THE UTERUS. 



1029 



The body gradually narrows from the fundus to the neck. Its anterior surface 

 is flattened, covered by peritoneum, which becomes separated from it at its union 

 with the cervix, in order to form the utero-vesical pouch, which lies between the 

 uterus and bladder. Its posterior surface is convex transversely, covered by 

 peritoneum throughout, and separated from the rectum by some convolutions of 

 the intestine. Its lateral margins are concave, and give attachment to the Fal- 

 lopian tube above, the round ligament below and in front of this, and the ligament 

 of the ovary behind both of these structures. 



The cervix is the lower constricted segment of the uterus ; around its circum- 

 ference is attached the upper end of the vagina, which extends upward a greater 

 distance behind than in front. 



The supravaginal portion is not covered by peritoneum in front ; a pad of 

 cellular tissue is interposed between it arid the bladder. Behind, the peritoneum is 

 extended over it. The vaginal portion is the rounded lower end projecting into 



ROUND 

 ^/LIGAMENT. 



E.ctci-iial iliac 



artery. 

 Ureter. 



Apex of I)ou(il<iK'.- 

 ponch. 



E.ricrunl iliac 

 artery. 



FIG. 571. Douglas's pouch. (From a preparation in" the Museum of the Royal College of Surgeons of 

 England.) 



the vagina. On its surface is a small aperture, the os uteri, generally circular in 

 shape, but sometimes oval or almost linear. The margin of the opening is, in the 

 absence of past parturition or disease, quite smooth. 



Ligaments. The ligaments of the uterus are eight in number : one anterior ; 

 one posterior ; two lateral or broad ; two sacro-uterine, all these being formed of 

 peritoneum and, lastly, two round ligaments. 



The anterior ligament (vesico-uterine) is reflected on to the bladder from the 

 front of the uterus, at the junction of the cervix and body. 



The posterior ligament (recto-uterine) passes from the posterior wall of the 

 uterus over the upper fourth of the vagina, and thence on to the rectum and sacrum. 

 It thus forms a pouch called Douglas 's pouch (Fig. 571), the boundaries of which are, 



