This document provides an overview of the anatomy and embryology of the female genital system. It describes the major external and internal structures including the vulva, vagina, uterus, fallopian tubes, ovaries, and related pelvic structures. It also discusses the embryological development of the Mullerian ducts into the internal female reproductive organs and the differentiation of the genital tubercle and folds into the external genitalia. Some common congenital anomalies are also briefly mentioned.

1. Anatomy and Embryology of Female
Genital System
Prof. Diaa El-Mowafi
MBBCh, MSc, MD, PhD
Professor Obstetrics & Gynecology
Fellow, Wayne State University, USA
Fellow, Geneva University, Switzerland

2. Anatomy of female genital system
Female Genital Organs
(1)Vulva
(2)Vagina
(3)Uterus
(4)Tubes
(5)Ovaries
Related Structures
(1)Pelvic floor
(2)Perineum
(3)Anal canal
(4)Pelvic ureter

3. VULVA
(1) Mons Pubis (Veneris):
Mass of fat
Hair
(2) Labia Majora
= Scrotum
Skin
Hair
Sweat & sebaceous Gl.
Termination of round ligaments
Ant. Mons ---Post. Post. Commissure
(3) Labia Minora
= Penile urethra
Hairless, non keratinized, pigmented skin
Connective tissues, no fat, very vascular
Split ant. Prepuce and frenulum of clitoris
Fossa navicularis

4. (4) Clitoris:
= Penis, except
Erectile tissues
Suspensory ligament
Glans---rich in nerve
(5) Vestibule:
Triangle---Apex clitoris
Ext. urinary M.
Vaginal orifice
Bartholin gl. Openings
(6) Ext. Uretheral Meatus:
2 cm post. Clitoris
Skene’s tubules
F. urethera 3-4 cm

5. (7) Hymen:
Mucus membrane
covered by St. Sq. Epith
One or more opening
Annular, cresentic,
biporforate, cribriform
or imperforate
Torn by sex., trauma,
surgery unless elastic with
slight blood
Carunculae myrtiformes
(8) Vestibular Bulbs:
2 erectile collections
= corpus spongiosum

6. (9) Bartholin Glands:
= Bulbouretheral gl.
2 in vestibular bulbs
oval, 1 cm
Duct 1 inch, open at 5 & 7
Normal, not felt or seen
Mucoid, colorless secretion

7. Blood Supply:
Branches from Int. & Ext. Pudendal A.
Lymphatic Drainage:
Inguinal & Femoral LN---Ext. iliac---
Common iliac-----Aortic
Nerve Supply:
- Pudendal
- Ilio-inguinal
- Genital Br. of genito-femoral
- Post. Cutan. N. of thigh

8. VAGINA
Anatomy:
- compressed, distensible
fibromuscular canal.
- Directed upwards &
backwards.
- Curved lower 1/3---60 d---
upper 2/3 130 d.
- Lumen H-shaped.
- Ant. wall 7 cm related to
urethra & bladder, Post. 10
cm. related to DP, rectum &
PP.
- 4 Fornices.

9. Histology:
1- Mucosa:
Rugae
Non-keratinized St. Sq. Epith.
Doderleine’s bacilli act on glycogen
Lactic a. (pH 4-5)
E2 increases thickness and glycogen
No glands but serous transudate
2- Submucosa
3- Muscularis
4- Adventia
Blood Supply:
1- Vaginal a. from Int. iliac.
2- Branches ut. A., Int. pudendal, middle
and inf. rectal.
Lymphatic Drainage: 3/3

10. UTERUS
Anatomy:
1. Muscular, hollow, pear shaped
2. 1X2X3 inches
3. Body, cervix & isthmus
Histology of body:
1- Endometrium
2- myometrium
3- Perimetrium
Histology of cervix:
1- Endocervix
2- Exocervix (Portio-vaginalis)
3- Transformation Zone

11. Uterine ligaments:
(1) Attached to body:
- Round ligaments
- Ovarian ligaments
- Broad ligaments
(2) Cervical ligaments:
- Transverse (Mackenrodt or
cardinal)
- Uterosacral
- Pubocervical
Position of uterus:
- AVF
- RVF
Blood supply:
- Uterine from Int. iliac
- Branch from ovarian

12. FALLOPIAN TUBES
Anatomy:
10 cm divided into:
• Interstitial (intramural)
• Isthmus
• Ampulla
• Fimbria
Histology:
• Endosalpinex
• Muscular layer
• Peritoneal coat
Blood supply:
Branches from uterine and ovarian

13. OVARY
Anatomy:
- 1 X 2 X 3 cm
- Lies in fossa ovarica
- Upper pole----infudibulo-pelvic
- Lower pole----ovarian ligam.
- Ant. Border----mesovarium
- Post. Border---free
Histology:
- Cortex----primary follicles 150-
250000
- Medulla—CT
- Hilum---ovarian vessels, lymph
and nerves via mesovarium

14. Functions of ovary:
1- Ova Production
2- Hormones (E2,
Progesterone, androgen)
Blood supply:
Ovarian (Aorta) & uterine a.
Lymph drainage:
Para-aortic LN.

15. PERINIUM
- Diamond shaped
- Ant.---Symphysis pubis
- Post.---Coccyx
- Lat. Ischial tuberosities &
ischiopubic rami
- Superficially-----skin
- Deep-----pelvic diagphram
Divided:
By imaginary line ( ) ischial tuberosities
1- Urogenital triangle ---ant.
2- Anal triangle----------Post.
Perineal body: in the center

16. Perineal membrane divides urogenital
into:
1- Superficial compartment:
- Crus of clitoris
- Bartholin gl.
- vestibular bulbs
- superficial transverse perineal ms.
2- Deep compartment:
- urethral sphincter ms.
- deep transverse perineal ms.
Anal triangle:
- Ext. anal sphincter
- anus
- ischiorectal fossa

17. ANAL CANAL
- 4 cm
- Ant. ---perineal body
- Post.---levator ani which
separates it from coccyx and
lat. from ischiorectal fossa
- 2 sphincters:
A- Int. anal sphincter (smooth
circular ms. under autonomic NS)
B- Ext. anal sphincter:
- Deep
- Superficial
- Subcutaneous

18. PELVIC URETUR
Anatomy:
- 15-20 cm length, 6-10 mm diameter.
- Begins near sacroiliac joint,
crossing bifurcation of common
iliac, along lat. Pelvic wall ant. To int.
iliac a. & post. to ovarian vessels. At
ischial spines level runs forward &
medially ---bladder in the most inf. Of
broad lig.----crossed by uterine a. at
level of int. OS.

19. Blood supply:
Branches from:
Int. iliac + common iliac + lower aorta +
uterine + vaginal + middle rectal + vesical

20. Dangerous points of the ureter:
- Clamping infundibulo-pelvic lig.
- Clamping uterosacral lig.
- Removal of broad lig. Or cervical tumors.
- Clamping uterine a.
- Presacral neurectomy.
- Peritoneal closure after hysterectomy.
- Vaginal operations for prolapse.
How to protect?
- Preoperative IVP.
- Exposure at pelvic brim.
- Ureteric catheter.
- Clamping lig. & pedicles under vision.
- Cervical fibroids removed intracapsular.

21. EMBERYOLOGY

23. • Both testis & ovary pass through indifferent
stage where they are similar histologically till
7 week although they are genetically
determined.
• Ovaries develop in abdomen at level of 10th &
11th dorsal segment---descent to enter pelvis
by traction of gubernaculum, a fibromuscular
band from lower pole of ovary to inguinal
region.
• Gubernaculum will form ovarian & round
ligaments.

24. • Testis determining factor (TDF): on distal arm of Y
chromosome---differentiate gonds into testis.
• Testosterone Hormone: differentiation of mesonephric
(Wollfian) ducts into epidydimis, vasa effrentia and vas
deferens.
• Mullerian inhibiting factor (MIF): produced by sertoli cells—
suppressing mullerian tube---internal organs develop in
male direction.

25. Development of the genital tract
- Longitudinal groove called Muller’s
groove arise from coelomic epith. on
each side lat. to mesonephric duct.
- Edges fuse to form Mullerian
(paramesonephric) duct.
- Cranial end remains open in the
peritoneal cavity.
- Caudal ends turn medially, pass
caudally side by side to reach
urogenital sinus.
- Each duct now formed of cranial &
caudal vertical parts and middle
horizontal part.

26. - 2 caudal vertical parts fuse to form utero-
vaginal canal. Its caudal end pushes
urogenital sinus to produce Muller’s
tubercle.
- Fallopian tubes develop from the 2
cranial vertical parts.
- Uterus develops from middle horizontal
part & cranial part of uterovaginal canal.
- Vagina develops from 2 origins:
* upper 4/5 from caudal part of
uterovaginal canal.
* lower 1/5 from urogenital sinus.
The hymen is the junction in between.
- After canalization of utero-vaginal canal,
Mullerian columnar epith. is replaced by
migration of sq. epith. from urogenital sinus

27. Development of Ext. Genitalia
(I) Indifferent stage:
- In both sexes, 2 folds develop on
each side of urogenital membrane.
- Inner (uretheral) & outer (genital)
folds
- genital folds forms cranially the
genital tubercle that elongates to form
the phallus.
(II) Differentiation stage:
- Phallus will form clitoris.
- Genital folds will form labia majora.
- Urethral folds will form labia
minora.

28. In female:
Mesonephric (Wollfian) ducts
atrophy to form:
- Kobelt tubules
- Epoophron
- Paraoophron
- Gartner’s duct
Between the 2 layers of broad
lig.

29. Congenital anomalies

30. Thank you