Anatomy of Female Reproductive Tract

James Marion Sims- Father of modern gynaecology

Sims position

The Sims' position is a medical position where a patient lies on their left side with their right hip and knee bent, and their left hip and leg straight. It's also known as the lateral recumbent position or semi-prone position.

The Sims' position is used for a variety of procedures, including: Rectal exams, Enemas, Vaginal wall prolapse exams, and Foley catheter insertion. 

SRY gene present in Y chr....responsible for Male being male.

2nd-week 

Paramesonephricduct-1 pair

Mullerian duct 

AFS classification

Mullerian Anomoly in Females, not in males.

mesonephros-?

sertoli cells? and Ley dig cells?

mullerian Inhibiting substance (MIS) is secreted by?

Uterine cavity formation  

10 weeks - 20 weeks  

Dissolution of septum  

Caudal to cranial  

This diagram is imp. for exam.

what are the ligaments which support uterus?

what determine the position of uterus?

what is flexion and version?

What is fornix?

Need for Mullerian duct in males and Wolffian duct in Females.

Another name for Urogenital sinces

Day 2

PERINEUM  

- ANATOMICAL BOUNDARY: DIAMOND SHAPED SPACE OF THE BONY OUTLET BOUNDED 

 

ABOVE: INFERIOR SURFACE OF PELVIC FLOOR 

BELOW: SKIN BETWEEN BUTTOCKS AND THIGH 

LATERALLY: ISCHIOPUBIC RAMUS, ISCHIAL TUBEROSITIES AND SACROTUBEROUS LIGAMENT 

POSTERIORLY: COCCYX 

THIS DIAMOND SHAPED SPACE OF BONY PELVIC OUTLET IS DIVIDED INTO TWO TRIANGULAR SPACES WITH THE COMMON BASE FORMED BY FREE BORDER OF UROGENITAL DIAPHRAGM  

‣ UROGENITAL TRIANGLE: PIERCED BY THE TERMINAL PART OF THE VAGINA AND URETHRA. IT IS THEN DIVIDED BY ILL DEFINED FASCIA INTO:  

a. SUPERFICIAL PERINEAL POUCH:  

b. DEEP PERINEAL POUCH  

LAYERS OF UROGENITAL TRIANGLE OF THE PERINEUM

Layers of the Anterior Triangle of the Perineum

Skin

Subcutaneous tissue 

-Camper fascia

-Colles fascia

Superficial space

-Clitoris and its crura

-Ischiocavernous muscle

-vestibular muscle

-Bulbocavernous muscle

Greater vestibular gland

-Superficial transvere perineal muscle 

Deep space-perineal membrane 

-Compressor urethrae

-Urethrovaginal sphinctor

PUDENDAL VESSELS AND NERVES  

⁃ Sensory and motor nerves of the perineum , $2-$4 sacral plexus. ‣ The pudendal vessels originate from anterior division of internal iliac artery ‣ Vessels and nerve leave the pelvis through greater sciatic foramen hooking around the ischial spine and sacrospinous ligament to enter the pudendal (Alcock) canal through lesser sciatic foramen. ◦ The nerves and vessels has three branches: clitoral, perineal and internal haemoroidal  

PERINEAL MEMBRANE(UROGENITAL DIAPHRAGM)  

‣ It is a triangular sheet of dense fibromuscular tissue that spans the anterior triangle. ◦ Because of the vagina, it cannot form a continuous sheet to close off the anterior pelvis in women as it does in males Ilt provides support by attaching the vagina and perineal body to the ischiopubic rami to prevent their downward descent. By attaching these structures to the bony outlet it supports the pelvic floor against the effects of increase in intra abdominal pressure  

‣ Musculofascial structures involved are; ‣ Fascia: Two layers of superficial perineal fascia-superticial fatty and deeper layer(Colles Fascia) ◦ Muscles: Superficial and deep transverse perinei[pared)-4 Bulbospongiosus-I Fibres from external urethral sphicter Levator ani- Pubococcygeus[paired)-2 Sphincter anl externus-I Significance: Directly supports the posterior vaginal wall ond indirectly the anterior vaginal wall, bladder, uterus and rectum. It is vulnerable to get damaged during childbirth. A dellberate cut made during delivery is called an Episiotomy.  

‣ PELVIC CELLULAR TISSUE: Fibrofatty tissue and unstriated muscle fibres which fils up the space between the pelvic peritoneum and pelvic floor. It is distributed around the vaginal vault, supravaginal cervix and into layers of broad ligament. ◦ Condensation of these tissues forms the ligaments which extend from the viscera to pelvic side walls forming strong support system.  

Course of ureter  

◦ Enters the pelvis in front of bifurcation of common iliac artery over the sacroiliac joint. ◦ As it enters it lies anterior to internal iliac artery and behind the ovary forming posterior boundary of ovarian fossa. ◦ Further downwards it is crossed by uterine anteriorly ◦ At the level of ischial spine it lies on the pelvic floor and courses forward and medially to enter the ureteric tunnel to lie close to the supravagina portion of cervix(around 1.5 cms lateral to it, ⁃ It then enters the bladder aftfer coursing through the anterior vaginal fornkx ◦ It courses around 2cms into the wall of bladder by piercing the lateral angle before opening into the bladder trigone.  

BREAST  

‣ large modified sebaceous glands.Accessory reproductive organ - Extent: 2nd to 6"h rib in the midclavicular line It lies in subcutaneous tissue over the fascia covering pectoralis major or even beyond to lie over serratus anterior and external oblique., Laterally extends towards the axilla and is known as AXILLARY TAIL OF SPENCE.,  

◦ Mature breast consists of 20% giandular tissue and 80% fat. Each breast has 12-20 lobes, Each lobe has one excretory duct |lactiferous duct) that opens at the nipple. Each lobe has 10-100 lobules. The lining epithelum of the duct is cubical which becomes stratified squamous near the openings. Alveolus is lined by columnar epithelium where milk secretion occurs. 

 ‣ Cooper's ligaments are fibrous septa that extend to the skin to undertying pectoral fascia.