External genitalia/ Vulva
Blood supply: Pudendal arteries
Venous: Labial veins – drain to pudendal veins
Nerves: Urogenital plexus
- Anterior – ilioinguinal and genital branch
- Posterior – pudendal and posterior cutaneous nerves of thigh
Lymphatics: Superficial inguinal, deep inguinal (glans clitoris)
Clinicals:
- Infection of Bartholin’s glands
- STD
- Vulvar trauma – disruption of vessels
Uterus
Location: Posterosuperior to bladder , anterior to rectum
Supports:
- Pelvic diaphragm and urogenital diaphragm – main support
- Broad ligament – sides of uterus to pelvis
- Round ligament – uterine horns to labia majora via inguinal canal
- Ovarian ligament – ovaries to uterus
- Cardinal ligament – from cervix to lateral pelvic walls, contains uterine vessels
- Uterosacral ligament – cervix to sacrum
- Pubocervical ligament – cervix to pubic symphysis
Relations:
- Anterior – Uterovesical pouch, superior surface bladder
- Posterior – Rectouterine pouch, sigmoid colon
- Lateral – Broad ligament, uterine vessels
Blood supply: Uterine and ovarian arteries
Venous: Uterine venous plexus
Nerves: Pelvic splanchnic and lumbar – inferior hypogastric plexus
Lymphatics: Iliac and sacral
Clinicals:
- Hysterectomy – surgical removal of uterus
- Cervical cancer
- Endometriosis – ectopic endometrial tissue usually at ovaries and uterus ligaments
- Fibroids – benign tumors, can cause pelvic pain and infertility
- Endometrial carcinoma – often during or after menopause
Vagina
Relations:
- Anterior – Bladder fundus and urethra
- Posterior – Rectum, anal canal, rectouterine pouch
- Lateral – Ureter, uterine artery, levator ani
Blood supply: Uterine and vaginal arteries
Venous: Vaginal veins drain into vaginal venous plexus
Nerves:
- Autonomic: Uterovaginal nerve plexus (from inferior hypogastric plexus)
- Somatic: Deep perineal nerve (from pudendal nerve)
Lymphatics: Iliac and superficial inguinal lymph nodes
Clinicals:
- Vaginal infections – candidiasis and bacterial vaginosis (during pregnancy, diabetes, antibiotic treatment)
- Vaginal fistula – due to long and traumatic childbirth
Ovaries
Location: Ovarian fossa, posterior wall of broad ligament
Support:
- Mesovarium – part of broad ligament
- Suspensory ligament of ovary – contains neurovascular srtuctures
- Ovarian ligament
Blood supply: Uterine and ovarian arteries
Nerves:
- Sympathetic: Ovarian plexus
- Parasympathetic: Uterine plexus
Lymphatics: Paraaortic nodes
Clinicals:
- Ovarian cyst
- Tumors
- Polycystic ovary syndrome – elevated male hormones, irregular/no periods, body and facial hair
Fallopian tubes
Location: Upper border of broad ligament, from uterus to abdominal cavity
Blood supply: Tubal branches of uterine and ovarian arteries
Nerves:
- Sympathetic: Ovarian plexus
- Parasympathetic: Uterine plexus
Lymphatics: Iliac, sacral, aortic nodes
Clinicals:
- Ligation of uterine tubes – sterilization
- Ectopic pregnancy
- Salpingitis – inflammation due to bacterial infection
These are summarized notes from various sources, mainly TeachMeAnatomy and Wikipedia