Ovary, Paraovarian Tissue – Cyst
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Chapter 28 *Lecture Powepoint
Chapter 28 *Lecture PowePoint The Female Reproductive System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • The female reproductive system is more complex than the male system because it serves more purposes – Produces and delivers gametes – Provides nutrition and safe harbor for fetal development – Gives birth – Nourishes infant • Female system is more cyclic, and the hormones are secreted in a more complex sequence than the relatively steady secretion in the male 28-2 Sexual Differentiation • The two sexes indistinguishable for first 8 to 10 weeks of development • Female reproductive tract develops from the paramesonephric ducts – Not because of the positive action of any hormone – Because of the absence of testosterone and müllerian-inhibiting factor (MIF) 28-3 Reproductive Anatomy • Expected Learning Outcomes – Describe the structure of the ovary – Trace the female reproductive tract and describe the gross anatomy and histology of each organ – Identify the ligaments that support the female reproductive organs – Describe the blood supply to the female reproductive tract – Identify the external genitalia of the female – Describe the structure of the nonlactating breast 28-4 Sexual Differentiation • Without testosterone: – Causes mesonephric ducts to degenerate – Genital tubercle becomes the glans clitoris – Urogenital folds become the labia minora – Labioscrotal folds -
The Morphology, Androgenic Function, Hyperplasia, and Tumors of the Human Ovarian Hilus Cells * William H
THE MORPHOLOGY, ANDROGENIC FUNCTION, HYPERPLASIA, AND TUMORS OF THE HUMAN OVARIAN HILUS CELLS * WILLIAM H. STERNBERG, M.D. (From the Department of Pathology, School of Medicine, Tulane University of Louisiana and the Charity Hospital of Louisiana, New Orleans, La.) The hilus of the human ovary contains nests of cells morphologically identical with testicular Leydig cells, and which, in all probability, pro- duce androgens. Multiple sections through the ovarian hilus and meso- varium will reveal these small nests microscopically in at least 8o per cent of adult ovaries; probably in all adult ovaries if sufficient sections are made. Although they had been noted previously by a number of authors (Aichel,l Bucura,2 and von Winiwarter 3"4) who failed to recog- nize their significance, Berger,5-9 in 1922 and in subsequent years, pre- sented the first sound morphologic studies of the ovarian hilus cells. Nevertheless, there is comparatively little reference to these cells in the American medical literature, and they are not mentioned in stand- ard textbooks of histology, gynecologic pathology, nor in monographs on ovarian tumors (with the exception of Selye's recent "Atlas of Ovarian Tumors"10). The hilus cells are found in clusters along the length of the ovarian hilus and in the adjacent mesovarium. They are, almost without excep- tion, found in contiguity with the nonmyelinated nerves of the hilus, often in intimate relationship to the abundant vascular and lymphatic spaces in this area. Cytologically, a point for point correspondence with the testicular Leydig cells can be established in terms of nuclear and cyto- plasmic detail, lipids, lipochrome pigment, and crystalloids of Reinke. -
The Reproductive System
27 The Reproductive System PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • The reproductive system is designed to perpetuate the species • The male produces gametes called sperm cells • The female produces gametes called ova • The joining of a sperm cell and an ovum is fertilization • Fertilization results in the formation of a zygote © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • Overview of the Male Reproductive System • Testis • Epididymis • Ductus deferens • Ejaculatory duct • Spongy urethra (penile urethra) • Seminal gland • Prostate gland • Bulbo-urethral gland © 2012 Pearson Education, Inc. Figure 27.1 The Male Reproductive System, Part I Pubic symphysis Ureter Urinary bladder Prostatic urethra Seminal gland Membranous urethra Rectum Corpus cavernosum Prostate gland Corpus spongiosum Spongy urethra Ejaculatory duct Ductus deferens Penis Bulbo-urethral gland Epididymis Anus Testis External urethral orifice Scrotum Sigmoid colon (cut) Rectum Internal urethral orifice Rectus abdominis Prostatic urethra Urinary bladder Prostate gland Pubic symphysis Bristle within ejaculatory duct Membranous urethra Penis Spongy urethra Spongy urethra within corpus spongiosum Bulbospongiosus muscle Corpus cavernosum Ductus deferens Epididymis Scrotum Testis © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • The Testes • Testes hang inside a pouch called the scrotum, which is on the outside of the body -
Abdominal Total Hysterectomy: the Modified Aldridge's Procedure With
Published online: 2018-11-19 THIEME S22 Precision Surgery in Obstetrics and Gynecology Abdominal Total Hysterectomy: The Modified Aldridge’s Procedure with Noda’sMethod Yoh Watanabe, MD, PhD1 1 Department of Obstetrics and Gynecology, Tohoku Medical and Address for correspondence Yoh Watanabe, MD, PhD, Department of Pharmaceutical University, Sendai, Japan Obstetrics and Gynecology, Tohoku Medical and Pharmaceutical University, 1-15-1, Fukumuro, Miyagino-ku, Sendai 983-8536, Japan Surg J 2019;5(suppl S1):S22–S26. (e-mail: [email protected]). Abstract Although laparoscopic surgery or robotic surgery has recently been the main proce- dure adopted for managing benign uterine tumors, abdominal total hysterectomy must still be learned as a basic surgical skill for obstetricians and gynecologists. Total hysterectomy is divided into two types: the extrafascial and intrafascial approaches. Intrafascial hysterectomy, represented by the Aldridge’s method, is a useful and safe procedure for treatment when the patient has no cervical malignancy, including cervical intraepithelial neoplasia. Furthermore, the intrafascial approach is safely performedeveninpatientswithfirm adhesion in the Douglas’s pouch and/or around the uterine cervix due to endometriosis, pelvic inflammatory diseases, or a history of intrapelvic surgery. The intrafascial approach can also effectively prevent descent of Keywords the vaginal stump after hysterectomy via the partial preservation of the uterine ► abdominal retinaculum. Although the Aldridge’s method was originally reported to start via an hysterectomy intrafascial approach at the position of the internal cervical os using scissors, Dr. ► intrafascial method Kiichiro Noda created a modified version of the procedure that increases its ease and ► Aldridge’s procedure safety by changing the position and management of the parametrial tissue including ► gynecologic surgery the uterine artery. -
Female Genital System
The University Of Jordan Faculty Of Medicine Female genital system By Dr.Ahmed Salman Assistant Professor of Anatomy &Embryology Female Genital Organs This includes : 1. Ovaries 2. Fallopian tubes 3. Uterus 4. Vagina 5. External genital organs Ovaries Site of the Ovary: In the ovarian fossa in the lateral wall of the pelvis which is bounded. Anteriorly : External iliac vessels. Posteriorly : internal iliac vessels and ureter. Shape : the ovary is almond-shaped. Orientation : In the nullipara : long axis is vertical with superior and inferior poles. In multipara : long axis is horizontal, so that the superior pole is directed laterally and the inferior pole is directed medially. External Features : Before puberty : Greyish-pink and smooth. After puberty with onset of ovulation, the ovary becomes grey in colour with puckered surface. In old age : it becomes atrophic External iliac vessels. Obturator N. Internal iliac artery Ureter UTERUS Ovaries Description : In nullipara, the ovary has : Two ends : superior (tubal) end and inferior (uterine) end. Two borders : anterior (mesovarian) border and posterior (free) border. Two surfaces : lateral and medial. A. Ends of the Ovary : Superior (tubal) end : is attached to the ovarian fimbria of the uterine tube and is attached to side wall of the pelvis by the ovarian suspensory ligament. Inferior (uterine) end : it is connected to superior aspect of the uterotubal junction by the round ligament of the ovary which runs within the broad ligament . B. Borders of the Ovary : Anterior (mesovarian) border :presents the hilum of the ovary and is attached to the upper layer of the broad ligament by a short peritoneal fold called the mesovarium. -
MRI Anatomy of Parametrial Extension to Better Identify Local Pathways of Disease Spread in Cervical Cancer
Diagn Interv Radiol 2016; 22:319–325 ABDOMINAL IMAGING © Turkish Society of Radiology 2016 PICTORIAL ESSAY MRI anatomy of parametrial extension to better identify local pathways of disease spread in cervical cancer Anna Lia Valentini ABSTRACT Benedetta Gui This paper highlights an updated anatomy of parametrial extension with emphasis on magnetic Maura Miccò resonance imaging (MRI) assessment of disease spread in the parametrium in patients with locally advanced cervical cancer. Pelvic landmarks were identified to assess the anterior and posterior ex- Michela Giuliani tensions of the parametria, besides the lateral extension, as defined in a previous anatomical study. Elena Rodolfino A series of schematic drawings and MRI images are shown to document the anatomical delineation of disease on MRI, which is crucial not only for correct image-based three-dimensional radiotherapy Valeria Ninivaggi but also for the surgical oncologist, since neoadjuvant chemoradiotherapy followed by radical sur- Marta Iacobucci gery is emerging in Europe as a valid alternative to standard chemoradiation. Marzia Marino Maria Antonietta Gambacorta Antonia Carla Testa here are two main treatment options in patients with cervical cancer: radical sur- Gian Franco Zannoni gery, including trachelectomy or radical hysterectomy, which is usually performed T in early stage disease as suggested by the International Federation of Gynecology Lorenzo Bonomo and Obstetrics (FIGO stages IA, IB1, and IIA), or primary radiotherapy with concurrent ad- ministration of platinum-based chemotherapy (CRT) for patients with bulky FIGO stage IB2/ IIA2 tumors (> 4 cm) or locally advanced disease (FIGO stage IIB or greater). Some authors suggested the use of CRT followed by surgery for bulky tumors or locally advanced disease (1). -
Uterine and Ovarian Countercurrentpathways in The Control of Ovarian Function in the Pig
Printed in Great Britain J. Reprod. Pert., Suppl. 40 (1990), 179-191 ©1990 Journals of Reproduction & Fertility Ltd Uterine and ovarian countercurrentpathways in the control of ovarian function in the pig T. Krzymowski, J. Kotwica and S. Stefanczyk-Krzymowska Department of Reproductive Endocrinology, Centre for Agrotechnology and Veterinary Sciences, 10-718 Olsztyn, Poland Keywords: counter current transfer; ovary; oviduct; uterus; pig Introduction Countercurrent transfer of heat, respiratory gases, minerals and metabolites has been known for many years to be a fundamental regulatory mechanism of some physiological processes. In sea mammals, wading birds and fishes living in polar seas countercurrent systems in the limbs, flippers or tail vessels protect the organism against heat loss (Schmidt-Nielsen, 1981). In most mammals countercurrent heat exchange between the arteries supplying the brain and veins carrying the blood away from the nasal area and head skin forms the so-called brain cooling system, which protects the brain against overheating (Baker, 1979). The countercurrent transfer of minerals and metab- olites in the kidney is a well-known system regulating the osmolarity and concentration of urine (Lassen & Longley, 1961). Countercurrent transfers in the blood vessels of the intestinal villi take part in the absorption processes (Lundgren, 1967). The pampiniform plexus in the boar partici- pates in a heat-exchange countercurrent, thus decreasing the temperature of the testes (Waites & Moule, 1961), as well as in local transfer of testosterone (Free et al., 1973; Ginther et al., 1974; Einer-Jensen & Waites, 1977). Studies on the influence of hysterectomy on the function of the corpus luteum in different species, made in the 1930-1970s, suggested the existence of a local transfer of a luteolytic substance from the uterus to the ovary. -
Alekls0201b.Pdf
Female genital system Miloš Grim Institute of Anatomy, First Faculty of Medicine, Summer semester 2017 / 2018 Female genital system Internal genital organs Ovary, Uterine tube- Salpinx, Fallopian tube, Uterus - Metra, Hystera, Vagina, colpos External genital organs Pudendum- vulva, cunnus Mons pubis Labium majus Pudendal cleft Labium minus Vestibule Bulb of vestibule Clitoris MRI of female pelvis in sagittal plane Female pelvis in sagittal plane Internal genital organs of female genital system Ovary, Uterine tube, Uterus, Broad ligament of uterus, Round lig. of uterus Anteflexion, anteversion of uterus Transverse section through the lumbar region of a 6-week embryo, colonization of primitive gonade by primordial germ cells Primordial germ cells migrate into gonads from the yolk sac Differentiation of indifferent gonads into ovary and testis Ovary: ovarian follicles Testis: seminiferous tubules, tunica albuginea Development of broad ligament of uterus from urogenital ridge Development of uterine tube, uterus and part of vagina from paramesonephric (Mullerian) duct Development of position of female internal genital organs, ureter Broad ligament of uterus Transverse section of female pelvis Parametrium Supporting apparatus of uterus, cardinal lig. (broad ligament) round ligament pubocervical lig. recto-uterine lig. Descent of ovary. Development of uterine tube , uterus and part of vagina from paramesonephric (Mullerian) duct External genital organs develop from: genital eminence, genital folds, genital ridges and urogenital sinus ureter Broad ligament of uterus Transverse section of female pelvis Ovary (posterior view) Tubal + uterine extremity, Medial + lateral surface Free + mesovarian border, Mesovarium, Uteroovaric lig., Suspensory lig. of ovary, Mesosalpinx, Mesometrium Ovary, uterine tube, fimbrie of the tube, fundus of uterus Ovaric fossa between internal nd external iliac artery Sagittal section of plica lata uteri (broad lig. -
The Distribution and Significance of the Parametrium
178 Journal of Obstetrics and Gynzcology The Distribution and Significance of the Parametrium. By MANFREDMORITZ, M.A. (Cantab.), M.D. (Manch.), Gpmological House Surgeon, St. iMary’s Hospatals, Manchester. OF recent years the descriptive anatomy of the pelvic connect1;e- tissue has changed completely. The great majority of this work has, however, been done on male subjects. In studying the follow- ing details, I availed myself of the newer methods of demonstrating these tissues, and I confined my attention to the female pelvis. The importance and significance of the connective-tissues of the female pelvis were almost completely overlooked by the older anatomists. Recently French anatomists in particular, stimulated perhaps by pathological and gynaxological problems, have paid more attention to these tissues, but there still remains room for a much fuller description of their relations and structure. Engl ill text-books of anatomy, as well as those of gynaecology, give Fnt a meagre description of these very important tissues. The first allusion to the “ parametrium ” and the first use of this word itself we owe to Virc1iow.l (Hereafter I intend to use t is term synonymously with “ the pelvic connective tissues,” of wlfi 11 it forms an inseparable part-not in its original sense, viz., the triangular area of tissue surrounding the lower uterine segrnen ) Virchow, without in any way drawing attention to the significance or anatomical relations of this tissue, described in 1P62 a loose cunnective-tissue round the cervix uteri ; in fact the supravaginnl parametrium. Having apologized for introducLng the term ‘‘ para- metrium ” into medicine, he proceeds to lay stress on the part mi~ir11 this tissue plays as the seat of inflammatory changes. -
Suspensory Ligament Rupture Technique During Ovariohysterectomy in Small Animals
3 CE CREDITS CE Article In collaboration with the American College of Veterinary Surgeons Suspensory Ligament Rupture Technique During Ovariohysterectomy in Small Animals Lawrence N. Hill, DVM, DABVP The Ohio State University Daniel D. Smeak, DVM, DACVSa Colorado State University Abstract: During ovariohysterectomy, suspensory ligament (SL) rupture permits retraction of the ovary and distal ovarian pedicle through a limited ventral midline incision. This allows the surgeon to confirm that the pedicle is securely double ligated and includes no ovarian remnant. For less experienced surgeons, SL rupture is often difficult and daunting because the ligament is buried within the abdominal viscera and must be identified blindly by palpation. Furthermore, in dogs, the ligament must be digitally disrupted, which may cause hemorrhage and serious injury to surrounding structures such as the ovarian pedicle. This article describes step-by-step techniques to disrupt the SL in dogs and cats. We have found that these techniques can be taught easily and successfully to novice surgeons. variohysterectomy is the most common elective surgi many different ways to safely control the rupture of this cal procedure performed by small animal practition structure. For inexperienced surgeons, however, the pro Oers.1,2 In young, healthy patients, the technique can cedure is often daunting and difficult because the ligament be performed safely through a small ventral midline laparo is buried within the abdominal viscera and must be identi tomy incision to save time and reduce trauma. This limited fied blindly by palpation. Additionally, in dogs, the SL must approach makes exposure of the ovarian pedicle for ligation be digitally disrupted with considerable force, creating the one of the most challenging aspects of ovariohysterectomy, potential for serious damage to other soft tissue structures, particularly for inexperienced solo surgeons. -
ARTERIES and VEINS of the INTERNAL GENITALIA of FEMALE SWINE Missouri Agricultural Experiment Station, Departments Ofanimal Husb
ARTERIES AND VEINS OF THE INTERNAL GENITALIA OF FEMALE SWINE S. L. OXENREIDER, R. C. McCLURE and B. N. DAY Missouri Agricultural Experiment Station, Departments of Animal Husbandry and School of Veterinary Medicine, Department of Veterinary Anatomy, Columbia, Missouri, U.S.A. {Received 22nd May 1964) Summary. The angioarchitecture of the internal genitalia of twenty-six female swine was studied. The arteries of the genitalia of female swine anastomose freely allowing fluid injected into one artery to flow into all other arteries of the genitalia. A similar degree of anastomosis exists in the veins. There is no branch to the uterine horn from the so-called utero- ovarian artery and a more descriptive name for the artery would be ovarian. Also, it is more appropriate to refer to the artery originating from the umbilical artery as the uterine instead of middle uterine artery since it supplies the entire uterine horn and there is no cranial uterine artery in the pig. The uterine branch of the urogenital artery supplies the cervix and uterine body. Two large veins are located bilaterally in the mesometrium of the uterus. The larger is nearer the uterine horn, runs the entire length of the horn and is a utero-ovarian vein. It follows the ovarian artery after receiving one or two venous branches from the ovary. An additional large vein which parallels the utero-ovarian vein in the mesometrium is designated as the uterine vein since it follows the uterine artery. The uterine vein anastomoses with the utero-ovarian vein through one large branch and many smaller branches and enters a ureteric vein as the uterine artery crosses the ureter. -
Salpingectomy After Vaginal Hysterectomy: Technique, Tips, and Pearls
SURGICAL Techniques Salpingectomy after vaginal hysterectomy: Technique, tips, and pearls This expert surgeon emphasizes a careful and deliberate approach in the following technique for vaginal removal of the fallopian tube with ovarian preservation. He also describes a vaginal approach to salpingo-oophorectomy. John B. Gebhart, MD, MS n this article, I describe my technique Right salpingectomy for a vaginal approach to right salpingec- Start with light traction I tomy with ovarian preservation, as well Begin by placing an instrument on the round as right salpingo-oophorectomy, in a patient ligament, tube, and uterine-ovarian pedicle, lacking a left tube and ovary. This technique exerting light traction. Note that the tube is fully illustrated on a cadaver in the Web- will always be found on top of the ovary IN THIS based master course in vaginal hysterectomy FIGURE 1 ARTICLE ( ). Take care during placement of produced by the AAGL and co-sponsored by packing material to avoid sweeping the fim- Technique the American College of Obstetricians and briae of the tube up and out of the surgical for salpingo- Gynecologists and the Society of Gynecologic field. You may need to play with the packing a oophorectomy Surgeons. That course is available online at bit until you are able to deliver the tube. https://www.aagl.org/vaghystwebinar. Once you identify the tube, iso- Page 29 For a detailed description of vaginal late it by bringing it down to the midline hysterectomy technique, see the article (FIGURE 2, page 28). One thing to note if Salpingectomy: entitled “Vaginal hysterectomy using basic Key take-aways instrumentation,” by Barbara S.