THE ABDOMEN 925 



explored, and, on introducing the finger into the posterior fornix, the dissector 

 will find that he can palpate the recto-uterine pouch of peritoneum or pouch 

 of Douglas. The uterus is next to be carefully examined, and its relations, 

 peritoneal included, are to be revised. The fundus, body, isthmus, and cervix 

 are to be attended to. On each side of the upper part of the vagina and cervix 

 uteri a collection of fat, called the parametrium, is to be shown. The body of 

 the uterus is now to be laid open from before by a triangular incision, the apex 

 of which is on a level with the isthmus, whence the two limbs diverge upwards 

 and outwards to each lateral angle. The thick, triangular flap of the anterior 

 wall thus formed having been raised, the cavity of the body is to be examined. 

 The smoothness of the mucous lining is to be observed, and the uterine 

 openings of the Fallopian tubes at each lateral angle, as well as the os uteri 

 internum at the isthmus, are to be studied. The cers'ix is then to be opened 

 along its anterior wall on one side of the middle line, and the arrangement of 

 the mucous membrane, known as the arbor vitae uterina, is to be noted. The 

 Fallopian tube, with the corpus fimbriatum at its outer end, is to be studied, 

 followed by the round ligament of the uterus. The ovary is next to be fully 

 examined, and the scarred condition of its surface noted. The part of the 

 broad ligament between the ovaryand Fallopian tube, called the mesosalpinx, 

 on being held up to the light, may be seen to contain the epoophoron (paro- 

 varium, or organ of Rosenmuller). la a young subject a few other tubules 

 may be seen nearer the uterus, which are knowm as the paroophoron. The 

 ovarian and uterine arteries, if injected, are to be followed to their 

 distribution. 



Articulations of the Pelvis. — The sacro-vertebral joint is to be examined, 

 and the sacro-vertebral and ilio-lumbar ligaments dissected. The symphysis 

 pubis is to receive careful attention, and the oblique direction of the joint is to 

 be noted. Its ligaments are to be shown, and the interarticular fibro-cartilage 

 is to be examined. Occasionally an interspace will be found in it towards the 

 upper and back part, in which there may be a Uttle fluid. The movement at 

 this joint is only of a very slight yielding nature, except in the female during 

 parturition. The sacro-iliac joint or synchondrosis is next to be examined. 

 Its anterior ligament is weak. The posterior ligament, however, which is to 

 be studied by partially separating the bones, is of considerable strength, and 

 the part which it takes in supporting weight is to be carefully studied. The 

 great and smaU sacro-sciatic ligaments are to be studied, and the manner in 

 which they convert the sciatic notches on the posterior border of the hip- 

 bone into foramina is to be noted. The dissector is to observe the cartila- 

 ginous facing of the small sciatic notch, and the grooves, with intervening 

 ridges, which it presents, for the columns on the under surface of the tendon 

 of the obturator intemus. Finally, the sacro-coccygeal and intercoccygeal 

 joints are to be examined. 



