20 18 professional knowledge of gynecologists: anatomy of female reproductive system
I. Female external genitalia
Yin Fu, labia majora, labia minora, clitoris and vaginal vestibule (frontcourt ball, vestibular gland, urethral orifice, vaginal orifice and hymen).
Second, the female internal genitalia.
1. vagina
(1) Vaginal stratified epithelium: glandular, which changes periodically under the influence of estrogen and progesterone.
(2) The vaginal wall is rich in venous plexus, which is easy to form hematoma after injury.
(3) The depth of the posterior vaginal vault is 12cm, and the top is adjacent to the uterorectal recess (the lowest point of abdominal cavity), which can be used for the diagnosis of puncture (ectopic pregnancy) or drainage.
(4) Self-cleaning function: In the first half of menstruation, squamous epithelium proliferates under the influence of estrogen, which decomposes glycogen and increases lactic acid under the action of physiological normal bacteria Vagina, and PH↓ inhibits pathogenic bacteria. In the second half of menstruation, progesterone, squamous epithelial shedding, pH =, self-cleaning function decreased, and it is easy to be infected after menstruation. Don't clean the vagina often at ordinary times.
2. The uterus
(1) Uterine isthmus: It is the narrowest part formed between the uterine body and the cervix. The length of non-pregnancy is 1cm, and the lower end is connected with the internal cervix. The upper end is the anatomical internal orifice, and the lower end is the histological internal orifice. Pregnancy can be as long as 7-LOCM.
(2) Endometrium:
Basal layer: the inner layer is 1/3, which is close to the myometrium of uterus. It is not affected by hormones and does not change periodically, and it is easy to cause amenorrhea after excessive injury.
Functional layer: the outer 2/3, close to the uterine cavity, changes periodically under the influence of hormones, and can shed and bleed. (divided into dense layer and sponge layer)
(3) Four pairs of ligaments in uterus:
① Ligamentum teres: keep leaning forward.
② Ligament of uterosacral ligament: Pull backward and keep forward.
③ Broad ligament: Keep the uterus in the middle position.
④ Main ligament: fix the position of cervix to prevent uterine prolapse.
3. Fallopian tube: interstitial part; Isthmus; Ampulla (normal fertilization site \ ectopic pregnancy multiple sites); Umbrella (egg picking)
4. Ovarian function: laying eggs, endocrine function.
Three, blood vessels, lymph and nerves
1. Uterine artery: the anterior branch of the internal iliac artery, from posterolateral to anteromedial, passes through the ureter (with water under the bridge) to the lateral edge of the uterus 2cm outside the internal cervical orifice, and should be placed inward during operation to avoid damaging the ureter.
Fourth, pelvis.
1. Composition of pelvis:
(1) Hip bone 2 (ilium, ischium, pubis), sacrum 1, coccyx 1.
(2) Three joints: the left and right sacroiliac joints; Sacrococcygeal joint and pubic symphysis
(3) Two ligaments: sacrospinous ligament and sacral tubercle ligament (sacrum-ischial tubercle)
2. Pelvic boundary: the sacrum promontory, iliopubic line and pubic symphysis are divided into large pelvis (false) and small pelvis (true).
V. Pelvic floor
1. Perineal body: Wedge-shaped soft tissue between anus and vagina, about 3-4cm thick, consisting of skin, subcutaneous fat fascia, central perineal tendon and levator ani. It is easy to tear when giving birth, so pay attention to protection.
2. levator ani consists of pubic coccyx muscle, iliococcyx muscle and coccyx muscle.
Six, adjacent organs
Urethra, bladder, ureter, rectum, appendix