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Structure

Ovary

Not medically reviewed · Content last updated · 2 min read ·

This is the date the draft was written, not a medical review date.

The ovaries are paired almond-shaped gonads that produce oocytes and the hormones oestrogen and progesterone. They lie on the lateral pelvic wall and are not covered by peritoneum.

Terminologia Anatomica (Latin): Ovarium · Open in the 3D atlas

Location

Each ovary lies in the ovarian fossa on the lateral pelvic wall near the division of the common iliac artery, in relation to the obturator nerve and the ureter. It is attached to the broad ligament by the mesovarium, to the uterus by the ovarian ligament and to the pelvic wall by the suspensory ligament, which carries the ovarian vessels.

Structure

The ovary has an outer cortex containing follicles at various stages, corpora lutea and corpora albicantia, and an inner vascular medulla. The surface is covered by a single layer of cuboidal germinal epithelium over the tunica albuginea. Dimensions are roughly 3 x 2 x 1 cm and change with age and cycle.

Blood supply

The ovarian artery arises directly from the abdominal aorta below the renal arteries, descends in the suspensory ligament and anastomoses with the uterine artery. The right ovarian vein drains into the inferior vena cava and the left into the left renal vein. Lymph drains to the para-aortic (lumbar) nodes, which explains the spread pattern of ovarian cancer.

Innervation

Autonomic fibres reach the ovary through the ovarian plexus along the ovarian vessels (sympathetic T10-T11, vagal and pelvic parasympathetic contributions are described variably). Pain is referred to the T10 dermatome, around the umbilicus; irritation of the peritoneum over the obturator nerve can cause pain in the medial thigh.

Function

The ovary releases a mature oocyte at ovulation and secretes oestrogen (granulosa and theca cells) and progesterone (corpus luteum) under FSH and LH control from the anterior pituitary, forming the ovarian cycle.

Clinical correlations

Functional and haemorrhagic cysts, polycystic ovary syndrome, torsion of the ovarian pedicle (acute pain, an emergency), endometrioma and epithelial, germ-cell or sex-cord tumours are encountered. Ovarian cancer often presents late because the organ is intraperitoneal; pelvic pain mimicking appendicitis can occur on the right side.

Common exam points

  • Ovarian artery from the aorta (L2); right vein to IVC, left vein to left renal vein.
  • Suspensory ligament carries the ovarian vessels; ovarian ligament attaches to the uterus.
  • Ovarian fossa: related to the obturator nerve and ureter (injury risk in oophorectomy).
  • Lymphatics to para-aortic nodes, as for the testis.
  • Ovary is intraperitoneal and lacks a peritoneal covering; visceral pain refers to T10.

References

  1. Drake RL, Vogl AW, Mitchell AWM. Gray's Anatomy for Students. Elsevier — Tier 3 (textbook)
  2. Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. Wolters Kluwer, 8th edition (2018) — Tier 3 (textbook)
  3. Hall JE, Hall ME. Guyton and Hall Textbook of Medical Physiology. Elsevier, 14th edition (2020) — Tier 3 (textbook)

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