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Female Reproductive System
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Primary sex organ: ovaries
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Genital ducts: uterine tubes, uterus & vagina
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Accessory glands: Greater vestibular (Bartholin’s)
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External genitalia: The vulva
Ovaries
Site:
It usually lies against the lateral wall of the true pelvis in a depression called the ovarian fossa
Relations : . external iliac vessels above
. internal iliac vessels behind
N.B. The position of the ovary is variable
Shape:
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Almond In Shape
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About 4cmx2cm.
2 ends :
Upper (tubal) : is directed up & laterally & attached to:
Ovarian fimbria of the Falopian tube.
Suspensory (infundibulo-pelvic) ligament of the ovary,
Lower (uterine) : is directed down & medially & attached to:
the upper lateral angle of the uterus by the ligament of the ovary.
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2 surfaces:
Lateral : related to the lateral pelvic wall & obturator nerve and vessels (in the floor of the fossa).
Medial : related to fimbriated end of Fallopian tube
Ligaments of the ovary

Suspensory ligaments:
It is a peritoneal fold that extends from the tubal end of the ovary to the side wall of the pelvis.
It transmits the ovarian vessels & nerves from the side wall of the pelvis to the broad ligament.

Mesovarium:
It is peritoneal fold that extends from the upper layer of broad ligament to the anterior border of
the ovary.
. .It transmits the ovarian vessels & nerves to the ovary

Ligament of the ovary:
It is a fibromuscular cord that extends from the uterine end of the ovary to the lateral angle of the
uterus.
Blood supply
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Arterial supply: by the ovarian artery
It is a branch of the abdominal aorta
It anastomosis with the uterine artery
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Venous drainage:
Right ovarian vein drains into the inferior vena cava
Left ovarian vein drains into the left renal vein
Lymphatic drainage
Into the paraortic lymph nodes
Nerve supply
By the Autonomic nervous system
Function
Produces
. . female germ cells= ova
. . female sex hormones =estrogen & progesterone
Uterine Tubes
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Site:
In the medial 4/5 of the upper free border of the broad ligament.
It extendes from the superior angle of the uterus to the ovary on the side wall of the pelvis.
Length: 10 cm.
Course
• It runs laterally & backwards from the uterus to the side wall of the pelvis.
• Then, it curves backwards piercing the upper layer of the broad ligament to end on the medial
surface of the ovary.
Parts: (from medial to lateral)
Intramural (uterine) part:
• It is the shortest (1 cm) and narrowest part.
• It passes through the wall of the supereoateral angle of the uterus to open into the uterine cavity
Isthmus:
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It is 2 cm in length, rounded, narrow and thick-walled.
Ampulla:
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It is the longest (5 cm), thin-walled, tortuous and widest part.
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It is the site of fertilization.
Infundibulum (fimbriated end):
• It is 2cm in length and funnel-shaped.
• It opens into the peritoneal cavity near the ovary.
• Its margins carry fimbria which spread over the medial surface of the ovary.
• The largest fimbria is called the ovarian fimbria which is attached to the upper end of the ovary.
Blood supply:
Arterial supply
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Medial 2/3: by the uterine artery.
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lateral 1/3 : by the ovarian artery.
Venous drainage:
By veins accompanying the arteries into the uterine and ovarian veins.
Lymph drainage:
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Most of the tubal lymphatics pass to the paraortic L.Ns.
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Lymphatics of the isthmus pass to the superficial inguinal L.Ns.
Function
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It receives the ova from the ovary
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It provides site for fertilization of the ova
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It provides nourishment to the fertilized ova
Vagina
It is fibro-muscular tube between the cervix and vestibule (the cleft between the 2 labia minora).
It is directed up & backwards forming a right angle with the uterus.
Relations:
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Anterior wall:
(7 cm)
• Not covered by peritoneum
• Its upper 1/3  is pierced by the cervix.
• Its middle 1/3  is related to the base of U.B.
• Its lower 1/3  is intimately related to the urethra.
Posterior wall: (9 cm)
• Its upper1/4 is covered by peritoneum which is reflected to the rectum to form the rectovaginal (Douglas pouch) which contains coils of ileum
• Its middle 2/4 related to rectum.
• Its lower 1/4 is related to perineal body and anal canal
Lateral relations
Upper part is related to the uterine artery & ureter
Middle part is related to the levator ani muscle (sphincter vaginae)
Fornices of vagina:
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– These are 4 pouches formed by the upper part of vagina around the vaginal part of cervix
– 2 lateral, 1 anterior & 1 posterior
– The posterior fornix is the deepest one & the only one covered by peritoneum
Blood Supply
Arterial supply Uterine artery.
Vaginal artery.
Middle rectal artery.
Internal pudendal artery.
N.B.These arteries Anastomose in front & behind the vagina to form anterior & posterior “azygos
arteries
Venous drainage
The vaginal veins form plexuses that drains into internal iliac vein.
Lymphatic drainage
Upper 1/3  external iliac L.Ns.
Middle 1/3  internal iliac L.Ns.
Lower 1/3  superficial inguinal L.Ns
Nerve supply
Upper 2/3 (pain insensitive)  by autonomic fibers
Lower 1/3 (pain sensitive)  brs. of pudendal nerve
Broad Ligament
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It is a double-layered fold of peritoneum which extends from the side of the uterus to the side
wall of the pelvis.
Parts of the broad ligament:
Mesosalpinx: the part between Fallopian tube & mesovarium & and round ligament of ovary.
Suspensory ligament of ovary: the part lateral to the ovary.
Mesometrium: the remaining medial lower part on the side of the uterus.
 It has:1) 2 layers: upper (posterior) layer: is related to the coils of small intestine, is
connected to the ovary by mesovarium & is pierced by the lateral end of Fallopian tube
 lower (anterior layer)
 2) 4 borders:
 upper free border: its medial 4/5 surrounds Fallopian tube its lateral 1/5 forms the
suspensory ligament of the ovary
 lower border: rests on the pelvic floor
 medial border: attached to the side of the uterus
 lateral border: attached to the side wall of the pelvis
Contents Of The Broad Ligament:
 2 tubes: 1-Fallopian tube: in the medial 4/5 of the upper free border.
2- ureter at root of the ligament.
 2 ligaments: round ligament of ovary & round lig. of uterus.
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 2 arteries: 1)Uterine A. (in the root then along the medial border then along the upper border).
2) Ovarian A. (in the suspensory ligament of ovary).
 sympathetic nerve plexus plexus.
 2 embryological remnants: epioophoron & paraoophoron.
 Connective tissue (parametrium) & lymphatics & L.Ns.
Supporting Factors Of Uterus
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The uterus is supported mainly by: A) muscles
1) The tone of the Pelvic diaphragm (pelvic floor) muscles: levator ani muscles and coccygeus
muscle. resisting downward push of uterus during increased intra-abdominal pressure.
2) Urogenital diaphragm: the muscles of the deep perineal pouch.
3) Perineal body: is a fibromuscular body between the vagina & anal canal; receiving the
insertions of all perineal muscles. Thus, maintains the integrity of the pelvic floor.
Ligaments of the cervix:
1. Transverse cervical (Mackenrodt’s ) cardinal ligament:

It is the main supporting factor of the uterus.
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It a fan-shaped ligament, which is formed of condensed extraperitoneal tissue between the
side wall of the pelvis and side of cervix & vagina.
2. Pubo-cervical ligament:
It is a condensation of extraperitoneal tissue, which extends from the front of cervix & upper part
of vagina to the back of the pubis, around the sides of the urethra.
3. Utero-sacral (sacrocervical) ligament:
It is a condensation of extraperitoneal tissue, which extends from the back of the cervix to the
front of 2nd & 3rd pieces of sacrum, around the sides of the rectum.
4) The round ligament of the uterus,:
which represents the remains of the lower half of the gubernaculum, extends between the
superolateral angle of the uterus, through the deep inguinal ring and inguinal canal, to the
subcutaneous tissue of the labium majus. It helps keep the uterus anteverted (tilted forward) and
anteflexed (bent forward).
5)The round ligament of the uterus and the broad ligament are considered to play a minor role
in supporting the uterus.
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