Ovary (Left; Superior)

Structure/Morphology

The ovaries are approximately 4x2x3cm in size, whitish, and consist of an inner medulla and an outer cortex (Standring, 2016). The cortex surrounds the medulla except at the hilum, where the ovarian vessels and nerves enter the ovary. The cortex itself is covered by a collagenous tunica albuginea and an epithelial layer and contains the ovarian follicles.

Anatomical Relations

The ovaries sit on the lateral pelvic wall and are retained in place within the pelvic cavity by a portion of the broad ligament called the mesovarium, which encloses the ovary and helps form the ovarian bursa. In addition, the ovary is supported by the suspensory ligament of the ovary and the proper ovarian ligament (round ligament of the ovary).

The fimbriae of the uterine tube, fingerlike mucosal folds of the uterine tube, lie in close proximity to the superior pole of the ovary. On the right-hand side, the ileocecal junction, cecum, and appendix are superolateral to the ovary, while on the left, the sigmoid colon and upper rectum are superolateral to the ovary.

During pregnancy, the ovaries ascend within the pelvic cavity and during the third trimester are situated in the abdominal cavity.

Function

At birth, females have their full complement of primordial follicles. After puberty, each month, up to 20 primordial follicles begin to develop. However, only one follicle becomes the dominant follicle and undergoes ovulation. The remnant of this follicle becomes the corpus luteum and secretes progesterone and estrogen.

Arterial Supply

The ovarian arteries arise within the abdominal cavity as branches of the abdominal aorta. They descend into the pelvic cavity where they run within the suspensory ligament and divide into ovarian and tubal branches.

Venous Drainage

The venous drainage of the ovary forms via pampiniform plexus, which form two ovarian veins that travel with the ovarian artery. These veins usually unite to form a single ovarian vein that drains directly into the inferior vena cava on the right and via the renal vein on the left.

Innervation

Innervation of the ovary is supplied primarily through fibers that pass through the ovarian plexus. The upper region of the ovary is innervated by nerves derived from renal and aortic plexuses, while the lower portion is innervated by branches of the superior and inferior hypogastric plexuses. Sympathetic innervation of the ovary travels from the thoracic and sacral splanchnic nerves, whereas parasympathetic innervation is supplied through pelvic splanchnic nerves.

Lymphatic Drainage

Lymph from the reproductive organs such as the ovaries, uterine tube and uterus is received by the right, left, and intermediate lymph node groups (Földi et al., 2012).

List of Clinical Correlates

—Ovarian cysts

—Ovarian cancer

References

Földi, M., Földi, E., Strößenreuther, R. and Kubik, S. (2012) Földi's Textbook of Lymphology: for Physicians and Lymphedema Therapists. Elsevier Health Sciences.

Standring, S. (2016) Gray's Anatomy: The Anatomical Basis of Clinical Practice. Gray's Anatomy Series 41 edn.: Elsevier Limited.