1272 



UROGENITAL SYSTEM 



of its length, and is divided into a supravaginal [portio supravaginalis] and a 

 vaginal 'portion [portio vaginalis] by the attachment to it of the vagina (fig. 1031). 

 The line of this attachment is oblique, about one-third of the anterior surface of 

 the cervix and about one-half of the posterior surface belonging to the vaginal 

 portion. At the lower extremity of the cervix is the external orifice [orificium 

 externum] (external os uteri), which is round or oval before parturition has taken 

 place and is bounded by two prominent labia, anterior and posterior, the anterior 

 one [labium anterius] being shorter and thicker than the posterior [labium pos- 

 terius] and reaching a lower level (fig. 1032). In women who have borne children 

 the external orifice assumes a more slit-like form and the labia become notched 

 and irregular. The cavity of the cervix, known as the canal of the cervix [canalis 

 cervicis], is fusiform in shape, and extends from the internal to the external 

 orifice. On its anterior and posterior walls are folds known as the plicoe palmatce 

 (fig. 1033), consisting of a median longitudinal ridge from which shorter elevations 

 extend laterally and slightly upward; these are most distinct in young individuals 

 and are apt to become obliterated by parturition. 



Fig. 1033. — Frontal Section of the Virgin Uterus. (After Sappey.) 



Tuba uterina 



Uterine wall- — 

 Cavity of body 



Internal orifice 



Uterine wall 

 Canal of cervix with plicae palmats 



External orifice 

 Vaginal wall 



Position and relations. — The direction of the axis of the uterus is apparently 

 variable within considerable limits, not only in different individuals, but also in 

 any one individual in correspondence with the degree of distention of the bladder 

 anteriorly and the rectum posteriorly. In what may be regarded as the typical 

 condition (fig. 1034) the external orifice lies at about the level of the upper border 

 of the symphysis pubis and in the plane of the spines of the ischia. From this 

 point the axis of the cervix is directed upward and shghtly forward, the lower 

 level of the anterior labium being thus brought about. The entire uterus is, 

 accordingly, antcverted, and, furthermore, the body is bent forward (anteflexed) 

 upon the cervix at the isthmus, the axis of the two portions making an angle, 

 open anteriorly, of from 70° to 100°. Frequently, also, the body is slightly in- 

 clined either to the right or to the left. 



The anterior surface of the uterus rests upon the upper and posterior surfaces of the bladder 

 (fig. 1029), from which the body is separated by the utcro-vcsical pouch of peritoneum. The 

 anterior laj'or of the broad liganiont as it passes over the anterior surface of the uterus forms 

 the posterior wall of this pcnich and is reflected forward to the sui)erior surface of the bladder 

 at about the level of the isthmus (fiK. 1034), so that the whole of the anterior wall of the cervix 

 is belcMV the floor of the pouch and is separated from the posterior surface of the bladder only 

 by connective tissue. Posteriorly, however, the peritoneal covering of the uterus, which here 

 forms the anterior wall of the recto-uterine pouch, extends down as far as the uppermost 

 portion of the vagina and consequently invests the entire surface of the uterus, whose convex 

 posterior wall is thus separated from the rectum by the recto-uterine pouch (figs. 1029, 1035). 

 Coils of the small intestine rest upon the ])()sferior surface of the body and may also be inter- 

 posed between the cervix and the rectum. An important reliition is that of the ureters to the 

 cervix, these ducts, as they pass to the bladder, running parallel with the cervix at a distance 

 of from 8 to 12 mm. from it. 



Ligaments. — The hrond ligament between whose layers the uterus is situated 

 has already been described (p. 12G7). In addition there is attached to each border 



