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FEMALE REPRODUCTIVE SYSTEM
ANATOMY OF THE UTERUS
Uterus is the secondary sex organ of female reproductive system located between bladder and rectum. It functions to nourish a fertilized egg until the fetus ready to delivered. Shape: Inverted PearShaped muscular organ.
Anatomical position of uterus
Exact anatomical position of uterus varies with the degree of distention of the bladder. The uterus normally lies posterior to the bladder and anterior to the rectum. Uterus normally described as anteverted with respect to vagina and anteflexed with respect to cervix. Anteverted : Rotated forward, towards the anterior surface of the body. Anteflexed : Flexed towards the anterior surface the body.
Parts of the uterus
Uterus has mainly three parts.
Fundus : Dome shape, situated at the top of the uterus, broad and curved, connects fallopian tube to the uterus. Body : Main part of the uterus, starts directly below the fallopian tube and extends down words until the uterine walls and cavity begins to narrow called isthmus. Cervix : Cervix extends down word from the isthmus and continues down word until it opens in to vagina.
Histological structure
The fundus and body of the uterus are composed of three tissue layers. Peritoneum : A double layered membrane continues with the abdominal peritoneum. Myometrium : Thick smooth muscle layer. Muscle fibers runs longitudinally, circularly and obliquely. This cell undergoes hypertrophy and hyperplasia during pregnancy. Endometrium : Inner mucus membrane lining the uterus. It is further divided in to two.
- Deep stratum basalis: small changes occur during menstrual cycle and is not shed out during menstruation.
- Superficial stratum functionalis: Shed out during menstruation and proliferate from stratum basalis.
Blood supply and Lymphatics
Blood supply to the uterus is via uterine artery. Uterine artery is the branch of internal iliac artery [hypogastric artery]. Isthmus level uterine artery is divided in to ascending and descending artery. Ascending branch : anastomoses with ovarian artery. Ovarian artery supply oxygenated blood to ovary, fallopian tube and uterus.in myometrium uterine artery further divided in to arcuate artery radial artery spiral and basal artery. Descending branch : Supplies blood to cervix and vagina. Arcuate artery supplies blood to myometrium. Spiral artery supplies blood to endometrium. Basal artery supplies blood to endometrium.
Lymphatic drainage : lymphatic drainage by iliac, sacral, aortic and inguinal lymph nodes.
Innervation
Sympathetic nerve fibers : Arises from utero vaginal plexus. Parasympathetic : derived from pelvic splanchnic nerves[S2-S4]
CLINICAL ANATOMY
Uterine fibroids : Noncancerous growth of uterus. surgical removal of fibroids myomectomy. Endometriosis : Appearance of endometrial tissue outside uterus. Uterine prolapse : Herniation of uterus in to vaginal canal due to weakening of its support structures. Uterine tuberculosis : Bacterial infection of uterus often associated with infertility in women.
