Uterus and Vagina Anatomy PDF 2021-24

‫‪Uterus and vagina‬‬ ‫‪By dr. Mahmoud E. Salem‬‬ ‫انتومي سنه اولي بعد النصفي بلفس‬ ‫رقم ‪ 7‬كشك ايمن‬ ‫‪2021-4-24‬‬  2 UTERUS 3 1 Site ; In the Middle of the true pelvis Between Bladder & Rectum Flattened pear-shape...

‫‪Uterus and vagina‬‬ ‫‪By dr. Mahmoud E. Salem‬‬ ‫انتومي سنه اولي بعد النصفي بلفس‬ ‫رقم ‪ 7‬كشك ايمن‬ ‫‪2021-4-24‬‬  2 UTERUS 3 1 Site ; In the Middle of the true pelvis Between Bladder & Rectum Flattened pear-shaped ; Measurements ; about 3x2x1 inches lateral angle Parts of the uterus Cervix ; Lower 1/3 = one inch Body ; Upper 2/3 = two inches Fundus ; above the entrance of the uterine tube Lateral angle of the uterus ; At the site of entrance of the uterine tube  Parts of the cervix The cervix has two parts : Supra-vaginal part Vaginal part Supra vaginal part Its cavity named Cervical Canal Its cavity named Its upper opening named cervical canal internal os Its lower opening named Vaginal part external os  CERVIX SURROUNDED BY 4 VAGINAL FORNICES Lateral Fornix Anterior fornix Posterior fornix Two lateral fornices  Position of the uterus Ante-verted Ante-flexed Ante-Verted ; The long axis of cervix forms right angle with the vaginal axis Ante-Flexed ; The long axis of body forms angle with the axis of the cervix  Anterior relations of the uterus Urinary bladder : Body of uterus separated from the bladder by Utero vesical pouch But cervix lies in direct contact with superior surface of the bladder Posterior relations of the uterus Rectum with the rectouterine pouch in between The pouch filled by ileum & sigmoid colon  BROAD LIGAMENT Quadrilateral Peritoneal fold Suspends the uterus in the middle of the pelvis Broad Broad ligament ligament  The Broad ligament has Four Borders ; Medial border Attached to the Lateral margin of the uterus Lateral border Attached to the Lateral wall of the pelvis Inferior border Attached to the pelvic Floor Superior border Free & Filled by the uterine tube  Para-rectal fossa Para-vesical fossa  Parts of the broad ligament 1-Meso-Metrium ; Between the uterus & the ovarian ligament 2 3 2-Meso-Salpinx ; 1 Between the uterine tube & the ovarian ligament 3-Suspensory Ligament of the ovary ; Between the uterine tube & lateral wall of the pelvis  Mesovarium Peritoneal Fold connects the Ovary & Posterior Layer of the Broad Ligament Contents of the broad ligament 1-Two Tubes ; Uterine tube & ureter 2-Two Ligaments ; Round & Ovarian Ligaments 3-Two Vessels ; Uterine & Ovarian Vessels 4-Parametrium Fat & Lymph Nodes 5-Ep-oophoron & Par-oophoron  ROUND LIGAMENT Fibro muscular cord 10 cm long Maintains the Ante-Verted position of the uterus Labium Majus Round ligament 1-Beginning ; At the lateral angle of the uterus 2-Passes laterally in the broad ligament 3-Ascends on the side of the pelvis 4-descends in the inguinal canal 5-Ends finally in the Labium Majus  Uterosacral Pubo-cervical Ligaments attached to the cervix Uterosacral ligament and covering fold CERVICAL LIGAMENTS 1-Transverse [Lateral] [Cardinal Ligament] 2-Pubo-Cervical Ligament 3-Utero-Sacral Ligament  Uterine artery Origin : from Anterior division of the internal iliac artery Course : Passes medially on the pelvic floor Crossing the ureter Ascends on the side of the uterus , in the broad ligament Ends by anastomosing with the ovarian artery  Uterine veins The draining veins form plexus on each side of the uterus which end finally in the internal iliac veins  Lymph drainage 1-upper part of the body , tube and ovary end in lateral aortic lymph nodes 2-Lower part of the body , cervix and vagina end into external iliac lymph nodes 3-lower most part of the vagina and lateral angles of the uterus end in superficial inguinal lymph nodes  lateral aortic External iliac Superficial inguinal FACTORS SUPPORTING THE UTERUS 1-Peritoneal folds & Broad ligament 2-Round ligament 3-Cervical ligaments 4-Levator Ani & Perineal body  vagina Relations Anterior ; Bladder base & urethra Posterior ; Upper ¼ related to recto uterine pouch Middle 2/4 related to rectum Lower ¼ related to perineal body  Lateral relations of the vagina 1-Pubovaginalis part of Levator ani 2-extra peritoneal fatty tissue 3-Blood supply ; Vaginal artery & Venous plexus 4-inferior hypogastric plexus  The Uterine tube has 4 parts : 1-infundibulum Funnel – shaped Fimbriated One cm long 2-ampulla Dilated & tortuous 5 cm long 3-isthmus Narrow & cord like 3cm long 4-uterine part In the wall of the uterus One cm long