What is the location of Ovaries?
Ovaries are a pair of organs responsible for producing ovum (female gamete) and hormones. Ovary lies in the ovarian fossa on the lateral wall of the pelvis (floor of ovarian fossa is crossed by obturator nerve and vessels).
The boundaries of ovarian fossaare as follows:
- Anteriorly: External iliac vessels.
- Posteriorly: Ureter and internal iliac vessels.
- Inferiorly: Uterine tube.
Describe the gross features and relations of ovary.
Ovaries are almond shaped. They are approximately 3 cm. long , 2 cm. wide and 1 cm. thick. Each ovary has:
Two surfaces: Lateral and medial surfaces. Lateral surface is convex and is in contact with the peritoneum lining the ovarian fossa. The peritoneum separates the ovary from obtutator nerve and vessels. Medial surface is related to the uterine tube.
Two poles: Upper and lower poles. The upper pole is broader and is in contact with the uterine tube and external iliac vein. It provides attachment to suspensory ligament of ovary which contains ovarian vessels and nerve. The lower pole is narrower and is related to pelvic diaphragm.Is attached to the upper lateral angle of the uterus by the ligament of the ovary.
Two borders: Anterior and posterior. The anterior border is attached to the posterior layer of broad ligament by mesovarium. The posterior borderis related to ureter.
• Two borders: Anterior and posterior. The anterior border is attached to the posterior layer of broad ligament by mesovarium. The posterior borderis related to ureter.
Describe the blood supply and lymphatic drainage of ovary.
Arterial Supply of Ovary: Ovary is mainly supplied by ovarian artery which a branch of aorta and arises at the level of L1 vertebra. It is also supplied by ovarian branch of uterine artery (branch of internal iliac tery).
Venous Drainage: The right ovarian vein drains into inferior vena cava, wheras the left ovarian vein drains into the left renal vein.
Lymphatic drainage: Lymph from ovary drains into pre-aortic and para-aortic lymph nodes.
Which nerves supply the ovary?
Ovaries are innervated by autonomic nerves. Pre-ganglionic sympathetic fibers are from T10 and T11 spinal segments and the preganglionic parasympathetic fibers arise from S2,S3,S4 spinal segments.
Ovarian pain is referred to the umbilical region as both are innervated by T10 spinal segment.
Describe in brief the parts of uterine (Fallopian) tube.
Uterine tube is divided into four parts. From lateral to medial end they are:
- Infundibulum ( 1.25cm): is the most lateral part which opens into the peritoneal cavity.It is funnel shaped and has finger like processes called fimbriae surrounding its opening (ostium). The longest fimbria is attached to the medial surface of the ovary.
- Ampulla (5cm): is the widest and the longest part of uterine tube.It is the site of fertilization.
- Isthmus ( 2.5cm): is narrow and thick walled.
- Intramural/interstitial part (1.25cm): passes through the wall of the uterus and opens into the uterine cavity.
Name the arteries that supply the uterine tube.
The following arteries supply the uterine tube:
- Uterine artery (branch of internal iliac artery)supplies medial 2/3rd of the uterine tube.
- Ovarian artery (branch of abdominal aorta) supplies lateral 1/3rd of the uterine tube
Applied Aspects
Referred pain from ovary
Ovarian pain is referred to the umbilical region as both are innervated by T10 spinal segment.
Ovarian Cyst
Ovarian cysts may get formed due to the developmental arrest of the ovarian follicles.
Ovarian tumors
- Malignant growths may arise from germ cells, follicular cells .
- Secondary deposits from other places to ovary are common by retrograde lymphatic spread or trans-celomic spread from breast or abdominal organs.
- Secondary deposits are called KRUKENBERG’S tumors.
- Teratoma of ovary arises from undifferentiated cells persisting from embryonic life which comprise cells from all 3 germ cell layers and are usually benign (occurs in young age and contains hair, bone and nail inside it).
Ligation of uterine tube
Ligation of uterine tube is one of the methods of birth control.
The exterior of genital tract in females communicates with the peritoneal cavity through the uterine tube. This is a potential pathway for spread of infection to the tube (saplingitis) and pelvic cavity (pelvic inflammatory disease).
Ectopic pregnancy
Uterine tube is one of the sits of ectopic pregnancy.