Uterus (dave's notes) Flashcards
Describe the basic structure, dimensions and parts of the uterus
A muscular organ, 8x5x3cm, with a fundus, body and cervix
Describe the fundus of the uterus
The part above the entrance to the tubes. 5cm side to side and 3cmthick. Covered by peritoneum.
Describe the body of the uterus
The body tapers down from the fundus and is flattened anteroposteriorly, covered by peritoneum which becomes the broad ligament laterally
Describe the cervix
The cervix tapers below the body and proturdes into the vagina.
Where are the ureters located relative to the uterus?
They pass 1-2cm from the cervix
Where does the canal of the cervix start and end?
It starts at the internal os, running to the external os, and is continuous with the body.
What is the blood supply of the uterus?
The uterine artery. This is from the internal iliac artery through the base of the broad ligament.
What else does the uterine artery supply?
The cervix and vagina
What is the venous drainage of the uterus?
Veins course below the uterine artery at the lower edge of the broad ligament, forming a plexus on the pelvic floor to the internal iliac vein.
What is the lymphatic drainage of the uterus and cervix?
Mainly to external iliac nodes +/- inguinal nodes. Cervical lymph runs to external and internal iliac nodes (but not inguinal).
What is the nerve supply of the uterus?
Via branches of the pelvic plexus however much of uterine control is hormonal
Describe the structure of the uterine muscle
The bulk of the uterus is smooth muscle, in three ill-defined layers. The endometrium has a lining of columnar epithelium, with regular shedding.
What is the surface of the cervix?
The cervix has a transition from the columnar epithelium of the endometrium to the vaginal stratified squamous variety
Describe the development of the uterus and upper vagina
Development is by fusion of the paramesonephric ducts forming the uterus and upper vagina
What is the most common position of the uterus?
80% are anteverted
What are the anatomical supports of the uterus?
The most fixed part is the cervix, assisted by the bladder, vagina, pubovaginalis, and perineal body.
Describe the makeup and location of the broad ligament
The broad ligament is a lax double fold of peritoneum lying laterally between the sidewall of the uterus and pelvis
What does the lateral attachment of the broad ligament cross?
The obturator nerve, superior vesical and obturator artery and vein
What is the posterior relation of the broad ligament?
The posterior layer of the broad has the ureter adhering to it
Describe the upper border of the broad ligament
The upper border has a free edge and contains the uterine tube, therefore forms the mesosalpinx
The lateral quarter of the broad ligament forms what?
The suspensory ligament of the ovary
What does the suspensory ligament of the ovary contain?
The ovarian veins and lymphatics
What shapes the anterior layer of the broad ligament?
The round ligament bulges forward the anterior layer of the broad ligament
What is the course of the round ligament?
The round ligament extends from the uterus/tube junction to the deep inguinal ring, then to labium majus. It runs in the anterior layer of the broad ligament
What is the round ligament formed from?
Largely visceral muscle??
What is the round ligament continuous with? What does this form?
The ovarian ligament. This forms the gubernaculum.
What is the lateral ligament?
The lateral ligament consists of thickenings from the cervix to the pelvis supporting hte ureter, uterine artery, and iliohypogastric plexus
Where do the uterosacral ligaments run?
From the cervix embracing the rectouterine pouch and rectum
