UTERUS

GROSS ANATOMY

The ovaries are solid,

ovoid structures, about 2
cm in length and 1 cm in
width.
Like the testes, they
develop from embryonic
tissue along the
posterior abdominal
wall, near the kidneys.
Accessory organs
include the uterine
tubes, uterus, and
vagina.

The glistening white ovaries are generally oval in shape but may vary
in size, position, and appearance, depending on the age and the
reproductive activities of the individual.
The ovaries of a normal adult woman are2.55 cm long, 1.53 cm
thick, and 0.71.5 cm wide, with a weight of 38 g.
The ovaries contain 12 million oocytes at birth. A woman will
release up to 300 ova, on average, during her lifetime. Histologically
the ovary is divided into the outer cortex and the inner medulla. The
cortex consists of a cellular connective tissue stroma in which the
ovarian follicles are embedded.
The medulla is composed of loose connective tissue which contains
blood vessels and nerves. The cortex is surrounded by a single layer of
cuboidal epithelium called the germinal epithelium
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The hilus is the base of the ovary; at this point the ovarian blood vessels
enter. The ovarian arteries arise from the abdominal aorta just below the
renal arteries. They pass downward across the pelvic brim, cross the
external iliac artery, and traverse the infundibulopelvic fold of peritoneum.
Branches go to the ureter, round ligament, and tube and anastomose with
the uterine artery.
As the ovarian artery passes through the mesovarium, it separates into
multiple branches that enter the ovarian hilus. Each of these arteries
divides into two medullary branches which cross the ovary. Cortical
branches arise from the medullary branches and supply the cortex and
follicles. Two prominent veins enter the hilus and, in general, follow the
arterial pattern.
At the hilus venous drainage forms a pampiniform plexus, which
consolidates to form the ovarian vein. On the right side the ovarian vein
drains into the inferior vena cava, while the left ovarian vein drains into
the left renal vein. The ovarian as well as the uterine blood supply
frequently is anomalous.
The nerve supply derives from a sympathetic plexus accompanying the
vessels of the infundibulopelvic ligaments.6The plexus arises at the level of
the tenth thoracic segment, but fibers from renal and aortic plexuses as
well as from the mesenteric and celiac ganglia are present.

UTERINE TUBES
(FALLOPIAN TUBES)
Receive the ovulated oocyte and provide a site for
fertilization
Empty into the superolateral region of the uterus
via the isthmus
Expand distally around the ovary forming the
ampulla
The ampulla ends in the funnel-shaped, ciliated
infundibulum containing fingerlike projections
called fimbriae

The fallopian tubes are bilateral muscular structures of

paramesonephric duct origin.
They are from7 to 12 cm in length and usually less than 1 cm in
diameter.
The tubes or oviducts have a lumen that varies considerably in
diameter. It is extremely narrow, being less than1 mm at its opening
into the uterine cavity.
It is wider in the isthmus (2.5 mm) and in the ampulla is
approximately 6 mm in diameter. The tube begins in the uterine cavity
at the cornu and penetrates the myometrium (intramural or
interstitial portion).
The second portion is the relatively straight and narrow portion of the
tube which emerges from the uterus posterior to and a little above the
origin of the round ligament. The lumen of the narrow isthmus is
relatively simple, with a few longitudinal folds. This portion of its tube
is 2 or 3 cm long. There are three layers of musculature: the inner
longitudinal, the middle circular layer, and the outer longitudinal
layer. There is some evidence that the isthmus may act as a sphincter.
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FEMALE: LATERAL VIEW