THE UTERUS 391 



and the contents of the utero-vesical peritoneal fossa and, 

 posteriorly, to the rectum and coils of small intestine or pelvic 

 colon. The lateral border of the body is related to the broad 

 ligament and to the uterine artery (p. 392). 



The Ligaments of the Uterus. In addition to the broad 

 ligaments (p. 385), the uterus is more or less fixed in position 

 by two round ligaments and two utero-sacral ligaments. The 

 round ligament is a fibro-muscular band, which is attached to 

 the uterus near the point where it is joined by the uterine 

 tube. It passes downwards and laterally between the two 

 layers of the broad ligament and reaches the abdominal 

 inguinal ring (int. abdom. ring, p. 377), where it enters the 

 inguinal canal. Just outside the subcutaneous inguinal ring 

 (ext. abdom. ring) the round ligament is attached to the skin 

 and fascia in the neighbourhood of the pubic tubercle (spine). 

 By exerting a certain slight amount of traction on the upper 

 part of the body of the uterus, the round ligament assists in 

 maintaining the normal position of the organ. Consequently, 

 one of the surgical procedures adopted in the treatment of 

 retroversion of the uterus is shortening of the round ligaments. 



The utero-sacral ligaments are attached to the posterior 

 aspect of the lower part of the body of the uterus and they 

 extend backwards, raising ridges on the peritoneum, on each 

 side of the rectum. By exerting slight backward traction, 

 these ligaments maintain the normal degree of anteflexion, but, 

 if they become contracted and shortened following inflam- 

 matory processes, they produce acute anteflexion of the uterus 

 by drawing backwards the point of union of the body of the 

 uterus with the cervix. In this displacement, the contractions 

 of the uterus cannot readily expel the contents during men- 

 struation and the contractions become more violent, giving 

 rise to referred pains which may be exceedingly severe. 



Displacements of the Uterus. In addition to acute 

 anteflexion, retroversion, with or without some degree of 

 retroflexion, may also occur. These conditions are only 

 possible when the utero-sacral and round ligaments are 



