Medicine

Ovarian Anatomy

 

Embryology

Develops similar to the testes; from the paramesonephric gonadal ridge of the intermediate cell masss.
It is pulled down by the gubernaculum which enters the inguinal canal in males, while attaches to the labia majora in females. Migration stops in the pelvis and the gubernaculum persists as both the ovarian and round ligament.

The mesonephric tubules normally degenerate but can persist as the epoophoron (series of tubes in the lateral mesosalpinx. The mesonephric duct may persist (duct of Gartner) and open into the fornix of vagina or vestibul of external genatalia. A paroophoron is a number of small blind tubes that lies more medially. (Last Anatomy 12th Ed Page 306 quotes it to be near the base of the broad ligament). These can distend to form a parovarian cyst.

Ovary

Ovoid, 3cm x 2cm x 1cm organ that is smaller then the testes, and smallest during before menarche and post-menopause. Its tubal pole is overlapped by the fimbriated end of the uterine tube. The medial pole is attached to the ovarian ligament and runs with the round ligament. Collectively they are the remnants of the gubernaculum.
The anterior surface of the ovary is attached to the posterior surface of the broad ligament by it folding over the ovary forming a mesovarium.

Mesovarium

The ovary is not covered posteriorly by peritoneum and instead is lined by cuboidal epithelium. This side faces the peritineal cavity.

The obturator nerve passes laterally to the ovary (hugging the pelvic wall, laterally) & diseases can cause pain to inner thighs. (L2-L4).

Blood Supply

The Ovarian Artery (branch of the aorta, emerging just below the renal artery) is the main supply. They run behind the peritoneum and cross the ureters over the psoas muscle obliquely. It then crosses the pelvic rim and enters the suspensory ligament of the ovary through the lateral end of the broad ligament.
It supplies the uterine tube and anastamoses with the uterine artery at the cornu. A ends by entering the ovary directly. The veins form a plexus in the mesovarium and suspensory ligament (embryologically equivelent to the pampiniform plexus in males) and drain to the ovarian vein which follows the artery. The right ovarian vein drains to the inferior vena cava and the left to the left renal vein.

Lymph

To the paraaortic nodes along the ovarian artery. (L2 just above the umbilicus).

Nerve

Sympathetic (vasoconstritors) fibrs come forth from the preganglionic T10/T11 cell bodies. Parasympathetic reaches via the hypogastric plexus (vasodilators).
Sensory nerves follow the sympathetics & therefore referred to the umbilicus. (T10,T11 dermatome)

Structure

Ovary has an inner vascular layer (Medulla) which is surrounded by a cortex containing the ovarian follical that are covered by a fiberous tunica alberginea and that then again covered by alayer of cuboidal epithelium.

A primary oocyte surrounded by a single layer of epithelium is called a primordial follicle and is 7 million at 16 weeks gestation, 1 million at birth and 40,000 at puberty.
The Corpus Leuteum (remnants after ovulation; granulosa and thecal cells) persist for 7 days (without implantation) and 9 months (with implantation). Both eventually degenerate and form a scar; corpus albicans.