[ANAT] UTERUS & VAGINA Flashcards
fornices of vagina (4)
anterior
posterior
2 lateral
shallowest fornix
anterior
deepest fornix
posterior
only fornix covered by peritoneum
posterior
fornix giving attachment to mackenrodt’s ligament
lateral
which is longer:
anterior wall or posterior wall of vaginal cavity
posterior (9cm)
vaginal orifice is partially enclosed by
hymen
anterior relation of vagina
urethra (embedded in its ant wall)
base of bladder
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
lateral relations of vagina
lower pt: bartholins’ glands, bulbs of vestibule, urogenital diaphragm
middle pt: constrictor vaginae (levator ani)
upper pt: mackenrodt’s ligament
vagina arterial blood supply (4)
vaginal br of uterine artery
vaginal artery
middle rectal artery
internal pudendal artery
ant & post midline azygous arteries are formed by
vaginal branches of uterine artery
vaginal artery
vagina venous drainage
vaginal veins—>internal iliac veins
vaginal lymphatic drainage below hymen
superficial inguinal LNs
vaginal lymphatic drainage above hymen
external & internal iliac LNs
uterus site
b/w urinary bladder & rectum
uterus shape
pear shaped
apex: inferiorly
base: superiorly
uterus normal position
anteverted-anteflexed (AVF) w/ empty bladder
anteversion angle
angle b/w uterus & vagina axes
90°
anteflexion angle
angle b/w uterus & cervix axes
170°
retroverted uterus
axes of uterus & vagina are in ALIGNMENT
retroverted uterus position can lead to
prolapsed uterus in old multiparous women–> difficulties getting pregnant
fundus of uterus is related to
coils of ileum
sigmoid colon
part of uterus fully covered by peritoneum
fundus
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
anterior
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