Female Reproductive System 1

1. Female reproductive organs 2. Embryonic development 3. Female internal genital organs: uterine tube SPLANCHNOLOGY Female reproductive system

Female reproductive system, systema genitalia feminina: located in the Female reproductive organs, organa genitalia feminina: internal female genitalia: ovary, ovarium uterine tube, tuba uterina uterus, uterus , vagina external female genitalia (): , mons pubis fleshy lips, et minora pudendi , clitoris vestibule, vestibulum vaginae vestibular bulbs, bulbi vestibuli greater vestibular glands, gll. vestibulares majores (mammary gland), breast, mamma Prof. Dr. Nikolai Lazarov 2 SPLANCHNOLOGY Embryonic development

Embryonic origin – intermediate mesoderm: genital (gonadal) ridge – 5th we. Embryogenesis of genital organs: ovary, ovarium – absence of the SRY gene: the primitive sex cords – Dax-1 receptor o ovarian medulla cortical cords – 7th we.: o primordial germ cells oogonia o follicular cells  coelomic epithelium internal genital organs – induction from Hox genes: ductus mesonephricus (Wolffian duct) o degenerate along with the Wolffian body o Wolffian body rudimentary paraoophoron ductus paramesonephricus(Mülleri) – 6th we. o uterine tube o uterus o superior and inferior vaginal parts external genitalia – mesenchyme 3rd we. tuber genitale, sinus urogenitalis Prof. Dr. Nikolai Lazarov 3 SPLANCHNOLOGY Ovary, ovarium Ovary, ovarium (Gr. oophoron): female gonad produces egg cells (ova) secretes female sex hormones Ovary in situ: lateral part of the pelvis, fossa ovarica almond-shaped organ size: length – 3-4 cm width – 1.5-2 cm thickness – 1-1.5 cm weigth – 6-14 g macroscopic appearance: extremitas uterina et extremitas tubaria facies lateralis et facies medialis margo liber et margo mesovaricus lig. latum uteri, Prof. Dr. Nikolai Lazarov 4 SPLANCHNOLOGY Microscopic anatomy Main components: simple squamous or cuboidal epithelium, the germinal epithelium tunica albuginea – collagen fibers cortical region (zona parenchymatosa) ovarian follicles medullary region (zona vasculosa) stroma ovarii interstitium ovarii hilum ovarii

Prof. Dr. Nikolai Lazarov 5 SPLANCHNOLOGY Cortical region Ovarian follicles: primordial follicles, folliculi ovarici primordiales primary follicles, folliculi ovarici primarii secondary follicles, folliculi secundarii Regnier de Graaf mature (graafian) follicles, (1641-1673) folliculi ovarici vesiculosi (Graafi)

Prof. Dr. Nikolai Lazarov 6 SPLANCHNOLOGY Vessels of the ovary Blood supply to the ovary : a. ovarica – lig. suspensorium ovarii lig. latum uteri tunica vascularis a. uterina – r. ovaricus Venous drainage: plexus venosus ovaricus v. ovarica v. cava inf.

Prof. Dr. Nikolai Lazarov 7 SPLANCHNOLOGY Lymphatic drainage of the ovary

Lymph vessels along the blood vessels Lateral aortic and pre-aortic (para-aortic) lymph nodes, nodi lumbales paraaortales

Prof. Dr. Nikolai Lazarov 8 SPLANCHNOLOGY Innervation of the ovary Ovarian plexus, plexus ovaricus: postganglionic sympathetic fibers from plexus aorticus abdominalis parasympathetic nerve fibers autonomic afferent fibers

Prof. Dr. Nikolai Lazarov 9 SPLANCHNOLOGY Uterine tube, tuba uterina Uterine tube (oviduct), tuba uterina (Gr. salpinx), (Falloppio): two muscular tubes length 10-12 (5-20) cm diameter 3-4 – 8-9 mm Anatomical parts: pars uterina – 1 cm ostium uterinum tubae – d=1 mm isthmus tubae uterinae – 3-5 cm ampulla tubae uterinae – 6-8 cm infundibulum tubae uterinae ostium abdominale tubae, d=2-3 mm fimbriae tubae; fimbria ovarica appendices vesiculosae

Prof. Dr. Nikolai Lazarov 10 SPLANCHNOLOGY Microscopic anatomy tunica mucosa – longitudinal mucosal folds: lamina epithelialis – simple columnar ciliated epitheliocyti ciliati epitheliocyti microvilosi lamina propria mucosae: blood and lymphatic vessels, nerves tunica muscularis – smooth muscle: (stratum longitudinale int.) – in pars uterina stratum circulare – 0.2 mm stratum longitudinale tunica serosa – peritoneum

Prof. Dr. Nikolai Lazarov 11 SPLANCHNOLOGY Vessels of the uterine tube Blood supply to the uterine tube : r. tubarius a. uterinae r. tubarius a. ovaricae Venous drainage: homonymous veins plexus venosus uterinus

Prof. Dr. Nikolai Lazarov 12 SPLANCHNOLOGY Innervation of the uterine tube

Ovaric plexus, plexus ovaricus – postganglionic sympathetic fibers Uterovaginal plexus, plexus uterovaginalis – parasympathetic fibes – nn. splanchnici pelvici Sensory fibers of spinal origin

Prof. Dr. Nikolai Lazarov 13 SPLANCHNOLOGY Uterus or womb Uterus, uterus (Gr. metra, hystera): thick muscular chamber Topography and external appearance: in the pelvis, between the and rectum excavatio rectouterina excavatio vesicouterina (cavum Douglassi) pear-shaped organ weight – 30-45 g size: length – 7-8 cm width – 5 cm thickness – 2.5 cm two surfaces: facies vesicalis facies intestinalis margo uteri, sinister and dexter Prof. Dr. Nikolai Lazarov 14 SPLANCHNOLOGY Uterus, uterus Macroscopic anatomy: anatomical parts: body, corpus uteri – ⅔ o fundus, fundus uteri isthmus, isthmus uteri neck, (collum) uteri – ⅓ o portio supravaginalis o portio vaginalis cervicis , cavitas uteri: canalis cervicis uteri ostium uteri o labium anterius o labium posterius • fornix vaginae

Prof. Dr. Nikolai Lazarov 15 SPLANCHNOLOGY Uterine position Normal position: anteflexion, anteflexio uteri anteversion, anteversio uteri lateroposition – most often left-sided The pathological changes of the position: retroflexion and retrocession abnormal anteflexion

Prof. Dr. Nikolai Lazarov 16 SPLANCHNOLOGY Uterus support Major of uterus: lig. teres uteri – 10-12 cm lig. cardinale (transversum colli) lig. sacrouterinum lig. anterior (plica vesicouterina) lig. posterior (plica rectovaginalis) lig. latum uteri: mesovarium o o paraoophoron parametrium lig. ovarii proprium

Prof. Dr. Nikolai Lazarov 17 SPLANCHNOLOGY Uterine wall tunica serosa () tela subserosa tunica muscularis () – smooth muscle tissue stratum subserosum stratum supravasculosum – circular and longitudinal muscle fibers stratum vasculosum – circular and spiral muscle fibers stratum submucosum – absent in the cervix; longitudinal muscle fibers tunica mucosa (): plicae palmatae – in the cervix lamina epithelialis – simple columnar epithelium epitheliocyti ciliati epitheliocyti microvilosi stratified squamous nonkeratinized epithelium portio vaginalis cervicis lamina propria mucosae: deciduocyti, gll. uterinae et gll. cervicales Prof. Dr. Nikolai Lazarov 18 SPLANCHNOLOGY Microscopic anatomy Cyclic changes of the endometrium: basal layer – 1 mm thick functional layer Phases of the menstrual cycle: desquamative, menstrual phase proliferative or follicular (estrogenic) secretory (luteal) premenstrual phase

Prof. Dr. Nikolai Lazarov 19 SPLANCHNOLOGY Uterine vessels Arterial supply : ovary artery, a. ovarica uterine artery, a. uterina Venous drainage: plexus venosus uterinus Lymphatic drainage: fundus lumbar and para-aortal lymph nodes corpus and cervix iliac lymph nodes, inguinal lymph nodes

Prof. Dr. Nikolai Lazarov 20 SPLANCHNOLOGY Innervation of the uterus Uterovaginal plexus, plexus uterovaginalis: parasympathetic nerves – nn. splanchnici pelvici sympathetic nerves from inferior hypogastric plexus sensory fibers from thoracic nerves ХІ and ХІІ

Prof. Dr. Nikolai Lazarov 21 SPLANCHNOLOGY

to be continued ...

Thank you .... Prof. Dr. Nikolai Lazarov 22