THE OVARY 395 



the ovary, and the last-named are naturally much increased in 

 size. Owing to the constant alteration of the positions of 

 many of the abdominal viscera, the ovarian cyst may be twisted 

 on its pedicle in such a way as to cut off its blood-supply. 

 This condition at once produces symptoms which are similar 

 to those arising in cases of strangulated hernia. The simi- 

 larity of the symptoms is due to the similarity in nerve-supply, 

 for both viscera are supplied by sympathetic fibres which have 

 their origin in the lower thoracic segments. In this connexion 

 it is interesting to observe that in certain cases the differential 

 diagnosis between pain induced by inflammation of the 

 vermiform process (appendix) and pain having its origin in the 

 right ovary may be extremely difficult. 



The Ovarian Artery arises from the abdominal aorta 

 and descends to the pelvis on the surface of the psoas major. 

 It enters the broad ligament by passing between the two layers 

 of the suspensory ligament of the ovary at a point where they 

 separate from one another on the lateral wall of the pelvis 

 (Fig. 138). Running medially, it supplies branches to the 

 uterine (Fallopian) tube, some of which extend medially to 

 anastomose with the uterine artery, but the main part of the 

 ovarian artery enters the mesovarium to reach the hilum of 

 the ovary. When the ovaries and tubes are removed together 

 with the uterus, ligature of the uterine and ovarian vessels is 

 one of the first steps of the operation. The latter are secured 

 by clamping the suspensory ligament of the ovary. 



The ovarian lymph vessels terminate in the lumbar lymph 

 glands. 



The Uterine (Fallopian) Tube. The uterine tube lies in 

 the upper border of the broad ligament, but its lateral 

 extremity projects freely into the pelvic cavity. This 

 extremity of the tube is more or less funnel-shaped, and the 

 walls of the funnel are formed by a number of narrow pro- 

 cesses, termed the fimbrise. One of these fimbriae is attached 

 to the upper pole of the ovary, so that the two structures are 

 never far removed from one another. At the bottom of the 



