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Anatomi Organ Reproduksi Wanita

Ranti Pratiwi Pematasari


Vulva
Genitalia Externa
Labia majora = male scrotum
Superiorly: monspubis
Posteriorly: perinal body posterior commisure
Labium minus = Ventral shaft penis
Superiorly: 2 lamella lower form frenulum of
clitoris, upper form perpuce
Inferiorily: fourchette
Clitoris= penis
Composed: glands, corpus/body, two crura
Glands: covered stratified squamous epithelium
Corpus: 2 corpora cavernosa
Blood supply: branch internal pudendal artery
Genitalia Externa (2)
Vestibule: space
Laterally: hart line
Medially: hymen
Anteriorly: clitoral frenulum
Posteroirly: fourchette
Six opening: uretra,
vagina, two bartolin
gland ducts, two
paraurethral gland
(Skene)
Posterior portion
between fourchette and
vaginal opening: fossa
navicularis
Vulva
Artery: external and internal
pudendal arteries on each side
Lymph drainage: medial group of
superficial inguinal nodes
Nerve:
anterior part vulva: ilioinguinal nerve &
genital branch of genitofemoral nerve
Posterior part vulva: perineal nerve &
posterior cutaneous nerve
Vagina and Hymen
Hymen: nonkeratinized
stratified squamous
epithelium
Vagina:
Anteriorly: bladder and
urethra by vesicovaginal
septum
Posteriorly:
upper 1/3 rectouterine pouch
(douglas)
middle 1/3 ampula of rectum
by rectovaginal space
Lower 1/3 anal canal by
perineal body
Lateral: ureter, levator ani,
vestibule, uterine artery
Vagina and Hymen
Length :Vaginal anterior 6-8 cm, posterior
7-10 cm
Blood suply:
Arteries: vaginal artery, branch internal iliac
artery, branch uterine artery
Vein: plexus around vagina that drains into
internal vein
Lymph Drainage: upper 1/3 drains to external
and internal iliac nodes, middle 1/3 drains to
internal iliac nodes, lower 1/3 drains to
superficial inguinal nodes
Pelvic support
1. Perineum
2. Urogenital diaphragma
3. Pelvic diaphragm
4. Pelvic bone
5. Ligamentum and fascia
Pervic Floor

Contain: Perineum membran and Pelvic diaphragm


Perineum
Diamond shape space that lies bellow pelvic floor
Anteriorly: pubic symphysis
Anterolaterally: ischiopubic rami and ischial tuberositas
Posterolaterally: sacrotuberous ligament
Posteriorly: coccyx
Anterior triangle (urogenital triangle)
Superficial
Deep
Posterior triangle (anal triangle)
Perineal body:
Superficial: m. bulbocavernosus, m. superficial
transverse perineal, m. external anal sphincter,
Deep: m. pubococcygeus, m. internal anal spinchter
Urogenital Triangle
Bounded:
Superiorly: pubic rami
Laterally: ischial tuberosities
Posteriorly: m. superficial transverse perineal
Superficial: bartholin glands, vestibular
bulbs, clitoral body and crura, branches
pudenda vessel and nerve,m.
ischiocavernosus, m. bulbocavernosus, m.
superficial transverse perineal
Deep: portion of urethra, vagina, internal
pudenda artery branch, urethrovaginal
sphincter muscle
Anal Triangle
Contains: ischioanal fossae, anal
canal, levator ani, anal sphincter
complex (internal anal sphincter,
external anal sphincter, poborectalis
muscle), branches of pudendal nerve
and internal pudendal vessel
Perineum
Artery: internal pudendal artery, branches
of inferior rectal artery, and posterior
labial artery
Vein: internal pudendal vein
Nerves: via pudendal nerve (S2,S3,S4),
branches of inferior rectal nerve, dorsal
nerve of clitoris, perineal nerve
Blood supply perineum
Perineal nerve
Diaphragma
1. Urogenital diaphragma: muscle between
pubis symphysis and ischial tuberosities
including triangular area that support
perienum (sphincter urethra, m. deep
transverse perineal, internal and external
fascia)
2. Pelvic diaphragma: muscle from upper pubis
and ischium to the rectum that support
perineum (levator ani, m. coccygeal)
Levator ani: m. puborectalis, m. pubococcygeus,
m. iliococcygeus
Perineal body
A fibromuscular mass in the midline
ate the junction between anterior
and posterior triangle/ central tendon
perineum
Measure: 2cm tall&wide, 1.5cm thick
M.Bulbocavernosus, m. supervicial
transverse perineal, m. anal
sphincter
Pelvic
Bones

Composed of 4 bones: sacrum, coccyx, 2 innominate bone


Innominate bone formed by fusion: ilium, ischium and
pubis
Sagital View
Ligaments
Four Joints
1. Anteriorly: symphysis pubis
(cartilaginous joint)
2. Posteriolateraly: two sacroiliac joints
(synovial joints)
3. Posteriorly: sacrococcygeal joints
(cartilaginous joint)
False Pelvic
False Pelvic:
Anteriorly: lower
part of the anterior
abdominal wall
Laterally: Iliac fossae
and the iliacus
muscle
Posteriorly: lumbar
vertebrae
PELVIC INLET PELVIC OUTLET

Anteriorly: Symphysis pubis. Anteriorly: Symphysis pubis.


Posteriorly : Coccyx,
Posteriorly: Promontory of
Anterolaterally: ischiopubic ramus
sacrum, ala of sacrum.
Posterolaterally: Sacrotuberous
Laterally: linea terminalis ligament,
True Pelvic
The True pelvis
has:
1. An Inlet.
2. An Outlet.
3. A Cavity

The cavity is a
short, curved
canal, with a
shallow anterior
wall and a
deeper
posterior wall.
It lies between the
inlet and the
outlet.
Pelvic inlet
Fetal engagement:
biparietal diameter
that passing this
plane
Diameters:
Anteroposterior/ true
conjugate 11cm
Obstetrical conjugate
10.5cm
Diagonal conjugate:
measured clinically
12.5cm
Pelvic inlet
Anatomical
transverse
diameter: 13 cm
Obstetric
transverse
diameter
Pelvic inlet
Oblique diameter:
12cm
Sacrotyloid
diameter: 9.5 cm
Pelvic Cavity
Anteroposterior
diameter
12cm
Oblique diameter
Transverse
diameter

Interspinosus
diameter: 10cm
Pelvic Outlet
Anteroposterior
diameter
Transverse
diameter
FEMALE MALE

In female the Sacrum is usually wider and shorter.


Also, the Angle of the pubic arch is wider.
The promontory and the ischial spines are less projecting.
37
Types of Female Bony Pelvis

the shape
and
dimension
s of the
female
pelvis is of
great
importan
ce for
obstetrics
.
38
Uterus

5 cm
6 cm
Istmus

2.5 cm
Uterus dewasa:
Panjang: 7.5
cm
Panjang
rongga: 6cm
Tebal: 2.5cm Fundus, Corpus, Istmus, Cervix
Tebal dinding
otot sekitar:
Internal Organ
Uterus
Ovarium
Ligament
Blood supply
Anterior:
1. Umbilical
2. Inferior vesical
3. Obturator
4. Middle rectal
5. Uterine
6. Internal pudendal
7. Inferior gluteal

Posterior:
. Iliolumbar
. Lateral sacral
. Superior gluteal
Innervation
Peripheral nervous sys:
somatic and autonomic
Autonomic : sympathetic
and parasympathetic
Sympathetic: superior
hypogastric
plexus/presacral nerve
(T10-L2)
Parasympathetic: pelvic
splanchnic nerve (S2-S4)
Blending Inferior
hypogastric plexus/pelvic
plexus