11女性生殖.ppt

Female Genital System,Female internal genital organsGonad ovary 卵巢Genital ductsUterine tube 输卵管Uterus 子宫Vagina 阴道Female external genital organsfemale pudendum 女阴,Female internal genital organs,Gonad ovary 卵巢Genital ductsUterine tube 输卵管Uterus 子宫Vagina 阴道,Ovary 卵巢,PositionLies in the ovarian fossa in the angle between the internal and external iliac vessels on the lateral pelvic wallShapean ovoid organSuperior poletubal extremityInferior poleuterine extremityAnterior bordermesovarian border(hilum of ovary)Posterior borderfree borderTwo surfacesmedial and lateral FunctionProduce ova and secrete estrogens,Ovary 卵巢,Supporting structures of ovarySuspensory ligament of ovary 卵巢悬韧带Proper ligament of ovary 卵巢固有韧带Posterior layer of broad ligament of uterus 子宫阔韧带后层,Uterine tube 输卵管,General featuresAbout 10-14cm longLocated at upper edge of broad ligament of uterus Four partsUterine part 子宫部Isthmus of uterine tube 输卵管峡Ampulla of uterine tube 输卵管壶腹Infundibulum of uterine tube 输卵管漏斗,Uterine tube 输卵管,Uterine part 子宫部 Narrowest partPierces uterine wall and opens into cavity of uterus by uterine orifice of uterine tube,Uterine tube 输卵管,Isthmus of uterine tube 输卵管峡 Straight and narrow portion,thick wallsIt is the place where the tubal ligation is performed usually,Uterine tube 输卵管,Ampulla of uterine tube 输卵管壶腹 Relatively wide,tortuous,longest part,thin wallsFertilization of the ovum takes place in its complex lumen,Uterine tube 输卵管,Infundibulum of uterine tube 输卵管漏斗Fimbriae of uterine tube 输卵管伞Ovarian fimbria 卵巢伞,abdominal orifice of uterine tube输卵管腹腔口,Ectopic pregnancy,Uterus 子宫,General features muscular pear-shaped organ Three partsFundus of uterus 子宫底Neck of uterus 子宫颈Vaginal part of cervix 子宫颈阴道部Supravaginal part of cervix 子宫颈阴道上部Body of uterus 子宫体Horn of uterus 子宫角Isthmus of uterus 子宫峡 short constricted part,transition between the body and the neck of uterus,About 1cm or less in length,it enlarges greatly during pregnancy,thus it is referred to by obstetricians as the“lower uterine segment”.子宫下段。,Uterus 子宫,Interior cavityCavity of uterus 子宫腔 the cavity of body of uterustriangular in coronal sectionCanal of cervix of uterus 子宫颈管 the cavity of the neckspindle-shapedopens into the vagina at the orifice of uterus 子宫口,Uterus 子宫,Position Lies in the center of the pelvic cavityBetween bladder,anteriorly,and rectum,posteriorlyUsually it is anteversion and anteflexionAnteversion 前倾 axis of uterus at 90o with that of vagina Anteflexion 前屈 axis of body of uterus is bent forward with that of the cervix forming an angle of about 170o(body of uterus is bent slightly forward at isthmus),Supports of uterus,Pelvic diaphragm Surrounding organs:vagina and bladderLigamentsBroad ligament of uterus 子宫阔韧带Round ligament of uterus 子宫圆韧带Cardinal ligament of uterus 子宫主韧带Uterosacral ligament of uterus 子宫骶韧带,Supports of uterus,Broad ligament of uterus 子宫阔韧带Are enclose by two layers of peritoneum,extends from the lateral margin of the uterus to the lateral wall of the pelvis.The free superior edge of the ligament enclose the uterine tube,its inferior and lateral margins are continuatin with the peritoneum on the pelvic wall.in the ligament there are uterine tube,ovary,proper ligaments of ovary,round ligament of uterus,blood vessels,lymphatic vessels,nerves and connective tissue.,Supports of uterus,Broad ligament of uterus 子宫阔韧带Mesosalpinx 输卵管系膜Mesovarium 卵巢系膜Mesometrium 子宫系膜,Round ligament of uterus 子宫圆韧带 Maintain the anteversion position of uterus.is attached to the uterus just below and in front of the entrance of uterine tube,pass through the inguinal canal,insert into the subcutaneous tissue of greater lip of pudendum and mons pubis.maintain the anteversion position of uterus.,Supports of uterus,Cardinal ligament of uterus 子宫主韧带 Support the normal position of uterus to prevent the 脱垂prolapse of uterus.extend from the cervix and superior extremity of vagina to lateral pelvic wall.,Supports of uterus,Uterosacral ligament of uterus 子宫骶韧带 Maintain the anteflexion position of uterus.pass backward from each side of the cervix to the front of second and third sacral vertebrae.,耻骨宫颈韧带,Vagina 阴道,Flattened fibromuscular tube,about 89cm longExtends upward and backward from vestibule to uterusFornix of vagina 阴道穹Formed between cervix and walls of vaginaPosterior fornix deepest and larger than either anterior or lateral fornices,and related to the rectouterine pouch,Accessory gland,Great vestibular gland 前庭大腺On either side of vaginal orificeOpen into vestibule at orifice of vagina,截石位,Female external genital organs,Mons pubis 阴阜Greater lips of pudendum 大阴唇Lesser lips of pudendum 小阴唇Vaginal vestibule 阴道前庭Eternal orifice of urethraVaginal orificeClitoris 阴蒂Bulb of vestibule 前庭球,Clitoris 阴蒂,Crus of clitoris 阴蒂脚,Bulb of vestibule 前庭球,Great vestibular gland 前庭大腺,Mamma 乳房,PositionLie in superficial fascia over the pectorals major and pectoral fascia胸肌筋膜Extend from 3rd to 7th ribs vertically,and from parasternal line to midaxillary line transversally,Mamma 乳房,StructuresContains skin,mammary glands，fibrous tissue and adipose tissue.Lobes of mammary gland 乳腺叶 15 to 20 that radiate outward from the nipple lactiferous duct 输乳管 lactiferous sinuses 输乳管窦 Suspensory ligaments of breast 乳房悬韧带(coopers ligaments)Connective tissue septa that extend from the skin to the deep fascia,Mamma 乳房,Teaching outline1.Master the composition and function of the female reproductive system.2.Master the shape,position,supporting structures of the ovaries.3.Master the position and portions of the uterine tubes,the features of each part of the uterine tubes.4.Master the position,features,portions and supporting structures of the uterus.5.Master the position and shape of the vagina,the position of the fornix,the relationship of the posterior fornix and rectouterine pouch.,简答：1 卵巢的位置、形态与固定装置。2 试述输卵管的位置和分部。3 试述卵巢的位置与固定装置4 试述子宫的形态分部5 试述子宫的位置6 试述子宫的固定装置。7 试述子宫动脉与输尿管的关系。名词解释：前倾前屈、子宫峡、子宫颈管、输卵管壶腹、卵巢伞,会阴是指盆膈以下所有组织而言。盆膈（肛提肌、尾骨肌及其上、下面的筋膜）将上方的盆腔和下方的会阴分开。会阴的结构，除男、女生殖器外，主要是肌和筋膜。,广义的会阴是指封闭小骨盆下口的所有软组织。呈菱形，其境界：前方为耻骨联合下缘，后方为尾骨尖，两侧界为耻骨下支、坐骨支、坐骨结节和骶结节韧带。以两侧坐骨结节的连线为界，可将会阴前方的尿生殖区和后方的肛区。,狭义的会阴指肛门和外生殖器之间的区域。,Perineum 会阴,一、肛三角的肌,1肛提肌levator ani：,（1）耻骨阴道肌 pubovaginalis,前列腺提肌levator prostatae,（2）耻骨直肠肌puborectalis,（3）耻尾肌pubococcygeus,（4）髂尾肌iliococcygeus,2尾骨肌coccygeus,3肛门外括约肌sphincter ani externus,Pelivic diaphragm 盆膈Superior fascia of pelvic diaphragm 盆膈上筋膜Levator ani 肛提肌Coccygeus 尾骨肌Inferior fascia of pelvic diaphragm盆膈下筋膜,二、尿生殖三角的肌,（一）浅层肌,1会阴浅横肌superficial transverse muscle of perineum,2球海绵体肌bulbocavernosus：阴道括约肌。,3坐骨海绵体肌Ischiocavernosus,（二）深层肌,1会阴深横肌deep transverse muscle of perineum,2尿道括约肌sphincter of urethra,尿道阴道括约肌（女）,Urogenital diaphragm 尿生殖隔,Triangular in shapeAttached laterally to Inferior Rami of pubis and rami of ischiumFormed by sphincter of urethra尿道括约肌,deep transverse muscle of perineum会阴深横肌superior and inferior fascia of urogenital diaphragm.尿生殖膈上、下筋膜,三、会阴的筋膜,（一）浅筋膜：1肛三角的浅筋膜,坐骨肛门窝 ischioanal fossa 1）position：肛管两侧与骨盆侧壁之间。窝尖：由盆隔下筋膜和闭孔筋膜会合而成。窝底：肛门三角区的浅筋膜和皮肤构成。内侧壁：肛提肌、盆隔下筋膜和肛门外括约肌。外侧壁：闭孔内肌及其筋膜、坐骨结节内面。前壁：尿生殖隔。后壁：臀大肌下部、骶结节韧带。2）内容contents：阴部内动脉internal pudendal a：阴部内静脉internal pudendal v：阴部神经pudendal n：,2尿生殖三角的浅筋膜：,浅层与腹下部和股部的浅筋膜相延续。,深层：会阴浅筋膜superficial fascia of perineum,（二）深筋膜,盆膈上筋膜superior fascia of pelvic diaphragm,盆膈下筋膜inferior fascia of pelvic diaphragm,盆膈Pelvic diaphragm,尿生殖膈上筋膜superior fascia of urogenital diaphragm,尿生殖膈下筋膜inferior fascia of urogenital diaphragm,尿生殖膈urogenital diaphragm,会阴浅隙：会阴深隙：,Fornix of vagina,cardinal lig.of uerus,