2004 



HUMAN ANATOMY. 



Oviduct 



the cavity of the body. In cross-section the canal appears as a markedly compressed 

 oval. The position of the internal os corresponds with the slight external constriction 

 (isthmus uteri) that uncertainly marks the neck from the body of the uterus. In 

 contrast to the smooth mucous surface of the body, that of the anterior and posterior 

 walls of the cervical canal is marked by conspicuous ridges (plicae palmatae) — the 

 arbor vitce uterince of the older writers — consisting of a chief median longitudinal fold 

 from which numerous secondary rugae diverge upward and outward on each wall. 



Attachments and Peritoneal Relations. — In addition to the Fallopian tubes 

 that embryologically are direct continuations of the component Miillerian ducts by 

 the fusion of which the uterus is formed, the uterus is connected with the ovaries, 

 the abdominal wall, the lateral and posterior walls and the floor of the pelvis, the 

 vagina, the bladder, and the rectum by fibro-elastic tissue, muscular bands, and peri- 

 toneal folds. Most of these attach- 

 FiG. 1698. ments, or so-called ligaments, however, 



have little influence in supporting the 

 uterus, but, owing to the intimate con- 

 nection of the cervix with the vagina, 

 and thus with the pelvic floor, and with 

 the sacrum by fibro-muscular bands, 

 the lower segment enjoys a relatively 

 fixed position ; the body, on the con- 

 trary, being freely movable. 



The Broad Ligament. — With the 

 exception of a narrow strip along the 

 sides between the layers of the broad 

 ligaments, the body of the uterus is 

 completely invested by peritoneum. 

 The cervix, on the contrary, possesses 

 a serous covering only behind and at 

 the sides above the attachment of the 

 vagina. From each lateral border of 

 the uterus this serous investment is 

 reflected to the pelvic wall and floor 

 as a conspicuous trans\erse duplicature 

 of peritoneum, the broad ligament (lig- 

 amentum latum), that passes across the pelvis and encloses between its layers the round 

 and ovarian ligaments, the Fallopian tube, the epoophoron and the paroophoron, 

 together with the associated vessels and nerves. Although enclosed by a peritoneal 

 duplicature continued from its posterior surface, the ovary is attached to, rather than 

 lies within, the broad ligament. When detached from the pelvic wall and floor and 

 spread out (Fig. 1699), the broad ligament is wing-like in form and has four borders, 

 of which the median or uterine is vertical, the upper or tubal is horizontal, longest, 

 and free, the lateral short and approximately vertical to correspond with the plane 

 of the pelvic wall, and the lower sloping downward and inward in agreement with the 

 direction of the pelvic floor. Within the body, the plane of the median portion of 

 the fold depends upon the position of the uterus, in the erect posture usually extend- 

 ing more or less horizontally, so that the posterior surface presents upward and 

 backward, and the anterior downward and forward ; when the uterus assumes an 

 upright position, the fold likewise becomes erect. On nearing its lateral attachment, 

 the upper border of the broad ligament becomes not only more vertical, but also parallel 

 with the pelvic wall in consequence of the support afforded by the suspensory liga- 

 ment of the ovary. From their attachment to the pelvic walls and floor the two 

 serous layers of the broad ligament pass in opposite directions and are continuous 

 with the general peritoneal lining of the pelvis. Along the pelvic floor their 

 divergence leaves a non-peritoneal interval through which the vessels and nerves 

 and the ureter gain the side of the uterus. 



The free border of the broad ligament is occupied by the Fallopian tube, the 

 course of which it follows as .far as the outer end of the infundibulum, and thence 

 passes to the pelvic wall to become continuous with the suspensory ligament of the 



ternal os 



\'agina 



Uterus laid open by frontal section, sliowing 

 form of cavity of body and cervix. 



