[ANAT] UTERUS & VAGINA Flashcards by Aseel Maher

fornices of vagina (4)

anterior
posterior
2 lateral

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shallowest fornix

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deepest fornix

posterior

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only fornix covered by peritoneum

posterior

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fornix giving attachment to mackenrodt’s ligament

lateral

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which is longer:
anterior wall or posterior wall of vaginal cavity

posterior (9cm)

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vaginal orifice is partially enclosed by

hymen

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anterior relation of vagina

urethra (embedded in its ant wall)
base of bladder

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posterior relations of vagina

lower 1/4: anal canal & perineal body
middle 2/4: rectum & loose fibro-areolar tissue
upper 1/4: rectum & rectovaginal pouch

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lateral relations of vagina

lower pt: bartholins’ glands, bulbs of vestibule, urogenital diaphragm

middle pt: constrictor vaginae (levator ani)
upper pt: mackenrodt’s ligament

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vagina arterial blood supply (4)

vaginal br of uterine artery
vaginal artery
middle rectal artery
internal pudendal artery

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ant & post midline azygous arteries are formed by

vaginal branches of uterine artery
vaginal artery

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vagina venous drainage

vaginal veins—>internal iliac veins

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vaginal lymphatic drainage below hymen

superficial inguinal LNs

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vaginal lymphatic drainage above hymen

external & internal iliac LNs

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uterus site

b/w urinary bladder & rectum

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uterus shape

pear shaped
apex: inferiorly
base: superiorly

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uterus normal position

anteverted-anteflexed (AVF) w/ empty bladder

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anteversion angle

angle b/w uterus & vagina axes
90°

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anteflexion angle

angle b/w uterus & cervix axes
170°

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retroverted uterus

axes of uterus & vagina are in ALIGNMENT

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retroverted uterus position can lead to

prolapsed uterus in old multiparous women–> difficulties getting pregnant

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fundus of uterus is related to

coils of ileum
sigmoid colon

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part of uterus fully covered by peritoneum

fundus

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anterior surface of uterus is covered by peritoneum till

internal os

anterior surface of uterus is related to

urinary bladder w/ uterovesical pouch in between

posterior surface of uterus is covered by peritoneum till

cervix & posterior fornix

posterior surface of uterus is related to

sigmoid colon terminal ileum

upper ends of lateral border of uterus are an entry site of

uterine tube

upper ends of lateral border of uterus are an attachment site to

round ligament of uterus (antero-inferiorly) ligament of ovary (postero-inferiorly)

uterine tube & round ligaments of ovary and uterus run in

broad ligament

broad ligament extends from

lateral pelvic wall to lateral uterine border

artery ascending along lateral borders of uterus

uterine artery (tortuous course)

most fixed part of uterus

cervix

uterine artery crosses ureter____

2cm from cervix

vagina is divided into 4 fornices by

vaginal part of cervix

cervical canal is connected to vagina by

external os

supravaginal pt of cervix is related anteriorly to

bladder w/ parametrium in between

supravaginal pt of cervix is related posteriorly to

rectum w/ Douglas pouch in between

each side of supravagina pt of cervix is surrounded by

parametrium in which uterine artery crosses ureter 2cm from cervix

supravaginal pt of cervix fully covered by parametrium

posterior

supravaginal pt of cervix devoid of parametrium

in fetus which is larger: cervix or body

cervix

in a coronal section: cavity of the body of uterus appears

triangular

in sagittal section: cavity of body of uterus appears as a

transverse slit

apex of cavity of body of uterus is the

internal os

communications of cervical canal

cavity of body by--> internal os vagina by--> external os

base of cavity of body of uterus is b/w

openings of uterine tubes

external os in nulliparous women

circular (pin's head)

external os in multiparous women

transverse slit

isthmus corresponds to

upper 1/3 of cervix

isthmus resembles

uterine body

isthmus in non pregnant women

undergoes menstrual changes

isthmus is pregnant women

taken up into body--> lower uterine segment

peritoneal ligaments of uterus (3)

anterior lig posterior lig broad lig

fibromuscular ligaments of ovary (4)

transverse cervical ligaments pubocervical ligaments uterosacral ligaments round ligaments of uterus

ligaments SUPPORTING uterus

fibromuscular ligaments

ligaments NOT supporting uterus

peritoneal ligaments

uterovesical fold forms

anterior ligament of uterus

rectovesical fold forms

posterior ligament of uterus

broad ligament extends from

sides of uterus---> lateral pelvic wall

anterior ligament of uterus extends from

junction of body-cervix---->urinary bladder

posterior ligament of uterus extends from

front of rectum-->posterior fornix & uterus

transverse septum formed by uterus & 2 broad ligaments divides pelvic cavity into

ant compartment= bladder post compartment= rectum, pelvic colon, coils of ileum

superior layer of broad ligament is connected to ovary by

mesovarium

superior layer of broad ligament is pierced by

infundibulum of fallopian tubes

medial 4/5 of broad ligament contains

uterine tube

lateral 1/5 of broad ligament forms

suspensory ligament of ovary

posterior border of broad ligament rests on

pelvic diaphragm

lateral border of broad ligament is attached to

lateral pelvic wall

medial border of broad ligament is attached to

medial border of uterus

parts of broad ligament (4)

mesovarium mesometrium mesosalpinx suspensory ligament

mesovarium transmits

ovarian vessels, nerves, lymphatics

suspensory ligament of ovary transmits

ovarian vessels, nerves, lymphatics

mesosalpinx contains

anastomosis b/w uterine & ovarian arteries

mesometrium contains

uterine artery

largest part of broad ligament

mesometrium

contents of broad ligament

1-uterine tube 2-uterine vessels 3-ovarian vessels ----- 4-uterovaginal plexus 5-ovarian plexus 6-round ligament of uterus 7-ligament of ovary 8-epoophoron & garthner's ducts 9-paroophoron 10-lymphatics 11-parametrium

transverse cervical ligament

mackenrodt's ligament=lateral cervical

main supporting ligament of uterus

mackenrodt's ligament

infundibulopelvic part of broad ligament

suspensory ligament of ovary

uterosacral ligament function

pulls uterus backward against forward pull of round ligament keeps uterus in AVF position

round ligament of uterus attaches to

anterior surface of uterus & in front the uterotubal junctions

round ligament of uterus tranverses_______to reach______

inguinal canal to reach labia majora

round ligaments of ovaries extend from

posterior surface of uterus---> behind uterotubal junction & uterine ends of ovaries

uterus arterial supply

uterine artery

uterus venous drainage

uterine venous plexus

uterus nerve supply

uterovaginal autonomic plexus from inferior hypogastric plexus

cervix lymphatic drainage

external & internal iliac LNs & sacral

body lymphatic drainage

external iliac LNs

uterotubal junction lymphatic drainage

superficial inguinal LNs

fundus lymphatic drainage

para-aortic LNs