Uterus, Tubes, Ovaries, Vagina

UTERUS, UTERINES TUBES,
OVARIES & VAGINA
By: Dr. Mujahid Khan

Female Genital Organs
• Ovary
• Uterine Tubes
• Uterus
• Vagina
OVARY
• Oval shaped
• Measuring 4×2 cm
• Usually lies in ovarian fossa against the

lateral wall of the pelvis
• Bounded by the external iliac vessels

above and internal iliac vessels behind
Variable Positions
• Position is extremely variable

• Often found hanging in the rectouterine
Pouch (Pouch of Douglas)
• During pregnancy the enlarging uterus
pulls the ovary up in the abdominal cavity
• After childbirth when the broad ligament is
lax, it takes up a variable position in the
pelvis
Coverings
• Surrounded by a thin fibrous capsule,

Tunica Albuginea
• Capsule is covered by peritoneum called

germinal epithelium
• This epithelium does not give rise to ova

Support
• Attached to the back of the broad ligament
by mesovarium
• Suspensory ligament of the ovary is the

part of broad ligament between the
mesovarium and lateral wall of pelvis
• Round ligament of the ovary represents

the remains of upper part of
gubernaculum, connects lateral margin of
uterus to ovary
Appearance
• Is smooth before puberty
• Progressively scarred after puberty due to

degenerated corpora lutea
• After menopause is shrunken and surface

is pitted with scars
Functions
• Production of female germ cells OVA
• Production of female sex hormones,

ESTROGEN & PROGESTERONE
Blood Supply
• Ovarian Artery, from the abdominal aorta

arises at the level of 1st lumbar vertebra
• Ovarian vein drains into the inferior vena

cava on the right side and into the left
renal vein on the left side
Lymph Drainage
• Follow the ovarian artery and drain into the

para-aortic nodes at the level of 1st lumbar
vertebra
Nerve Supply
• Nerve supply is derived from the aortic

plexus and accompanies the ovarian
artery
• Enter the hilum of the ovary via the

mesovarium
UTERINE TUBES
• Are two, one on each side
• 10 cm long
• Lie in the upper border of the broad ligament
• Connects the peritoneal cavity with the uterine

cavity
Parts
• Infundibulum: Funnel shaped lateral end, have
fimbriae
• Ampulla: Widest part
• Isthmus: Narrowest part
• Intramural part: The segment that pierces the

uterine wall
Function
• Receives ovum from the ovary
• Provides a site for fertilization
• Provides nourishment for the fertilized

ovum
• Transport the Ovum to the uterine cavity

Blood Supply
• Uterine artery from the internal iliac artery
• Ovarian artery from the abdominal aorta
• Veins correspond to the arteries

Lymph Drainage
• Lymph vessels follow the corresponding

arteries and drain into the internal iliac and
para-aortic nodes
Nerve Supply
• Sympathetic and parasympathetic from

the inferior hypogastric plexus
Uterus
• Pear shaped
• Hollow
• Thick muscular wall
• In nulliparous adult: 8 cm long, 5 cm wide,

2.5 cm thick
Parts
• Fundus: Lies above the entrance of the
uterine tubes
• Body: Lies below the entrance of the

uterine tubes
• Cervix: Pierces the anterior wall of the

vagina, divided into supra vaginal and
vaginal parts of the cervix
Cavity
• Is triangular in shape
• Cervical canal communicates with the

cavity of the body through internal os
• Communicates with vagina through

external os which is circular before the
birth of first child
Relations
• Anteriorly: Uterovesical pouch, superior
surface of bladder
• Posteriorly: Rectouterine pouch (Pouch of

Douglas) with coils of ileum
• Laterally: Broad ligament, uterine vessels,

Uterine tubes, round ligaments of ovary
Function
• Serves as a site for the reception,

retention, and nutrition of fertilized ovum
Position
• Its long axis is bent forward in most females,
known as anteversion of the uterus
• Anteflexion: bent forward at the level of

internal os
• It is retroverted in some females, body is

bent backward
Structure
• Covered with peritoneum except anteriorly
• Myometrium or muscular wall is thick,

made up of smooth muscle
• Mucous membrane lining the body is

known as Endometrium continuous above
with the mucous membrane of uterine
tubes
Endometrium
• Endometrium is applied directly to the

muscle there being no submucosa
• Endometrium undergoes extensive

changes during menstrual cycle in
response to the ovarian hormones
Blood Supply
• Uterine artery, a branch of internal iliac

artery
• It gives off small descending branch that

supplies the cervix and vagina
• Veins drain into the internal iliac vein

Lymph Drainage
• Fundus drain into the para-aortic nodes
• Body and cervix drain into the internal &

external iliac lymph nodes
• From round ligament drain into the

superficial inguinal lymph nodes
Nerve Supply
• Sympathetic and parasympathetic nerves

from branches of inferior hypogastric
plexus
Support of the Uterus
• Levator ani muscle and perineal body
• Transverse cervical ligament
• Pubocervical ligaments
• Sacrocervical ligaments
• Round ligament of the uterus

Vagina
• Is a muscular tube
• Extends upward and backward from vulva
to the uterus
• Measures about 8 cm long
• Has anterior and posterior walls
• Upper end is pierced by cervix
• Cervix projects downward and backward
• Upper half lies above the pelvic floor and
lower half lies within the pelvis
Fornices of Vagina
• The area of the vaginal lumen, which

surrounds the cervix is divided into 4
regions or fornices
• Anterior, posterior, right lateral and left

lateral
Hymen
• Hymen is a thin mucosal fold in the virgin

vaginal orifice
• Is perforated at its centre
• After child birth it consists only of tags

Relations
• Anteriorly: Bladder above and urethra

below
• Posteriorly: Pouch of Douglas, ampulla of

the rectum, perineal body
• Laterally: ureter, levator ani muscle,

Functions
• Serves as the excretory duct for the

menstrual flow
• Forms part of the birth canal

Blood Supply
• Vaginal artery, a branch of internal iliac

artery
• Vaginal branch of uterine artery
• Veins drain into the internal iliac vein

Lymph Drainage
• Upper third drains into the internal and

external iliac nodes
• Middle third drains into internal iliac nodes
• Lower third into the superficial inguinal

nodes
Nerve Supply
• Nerve supply of vagina is from the inferior

hypogastric plexuses
Support of Vagina
• Levator ani muscles
• Transverse cervical ligament
• Pubocervical ligament
• Sacrocervical ligament
• Urogenital diaphragm (middle third)
• Perineal body (Lower part)

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UTERUS, UTERINES TUBES,

OVARIES & VAGINA

By: Dr. Mujahid Khan

• Usually lies in ovarian fossa against the

• Bounded by the external iliac vessels

• Position is extremely variable

• Surrounded by a thin fibrous capsule,

• Capsule is covered by peritoneum called

• This epithelium does not give rise to ova

• Suspensory ligament of the ovary is the

• Round ligament of the ovary represents

• Is smooth before puberty

• Progressively scarred after puberty due to

• After menopause is shrunken and surface

• Production of female germ cells OVA

• Production of female sex hormones,

• Ovarian Artery, from the abdominal aorta

• Ovarian vein drains into the inferior vena

• Follow the ovarian artery and drain into the

• Nerve supply is derived from the aortic

• Enter the hilum of the ovary via the

• Are two, one on each side

• Lie in the upper border of the broad ligament

• Connects the peritoneal cavity with the uterine

• Ampulla: Widest part

• Isthmus: Narrowest part

• Intramural part: The segment that pierces the

• Provides a site for fertilization

• Provides nourishment for the fertilized

• Transport the Ovum to the uterine cavity

• Uterine artery from the internal iliac artery

• Ovarian artery from the abdominal aorta

• Veins correspond to the arteries

• Lymph vessels follow the corresponding

• Sympathetic and parasympathetic from

• Thick muscular wall

• In nulliparous adult: 8 cm long, 5 cm wide,

• Body: Lies below the entrance of the

• Cervix: Pierces the anterior wall of the

• Cervical canal communicates with the

• Communicates with vagina through

• Posteriorly: Rectouterine pouch (Pouch of

• Laterally: Broad ligament, uterine vessels,

• Serves as a site for the reception,

• Anteflexion: bent forward at the level of

• It is retroverted in some females, body is

• Myometrium or muscular wall is thick,

• Mucous membrane lining the body is

• Endometrium is applied directly to the

• Endometrium undergoes extensive

• Uterine artery, a branch of internal iliac

• It gives off small descending branch that

• Veins drain into the internal iliac vein

• Fundus drain into the para-aortic nodes

• Body and cervix drain into the internal &

• From round ligament drain into the

• Sympathetic and parasympathetic nerves

• Transverse cervical ligament

• Round ligament of the uterus

• The area of the vaginal lumen, which