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Summary OBGYN Notes 5th year medical students

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OBGYN Notes for medical students.

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1. Anatomy of the female reproductive system.

Uterus and cervix

Function:
Uterus: Implantation, protection of fetus, menstruation
Cervix: entry of sperm, menstrual blood ow, secretion of clear and alkaline uid to facilitate
passage of sperm

Gross anatomy:
Topography: within the pelvis,
- uterus is located posterior to the bladder and
anterior to the rectum
- cervix: most distal part of the uterus and
protrudes into the fundus
- most of the uterine body and posterior
supravaginal cervix are covered by peritoneum
Position:
- uterus: anteverted by 90° and ante exed by
120° ( sometimes retro exion in 10% of women
Neighboring structures:
- anterior: uterovesical pouch
- posterior: rectouterine pouch
- laterally: fallopian tubes, fold of peritoneum,
round ligament, ovarian ligament, cardinal
ligament




Fallopian tubes
Function:
- most common site of fertilization
Gross anatomy:
Location:
- extend bilaterally from the horn of the uterus;
contained in the proximal ligament of the
board ligament
Structure
- mbriae, infundibulum, ampulla, isthmus,
intramural




fi fl fl fl fl

,Ovaries
Function:
- site of oogenesis
- sex hormone synthesis: estrogen, progesterone, testosterone
Gross anatomy:
Location: lateral to the uterus and close to the lateral pelvic wall; suspended in the mesovarium
Neighboring structures: close proximity to the cecum and appendix on the right side and the
sigmoid colon on the left side




Innervation: ovarian plexus and uterine plexus

Microscopy anatomy:
Layers:
- outer layer: peritoneum
- capsule (tunica albuginea): thick layer of collagen
- cortex: dense conn. tissue surrounding the ovarian follicles and corpora lutes
- medulla: loose connective tissue containing vessels and nerves
Ovarian follicle: functional unit of the ovaries that matures during the menstrual cycle
- oocyte: each follicle contains a single oocyte
- granulosa cells: form the stratum granulosum
- stimulated by FSH and inhibited by LH
- Theca cells
- interna: androstenedione synthesis
- externa: layer of connective tissue
Vagina and Vulva
Function:
- vagina: menstrual blood passage, childbirth, barrier against ascending infections
- vulva: secretion of alkaline uid for lubrication during sex, sexual arousal
Gross anatomy vagina:
Location: extraperitoneal in the pelvis; extends from the uterus to the vaginal vestibule
Neighboring structures:
- ant: urethra and bladder
- post.: rectum and anal canal
- sup: rectouterine pouch
- distally: pelvic oor and vulva
Structures: vaginal fornix, hy,en

Gross anatomy Vulva:
Location: external to the pelvis
Neighboring structures: cont. with he perineum
Structures: labia majora, minora, vulval vestibule,
clitoris




fl fl

,Ligaments:

, 2. Anatomy of the female pelvis.

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