Ovariun. Uterine tube

• Ovaries

  • Paired, almond- shaped organs located in female pelvic cavity

  
• Location of ovaries

  • Ovaries are situated on either side of uterus, bellow fallopian tubes
  • They are found in ovarian fossa: shallow depression on lateral wall of pelvis

  
• Size and shape

  • each ovary is approximately 3-5cm in lenght
  • 1.5 to 3cm in width
  • 1 to 1.5cm in thickness
• Supporting structures of ovaries

  • Ovarian ligament: connects ovary to lateral surface of uterus
  • Suspensory ligament (infundibulopelvic ligament): attaches ovaries to lateral pelvic wall and contains ovarian blood vessels and nerves
  • Mesovarium: part of broad ligament that directly supports the ovary

  
• Position of ovaries are different in nullipara and multipara women

  • In nullipara: ovaries posit is vertical
  • In multipara: ovaries position is horizontal

  
• external features of ovaries

  • in young girls before inset of ovulation ovaries have a smooth surface which is greyish-pink in colour.
  • After puberty, surface becomes uneven, and colour changes from pink to grey
  • Each ovary has: 2 poles (extremities): upper and lower

  2 surfaces: (lateral and medial)

  2 borders: anterior (mesovarian border) + posterior border (free border)

  
• Peritoneal relations of ovary

  • Ovaries are intraperitoneal, except at site where mesovarium attaches
  • Surface of ovary is covered by single layer of cuboidal cells- germinal epithelium
  • Mesovarium: part of broad ligament of uterus that connects anterior border of ovary to posterior layer of broad lig. Conducts vessels + nerves to ovaries
  • Broad ligament: double layer of peritoneum extending from site of uterus to lat wall of pelvis.
  • Suspensory lig of ovary: peritoneal fold that extend from lat aspect of ovary to lateral pelvic wall. Contains ovarian vessels (artery + nerve)

  
• Blood supply of ovaries

  • Ovarian arteries: branch of abdominal aorta. Travel in suspensory ligament
  • Uterine arteries:

  Venous drainage: right ovary drains into inferior vena cava while left drains into left renal veins

  Lymphatics: drain into para-aortic lymph nodes located near lumbar vertebrae

  Sympathetic: fibers from ovarian plexus and renal plexus

  Parasympathetic: fibers from pelvic splanchinc nerves
• gross anatomy of ovaries

  • Surface: covered by single layer of cuboidal epitheliu: germinal epithelium. Underneath epithelium there’s a dense Ct layer- tunica albuginea.
  • Cortex: outer region of ovary which contains ovarian follicles at various stages of developmen (primordial, primary, secondary and mature (graafian) folicles.) Cortex is where ovulation occurs.
  • Medulla: inner region of ovary, which contains blood vessels, lymphatics and nerves embedded in stroma of loose CT

  
• • Upper pole of ovary: related to uterine tube and external iliac vein. Ovarian fimbria and suspensory ligament are attaches.
  • Lower pole: related to pelvic floor. Connected to uterus by ligament of ovary.
  • Anterior border: related to uterine tube. Attached to back of broad ligament of uterus by mesovarium.
  • Posterior (free) border: related to uterine tube and urether.
• Functions of ovaries

  1. Oogenesis: ovaries produce snd release oocytes through oogenesis. during each menstrual cycle typically one oocyte matures and is ovulated.
  2. Hormones secretion: secretes oestrogen and progesterone which regulates menstrual cycle, maintain pregnancy and influence secondary characteristic.
• Uterus

  • Hollow, muscular organ located in female pelvis.
  • Plays role in reproduction, including implantation of fertilised ovum, gestation and childbirth.
• Uterus location, size and shape

  • location: in pelvic cavity between bladder anteriorly and rectum posteriorly.
  • nulliparous women: uterus is app 7.5cm lenght, 5cm width, 2.5cm thicknes. Pear-shaped with a wider upper part and narrower lower part

  
• Anatomical part of uterus

  • Fundus: dome-shaped upper most part of uterus above openings of fallopian tubes. Covered with peritoneum.
  • Body: Main, central portion of uterus, site of embryo implantation and fetus development during pregnancy. Continous with cervical canal at internal os
  • Isthmus: narrow, constricted region bellow body, leading to cervix. 1cm long and marks transition between body and cervix.
  • Cervix: lower, cylindrical part of uterus thst protudes into vagina. 2,5cm long and has an internal os (opening into uterine cavity) and an external os (opening into vagina).

  
• Uterus communicates superiorly with uterine tubes and inferiorly with vagina
• Body of uterus has an:

  • anterior (visicle) surface which is related to urinary bladder; covered with peritoneum and forms posteriosuperior wall of uterovesical pouch
  • posterior (intestinal surface) that is related with coils of terminal ileum and sigmoid colon; covered with peritoneum and forms anterior wall of retrouterine pouch

  
• Uterus has 2 lateral borders which provides attachment to braod ligaments of uterus.

  
• Cornua of uterus is a superiolateral angle of body at its junction with fundus.

  Attachment of: uterine tubes; ligament of ovary and round ligament of uterus

  
• Cervix


  2.5cm long, lower cylindrical part of uterus
• Cervix


  1. Lower part opens into anterior wall of vagina

  2. Dividing it into supravaginal and vaginal parts
• Supravaginal cervix


  • Above vagina
  • Related anteriorly to bladder and posteriorly to rectum and retrouterine pouch
• Vaginal part of cervix


  • Portion that protrudes into vaginal canal
• Cervical canal


  1. Connects external and internal os

  2. Lined with columnar epithelium that secretes mucous

  3. Mucous changes consistency during menstrual cycle facilitating/preventing sperm
• Cervical canal


  • Has anterior and posterior walls with mucosal folds (arbor vitae uteri)
  • Folds of both walls interlock to close the canal
• Peritoneal Ligaments of uterus


  Peritoneal ligaments : these are peritoneal folds, do not provide any support to uterus.

  • Anterior ligament: consists of uretovesical fold of peritoneum.
  • Posterior ligament: retro vaginal fold forming retrovaginal pouch
  • Right and left broad ligaments:
• Fibromuscular (True ligaments)ligaments of uterus

  Provides strctural support

  • Round ligament of uterus
  • Transverse cervical ligament
  • Uterosacral ligament
  • Pubocervical ligament

  
• Parts of broad ligament of uterus

  • Mesometrium: largest; extends from lateral pelvic wall to body of uterus
  • Mesosalpinx: portion enveloping fallopian tubeqs
  • Mesovarium: part that is attached to ovary, holding it in place. Suspensory ligament of ovary: connects ovary and uterine tubes to lateral pelvic wall

  
• Structures in broad ligament of uterus

  • 1 tube: uterine tube
  • 2 ligaments: round lig of uterus + ligament of ovary.
  • 2 vessels: uterine and ovarian vessels
  • 2 nerves: uterovaginal and ovarian plexus
  • 2 embryological remnants: epoophoron and duct of epoophoron + paroophoron
  • Lymphatic + fibroslveolar tissue (parametrium)

  
• Normal position and angulation of uterus

  Is anteverted and anteflexed

  • Anteverted: forward angulation btw cervix and vagina 90degress angle. This prevents uterus from sagging down through vagina.
  • Anteflexion: forward angulation btw body and cervix 120-125degrees angle

  
• Blood supply of uterus

  Arterial: 2 uterine arteries ( branch of internal iliac) and partially from ovarian artery.

  • Uterine artery is tortuous which permits expansion of uterus during pregnancy without stretching the artery.

  It supplies: uterus, vagina, contents in broad ligament, ovary, medial 2/3 of uterine tube.

  Anastomosis with ovarian artery.

  
• Venous drainage and lymphatic of uterus

  • Uterine, ovarian and vaginal veins plexus which drains into internal iliac. Veins forms plexus around lateral border of uterus

  
• Nerve supply of uterus

  • Sympathetic and parasympathetic through inferior hypogastric and ovarian plexus
  • Sympathetic: uterine contraction and vasoconstriction
  • Parasympathetic: inhibition and dilation
• Ovaries and uterus

  
• Uterus n