HUMAN ANATOMY. 



Normally their insertions and origins lie 

 - *' tlu-ir * 



' 



ow Ht, presenting the protrusion of the pelvic viscera, and directs the 

 !nal forward instead ol directly downward so that the mtra- 

 imiiw , , : : ,kes th, pelvic floor at a right angle ;. and by aiding in mam- 



:,g he vagma in its normal condition of a closed slit with its walls in contact, i 

 disturbance ol the forces which hold the uterus in place. If a laceration o 

 Ihe perineum converts the vagina intomn open air-containing tube, the equilibrium d 



nd prolapse often follows. In severe cases of prolapse the 



that, at their vesical ends, their lumen is narrowed and 



ition <-r hydronephrosis may result. , , , 



-\nt.rior and posh > ,\ fl, lions ,,f the uterus occur at the isthmus, which is the 



; .in.! is the junction of the larger and more movable portion the body 



.Her and more fixed portion the cervix. 



..unt of the normal ante flexion of the uterus, it is not always easy to 

 i.-tlu-r the degree of anteflexion is normal or abnormal. 

 abnormal the most important symptom is dysmenorrhcea, from obstruc- 

 mul by tin.- tlexion ; if irritability of the bladder occurs, it is probably 

 igin. 



iii.h weakens the support of the uterus, or increases its weight, 



u . m ls not onl - prolapse, but also to the production of rdroflexion or retro- 



\ the nit nts, the first degree of prolapse being associated with some retro- 



M, nt. Tin- uterus tlu-n loses its normal anteversion, and the intra-abdominal 



is brought to bear on its anterior surface, especially if the patient is either 



long in the supine position after labor, with the abdomen too tightly 



ves her bed too soon or undertakes any physical work. 



nd heavier than normal, as a result of imperfect involution ; 

 lax ; the vagina and the vaginal orifice are relaxed, and 



Mipport of the pelvic floor is consequently deficient; the abdominal walls are 



:ul tin- ntriiti\r po\\er of the abdomen is diminished. These are also the 



li.it favor prolapx- of the uterus ; in fact, a slight degrefe of uterine prolapse 



iiMi.illv ,i< - inpanit -^ sucfa : retrodisplacement. A certain amount of retro- 



:mM al\v.: ' n fore the uterus can pass along the vagina. It must turn 



parallel to the axis of the vagina (Penrose). 



In the purely xho-'trted positions the uterus revolves on the isthmus as on a 

 the funjlus j^oi-s in one direction the cervix passes in the other. 

 turned forward against the base of the bladder, the fundus 

 on the rectum, often producing retlex symptoms. 



The uterus : mid inclined to one side more usually the fundus to the 



inn of the presence of the sigmoid and rectum on the left 



me, >uch inclination i> not to be regarded as patho- 



the broad ligaments is a quantity of loose adipose cellu- 



'tametiium, -eparatin- the . ontained structures those of the most 



the ml.es .nul ovaries with their vessels and nerves from one 



.md trom the serous membrane. This cellular connective tissue is continuous 



1 areolar tissue of the pelvis, and is especially 

 tlie broad ligaments. 



infection of this loose cellular tissue, usually through 



in. It may follow other septic intrapelvic 



ilpiniijtis, but a simple cellulitis unaccompanied by tubal 



* m ll 'hie to infection through the uterus from 



: ill" laxity of the tissue it may spread rapidly and 



11 ' '1 backward along the utero-sacral liga- 



'"I 1 " thl> retroperitoneal tissue, as tar as the kidneys. It may 



<l to th,. ,-roin, where, should an abscess form, it maybe 



