THE UTERUS 393 



hysterectomy, ligature of the artery is carried out in the interval 

 between the point where it crosses the ureter and the point 

 where it gives off its vaginal branch. The greatest care must 

 be taken to avoid including the ureter in the ligature. The 

 pulsations of the uterine artery may be felt when the fingers 

 are examining the lateral vaginal fornix. 



The LYMPH VESSELS from the body and fundus of the 

 uterus terminate in the lumbar and the external iliac lymph 

 glands for the most part, but a few pass along the round 

 ligament and reach the superficial subinguinal group (p. 388). 

 The lymph vessels from the cervix pass to the hypogastric and 

 the external iliac lymph glands (p. 388) and also to the lymph 

 glands which lie on the anterior aspect of the sacrum. 



The NERVES OF THE UTERUS are mainly derived from the 

 hypogastric plexus of the sympathetic, and they are ultimately 

 derived from the lower three thoracic and the first lumbar 

 segments and the second, third and fourth sacral segments. 

 The relation of the viscero-sensory reflex of Mackenzie to 

 uterine pain has not been at all fully worked out. When the 

 uterus gives rise to referred pains, they are usually experienced 

 in the regions supplied by the posterior rami of the lower 

 thoracic nerves (Fig. 60), but the areas supplied by the anterior 

 rami are sometimes affected. As in the case of other viscera 

 supplied from the sacral part of the spinal medulla, referred 

 pains are usually experienced in the perineum and only very 

 rarely in the lower limb. 



The Ovary. The ovary lies between the two layers of the 

 broad ligament and projects backwards from the posterior 

 layer (Fig. 135). Some authorities do not regard the ovary as 

 lying between the two layers, on the ground that its surface is 

 covered not by peritoneal endothelium but by germinal epi- 

 thelium. The small fold which connects the ovary to the 

 posterior layer of the broad ligament and transmits its vessels 

 and nerves is termed the mesovarium. In the nullipara the 

 ovary lies with its long axis nearly vertical in a small peritoneal 

 depression, the fossa ovarica, on the side of the pelvis. In 



