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Female reproductive organs

Last updated: May 19, 2021

Summarytoggle arrow icon

The female reproductive organs can be divided into the upper genital tract (i.e., uterus, fallopian tubes, ovaries, and cervix) and the lower genital tract (i.e., the vagina and vulva). The upper genital organs and the vagina are located in the pelvis, while the vulva is a part of the perineum. These organs participate in several hormonal and mechanical pathways that are responsible for secondary sexual development and reproduction. The uterine cavity is the site of embryonic implantation and fetal development. The cervix is the lower portion of the uterus and provides a passageway for the expulsion of uterine contents or the entry of spermatozoa into the uterine cavity. The ovaries are paired organs responsible for gametogenesis and sex hormone synthesis in females. In the middle of each menstrual cycle, a mature ovum ruptures out of a Graafian follicle and travels along the fallopian tubes, where it may be fertilized by sperm. The vagina is a hollow muscular structure that receives ejaculate during copulation and serves as a conduit for the expulsion of uterine contents. The vulva is the anterior portion of the perineum and is composed of the labia majora, the labia minora, the clitoris, and the mons pubis. The labia envelop the clitoris, the urethral orifice, and the vaginal introitus.

Function [1]

Gross anatomy [1]

Overview

Structure

  • Uterine fundus: superior, rounded aspect of the uterus
  • Body
    • Uterine horns: site of the opening of the fallopian tubes bilaterally
    • Uterine cavity: triangular; continuous with the uterine tube and internal os
  • Isthmus:
    • Constriction between the body and the cervix
    • Corresponds to the level of the internal os of the uterus
  • Cervix: fibrous, cylindrical part of the distal uterus between the internal and external orifice

Vasculature

Blood vessels of the uterus
Vessel Course Function

Ovarian artery

  • Supplies the proximal portion of the uterine body
Uterine artery
Uterine vein

Ligation of the uterine arteries (e.g., during hysterectomy) carries a risk of ureter injury!

Lymphatics

Lymphatic drainage of the uterus
Structure Drainage Course
Fundus
  • Ovarian vessels
Body and сervix
  • Uterine vessels
  • Obturator nodes
  • Obturator fossa

Innervation [1][2]

Innervation of the uterus
Type Course Function
Sympathetic
Parasympathetic
Viscerosensory


Ligaments

Uterus

The uterus is composed of three layers. From internal to external:

  1. Endometrium: mucosal layer consisting of two layers
    1. Simple columnar epithelium with tubular glands
    2. Connective tissue (stroma)
  2. Myometrium: smooth muscle layer
  3. Perimetrium

Cervix

Composed primarily of fibroelastic connective tissue. Can be divided into:

  1. Endocervix: inner part of the cervix proximal to the uterine external os
  2. Cervical transformation zone: physiologic transition zone between the endocervix and ectocervix
  3. Ectocervix: outer part of the cervix distal to the uterine external os

Embryology [1][3]

Function [1]

Gross anatomy [1]

Overview

Structure

Vasculature

Blood vessels of the fallopian tubes
Course Function
Ovarian artery
Uterine artery
Ovarian veins
Uterine veins

Lymphatics

Innervation

Nerves of the fallopian tubes
Type Course Function
Sympathetic
Parasympathetic
Viscerosensory
  • Afferent fibers follow sympathetic efferent fibers to T11–L1

Ligaments

Microscopic anatomy [1]

The fallopian tubes are made up of three layers. From internal to external:

Embryology [3]

Function

Gross anatomy [1]

Overview

Vasculature

Blood vessels of the ovaries
Course Function
Ovarian artery

Ovarian vein

The Left Gonadal vein is the LonGest.

Lymphatics

Innervation

Ligaments

Microscopic anatomy [1]

Layers of the ovary

Ovarian follicle

The ovarian follicle is a functional unit of the ovaries that matures during the menstrual cycle (see “Folliculogenesis” below).

Embryology

Oogenesis [1]

Steps of oogenesis
Period Events Resulting cell Chromosome count
Fetal period 4th week of gestation
  • Oogonium
Until ∼ 4 weeks before birth
  • Primary oocyte
Until ovulation
During ovulation
  • Secondary oocyte
Until fertilization
Fertilization If it does not occur
If it occurs
  • Ovum

Folliculogenesis [1]

Steps of folliculogenesis
Period Follicle stage Description
Birth
  • Primordial follicle
Puberty
  • Primary follicle
Menstrual cycle: 1st week
  • Secondary follicle
Menstrual cycle: 2nd week
After ovulation
  • Corpus luteum


Primary oocyte arrest occurs in prophase I of meiosis I (think PROphase = PRior to Ovulation).
Secondary oocyte arrest occurs in metaphase II of meiosis II (think METaphase = before egg MET sperm).
Primary oocytes are formed prior to birth to serve as an ovarian reserve.

Function [1]

Gross anatomy [1]

The vagina and vulva collectively make up the lower genital tract.

Vagina

Position

Structures

Hymen atresia causes complete occlusion of the vagina, which obstructs blood flow at menarche, causing primary amenorrhea.

Vulva

Position

  • Location: external to the pelvis
  • Neighboring structures: continuous with the perineum

Structures

  • Labia majora: folds of skin that surround and cover the vaginal ostium and the labia minora
  • Labia minora: folds of hairless skin that surround the vaginal vestibule
  • Vulval vestibule: cavity between the labia minora that contains the vaginal and urethral orifices
    • Greater vestibular glands (Bartholin gland)
      • Homologous to the male bulbourethral glands
      • Secrete alkaline fluid for lubrication
    • Skene glands:
    • Bulbs of the vestibule: erectile tissue that flanks the vaginal orifice
  • Clitoris: anterior to the labia minora; erectile tissue composed of corpora cavernosa

Estrogen stimulates proliferation and keratinization of the vulvar epithelium. Menopause with decreased estrogen levels results in vulvar atrophy.

Vasculature, lymphatics, and innervation of vagina and vulva [1]
Vagina Vulva
Arteries
Veins
Lymphatics

Parasympathetic innervation

Sympathetic innervation
Sensory innervation
Motor innervation

Pudendal nerve block is often used for anesthesia prior to vaginal procedures, childbirth, or episiotomy.

Microscopic anatomy [1]

Vagina

The vagina is a fibromuscular structure with numerous transverse vaginal rugae.

Vulva

Embryology [1]

References:[4]

Ligament Structures connected Description Structures contained

Broad ligament

Round ligament of the uterus

Cardinal ligament

Ovarian ligament
Infundibulopelvic ligament

During ligation of the ovarian artery and vein, care must be taken not to damage the ureter, which is located directly posterior to the infundibulopelvic ligament, close to the medial leaf of the broad ligament.

The Cardinal ligament connects the Cervix with the pelvic wall.

References: [1]

General conditions

Uterine conditions

Cervical conditions

Ovarian conditions

Vaginal and vulvar conditions

  1. Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice. Elsevier Health Sciences ; 2016
  2. Sadler TW. Langman's Medical Embryology. LWW ; 2018
  3. Netter FH. Atlas of Human Anatomy. Saunders W.B. ; 2018
  4. Chapter 36: Female Reproductive System and the Contents of the Female Pelvis. http://www.oganatomy.org/projanat/gross/36/six.htm. Updated: January 1, 2018. Accessed: November 24, 2018.
  5. Gilman S. Neurobiology of Disease. Academic Press ; 2007