UTERUS Rectouterine pouch (with coils of

Uterus (also known as womb) is the pear-shaped,
hollow muscular organ located in the female
pelvis, in which the fertilized ovum implants and
develops. In a young nulliparous female, the
uterus measures about 3 inches long, 2 inches
wide and 1 inch thick.
External structure:
The uterus is divided into three parts:
Fundus: It is the part of uterus that
lies above the entrance of the uterine
tubes.
Body: It is the part of the uterus
that lies below the entrance of the
uterine tubes.
Cervix: It is the narrow part of the
uterus that pierces the anterior wall
of the vagina.
The cavity of the body of uterus is triangular in
frontal plane; however, it is merely a cleft in
sagittal plane. The cavity of the cervix is called
cervical canal. It is connected to the cavity of the
body through the internal os and to the vagina
through the external os.
ileum or sigmoid colon within it)
Lateral:
Broad ligament of uterus
Uterine artery and vein
Common Positions of uterus inside female
pelvis:
In most women, the uterus is anteverted and
anteflexed. Anteversion refers to the position of
the uterus in which its long axis is bent forward
on the long axis of the vagina. Anteflexion refers
to the position in which the long axis of the body
of the uterus is bent forward on the long axis of
the vagina at the internal os. Therefore, with
body in erect position and the bladder empty, the
uterus lies almost in the horizontal plane.
In some women, the uterus may be retroverted
and/or retroflexed. Retroversion refers to the
position in which the fundus and the body of
uterus are bent backward on the vagina, so that
they lie in the rectouterine pouch. Retroflexion
refers to the position in which the body of the
uterus is bent backward on the cervix at the
internal os.

Internal structure:
The uterus is composed of three distinct layers:
endometrium, myometrium and parametrium.

Endometrium: It is the mucous

membrane lining of the uterus, which
is continuous above with the mucous
membrane lining the uterine tubes
and below with the mucous
membrane lining the cervix. In the
uterus, the mucous membrane is
applied directly to the myometrium
and there is no submucosa.
Myometrium: It is the thick
muscular wall of uterus, which is
made of smooth muscle fibers
Blood supply:
supported by connective tissue.
The arterial supply is provided
Parametrium: It is the visceral
mainly by the uterine artery, which is
pelvic fascia that surrounds the
a branch of the internal iliac artery. It
supravaginal part of the cervix. It is
gives off a small descending branch
here that the uterine artery crosses
that supplies the cervix and the
the ureter on each side of the cervix.
vagina.
Peritoneal covering of uterus: The venous blood drains by way of
The uterus is covered with the peritoneum except the uterine vein which is a tributary
its anterior aspect below the internal os. Here the of the internal iliac vein.
peritoneum passes forward onto the bladder and
as a result the uterus is devoid of peritoneum at Lymph drainage:
this place. Laterally, there is also a little space
The lymphatics from the fundus and upper part of
devoid of peritoneum, lying between the
body of the uterus accompany the ovarian artery
attachments of the layers of the broad ligament.
and drain into the paraaortic nodes at the level of
the first lumbar vertebra. The vessels from the
Important relations:
lower part of body and the cervix drain into the
Anterior: internal and external iliac lymph nodes.
Uterovesical pouch
Nerve supply:
Superior surface of the bladder
Inferior hypogastric plexus supplies both the
Posterior: sympathetic and parasympathetic fibers to the
uterus.
Support:
The primary support for the uterus is the tone of
the levatores ani muscles. In addition the
condensations of the pelvic fascia, which form
three important ligaments, also add to the
support. These ligaments are sacrocervical
ligament, pubocervical ligament, and transverse
cervical ligament.
Function of uterus:
Uterus is the site for reception, retention and
nutrition of the fertilized ovum. During the entire
period of gestation, the fetus is developed within
the uterus.
Role in parturition:
Parturition, also known as labor, is the series of
processes by which the baby, the fetal
membranes and the placenta are expelled from
the genital tract of the mother. Normally it occurs
at the end of the 9th month of pregnancy. During
parturition, the contractility of uterus develops
fully, in response to estrogen. Once the cervix is
stretched by the head of the baby, a nervous
reflex mechanism is initiated that increases the
force of contractions of the uterine body.
Uterus:
Uterus is the pear-shaped, hollow muscular organ
located in the female pelvis, in which the
fertilized ovum implants and develops. In a young
nulliparous female, the uterus measures about 3
inches long, 2 inches wide and 1 inch thick.
External structure:
The uterus is divided into three parts:
Fundus: It is the part of uterus that lies
above the entrance of the uterine tubes.
Body: It is the part of the uterus that lies
below the entrance of the uterine tubes.
Cervix: It is the narrow part of the uterus
that pierces the anterior wall of the
vagina.
The cavity of the body of uterus is triangular in
frontal plane; however, it is merely a cleft in
sagittal plane. The cavity of the cervix is called
cervical canal. It is connected to the cavity of the
body through the internal os and to the vagina
through the external os.
Internal structure:
The uterus is composed of three distinct layers:
endometrium, myometrium and parametrium.
Endometrium: It is the mucous membrane
lining of the uterus, which is continuous
above with the mucous membrane lining
the uterine tubes and below with the
mucous membrane lining the cervix. In
the uterus, the mucous membrane is
applied directly to the myometrium and
there is no submucosa.
Myometrium: It is the thick muscular wall
of uterus, which is made of smooth muscle
fibers supported by connective tissue.
Parametrium: It is the visceral pelvic fascia
that surrounds the supravaginal part of
the cervix. It is here that the uterine artery
crosses the ureter on each side of the
cervix.
Peritoneal covering of uterus:
The uterus is covered with the peritoneum except
its anterior aspect below the internal os. Here the
peritoneum passes forward onto the bladder and
as a result the uterus is devoid of peritoneum at
this place. Laterally, there is also a little space
devoid of peritoneum, lying between the
attachments of the layers of the broad ligament.