THE UTERUS. 



2009 



and in others long and spindle form. During pregnancy their usual length (from 

 .040-. 060 mm.) may increase tenfold. 



The serous coat, or perimetrium, continuous laterally with the peritoneal invest- 

 ment of the broad ligament, is so closely adherent to the uterine muscle over the 

 fundus and adjacent parts of the anterior and posterior surfaces that it is removed 

 with difficulty. Lower, the presence of the intervening loose connective tissue (para- 

 metrium) renders the attachment less intimate. 



Vessels. The arteries supplying the uterus are the two uterine, each a branch 

 of the internal iliac that accompanies the ureter along the pelvic wall, behind and 

 below the ovarian fossa, to the attached border of the broad ligament beneath which 

 it passes in its course to the uterus. On gaining a point about 2 cm. from the 

 cervix and on a level with the internal os (Merkel), the uterine artery bends medially 

 and crosses the ureter obliquely and in front. It then traverses dense connective 

 tissue, and on approaching the lateral wall of the cervix bends sharply upward to 

 course between the layers of the broad ligament along the lateral borders of the 

 uterus, as far as the lateral angle. Immediately below the ovarian ligament the 



FIG. 1702. 



Anterior surface 



"Longitudinal muscle 



^ Blood-vessels 





-Circular muscle 



y 



Mucosa (endometrium) ' - c Xx^ 

 Longitudinal muscle 



'-^''^^ Peritoneum (perimetrium) 



i-^" -'"-'-" 



Posterior surface 

 Transverse section of uterus through body. X 2. 



uterine artery divides into its terminal branches distributed to the fundus, Fallo- 

 pian tube, and ovary. In addition to a small branch to the ureter, just before 

 bending upward it gives off the vaginal artery that passes downward and assists 

 in supplying the cervix and the vagina. As it ascends along the sides of the 

 uterus, from 5-10 mm. removed and surrounded by a dense plexus of veins, the 

 very tortuous uterine artery sends numerous but variable branches to the cervix and 

 body, as well as to the broad ligament, those distributed to the posterior surface 

 being somewhat larger than those to the anterior (Robinson). The terminal branch 

 passing to the fundus framus fundi) is especially strong and freely anastomoses with 

 the corresponding vessel from the opposite artery, thus insuring exceptional vascu- 

 larity to that part of the uterus in which the placenta is usually attached (Charpy). 

 Twigs also accompany the ovarian and round ligaments. After the establishment of 

 the junction between the ovarian artery and its ovarian branch, the uterine artery 

 plays an important part in maintaining the nutrition of the ovary. On gaining the 

 muscular coat the larger branches divide into vessels that penetrate the outer layer 

 of the myometrium and within the inner muscular layer break up into numerous 

 minute twigs that confer upon this stratum its highly vascular character. Within 



