Uterus (dave's notes)

Question 1

Describe the basic structure, dimensions and parts of the uterus

Answer 1

A muscular organ, 8x5x3cm, with a fundus, body and cervix

Question 2

Describe the fundus of the uterus

Answer 2

The part above the entrance to the tubes. 5cm side to side and 3cmthick. Covered by peritoneum.

Question 3

Describe the body of the uterus

Answer 3

The body tapers down from the fundus and is flattened anteroposteriorly, covered by peritoneum which becomes the broad ligament laterally

Question 4

Describe the cervix

Answer 4

The cervix tapers below the body and proturdes into the vagina.

Question 5

Where are the ureters located relative to the uterus?

Answer 5

They pass 1-2cm from the cervix

Question 6

Where does the canal of the cervix start and end?

Answer 6

It starts at the internal os, running to the external os, and is continuous with the body.

Question 7

What is the blood supply of the uterus?

Answer 7

The uterine artery. This is from the internal iliac artery through the base of the broad ligament.

Question 8

What else does the uterine artery supply?

Answer 8

The cervix and vagina

Question 9

What is the venous drainage of the uterus?

Answer 9

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.

Question 10

What is the lymphatic drainage of the uterus and cervix?

Answer 10

Mainly to external iliac nodes +/- inguinal nodes. Cervical lymph runs to external and internal iliac nodes (but not inguinal).

Question 11

What is the nerve supply of the uterus?

Answer 11

Via branches of the pelvic plexus however much of uterine control is hormonal

Question 12

Describe the structure of the uterine muscle

Answer 12

The bulk of the uterus is smooth muscle, in three ill-defined layers. The endometrium has a lining of columnar epithelium, with regular shedding.

Question 13

What is the surface of the cervix?

Answer 13

The cervix has a transition from the columnar epithelium of the endometrium to the vaginal stratified squamous variety

Question 14

Describe the development of the uterus and upper vagina

Answer 14

Development is by fusion of the paramesonephric ducts forming the uterus and upper vagina

Question 15

What is the most common position of the uterus?

Answer 15

80% are anteverted

Question 16

What are the anatomical supports of the uterus?

Answer 16

The most fixed part is the cervix, assisted by the bladder, vagina, pubovaginalis, and perineal body.

Question 17

Describe the makeup and location of the broad ligament

Answer 17

The broad ligament is a lax double fold of peritoneum lying laterally between the sidewall of the uterus and pelvis

Question 18

What does the lateral attachment of the broad ligament cross?

Answer 18

The obturator nerve, superior vesical and obturator artery and vein

Question 19

What is the posterior relation of the broad ligament?

Answer 19

The posterior layer of the broad has the ureter adhering to it

Question 20

Describe the upper border of the broad ligament

Answer 20

The upper border has a free edge and contains the uterine tube, therefore forms the mesosalpinx

Question 21

The lateral quarter of the broad ligament forms what?

Answer 21

The suspensory ligament of the ovary

Question 22

What does the suspensory ligament of the ovary contain?

Answer 22

The ovarian veins and lymphatics

Question 23

What shapes the anterior layer of the broad ligament?

Answer 23

The round ligament bulges forward the anterior layer of the broad ligament

Question 24

What is the course of the round ligament?

Answer 24

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

Question 25

What is the round ligament formed from?

Answer 25

Largely visceral muscle??

Question 26

What is the round ligament continuous with? What does this form?

Answer 26

The ovarian ligament. This forms the gubernaculum.

Question 27

What is the lateral ligament?

Answer 27

The lateral ligament consists of thickenings from the cervix to the pelvis supporting hte ureter, uterine artery, and iliohypogastric plexus

Question 28

Where do the uterosacral ligaments run?

Answer 28

From the cervix embracing the rectouterine pouch and rectum