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Female Reproductive Organs

  1. Female reproductive organs include external and internal genital organs. External genital system is also known as Vulva, includes mons pubis, labia majora, labia minora, clitoris, vestibule of vagina, bulbs of vestibule and great vestibular glands (Bartholin's gland).
  2. Internal genital organs comprise ovaries, uterine (fallopian) tube, uterus (including cervix) and vagina.


The ovaries are female gonads. Each ovary lies in the ovarian fossa on the lateral pelvic wall which is bound anteriorly by obliterated umbilical artery and posteriorly by ureter and internal iliac artery. Each ovary has two poles (upper and lower), two borders (anterior and posterior) and two surfaces (medial and lateral).

  1. Upper pole (tubal end) is related to ovarian fimbria of fallopian tube and external iliac artery. Suspensory ligament of ovary (infundibulopelvic ligament) connects it with pelvic brim.
  2. Lower pole (uterine end) is connected with lateral angle of uterus by ligament of the ovary, just posteroinferior to the attachment of fallopian tube.
  3. Lateral surface is related to ovarian fossa and is covered with peritoneum which separates it from Obturator vessels and nerve.
  4. Medial surface is related to fallopian tube and is separated by a peritoneal recess, called ovarian bursa.
  5. Anterior border (mesovarian border) is straight and related to fallopian tube and obliterated umbilical artery. It is attached to posterior surface of broad ligament of uterus by mesovarium and forms the hilus of ovary.
  6. Posterior border (free border) is convex and is related to fallopian tube and ureter.
Only lower pole and lateral surface are not related to fallopian tube, remaining two borders, upper pole and medial surface are related to fallopian tube.

Blood supply and lymphatic drainage

  1. Ovary is supplied by ovarian artery, a branch of aorta. It addition to ovary, ovarian artery also supply fallopian tube, side of uterus and ureter. Minor blood supply to ovary also comes from uterine artery.
  2. Venous drainage is through ovarian vein. Right ovarian vein drains into IVC and left ovarian vein drains into left renal vein.
  3. Lymphatic drainage is into para-aortic (lateral aortic) nodes at L1.

Nerve supply

Ovaries are predominantly supplied by the sympathetic nerves, from T10-T11 segments via aortic plexus. Sensory fibers accompany the sympathetic nerves, so that ovarian pain may be referred to periumblical area. Ovarian pain may also refer along distribution of obturator nerve on medial side of thigh because obturator neurovascular bundle lie lateral to ovary in ovarian fossa. Some parasympathetic fibers may also reach ovary from inferiorHypogastric plexus.

Fallopian Tube (Uterine Tube)

  1. Fallopian tubes are present in upper free margins of broad ligament of uterus. Each tube is 10 cm long. Each tube is divided into 4 parts, from lateral to medial.
    1. Infundibulum: - It is lateral end and possesses fimbriae, therefore also called as fimbriated end. It opens into abdominal cavity through abdominal ostium. One of the fimbriae is longer and is attached to upper (tubal) pole of ovary. It is known as ovarian fimbria.
    2. Ampulla: - It is lateral2/3rd (6-7 cms) of the tube. Ampulla is the site of fertilization and is the longest part of fallopian tube.
    3. Isthmus: It forms medial l/3rd (2-3 cm) of tube.
    4. Intramural part (uterine or interstitial part):- It is about 1 cm long and opens at superior angle of uterine cavity by uterine ostium.
  2. Living epithelium of uterine cavity is ciliated columnar epithelium.
  3. The blood supply is through uterine artery (medial 2/3 of tube and ovarian artery (lateral 1/3 of tube).
  4. Lymphatics drains into para-aortic (lateral aortic) nodes, joining the lymphatics of ovary. The lymphatics from isthmus drain into superficial inguinal nodes.


  1. Uterus is a thick-walled hollow muscular organ, situated obliquely in the lesser pelvis between the urinary bladder (in front) and rectum (behind). Uterus is pear shaped (pyriform). Its dimensions are 7.5 cm (length), 5cm (breath) and 2.5 cm (thickness) and weight is 30-40 gm. The uterus is subdivided into three parts from above downwards: fundus, body and cervix.
  2. Fundus is the part of body which lies above the entrance of two uterine tubes. Body extends from the fundus to its junction with cervix at isthmus which corresponds with internal os of cervix. Cervix of uterus lies below the isthmus and is subdivided by vaginal wall into supra-vaginal and vaginal parts.

The superolateral angle of the body projects outwards at the junction of body and fundus and is called Cornua of uterus. The fallopian (uterine) tube, ligament of ovary and round ligament are attached to it on each side.

  1. Cervical canaL (cavity of cervix) communicates above with cavity of the body of uterus through internal os and below with vaginal cavity through external os. Cervix is about 2.5 cm long.
  2. Uterine cavity is lined by ciliated columnar epithelium and cervical canal is lined by non-ciliated simple columnar epithelium.

Description: C:\Users\ashwani\Pictures\ashwani sir\GraysAnat 40th ed\section 8\fig77.12.jpeg

Blood supply and lymphatic drainage

  1. The chief blood supply of uterus is through uterine artery, a branch of anterior division of internal iliac artery. Partly ovarian arteries also supply uterus.
  2. Lymphatic drainage is as follows-
    1. Cervix (lower lymphatics); - Lymphatics drain into external iliac, internal iliac and sacral nodes.
    2. Lower part of body (middle lymphatics); - Lymphatics drain into the external iliac nodes.
    3. Fundus and upper part of body (upper lymphatics); - Lymphatics drain mainly into para-aortic nodes and a few lymphatics from the uterine cornu accompany the round ligaments to reach the superficial inguinal nodes.

Nerve supply


The uterus is supplied by both systems, sympathetic and parasympathetic. Sympathetic system fibers arise from T12, L1 segments and carry painful sensations from the body of uterus. Parasympathetic fibers arise from S2, S3, S4 (in pelvic splanchnic nerve) and carry painful sensations from cervix.


Description: C:\Users\ashwani\Pictures\ashwani sir\GraysAnat 40th ed\section 8\fig77.19.jpeg


Supports of the uterus


The normal position of the uterus is one of the anteflexion and anteversion, i.e. the fundus and upper part of the body bent forward in relation to the long axis of the cervix (angle of anteflexion: normal 125°), while the organ thus leans forward as a whole from the vagina (angle of anteversion: normal 90°).

  • The most fixed part of the uterus is the cervix, because of its attachment to the back of the bladder and to the vaginal fornix and a number of structures help directly or indirectly to maintain the normal position. The supports of uterus are -

Supports of uterus

Primary supports

Muscular supports (active supports)         

  1. Pelvic diaphragm (levator ani)
  2. Perineal body
  3. Distal urethral sphincter mechanism

Fibromuscular supports (mechanical supports)

  1. Uterine axis
  2. Pubocervical ligaments
  3. Transverse cervical ligaments of Mackenrodt
  4. Uterosacral ligaments
  5. Round ligament of uterus


Secondary supports

These are of doubtful value and are formed by peritoneal ligaments.


These are broad Iigaments, Vesicouterine pouch and rectovaginal (rectouterine) pouch.


Broad ligament

  1. The right and left broad ligaments are folds of peritoneum which attach the uterus to lateral pelvic wall. The ovary' attached to posterior surface of broad ligament through the mesovarium. The part of broad ligaments between the uterine tube and ligament of ovary is called the mesosalpinx, while the part below the ligament of ovary is called the mesometrium. The part of the broad ligament that stretches from the upper pole of the ovary and the infundibulum of uterine tube to lateral pelvic wall is called the suspensory ligament of the ovary (or infundibulopelvic ligament),
  2. The broad ligament contains
    1. Fallopian (uterine) tube;
    2. Round ligament of uterus.
    3. Ligament of ovary,
    4. Uterine vessels,
    5. Ovarian vessels (in infundibulopelvic ligament),
    6. Uterovaginal and ovarian nerve plexuses
    7. Epoophoron and its duct,
    8. Parophoron.
    9. Lymphatics and
    10. Dense connective tissue or parametrium.

Description: C:\Users\ashwani\Pictures\ashwani sir\GraysAnat 40th ed\section 8\fig77.20.jpeg


  1. The vagina is a fibromuscular canal forming the female copulatory organ. It extends from vulva to uterus. Mucous membrane is lined by non-keratinized stratified squamous epithelium. There are no glands in vaginal mucosa. It is kept moist by the cervical glands from above and great vestibular gland below. The anterior wall is about 8 cm long and the posterior wall is about 10 cm long. The lumen is circular at the upper end because of the protrusion of the cervix into it. Below the cervix, anterior and posterior walls are in contact. The interior of the upper end of the vagina (or vaginal vault) is in the form of a circular groove that surrounds the protruding cervix. The groove becomes progressively deeper form before backwards and is arbitrarily divided into four parts called the vaginal fornices:
  2. Anterior fornix lies in front of the cervix and is shallowest.
  3. Posterior fornix lies behind the cervix and is deepest.
  4. Two lateral fornices lie one on each side of the cervix. Lateral fornix is related to the transverse cervical ligament of pelvic fascia in which are embedded a network of vaginal vein and the ureter gets crossed by the uterine artery.  
  1. Relations of vagina
    Anterior wall
    1. Upper half is related to the base of the bladder.
    2. Lower half to the urethra.
  2. Posterior wall
    1. Upper one-fourth is separated from the rectum by the rectouterine pouch.
    2. Middle two-fourth is separated from the rectum by loose connective tissue.
    3. Lower one-fourth is separated from the anal canal by the perineal body and the muscles attached to it.
  3. Lateral walls
    One each side:
    1. Upper one-third is related to the transverse cervical Iigament of pelvic fascia in which are embedded a network vaginal veins, and the ureter gets crossed by the uterine artery.
    2. Middle one-third is related the pubococcygeus part of the levator ani.
    3. Lower one-third pierces the perineal membrane, below which it is related to the bulb of the vestibule, the bulbospongiosus and the duct of greater vestibular gland of Bartholin’s.
  4. Arterial supply
    Vaginal branch of internal iliac (main supply)
    1. Cervicovaginal branch of uterine artery (in upper part).
    2. Middle rectal and internal pudendal arteries (in lower part).

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