REPRODUCTIVE SYSTEM

Male reproductive system

M genital organs are situated both outside the pelvic cavity and
Within the pelvie cavity referred to as the external genital organs and
internal genital organs respectively.
External genital organs -They include,
1. Penis 2. Scrotum
3. Testes 4. Epididymes
5. Spermatic cords
Internal genital organs - They include,

1. Ductus deferens 2. Seminal vesicle

3. Ejaculatory ducts 4. Prostate

5. Male urethra.
Female reproductive system
outside the pelvic cavity
The Female genital organs are situated both
external genital organs
and within the pelvic cavity referred to as the
and internal genital organs respectively.
Pudedum or Vulva -

External genitalia or

1. Mons pubis 2. Labia majora

3. Labia minora 4. Clitoris

5. Vestibule of vagina 6. Bulbs of vestibule

7. Greater vestibular glands

Internal genitalia -

1. Ovaries 2. Uterine tubes

3. Uterus 4. Vagina

Accessory organs Mammary glands (Breast)

-

115
 R Reprodu tive System M a l e E x t e r n a l G e n i t a l i a

1. PENISs (9Ia)
the lower part
root in
front of
It is composed of thre
of the
Introduction symphysis.

e r e c t i l e tissue.
of masses become r During elon
The penis is the male organ of copulation penis, these
m a s s e s

engor
ec
erecto
Parts It is made up of two parts nameiy
blood leading
to considerable enl
root and body. two surfaces,
The penis has
1. Root
2 of penis Ventral surface
-

Faces backw
lt is the attached part of the penis situat a)
3 1s
downwards.

1n
superficial perineal pouch. It
the
surface
-

Faces for
4 composed of three masses of erectile tissue, b) Dorsal
namely the two crura and one bulb. upwards.

masses are,
a) Crus (Pleural-Crura)- Each crus is
-
The three
firmly attached to the margins of the pubic cavernosa

arch and is covered by the ischiocavernosus.

a) Right corpora
cavernosa
b) Left corpora
b) Bulb-The bulb is attached to the perineal
is c) Corpus spongiosum.
membrane in between the two crura.
it
covered by bullbospongiosus. Its deep surtace 1. Right and left corpora cavernosa
is pierced by the urethra, which traverses its
They the forward continuation of
are
substance to reach the corpus spongiosum
crura. They are in close apposition
(located in the body).This part of the urethra each other throughout their length.
within the bulb shows a dilatation in its floor
called the intrabulbar navicularfossa. The corpora cavermosa do not reach the
Body of penis of the penis. Each of them terminates i
2.
blunt conical extremity under the cover
It is the free portion of the penis completely
the glans penis.
enveloped by skin. It is continuous with the

Crus of penis Superficial

dorsal vein Deep dorsal ver
Skin Dorsal artery
Dorsal nene
Superficial fascia-
Common sheath Deep artery
of penis
- for corpora
cavernosa and Corpus
cavemosum
corpus spongiosum
Sheath for corpus- Corpus
cavernosum spongiosum

Sheath for corpus -Urethra

Bulb of penis
Perineal body Perineal membrane spongiosum
Fig. Parts of root of penis Fig. Cross-section of free part of penis

116
22
 urethral orifice.
of glans to external
Corpus cavernosum Prepucs
Glans penis formed
Coverings of Penis
by enlarged end of
The coverings include the skin, superficial
corpus sponglosurn
fascia and fibrous sheath.
Urethral orifMce

Frenulurn Skin
Corpus Urethra is very thin
Skin
sponglosum The skin covering the penis
colour. It is loosely
hairless and dark in
Fig. Parasagittal section through penis sheath. At the neck
attached with the fascial
reflected over the glans
They are surrounded strong by a fibrouss of penis, the skin is on
called A median raphe
sheath called the tunica albuginea. as a fold prepuce.
indicates the
fusion

ventral surface of penis

The tunica albuginea has superficial folds.
of two genital
longitudinal fibres enclose both the corpora
each corpus fascia
and deep circular fibres enclose 2. Superficial
devoid of
separately and also form a median septum. The superficial fascia of penis islies in the
dorsal vein
fat. The superficial
2. Corpus spongiosum
bulb of midline. fascia is
continuation ofthe
I t is the forward of the superficial
traversed by the urethra The deep layer
the penis and it is membranous and is called thefascia ofpenis
It is also surrounded
common
the
throughout its length. or Buck's fascia
which forms
masses.
This
erectile
by a sheath. the three
covering for
and conical in c o v e r the glans.
Its terminal part is expanded fascia does not
base of anteriorly

shape called the glans penis. The Fascia of penis is continuous

wall
presents a projecting margin fascia of
abdominal

the glans penis Just behind the with the Scarpa's muscle of
the
called the corona glandis. with dartos
circular sulcus and posteriorly attached to
the pubic
there is a fascia is
corona glandis, Within the s c r o t u m . The

known as the neck of thepenis. symphysis by

suspensory
ligament.
dilatation called
urethra shows a
glans, the (Tunica albuginea)
Fibrous sheath
the navicular fossa. 3.
3.
erectile tissue
in each mass of
are present It c o v e r s
sebaceous glands surface of tunica
Numerous
neck of penis,
which From the inner
separately. within
the corona glandis and trabecular septa project
smegma.
sebaceous
material called albuginea, divide it into
secrete a cavernosa
and
fold of the corpora
is covered by a

The glans penis It can be cavernous spaces.

or foreskin.
called prepuce
skin the glans. Ligaments of Penis
Penis
retracted
backwards to expose ugaments of
between the prepuce
suspend the body
The potential space The ligaments of penis
sac. and thus
is called preputial from pubic symphysis
and glans of penis
connected to
the prepuce on
provide support.
The glans is median fold called
It extends
undersurface by a
base 1. Fundiform ligament
its extends from the base 1.
Frenulum
frenulum.
117
 Reproductive Systenm
Nerve supply
downwards from the linea alba and splits to Autonomic innervation
enclose the penis. It lies superficial to the 1.
Sympathetic - Superior hypogastric
Suspensory ligament. and their ple
2 Suspensory ligament- It extends from the via pudendal
nerves
branches
Parasympathetic - Pelvic splanchnic
pubic symphysis and blends below with the ner
fascia of penis (Buck's fascia) on either side
of the penis. It lies deep to the fundiform S,,S,,S
Somatic
innervation-Dorsal nerve of
ligament. 2.
Muscles of penis are supplied by
Blood supply nerve.
peTite
branch of pudendal
. Internal pudendal artery gives three branches Clinical Aspect
which supply the penis,
1) Deep artery of penis - Helicine arteries 1. Phimosis-It is the mostcommonabnormal
the prepuce is too
of penis in which nan
ii) Dorsal artery of penis to be retracted.

ii) Artery of bulb of penis Circumcision It is the surgical removal

2 prepucial skin in a condition like phimoi
Femoral artery gives off the superficial
external pudendal artery which supplies the Circumcision is also practised as a religio
skin and fascia of the penis. ritual by Muslims and Jews.

Venous drainage 3 Other anomalies of the penis include partiz

1 Superficial dorsal vein which drains into the or complete absence ofpenis, double or bif
external pudendal vein. penis and penis placed behind the scrotum

2 Deep dorsal vein which drains into the 4 Hypospadias I t is a congenital anomah
where the urethral opening is located on the
internal pudendal vein.
undersurface of the penis or in the perineum
Lymphatic drainage
5. Epispadias- It is
1. The glans penis- Deep inguinal nodes (gland where the urethral
a
congenital anomaly
of Cloquet) opening is on the dorsal
surface.
2 Rest of the penis- Superficial inguinal nodes.
 Reproductive System
2. SCROTUM ( q r a )
nodtion muscle projects into a median vertical

septum bet ween the two halves of scrotum.

eiwhn i iungs w heow ihe puhie Vaternal spermatic fascia It is derived

symphos hetween e ante dal uspects Irom he external oblique muscle.

f ligis Iilndues i estes, e epididymis 4 Cremasterie fascia - It contans cremasteric

internal
muscle vwhich is derived from the
oblique nuscle.
derived
a vides i l ighi and lell pants by 5 Jnternal spermatje fascia- It 1s

nednaphe wich is c l n u s vwith the from the fascia transversalis

cremasteric
aphe venlial sur fce ol jpeis anterjorly Contraction of dartos muscle and
the
wud aphe petineu prosteriurly. muscle causes estis to be drawn against

he iet hall of thhe seotum bangsat a slighily body.

wer level m ndate the greater length relaxes and allow
In hot weather, scrotum
fte e semalic nd Irom the body.
estes o hang Ireely away
surface area for the
.ayero ul ourotu This provides a large
dissipation of heat.
e sclum is made up of the following
reflexes of scrotum in
response
ayers I r ) usde imwards, These
stable
help to maintain a
Lo Lemperature
Skin sual skin is thin, pigmented Lemperature. It is an
function
important
Ad rug3 I1 contains thin, scatlered hair,
because spermatogenesis get
impaired by
numers swest glsnds and sebaceous extremes of heat o r cold.

glands
Blood supply
2 Dart muscle ssuheutneous and
fascia. The dartos .Superficial external pudendal
replaces the ouperficial
2. Deep external pudendal

3. Scrotal branches of internal pudendal

Cremasteric branch of inferior

4
tenalqpermal epigastric.
lasia
Gematst msle Vas deferens Venous drainage

besnal yesniat Corresponding veins drain into,

Epididymis
I. Great saphenous vein
urica vanalis Testis
2. Internal iliac vein

Lymphatic drainage
Superficial inguinal lymph nodes.

119
 Rephuwtive Sy sten NInCe nuCroUN Nb.
NOTOU,
Neave supply in Nerotal nkin
NO preset
arta nmusee icnital buanch ot gonil0 Due lolaxit
temoral nerve Serotal oedema- Kily
the "
l sk
dependent ponition,
Anterior /3 ot
serotum
its
most common sile lor ocdema. erolum
[Link] neve. In thio
iental braneh ot
genitotemowal nerve. Serotal elephantlass
Pusterlor 3 of servtum there is assive ol largement we
the nceumulation of inte.
due to
teror sevtal branches
ol puleia wall following
iwal
serotal
the the
Pernneul branch ut posterior eutaneoN
in
lymph vessels by lilarial worms blocka
terne ot thigh.
. lydrocoele- It is a condition in
which
Clinical Aspect accumulates in the processus va
vagmali,
Sebaccous eyst -These cysts are commo in the peritoneum.

3. TESTIS (Juuriet)
lntroduetion Poles
Testes (singular-testis) are a Upper pole - t is convex and smou
pair of male
eprductive gonads. They are homologous provides attachment to the spermatic
with the ovaries of the female. lt also gives attachment to a small oval b,
Position called the appendix of testis (remna
lt paramesonephric duct).
is
suspended in the serotum
by the
Spematie cond. It lies obliquely, so that its 2 Lower pole - It is convex and
smooth.
connected to the tail of
upper pole is tilted torwards and laterally. epididymis
The lett testis is
slightly lower than the right Borders
because ot greater length of lett
spermatic Anterior border It is convex
cond and smoe
-

It is
fully covered by the tunica vaginalis
Shape- Oval and compressed trom side to
side Spermatic cord -

Dimensions 3.75
-

cm long. 2.5 em broad Ductus deferens Appendix of epidu

and I.8 em thiek. Head of epididyms
Weight 10 to 15 g Body- Appendix of tests
Sinus
External features and tail of
epididymis
The testis has 2 poles, 2 borders and 2 Testis
surfaces.
[Link] and epididymis
120
 Rop ive iyle

2 Posterior border - It is straight and in only Struoture of Testls

partially covered by the tunica vaginalin comata l
The glumlulur punt «ol the testis
The epididymis lies along the latleral part of contais

the posterior border. 2000lo 30) lobules, neh lobule

to Neminlferuustuhule
The medial surface of cpididymis is itnell Th
nch ubule in highly coiled o
separated from the testis by n extension unml tiameter
lenglh of the ubule in d) c m
of the cavity of the tuniea vaginalis. This cells
une lied by
about 0.2 mm. The tubulen
extension is called the sinus of epididymis. ntngen in the fomaton
wlhich reprenenl
Surfaces NpCrlOZM
il
Medial surface It is and tuubulen join togeter lhe
1. -
convex smooth 2.
2. The NCniniferous
30 Ntrulgl
to lorm 20 to
2 Lateral surface - It is convex and smooth upices of he lobules
tuhules which cnter the modntinun
Coverings of Testis 3. In the mcdiuntinun, the ntraight
ubulcs
lom a
The testis has threc coverings from outside
stomose willh cac1 other t
inwards namely tunica vaginalis, tunica the rete wstls
nctwork of tubules called
albuginea and tunica vasculosa. riNe Iron
4. About 12 to 30 efferent ductules
1. Tunica vaginalis emerge ncar
the upper
the rete testis which
epididymiN
It represents the lower persistent portion of pole of thc testis and cnter the
the processus vaginalis. It is invaginated by coiled and
becomes highly
5. Here, cach tubule
the testis from behind and therefore has a hed of the epididymiN
forms a lobe of the
parietal and a visceral layer with a cavity in a single
duct whichis
The tubules end in and lail
between. lt covers the whole testis, except form the body
coiled on itsclf to
for its posterior border. continuous with the
It is
of the epicdidymis.
2. Tunica albuginea ductus deferens.
testis tubule
It is a dense, white fibrous coat covering the listology of
seminiferous
all around. lt is covered by the visceral layer of
tubule is covered by
the Each seminiferous
tunica vaginalis except posteriorly where lined internally by
basement membrane and
testicular vessels and nerves enter the gland.
two types of cells, namely,
is
The posterior border of tunica albuginea
vertical Vas deferens
thickened to form an incomplete LIgamentus remnant

mediastinum testis which of processus vaginalis

septum called the Head (Caput)
of epididymis
is wider above than below. Straight tubule Lfferent ductules
mediastinum
Numerous septa extend from the Seminiferous Rete tests in

tunica albuginea. tubule mediastinum

to the inner surface of the
Body (Corpus)
divide the testis into 200- TunicaParietallayer
They completely Cavity
vaginal's L Visceral layer
of epididymis

300 lobules.
Capsule Tail (Cauda)
3 Tunica vasculosa (tunica albuginea) of epididymis

coat of testis
It is the innermost, vascular Fig. Structure of Testis
lining its lobules.

121
R Reproductive System nterstitinl cell slinuluting hurnone

pituitury
plund
1. Spermatogenie cells of' the
Descent of Testis
Supporting cells or cells of Serton.
tenles develop lmbare
in
Spermatogenic cells In
letus,

hey descend
veyn
ne spematogenic
three ill-defined zones.
cells are arrangeu Subsequently
cunal nlo
the seroluu " hwonyh
inguinal
a) Outer zone It consists ofspermatogoni traverse
inguinal canal durin 7
They
-

ler rech the bottom the NC

of he
of
serolum h
b) InternmediateI t comsists ot ou
zone d
of letul
lile
layer of primary spematoeytes and inne nonth

layer of secondary spermatocytes. Blood supply

3. C)Inner zone - 1 consists of wo or more
Testicular arlery (a
brunch of abdominal
4. rows of spermatids. oar
Venous drainage
Supporting cells or cells of Sertoll
St A posterior border of teu.
the lestis
Sertoli cells are tall and columnar in shape 15 to 20 veins unite t
epididymis
extending from the basement membrune to the pampiniform plexus. At the erli
the lumen of the senminiferous tubule. They this plexus condenses
support and protect the developing ger inguinal ring,
four veins and nto two veins at the
cell and help in maturation of spermatozoa. These two veins accom
Spermatogenesis is controlled by follicle inguinal ring.
the testicular artery and again join to
stimulating hormone (FSH) of the pituitary
single vein in the posterior abdominal
gland.
The right testicular vein drains into inte
Interstitial cells or cells of Leydig vena cava. The lett testicular vein da
They are found as a clusters between the
into left renal vein.
seminiferous tubules. They secrete a
hormone, testosterone or androgen. The Lymphatic drainage
activity of Leydig cells is controlled by Preaortic and paraaortic lymph nodes.
Testis 20 Nerve supply
Basemen Spem
The testis is supplied by sympathetic nen
Membranee Tall(in Lumen)
Sertoli arising from segment T of the spinal cox
Cells
They pass through the renal & aortic pleu
Clinical Aspect
26 Monorchism- Unilateral absence ot lcsli
2. Anorchism Bilateral absence of tests
3.
Cryptorchism- (Undescended testis)
The testis during its descent fails
the serotum. It
to
Fig. Histology of seminiferous tubule
may lie in the lun

122
 of
f the
the
temina
t e r m i n a l

branches
Reproductive System
o n e

superior vesical artery.

from
R
4.
i n g u i n a l

At the deep
V e n o u s d r a i n a g e

greater pelvis cord

and
which o.

ring, it leaves the spermatic inferi

v e n o u s
plexus opens i
hooks round the lateral side of V
i ne
tes irc
naall i l i a c v e i n .

epigastric artery. It then

passes

hackwards
backward:

vessels
iliac Lymphatic drainage
and medially across the external

nodes,
and enters the lesser lymph
pelvis. runs [Link]
iliac

5. In the lesser pelvis The ductus defere Iymph nodes

lateral
-

lateral iliac
the Internal
downwards and backwards on
After 2.
perineum.
. pelvic wall decp to the it Nerve supply
course,
its plexus. Its ner
nere
crossing various structures in hypogastricj
plexus.
bladder wnc
reaches the base of the urinary
Inferior
nature.
in
truns downwards and forwards meda is
autonomic

to the seminal vesicle. Here, it approaches Aspect

the base or Clinical

ne opposite duct and reaches

palpable
because
b ecause of its
of itsthi
this

the prostate. At the base of

the prostate, It is easily a c c e s s via scr
1.
the duct of and easy
the ductus deferens joins with
structure
like
Seminal vesicle to form ejaculatory
duct.
It is o n e of
-
the come
Vasectomy
deferens is 2. done for ple family
The lower part of the ductus operation being defer
as the of the vas
dilated and tortuous and is known where small part
under local anesthesia
ampulla. removed
reversible and recanali
Blood supply operation is
which arises can be done if required.
Artery to the ductus deferens

2. SEMINAL VESICLE (JHJTYT)

ejaculatory duct.
Introduction
thick al
lobulated sacs. The seminal vesicle secrete a
These are two thin walled fluid that forms a large part of the s

Location The secretion contains fructose

the bladder and the rectum coagulation enzyme called the vesicui
They lie between
and laterally.
and directed upwards Blood supply
Shape Pear shaped. 1. Inferior vesical artery
Length- 5 cm long. 2. Middle rectal arteryy
The upper pole is cul-de-sac (blind) and the
to form a straight duct Venous drainage
lower pole is narrow

of seminal vesicle. Internal iliac veins

called the duct
seminal vesicle joins the vas
The duct of Lymphatic drainage
base of the prostate to form
deferens at the
Internal iliac nodes.

126
22
 Reprmclive Syste

Female External Genitalia

Female external genitalia is also called the Posteriorly, the two lubin minon meel
vulva or pudendum. lt consists of mos form the /renulum of/ ventlbule
pubis, labia majora, labia minora, elitoris, . The inner rlace ol the ubin nimo
vestibule of vagina, bulbs of vestibule and COntains nerous Ncbaccou glunds.
greater vestibular glands.
4 Clitoris
. Mons pubis homolopoun with
t is a rounded median cutaneous clevation I is an erectile organ, I urcthra
penis, but it is not
Iraversed by
in front of pubic symphysis. I is formed
lics in the anterior part of the pudendal
clcfh.
by accumulation of subcutaneous fat. Itis of a pa
The body of the clitorin in made up
covered by coarse hair called pubic hair. cavernonu
of ercctile tissuc, the corporu
to the
2. Labia majora sheath and arc atlached
Cncloscd in a

These are two prominent fat filled ischiopubic rami. Thcy are partly weparalcd
Thec
longitudinal cutaneous folds. They extend by an incompletepectinifarm septum.
from the mons pubis to the perineum. corpus spongiosus
is abscnt.
of a
Their outer surfaces are covered with hair The tip of the clitoris is in the lorm
and the inner surfaces are studded with large rounded tubercle, glans clitoridis which i
of the
continuation
sebaceous glands. rmed by the cephalic
surface of the
bulbs of the vestibule. The
They form the lateral boundary for pudendal
glansis highly sensitive and plays important
cleft into which the urethra and vagina open.
role in sex ual responscs.
The two labia join in the front to formn
5. Vestibule of vagina
anterior commissure and posteriorly
minora. It
they meet indistinguishably at posterior It is a space betwcen the labia
commissure which overlies perineal body. shows following features,
Urethral orifice It lies just in front of
the
The area between the posterior commissure -
and anus which is about 2.5 cm long vaginal orifice.
the
constitutes the gynaecologicalperineum. Vaginal oritice or introitus It lies in
-

3. Labia minora posterior part of the vestibule. In virgin, it

is partly closed by a thin membrane called
These thin folds of skin which lie
are two
Mons pubis Clitorls
within the pudendal cleft. These are hairless Superior labial-
and devoid of fat. commissure Prepuce
-Glans
Anteriorly, each labium minus split into two
Lablum majus-
-Frenulurr
of cltoris
layers, Lablum minus Urethral
a) The upper layer joins the corresponding onfice
Frenulum of-
layer of opposite side to form the prepuce vestibule
Hymen
ofthe clitoris. Posterior labial- Vaginal
orifice
b) The lower layers oftwo sides join to form Commissure
Fig. Female external genitalia
the frenulum of the clitoris.

131
 Reproductive Systenm Blood supply
R is deep
the hymen. In married women, the hymen i I. Superficial
and exteme
mal puder
tissue cane
of femoral artery
epresented by rounded tags of branches
the carunculae hymenales. Labial
branches of interna
Orifices of the ducts of greater vestibun
2. puder
artery.
glands- They lie one on each side of vaginal
Venous drainage
orifñce between the hymen and labium
minus. Corresponding
veins drain into.
vein.
Openings of lesser vestibular glands or 1. Great saphenous
mucous glands- Numerous lesser
vestibular 2. Internal
iliac vein.
or mucous
glands open on the surface o Lymphatic drainage
vestibule.
vestibular fossa- The posterior part of the Superficial inguinal lymph nodes
vestibule between the vaginal orifice and Nerve supply
the frenulum of vestibule forms a shallow 1. Dorsal nerve of clitoris.
depression called vestibular fossa.
2. Ilioinguinal nerve.
6. Bulbs of vestibule
Bulbs of vestibule are a pair of two oval 3. Genital branch of genitofemoral nenerve
bodies of the erectile tissue that 4. Perineal branch of posterior cutane
correspona
to the two halves of the bulb of the nerve of thigh.
penis.
The bulbs lie on the either side of the 5. Posterior labial nerves.
vaginal and urethral orifices, superficial to 6. Perineal branch of pudendal
the perineal membrane. nerve
The tapering anterior end
Clinical aspect
of the bulbs unite The clitoris may be absent, double or
in front of the urethra
by a venous plexus It is
bi
called the bulbar commissure. enlarged in hermaphrodism.
The expanded 2. The labia minora may show
posterior ends of the bulbs partial fusion
partly overlap the greater vestibular 3. The female urethra
glands. may open on the anter
7. Greater vestibular wall of the vagina instead of
glands the vestibule. opening i
(Bartholin's glands)
4. Abnormal
These are homologous with the
bulbourethral development of gonads
glands of Cowper in the male. These lies in genitalia give rise to various
the superficial perineal hermaphrodism. types
space. These glands
secrete mucous. 5. The cutaneous
nerves of
Each gland has a long duct
about 2 cm derived from the perineum
sacral nerves
long which opens at the side of the segments also [S,3
between the hymen and the labium hymen, nbres to the
supply parasympathe
minus. pelvic organs. Diseases of
organs may, therefore
the perineum. cause referred pa

132
22
 Reproductive System

Female Internal Genitalia

1. OVARY (aiet)
Introduction Surfaces
The ovaries are a pair of female 1. Lateral surface
reproductive
organs and are the female [Link] female
2. Medial surface.
gametes, called the ova (singular-ovum) are
produced in them. Relations
Location a.
a. Peritoneal relations
to
connected
Mesovarium ovary is
The
Each ovary lies in the ovarian fossa on the 1. broad ligament
of the
lateral pelvic wall on each side of the uterus. the posterior layer called the
fold of peritoneum
by a short transmits the
In embryonic and early fetal life, the ovaries mesovarium. The
mesovarium

from the ovary.

to and
are situated in the lumbar region near the vessels and nerves

kidneys. They gradually descend along the ligament of ovary or

or

gubernaculum to reach at the lesser pelvis. 2. Suspensory - The lateral

infundibulopelvic
ligament
of uterus,
ligament
of the broad the
Position part i n f u n d i b u l u m of
from the
extending of the ovary
Position of the ovary is variable. tube and the upper pole
uterine distinct
vessels form
a

In nulliparous women, its long axis is nearly the external iliac

1. to
ligament of
ovary.
suspensory
vertical. fold known as and nerves.

the ovarian vessels

axis is contains the
2. In multiparous women, its long It attachments,
Because of its peritoneal to
horizontal. considerable mobility leading
ovary has
orientation.
Shape Oval in shape. variation in its
in
girl it is greyish-pink Visceral
Visceral relations
Colour- In young b.
to grey.
[Link] puberty the colour changes 1. Uterine tube
width 3 cmand Upper pole
Dimensions -
Length 4 cm, 2. External iliac
vessels

thickness 2 cm- 1 . Pelvicfloor

Lower pole
External features 1. Uterine tube
& 2 surfaces. Anterior border-
borders
2 poles, 2
Each ovary has 2. Obliterated umbilical artery
Poles tube
Posterior border -1. Uterine
or tubal pole.
1. Upper pole 2. Ureter
uterine pole.
2. Lower pole or

Lateral surface -

1 . Ovarian fossa
Borders 2. Obturator vessels & nerves
border.
mesovarian
. Anterior or
Medial surface - 1. Uterine tube
free border
2. Posterior or

133
 Reproductive System Secondary Follicular Follicular

oocyte
cells fluid
Suspensory Developing
Stroma
/ Ligament Fallopian Tube
primary folicle

( O

OVARY Mature
fgyaaf
olNlcdeian)
Ruptured
follicle
Oyary Uterus
Corpus Mum ree
Utero-Ovarian
albicans

Atretic follicle
Early corpUs luteum
(Ovulation
Ligament Corpus luteum

Broad fully formed

Ligament of ovary
Fig. Structure
[Link] and fallopian tube
.Maturing follicles
Structure of ovary Graafian follicles
or
1. The ovary is covered by a single layer .Corpusluteum
cuboidal epithelium called as the germinal
Corpus albicans
epithelium.
The medulla is
the inner part and consists
2 Immediately beneath the surface epithelium, 5.
a tough collagenous coat called the
funica
loose connective
tissue containing vesek
There are Sma
albuginea which surrounds the ovarian nerves and lymphatics.
cells' which
substance is present. collection of cells, "hilus
interstitial cells of tests
The substance of the ovary is divisible into homologous to the
outer cortex and inner medulla.
6. The hormone oestrogen is secreted by the
The cortex forms the major part of the ovary follicular cells of ovarian follicles. Anotie
and consists of stromal cells. The cortex hormone, progesterone is secreted by th
contains ovarian follicles at various stages corpus luteum.

of development. Each follicle contains one Blood supply

oocyte. One follicle matures every month
and sheds an oocyte. Total of 400 oocytes 1. Mainly by ovarian artery

are ovulated in the reproductive life. After 2. Uterine artery.

is
the oocyte is liberated the Graafian follicle
converted into a structure called the corpus Venous drainage
luteum. Changes involving formation of Number of veins arise from the ovary an
of
ovarian follicles till the degeneration form a pampiniform plexus around
constitute the ovarian cycle. artery. The plexus condenses into a sing
corpus luteum
with numerous
Hence the cortex is studded ovarian vein near the pelvic inlet. This
follicular structures which include, ascends on the posterior abdominal wall a
Primordial follicles drain into the inferior vena cava on the n
side& into the left renal veinon the left st

134
 Reproductive System
radioopaque dye and visualise them in a 5. Tubal pregnancy- Sometimes fertilisedd
radiograph. Spillage of the dye into the ovum instead of reaching uterus
adheres
peritoneal cavity through the lateral end of to the walls of the uterine tube
and starts
the tubes indicates called tubal
its
pateney. developing there. This is Iead
Tubectomy- For the pregnancy. The enlarging embryo may
purpose of family
planning, a woman can be sterilised by to rupture of tube.
removing a segment of the uterine tube on
both sides.
3. UTERUS |Hystera| (THTVT)
Introduction Dimensions
cm thick.
broad and 2.5
The uterus is thick walled, hollow, muscular 7.5 cm long, 5 cm

organ situated obliquely within the lesser Weight-30 to 40 g

pelvis between the urinary bladder and Position
rectum. It is primarily concemed with the uterus Is
woman, the
implantation of the fertilised ovum, enabling In a nulliparous
is normally
within the pelvis. It
it to grow into a fully form fetus. At the time completely
the anteverted and anteflered in position.
of parturition, contractions of muscles in
T h e forward
bending
wall of the uterus result into expulsion of a) Anteversion to the
uterus relative
cervix of the
the fetus from the uterus. of the
anteversion.
Here,
reterred to as
vagina is makes an angle
Location axis of the vagina
the long axis of the cervIX
It is situated in the pelvic cavity with urinary of about 90° with the long
behind.
bladder in front and the
rectum (angle of anteversion).

Shape -
Piriform or pear shaped.

Uterine tube

Ovarian Fundus of
Body of
uterus
ligament uterus
Suspensory
ligament Eggcell

Round ligament
(cut) Fimbriae

Endometrium

Myometrium
Ovary
Perimetrium
Broad ligament

Cervix

Vagina
Fig. Uterus
 are
convex
and provi
and

Reproductive System lateral

borders
broad ligament ae
ligament of uten
is to the
of the uterus nds along
along the
a t t a c h m e n l

ascends
D) Anteflexion The body relative artery later
uterine
also slightly bent forwards on itself The
uterus
between the
the two la
Here, of
to the cervix referTed to as anteflexion. borders
The uterine tubes
ne long axis of the body ofthe uterus nakes
the broad
ligament.
of this
ope
long axis ot uterus at
the upper end his borde
n angle of about 125" with the into the borderalso gives attach
the cervix
(angle of antetlexion) This end ofthe of uterus and to
round liganent the
Parts to the
ligament ofovary.
The uterus is divided into two parts-bo4y
and cervix. The junction of these iwo par Uterine cavity
IS marked by a cireular constriction calle
sagittal section through the uten
In a
the isthmus. seen as narrow slit as ita
the cavity is
In the corona
Body compressed anteroposteriorly.
the uterus is trianonl
It is the upper expanded part of the uterus. It section, the cavity of
forms the upper 2/3 of the uterus. It shows with the apex directed downwards. T
are opened in
following features, right and left uterine tubes
the superolateral angles of this cavity.
. Fundus- The fundus is a part of the uterus
which lies above the openings of fallopian b. Cervix
tubes. It is formed by the upper end of the
The cervix is the lower, cylindrical parn od
uterus. It is convex and dome-like. The
implantation of the fertilised ovum takes the uterus. It is about 2.5 cm long and les
place in the posterior wall of the fundus. mobile than the body of the uterus.

The superolateral angles of the body project The lower part of the cervix projects likea
outwards at the junction of the body and inverted cone into the vault of vagina whid
fundus called cornua of uterus which gives divides it into 2 parts,
attachment to the uterine tube, ligament of 1. Supravaginal part- It is related to, A.
ovary and round ligament of uterus.
2 Two surfaces - The body shows two
Anteriorly - Bladder

surfaces, Posteriorly - Rectouterine pouch

a) Anterior or vesical surface-It is flat and -

Coils of intestine
related to the urinary bladder. It is covered 1.
- Rectumn
with the peritoneum and forms the posterior
On each side
or superior wall of the uterovesical pouch.
-

Ureter
- Uterine artery
b) Posterior or intestinal surface- It is
2.
convex and related to coils of the terminal Vaginal part- It projects into the anten
ileum and to the sigmoid colon. It is covered wall of the
with peritoneum & forms the anterior wall of is vagina. This part of the cen
separated from the vaginal wall by spaci
the pouch of Douglas (rectouterine pouch). or recesses called the anterior, lateral an

3. Two lateral borders- The right and left posterior vaginal -forni
3. The fornices. (singula
posterior fornix is the deepest.

2 138|
 Revtagenal tstula The va
eprmiucve Sysm
Egisintnmy- t s Traua sdurnng h
hid birth can
Seiarerai saie vana T enmen the va
urier ir he uv unng S
and the r v n u m
sage of abour
ga an
peculam euminatina s n
nur ta h e vagi
the vagina 1 ntrnduae instrume
dacmg * specuhum ma careiw
spect the cert as
and vagnal vault at Pertiratve ot the psterior forni
as to akE the vagmal smat ikad A penivitis and dcath
can
way
Carcine Srondar ohement
ot s
vapna h e cancer of senin v
commo
5. BREAST |Mammary gland] (FAAJT)
Iatroduction quadrant. called the arillary tail of Spen
The breast s found in
passes through an open1ng in the deep fas.|
both genders. bu
t S
rudimentary in the male and is well and lies in the axilla. The opening is cal
developed in the female after foramen of Langer.
puberty. The
breast is a modified sweat gland. It forms
an Structure
important accessory organ of the female
reproductive system and 1
1. Skin- It covers the breast and
to
nutrition sshou
the newborn in the formprovides
of milk. following features.
Location a.
Nipple It is a conical projection prese
It lies in the just below the centre of the breast at the lev:
superficial fascia of the pectoral of the 4 intercostal
region. space, 10 cm from k
Extent
midline. It is pierced
ducts. It
by 15 to 20 lactifenus
contains circular and
The base of the breast extends
vertically smooth muscles. It has longituu
from to 6 ribs and
the 2 and
few modified swe
from sebaceous glands. It is rich in
the lateral border of the horizontally
sternum to the mid- supply. nen
axillary line. b.
Areola -The skin
Parts Quadrants- The breast is the the basee'
into four quadrants,
divided nipple is surrounding cirular
area called pigmented and forms a
the [Link] is
I. Upper medial modified sebaceous region neu
its glands, particularly
2. Upper lateral margin. These become arged durnn
pregnancy and aisev
3. Lower medial lactation to form
tubercles
of of secretions
4. Lower lateral these Montgomery. Oily
glands lubricatethe nipple and
A small extension of the upper areola to prevent them during
lateral lactation. from erackmE
 Suspensory ligament of
the breast (Cooper's ligament)

Rib
Lobule containing
Deep
alveoli
fascia

Intercostal Secondary Fat in

m u s c l e s
tubule Superficial
fascia
Pectoralis

major muscle
Mammary
duct
Areola
Lactiferous-
sinus Nipple
Lactiferous
duct
Nipple
Areola
Fat in
Superficial
fascia

sectioned
partially
Anterior view,
(b)
(a) Sagittal section

Fig. Breast of
the main bulk
It forms
the breast
-

stroma

areola also
b) Fatty all o v e r
glands, the is
distributed
It
from sebaceous
the gland. It areola and nipple.
Apart the
glands and
accessory beneath
sweat contour.
contains some except rounded in
breast
mammary glands. makes the
devoid
the nipple and areola is Blood supply
The skin of sinus
Below the areola
lie lactiferous artery,
ofhair. 1. Internal thoracic
stored milk is
seen.
where thoracic artery,
compound
tubulo- 2. Lateral
Parenchyma
-
It is a
milk. The thoracic artery,
which secretes
3. Superior
alveolar gland lobes. Each
lobe
consists of 15 to 20 4. Thoracoacromial artery,
gland is drained by intercosta
is a cluster of alveoli and ducts branches of posterior
The lactiferous 5. Lateral
a lactiferous duct.
and open on arteries.
towards the nipple
coverage
each duct has
a

I. Near the termination, Venous rainage

sinus.
dilatation called a lactiferous Internal thoracic vein
1. Superficial veins
the lower part ofth
framework
Stroma- It forms the supporting and superficial veins of
of the gland. It is partly fibrous
& partly fatty. neck.
known as
It forms septa veins Axillary and posterior inter
3) Fibrous stroma- 2. Deep -

which
e
Suspensory ligaments of Cooper costal veins.
gland to the pectoral
anchor the skin and
fascia.