorta
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Adjacent organs
Urethra Urinary bladder Ureter Rectum Vermiform appendix
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Adjacent organs
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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?
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