uterus - anatomy

UTERUS- GROSS & MICRO ANATOMY -

By-V.Janarthanan

II-MBBS

(29/10/2008)

SURFACE LOCATION

DEFINITION

• The uterus is a hollow, thick-walled and pear-shaped muscular child-bearing organ, normally situated in the female lesser pelvis between the urinary bladder and rectum.

ANTERO-LATERAL VIEW

DIMENSIONS

LENGTH : 7.5 CM{Corpus - 5.0 cmCervix - 2.5 cm}BREADTH : 5.0 CMTHICK : 2.5 CMWEIGHT : 30-40 GMS

POSTERIOR VIEW

DIVISIONS

FundusCorpusCervix (internal os & external os)

SKETCH OF CORONAL SECTION-UTERUS

ALLIGNMENT• In the adult nulliparous state it is pear shaped, though somewhat

flattened anteroposteriorly, and its long axis tilted superiorly forwards. Its narrow end is therefore postero-inferior in position. The uterus lies behind the bladder and (unless the bladder is full) bent forward above it. It is situated inferior to the sigmoid colon and in front of the rectum, and completely below the pelvic inlet. The long axis usually lies approximately along the axis of the pelvic inlet, but since the uterus is movable, its position varies with the distension of the bladder and rectum. Except when displaced by a much distended bladder, the long axis of the uterus is nearly at right angles to that of the vagina, the latter's axis corresponding to the axis of the pelvic outlet.

Alignment of uterus

ROTATIONS OF UTERUS

Dextro rotation of fundusLaevo rotation of cervix

PARAMEDIAN SAGITTAL SECTION – IN SITU

LAYERS

Outer perimetrium – serosaMiddle myometrium – muscular layerInner endometrium – mucosa

SEROSA

VESICO-UTERINE POUCHPOUCH OF DOUGHLASBROAD LIGAMENT

cleared injected specimen

UTERINE CAVITY

Antero-posteriorly flattened6 cm in lengthTriangular in coronal section

SAGITTAL SECTION

CERVIX

VAGINAL PARTSUPRA VAGINAL PARTARBOR-VITAE ARRANGEMENT

UTERINE ADNEXA

SUPPORTS OF UTERUS PRIMARY :o muscular/active –• pelvic diaphragm• perineal body• urogenital diaphragmo fibromuscular/mechanical –• uterine axis• pubocervical ligaments• mackenrodt’s ligament• uterosacral ligaments• round ligament of uterus SECONDARY : broad ligaments uterovesical fold rectovaginal fold

UTERUS-INSITUANTERO SUPERIOR VIEW

APPLIED

RETROVERSIONRETROFLEXIONRETROCESSIONPROLAPSE

COURTESY

• GRAY’S TEXT BOOK OF ANATOMY• B.D.CHAURASIA’S TEXTBOOK OF ANATOMY• www.medindia.net/surgicalprocedures/

hysterectomy_uterus_anatomy.htm - 65k -• www.ama-assn.org/ama/pub/category/

7140.html - 10k