UTERUS (NORMAL ANATOMY). 



mencino; sometimes at a distance of 1'" 3'" 

 above the margin of the uterine lip and ex- 

 tending upwards either centrally or to one 

 side of the median line, and reaching as far as 

 the internal os, it terminates here in a bulbous 

 expansion, or branches out into numerous 

 small ramifications. From either side of this 

 median perpendicular fold are given off lateral 

 plica?, varying in number, but being usually 

 not less than 6 9. These soon bifurcate 

 once or twice, so that the number of folds will 

 vary considerably, according as they are 

 counted immediately at, or at some distance 

 from, their line of junction in the central 

 raphe. The uppermost pair of lateral plicae, or 

 those next to the raphe, often exhibit the 

 same bulbous extremity; and these together 

 fill the upper or narrowest portion of the cer- 

 vical canal. Lower down, where the canal be- 

 comes wider, the lateral plicae spread out on 

 either side of the central raphe, the upper 

 ones in an oblique, the middle and lower ones 

 in a more horizontal direction. These soon 

 bifurcate, and form a series of oblique, hori- 

 zontal, or arched laminae, whose arrangement 

 varies much according to the fulness of the 

 folds, the depth of the furrows between them, 

 and the distance by which the laminae are se- 

 parated. If the latter are prominent and very 

 closely set, their margins may overlie each 

 other, like the branchial laminae of a fish, so 

 that no intermediate furrows are perceptible; 

 or the folds, not being very prominent, may 

 merely lie in apposition, leaving no visible in- 

 terspace until they are drawn asunder ; but 

 when the plicae are less full and prominent a 

 furrow is perceptible between each. These 

 furrows of necessity take the same direction 

 as the plicae by which they are bounded. 



In another common form which the plicae 

 assume, the general lines of folds and interme- 

 diate furrows take a more vertical direction, 

 so that sometimes as many as six or eight of 

 the more central laminae may be traced run- 

 ning down side by side to the very margin 

 of the cervical lips (fig. 424.). Here often 

 the two most central folds appear to run 

 up from one end to the other of the cervical 

 canal ; but still commonly one of these is 

 more fully developed than the rest ; its upper 

 bulbous extremity occupying the position in 

 the narrow portion of the cervical canal, al- 

 ready described, while its lateral divisions 

 being more numerous than those of the plicae 

 next adjoining, it takes the office of a raphe, 

 though its position may be, as it often is, more 

 or less eccentric. 



On either side of this principal fold the 

 lateral plicae arrange themselves, inclining more 

 outwardlv in proportion as they occupy a still 

 lower place in the cervix. But in these cases 

 the curves of the lateral plicae are often very 

 abrupt the laminae rising obliquely up- 

 wards, and then making a sudden downward 

 bend like the ends of the leaves of a lily. 

 This arrangement of the plicae I think I have 

 more often observed upon the posterior wall 

 of the cervix, where the laminae are usually 

 thicker and bolder than upon the anterior 



629 



wall, upon which the arrangement first de- 

 scribed appears more commonly to prevail. 

 But so various are the forms which the prin- 

 cipal folds of the mucous lining of the cervix 

 assume, that it is not possible to fix upon any 

 one instance whose description, however mi- 

 nute and accurate, will serve as a strict ex- 

 ample of the rest. 



The more perpendicular the arrangement 

 of the plicae, the nearer is the approach to 

 that form which is most commonly found in 

 the terminal part, or neck of the uterus, in 

 the mammalia generally, where the folds al- 

 most invariably take the direction of the long 

 axis of the canal, reminding us of the ar- 

 rangement of the plicae in the Fallopian tube 

 already described. 



After repeated pregnancies these plicae 

 become much thickened and the folds more 

 prominent, while their extremities exhibit a 

 swollen and bulbous appearance resembling 

 leaflets attached to the branch of a tree. 

 Hence, apparently, the origin of the old term 

 arbor vitce, by which this structure was com- 

 monly designated; while to the more closely 

 arranged plicae, springing from a central shaft 

 or raphe, the term penniform ntges is more 

 strictly applicable ; and to those cases in which 

 several parallel folds, after ascending ob- 

 liquely, form a series of lateral arches, or 

 suddenly bend over and then downwards, the 

 title of plica palmate, or as some employ 

 it, palmce plicatcs, seems more appropriate. 



Thus upon both walls of the uterine cervix 

 the mucous membrane, being of greater extent 

 than the surfaces which it lines, is gathered 



Fig. 432. 



Portion of cervix uteri Enlarged 9 diameters. 

 (After Tyler Smith, and Hassall.)* 



* This figure is from a valuable Memoir on the 

 Pathology and Treatment of Leucorrhoea, in vol. 

 xxxv. of th.- Medieo-Chirnrgical Transactions, 

 l*.r_> ; where will be found also a description, with 

 illustrations, of several of the natural and abnormal 

 forms and conditions of the cervix. 

 s s 3 



