THE ABDOMEN 879 



and the urethra is very closely related to the anterior wall of 

 the vagina. The virgin uterus Ues upon the superior surface of the 

 bladder, and the broad hgaments extend from either side of it 

 to the lateral wall of the pelvis. The vagina passes off from the 

 lower end of the uterus, and in its outward course it lies between 

 the base of the bladder and the rectum. 



Peritoneum. — ^The peritoneum is related to the pelvic colon and 

 rectum as in the male. On leaving the rectum at a point fully 

 3 inches above the anus it passes to the posterior wall of the vagina, 

 which it covers for about its upper fourth. It then mounts up- 

 wards over the posterior surface of the supravaginal portion of the 

 cervix uteri and the body of the uterus. On reaching the fundus it 

 turns round to the anterior surface, which it invests as low as the 

 junction of the body and cervix. On leaving the viscus it passes 

 to the upper part of the base of the bladder, whence it extends 

 forwards over the superior surface, which it covers as far as the 

 apex. Its course thereafter is as in the male. Along each lateral 

 border of the bladder the peritoneum is reflected on to the lateral 

 wall of the pelvis. Along either side of the uterus it is reflected 

 on to the lateral wall of the pelvis, and in this manner the broad 

 ligaments are formed. Between the rectum and the upper portion 

 of the posterior wall of the vagina and supravaginal portion of the 

 cervix uteri the peritoneum forms a recess, called the pouch of 

 Douglas, which corresponds to the recto-vcsical pouch in the 

 male. The mouth of this pouch is bounded on either side by a 

 semilunar peritoneal fold, which extends from the front of the 

 sacrum over the side of the rectmn to the cervix uteri. These 

 folds are known as the sacro-uterine folds, or recto-uterine folds 

 of Douglas. Each fold contains a collection of fibrous and plain 

 muscular tissues, connected on the one hand with the fibrous 

 structures in front of the lower part of the sacrum, and on the 

 other with the cervix uteri. They become continuous with each 

 other over the back of the isthmus uteri (junction of body and 

 cervix), and there they give rise to a transverse ridge, called the 

 torus uterinus. The pouch of Douglas is bounded in front by the 

 upper part of the posterior wall of the vagina and the supravaginal 

 portion of the cervix uteri, and behind by the rectmn. In front 

 of the uterus the peritoneum gives rise to a small recess, called 

 the utero-vesical pouch, the entrance to which is bounded laterally 

 by two folds, called the utero-vesical folds. As regards the bladder, 

 the peritonemn forms for it false hgaments as in the male, namely, 

 one superior, two lateral, and two posterior. The latter are simply 

 the utero-vesical folds, and may be regarded not only as posterior 

 hgaments of the bladder, but also as anterior hgaments of the uterus. 



Pelvic Fascia. — The parietal pelvic fascia in the female is similar 

 to the corresponding fascia in the male. The visceral pelvic fascia, 

 however, is complicated by the interpolation of the vagina. On 

 either side of the pelvic viscera it divides into four laminae, as 

 follows : vesical, which forms, on either side, the lateral true liga-' 



