This presentation discusses the anatomy of female genital tract and the clinical associations

1. Obstetric Anatomy
-Dr Pooja Ostwal
-Department of Obstetrics and Gynaecology
Seth GSMC & KEM Hospital, Mumbai

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3. External Genitalia
UG Lecture, SGSMC & KEM Hospital,
Mumbai

4. External Genital Organs

5. Vulva
UG Lecture, SGSMC & KEM Hospital,
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Blood supply:
Arterial:
Internal Pudendal A. (chiefly)
Branches of Femoral A .also
Venous:
Internal pudendal vein
Long Saphenous vein

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Mumbai
Vulva
Nerve Supply:
• Ilioinguinal nerve
• Genital branch of Genitofemoral nerve (L1,L2)
• Pudendal branches from Posterior Cut Nerve of Thigh (S123)
• Labial and Perineal branches of Pudendal nerve (S234)
Lymphatics
• Superficial Inguinal nodes
• Gland of Cloquet
• External and Internal Iliac lymph node

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Vulva
Development:
• External genitalia: cranial aspect of ectodermal cloacal fossa
• Clitoris: Genital Tubercle
• Labia minora : Genital folds
• Labia majora: Labio-scrotal swelling
• Vestibule: Urogenital Sinus

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Internal Genital Organs

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Vagina
• Fibro-musculo-membranous sheath communicating the uterine cavity
with exterior at vulva
• Organ of copulation and forms birth canal during parturition
• Directed upward and backwards forming angle of 45 degrees (with
horizontal in erect posture)
• Long axis of vagina lies parallel to the plain of pelvic inlet and
perpendicular to the uterus
• Walls: Four (7cms and 9 cms)
• Fornices: Four (posterior is deepest)
• Layers: Four (Mucous, sub-mucous, muscular, fibrous)

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Internal Genital Organs; cross section

11. Vagina
• Secretions: Acidic (Dodderlein’s bacilli- pH varies with
estrogenic activity)
• Blood supply:
– Vaginal A.
– Branch of Uterine A.
– Internal Pudendal A.
– Middle Rectal A.
• Veins:
– Internal Iliac vn.
– Internal Pudendal vn.

12. • Lymphatics:
– Internal Iliac group
– Superficial Inguinal group
• Nerve:
– Sympathetic and Parasym: Pelvic Plexus
– Somatic: Pudendal nerve
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Vagina

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• Development: All 3 germ layers
• Upper 4/5th
:
• Mucosa: Endoderm of canalised sinovaginal bulb
• Musculature: Mesoderm of 2 fused Mullerian Ducts
• Lower 1/5th
: Endoderm of urogenital sinus
• External genital orifice: Genital fold of Ectoderm
Vagina

14. • Hollow pyriform muscular organ situated in pelvis
• Position: Anteversion, Anteflexion, usually dextro-rotated,
so that cervix is levorotated (left ureter)
• 8 x 5 cms; 50-80 gms
• Parts:
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Uterus

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Mumbai

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Uterus

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Mumbai

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Mumbai
Uterus

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Relations of the Uterus

20. Supports of UterusSupports of Uterus

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Vagina

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Mumbai

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Mumbai
Blood Suppply of Uterus

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• Vein: Internal Iliac Vein
• Lymphatics:
– Uterus:
• Fundus and upper part: Pre-aortic and Lateral
Aortic
• Cornu: Superficial Inguinal glands
• Lower part: External Iliac
– Cervix:
• External Iliac and Obturator and Paracervical
• Int. Iliac
• Sacral group

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•Nerves:
•Sympathetic: T5 to L1
•Parasympathetic: S234 ends in Ganglia of
Frankenhauser
•Somatic: T10 to L8
•Cervix is insensitive to touch, heat
•Development: Fused vertical part of two Mullerian
Ducts

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Mumbai
Fallopian Tubes
•Paired structures, 10cms long, in the upper free margin
of broad ligament
•Three layers

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•Blood supply: Uterine A. and Ovarian A.
•Venous drainage- Pampiniform plexus into Ovarian vein
•Tube is very sensitive to handling
•Development: corresponding Mullerian duct at 6-12
weeks

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Mumbai
Ectopic

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Ovary
•Paired sex gland concerned with germ cells , their storage
and release and steroidogenesis
•2 ends: Tubal and Uterine
•2 surfaces: medial and lateral
•Lies in ovarian fossa on the lateral pelvic wall
•Attached to pelvic wall by infundibulopelvic ligament and
to uterus by ovarian ligament
•Consists of cortex and medulla

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•Arterial supply: Ovarian A.
•Venous drainage:
•Right: into IVC
•Left: into Left renal vein at right angle
•Lymphatics: Para-aortic LN
•Development: Genital ridge

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Pelvic Floor
•Muscular partition separating the pelvic cavity from
anatomical perineum-Levator Ani+Coccygeous+Piriformis

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Pelvic Floor

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Perineal Body
•Pyramidal shaped tissue where the pelvic floor, the
perineal muscles and the fascia meet
•In between vagina and anal canal
•Measures 4 x 4 cms

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•Structures:
• Muscles:
•Superficial and Deep Transverse
Perinei paired
•Bulbospongeosus
•Levator Ani
•Sphincter Ani
•Fascia:
•Superficial
• Deep (Colle’s fascia)

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Ureter
• Measures 13 cms in length
• Clinically important because of crossing of the ureter
over important structures
• Forms posterior boundary of ovarian fossa
• Lies over the pelvic floor at the level of ischial spine
• Crossed by Uterine A. anteriorly at the base of broad
ligament
• Lies close to the supra vaginal part of the cervix

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Accessory Reproductive Organ- Breast
•Structures:
•Areola
•Nipple
•15-20 lactiferous ducts
•Myo-epithelial cells
•Blood supply: Lateral Thoracic A. and Internal
Mammary A.

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Mumbai

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Mumbai