The Pelvic Viscera

anococcygeal ligament, or anococcygeal raphe

 

The ovaries are intraperitoneal structures measuring approximately 3 x 1.5 x 1 cm. The ovary lies in the lateral wall of the pelvic cavity between the ureter, medially, and the external iliac vein, laterally. The uterine tube lies anteriorly. The distal portion of the tube curves around the lateral end of the ovary and is attached by one or more fimbriae. The ovary is attached to the superior surface of the broad ligament by the mesovarium and is attached to the uterus by the ligament of the ovary. The ovarian artery arises from the aorta below the renal artery and ascends  along the posterior abdominal wall, crossing the external iliac artery, and entering the lateral part of the broad ligament via the suspen­sory ligament of the ovary or infidulopelvic ligament.

The peritoneum covering the uterine tube forms the broad ligament that extends from both sides of the uterus to the lateral walls of the pelvis. The broad ligament can be divided into the mesovarium, mesosalpinx, and mesometrium (Fig. 1). The ovarian ligament proper connects the ovary to the uterus. The round ligament extends from the uterus to the labia majora. The uterine tube has three parts: the medial isthmus, middle ampula, and distal infundibulum, leading to the internal ostia and outer fimbria of the tube, respectively.

 

Female internal genitalia

(Fig. 1 ) Female internal genitalia. Viewing the ovaries and uterus from the posterior aspect, the structures that lie lateral to the uterus can be seen enclosed within the two layers of the broad ligament. The structures are shown intact on the left side and are revealed by removing the posterior leaflet of the broad ligament on the right.

 

The uterus is a fibromuscular organ, the dimensions of which vary considerably in premenopausal and postmeno­pausal women. This is a function of estrogenic stimulation and parturi­tion. The uterus is composed of the upper muscular corpus and the lower cervix. The portion of the corpus above the fallopian tubes is identified as the fundus. The isthmus of the uterus is located between the body and the cervix. The uterine corpus is lined by the endometrium, which is composed of epithelium, forming glands, and also contains a specialized stroma. The portion of the cervix protruding into the vagina is identified as the portio vaginalis. The cervix consists of predominant fibrous connective tissue with a small amount of smooth muscle. The border of the cervical canal, where the canal widens into the endometrial cavity, is termed the internal os.

 

The lower portion of the canal is the external os (Fig. 2). The uterine artery, which is a branch of the internal iliac artery, joins the uterus above the junction of the cervix and isthmus, where it communicates with the marginal artery along the lateral wall of the uterus. The marginal artery also communicates with the ovarian artery.

 

A schematic drawing of a posterior view of the cervix, uterus, fallopian tube, and ovary.

(Fig. 2) A schematic drawing of a posterior view of the cervix, uterus, fallopian tube, and ovary. Note that the cervix is divided by the vaginal attachment into an external portio segment and a supravaginal segment. Note that the uterus is composed of the dome-shaped fundus, the muscular body, and the narrow isthmus. Note the fimbria ovarica, or ovarian fimbria, attaching the oviduct to the ovary.

 

 

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