Reproductive health

1. Dr Anne Ngoiri

2. Female anatomy
 EXTERNAL GENITALIA
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4. INTERNAL REPRODUCTIVE anatomy
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6. A. External Genitalia
• blood supply: internal pudendal artery
• sensory innervation: pudendal nerve
 lymphatic drainage: inguinal nodes
B. Vagina
• muscular canal extending from cervix to vulva, anterior to
rectum, and posterior to bladder
• lined by rugated, stratified squamous epithelium
• upper vagina separated by cervix into anterior, posterior, and
lateral fornices
• blood supply: vaginal branch of internal pudendal artery with
anastomoses from uterine, inferior vesical, and middle rectal
arteries
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7. C. Uterus
• thick walled, muscular organ between bladder and
rectum, consisting of two major parts:
■ uterine corpus
 ◆ blood supply: uterine artery (branch of the internal
iliac artery, anterior division)
■ cervix
 ◆ blood supply: cervical branch of uterine artery
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9. UTERINE SUPPORTS
 Normally is anteverted and anteflexed in position whilst the cervix is at
the level of the ischial spines.
 It’s kept in this position and level by 3 groups of supports:
 UPPER SUPPORTS
 Endopelvic fascia covering the uterus
 Round ligaments ,2 :travel from anterior surface of uterus, through broad
ligaments, and inguinal canals (canal of Nuck) then terminate in the labia
majora
 function: anteversion/suspension
 blood supply: Sampson’s artery (branch of uterine artery running through round
ligament)
 Broad ligament: pass from lateral pelvic wall to sides of uterus; contain
fallopian tube, round ligament, ovarian ligament, nerves, vessels, and
lymphatics
 Note: These are weak supports
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10. Middle supports
▫ Transverse-cervical (mackenrodt’s)
ligaments
▫ Uterosacral ligaments :arise from sacral fascia
and insert into posterior inferior uterus
▫ function: mechanical support for uterus, prevent
prolapse, and contain autonomic nerve fibres
▫ Pubocervical fascia or ligaments
• These form the cardinal support of the uterus; if
weak the uterus descends into the vaginal canal
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11. Lower support
Endopelvic fascia
Pelvic floor: a muscular partition which separates the
pelvic cavity from the anatomical perineum. It consists of
three sets of muscles on either side—pubococcygeus,
iliococcygeus and ischiococcygeus.These are
collectively called levator ani
• These provide indirect supports to the uterus.
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13.  D. Fallopian Tubes
• 8-14 cm muscular tubes extending laterally from the
uterus to the ovary
• interstitial, isthmic, ampullary, and infundibular
segments; terminates at fimbriae
• mesosalpinx: peritoneal fold that attaches fallopian tube
to broad ligament
• blood supply: uterine and ovarian arteries
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15. E. Ovaries
• consist of cortex with ova and medulla with blood
supply
• supported by infundibulopelvic ligament (suspensory
ligament of ovary)
• mesovarium: peritoneal fold that attaches ovary to
broad ligament
• blood supply: ovarian arteries (branches off of aorta),
left ovarian vein (drains into left renal vein), right ovarian
vein (drains into inferior vena cava)
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16.  Because the ovary develops on the posterior abdominal
wall and later migrates down into the pelvis, it carries its
blood supply with it directly from the abdominal aorta.
 The ovarian artery arises from the aorta just below the
renal artery and runs downwards on the surface of the
psoas muscle to the pelvic brim, where it crosses in front
of the ureter and then passes into the infundibulopelvic
fold of the broad ligament.
 The artery divides into branches that supply the ovary
and tube and then run on to reach the uterus, where they
anastamose with the terminal branches of the uterine
artery.
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BLOOD SUPPLY

17. The internal iliac (hypogastic) artery
 This vessel is about 4 cm in length and begins at the
bifurcation of the common iliac artery in front of the
sacroiliac joint. It soon divides into anterior and
posterior branches; the branches that supply the pelvic
organs are all from the anterior division and are as
follows:
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18.  The uterine artery provides the main blood supply to
the uterus. The uterine artery supplies a branch to
ureter as it crosses it and shortly afterwards another
branch is given off to supply the cervix and upper
vagina
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19.  The vaginal artery runs at a lower level to supply the
vagina.
• The vesical arteries are variable in number and supply the
bladder and terminal ureter.
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