Anatomy of the Prostate Gland

Uterus Structure and Relations

• The uterus consists of two layers: the basal layer and the functional layer, which thickens in preparation for embryo implantation and sheds during menstruation if implantation does not occur.
• The uterus is related to the urinary bladder and vesicouterine pouch anteriorly, the rectum and rectouterine pouch posteriorly, the broad ligaments laterally, and the fallopian tubes superiorly.
• Inferiorly, the cervix extends into the upper portion of the vagina and is surrounded by the vaginal fornices.

Supports of the Uterus

• The uterus is supported by the pelvic floor muscles, including the levator ani muscles and the coccygeus muscle, which provide foundational support.
• The uterosacral ligaments extend from the posterior aspect of the cervix to the sacrum, providing posterior support and anchoring the uterus in place.
• The broad ligaments are large, flat bands of connective tissue that provide lateral support and contain blood vessels, nerves, and lymphatics.
• The round ligaments extend from the lateral aspects of the uterus through the inguinal canal to the labia majora, providing anterior support and preventing excessive movement.

Blood Supply, Lymphatic Drainage, and Nerve Supply of the Uterus

• The arterial blood supply to the uterus is primarily derived from branches of the internal iliac artery, including the uterine artery and ovarian artery.
• Venous drainage is via corresponding veins, including the uterine veins, ovarian veins, and vaginal veins, which ultimately drain into the internal iliac vein.
• Lymphatic vessels from the uterus drain into the pelvic lymph nodes, including the external iliac, internal iliac, and obturator lymph nodes, and ultimately into the lumbar lymph nodes.
• The nerve supply to the uterus is provided by autonomic nerves, including sympathetic and parasympathetic fibers, which regulate uterine blood flow, smooth muscle contraction, and sensation.

Peritoneal Folds Attached to the Uterus

• The broad ligaments are large, flat bands of connective tissue that provide lateral support to the uterus and contain blood vessels, nerves, and lymphatics.
• The round ligaments are fibrous bands that extend from the lateral aspects of the uterus through the inguinal canal to the labia majora, providing anterior support.
• The uterosacral ligaments extend from the posterior aspect of the cervix to the sacrum, providing posterior support and anchoring the uterus in place.

Parts and Structures Present Within the Broad Ligament

• The mesometrium is the largest part of the broad ligament, extending from the lateral aspects of the uterus to the lateral pelvic walls.
• The mesosalpinx is the portion of the broad ligament that encloses and supports the uterine tubes (fallopian tubes).
• The mesovarium is the fold of the broad ligament that supports and suspends the ovaries within the pelvic cavity.

Important Structures Contained or Attached Within the Broad Ligament

• Uterine blood vessels, including the uterine artery and vein, are located within the layers of the broad ligament.
• Uterine nerves, including sympathetic and parasympathetic fibers, traverse through the broad ligament.
• Uterine ligaments, including the round ligaments, uterosacral ligaments, and cardinal ligaments, attach to various structures within the pelvis and provide support and stability.