Internal Genital Organs (vagina, uterus, oviducts and ovary)

Organs placed internally and require special instruments for inspection. Include –

• Vagina
• Uterus
• Fallopian tubes
• The ovaries

Vagina

Vagina is a fibromusculomembranous
sheath communicating the uterine cavity with the exterior at the vulva.
🔶It constitutes the menstrual blood
🔶Organ of copulation & forms the birth canal of parturition.
🔶Canal is directed upward and backward forming an angle of 45 with the horizontal in erect position.
🔶Diameter of canal is about 2.5cm, being widest in the upper part & narrowest at its Introitus

◾Walls- Anterior(7cm), Posterior(9cm) and 2 lateral walls.
Looks H shape on transverse section

◾Relations- 🔶Anterior- upper 1/3rd- base of bladder
lower 2/3rd- urethra
🔶Posterior – upper 1/3rd- Pouch of Douglas
middle 1/3rd- Anterior rectal wall seperated by recto vaginal
lower 1/3rd – seperated from anal canal by perineal body
🔶Lateral wall- upper 1/3rd- related with the pelvic cellular tissue at the base
of broad ligament
middle 1/3rd- blended with levator ani
lower 1/3rd- bulbocavernosus muscles,
vestibular bulbs and Bartholin’s glands

◾ Structures- within outwards

• Mucous coat- lined by stratified squamous epithelium
• Submucous layer- loose areolar vascular tissues
• Muscular layer- indistinct inner circular and outer longitudinal muscles
• Fibrous coat- derived from endopelvic fascia

◾Vaginal secretion- It occurs from puberty to menopause is acidic because of presence of Doderlein’s bacilli which produce lactic acid. pH varies with oestrogenic activity and range between 4-5.

◾Blood supply-

Arteries- 1. Cervicovaginal branch of uterine artery. 2. Vaginal artery.

Veins- Internal iliac veins and internal pudendal veins

◾Nerve supply- upper part supplied by sympathetic and parasympathetic from the pelvic plexus. Lower part supplied by pudendal nerve.

Uterus

Hollow pyriform muscular organ, situated in the pelvis between the bladder in the front and rectum behind.

◾Position- normal position is one of the anteversion and anteflexion. Usually inclined to the right so that cervix is directed to the left.

◾ Measurements and parts- 8 cm long and 5 cm wide.

Walls- 1.25 cm thick. Weight varies from 50- 80 gm. Parts- body or corpus, isthmus and cervix

1. Body / corpus- further divided into fundus and body proper. Fundus is the part lying above the openings of uterine tubes. Body proper is triangular lies between opening of the tubes and isthmus.

◾Cornua of uterus- superolateral angles of the body, projects outward from the junction of fundus and body.

2. Isthmus- constricted part measuring about 0.5 cm situated between body and cervix.

3. Cervix- cylindrical in shape, measuring about 2.5 cm. Extends from isthmus and ends at the external is which opens into vagina.

Normal length of uterine cavity is 6.5- 7 cm.

◾ Structures- The wall consist of 3 layers-

🔶Parametrium – serous coat invest the entire organ except on the lateral sides. 🔶Myometrium- consists of thick bundle of smooth muscle fibres. During pregnancy- 3 layers – outer longitudinal,
middle interlacting, inner circular
🔶Endometrium- mucous lining of the cavity consist of lamina propria and surface epithelium.
endometrium gets changed to decidua during pregnancy. cervix composed of mainly fibrous connective tissue.

◾Secretion- Endometrial secretion is scanty and watery. Secretion of cervical gland is alkaline and thick, rich in mucoprotein, fructose and NaCl.

◾Blood supply- Arterial supply- uterine artery. Veins- Internal iliac veins

Fallopian tube

Synonyms- Uterine tube, oviduct

Paired structures, measuring about 10cm and are situated in medial 3/4th of the upper free margin of the broad ligament.

It has got 2 openings- Uterine opening (1mm diameter) and Pelvic opening / Abdominal ostium (2mm diameter)

Parts – It has 4 parts

1. Intramural / Interstitial – lying in the uterine wall
2. Isthmus- almost straight and measures about 3-4 cm in length.
3. Ampulla- tortuous part & about 5cm length
4. Wide infundibulum – 1.2 cm long & with fibrae

Structures-

1. Serous layer
2. Muscular layer
3. Mucous membrane lined by (a)columnar ciliated epithelial cells (b)Secretory columnar cells. (c)peg cells

Functions-

1. Transport of the gametes
2. To facilitate fertilization and survival of zygote through its secretion.

Ovary

Paired sex glands or gonads in females which are concerned for germ cell maturation, storage and its releases and in steroidogenesis.

Each gland – oval in shape, pinkish grey in Colour, 3 cm length, 2 cm breadth and 1 cm thickness.
The ovaries are intraperitoneal structures.
In nulliparous, ovaries lies in ovarian fossa on the lateral pelvic wall.

Structures-

Ovary is covered by single layer of cubical cells known as germinal epithelium.
Substance of the gland consist of
(i) outer cortex
(ii) Inner medulla

Cortex consists of stroma cells which are thickened beneath the germinal epithelium to form tunica albuginea. During reproductive period, cortex is studded with no. of follicular structure-
primordial follicles, maturing follicles,
Graafian follicle & corpus leutum.

Medulla consist of loose connective tissues, few unstriped muscles, blood vessels and nerves contain hilus cells.

Ovaries are sensitive to manual squeezing