PELVIS MINOR 497 



region of the upper part of the vagina and at the side of the 

 neck of the uterus. 



Ligamenta Teretia Uteri (Round Ligaments). The round 

 ligaments of the uterus are two cord-like bands, one on 

 each side, composed of involuntary muscle fibres and 

 connective tissue. They are attached to the body of the 

 uterus, immediately below and in front of the entrance of 

 the uterine tubes. Each ligament runs forwards and laterally 

 from the uterus, in a fold of the anterior layer of the corre- 

 sponding broad ligament, to the side wall of the pelvis. There 

 it lies for a short distance on the external iliac vessels, and 

 then turns round the inferior epigastric artery, and passes 

 through the abdominal inguinal ring into the inguinal canal, 

 where it has already been examined. It represents the lower 

 part of the gubernaculum of the ovary, the upper part being 

 represented by the ligament of the ovary. 



Position of the Uterus. In women who have borne 

 no children (nulliparae), and in whom the bladder and the 

 rectum are both empty, the uterus is normally anteflexed and 

 anteverted. The statement that the uterus is anteflexed 

 means that it is bent forwards on itself at the isthmus, so that 

 the body and the cervix meet at an angle which is open in 

 front. This forward flexion depends upon two circumstances, 

 viz. (i) upon the greater pliability of the body as compared 

 with the firmer consistence and greater resistance of the 

 cervix ; and (2) upon the fact that the cervix is more or less 

 held in position by its attachments to the anterior vaginal 

 wall and the fundus of the bladder in front, and to the posterior 

 vaginal wall behind. The term anteversion means that 

 the whole uterus body and cervix is inclined forwards 

 and forms an angle of greater or less magnitude with the 

 vertical axis of the trunk. When the uterus is in its usual 

 position, coils of small intestine and a loop of the pelvic colon 

 rest upon its posterior surface, and its anterior surface is 

 supported by the bladder. It is only on rare occasions that 

 a coil of small intestine is found between the uterus and the 

 bladder, in the vesico-uterine pouch of peritoneum. In 

 multipart (women who have borne children) the anteflexion 

 is not so marked as in nulliparse. 



The uterus possesses a great degree of mobility, however, 

 and its position is constantly liable to change, but under no 

 circumstances does it occupy an exactly median position. 



VOL. ii 32 



