1

Function of uterus

Reception Implantation Nutrition

of fertilized Ovum

Position of uterus
• Normally : Uterus forms an angle with vagina called (anteversion)
Body of uterus forms an angle with cervix called( anteflexion)

• Abnormally : uterus bent backward on vagina & lies in pouch of

Douglas called (retroversion &retroflexion)
 2

Myometrium (muscles of wall)

Structure of uterus Endometrium(mucous membrane lining)

Parametrium(pelvic fascia that covers uterus)

Blood supply :
--Uterine artery—branch from internal iliac artery
--Uterine vein –drains into internal iliac vein

Lymphatic drainage

From fundus from body&cervix from round lig.of uterus

Drains into drains into drains into

Paraaortic lymph internal&external iliac superficial inguinal

L.N. L.N. L.N.

Nerve supply : Inferior hypogastric plexus

 3

Support of uterus

Muscle & Fibrous tissue Ligaments

Levator ani M. Perineal body

Transverse cervical pubocervical Sacrocervical

Position of uterus (anteflexion & anteversion)which is maintained by round

ligament of uterus
 4

Vagina

• Muscular tube extends upward backward from vulva to uterus

• Its length is 8 cm
• Upper half of vagina lies above pelvic floor
• Lower half of vagina lies within perineum
• Upper half of vagina is pierced by cervix
• The upper part of vagina which surrounds the cervix is called
fornices
(anterior—posterior—right lateral—left lateral)
 5

• Vaginal orifice is closed by thin fold of mucous membrane called

(Hymen)

Relations
 6

Blood supply :Vaginal artery (from internal iliac art.&from uterine art.)

Lymphatic drainage

Upper 1/3 Middle 1/3 lower 1/3

External&internal iliac Internal iliac. superficial inguinal

L.N. L.N. L.N..

Nerve supply : Inferior hypogastric plexus

Support of vagina

Upper part Middle part Lower part

Muscle Ligaments urogenital diaphragm perineal body

Levator ani transverse cervical
pubocervical
sacrocervical
 7

contents of broad ligament

Uterine tube—Round lig. of ovary—Round lig.of uterus—Uterine art.—
Ovarian art.—lymph vessels
8
 9

Nerves of pelvis

Sacral plexus
• It lies on posterior pelvic wall in front of piriformis
• It is formed by anterior(ventral) rami of L4-L5+anterior rami of
S1-S2-S3-S4
• During later stages of pregnancy,fetal head compresses sacral
plexus causes pain &discomfort in the lower limb of the mother,which is
relieved by changing the position in bed

Ant.rami of L4
Lumbosacral trunk + Sacral nerves
Ant.rami of L5
10
 11

Relation

Anterior Posterior

Parietal pelvic internal iliac V. Rectum Piriformis M.

fascia

• Branches :

1-Branches to lower limb

that pass through greater sciatic foramen

2-Branches to pelvic muscles,pelvic viscera &perineum

 12

Sciatic N.—largest N. in the body(supplies M.of back of thigh&leg)

L4,5+S1,2,3

Superior gluteal N(supplies gluteus medius& minimus)

L4,5+S1

Inferior gluteal N.(supplies gluteus maximus)

L5+S1,2

Branches to
lower limb

N.to quadratus femoris(supplies inferior gemellus )

L4,5+S1

N.to obturator internus(supplies superior gemellus)

L5+S1,2

Posterior cutaneous N. of thigh(supplies skin of buttock&thigh)

S2,3

Pudendal N.(leaves pelvis&enters gluteal region through greater sciatic

S2,3,4 foramen then enters perineum through lesser sciatic foramen)

N.to piroformis
S1,2

Branches
to pelvic M.
&organs

Pelvic splanchnic N.(to pelvic viscera)

S2,3,4

Perforating cutaneous N. of thigh(supplies skin of lower medial part of

S2,3 Buttock)

Lumbar plexus

• This plexus supplies mainly the lower limb

• It is formed by ventral rami of L1+L2+L3+L4
• Branches of this plexus emerge from lateral & medial
borders of psoas muscle+anterior surface of psoas M.
13
 14

Iliohypogastric N.(supplies skin of lower part of ant.abd.wall)

L1

Ilioinguinal N.(passes through inguinal canal,supplies skin of groin,

L1 scrotum or labia majora)

Branches from
lateral border
of psoas M.

Lateral cutaneous N. of thigh(crosses iliac fossa ,enters thigh behind inguinal

L1,2 ligament,it supplies skin of lat. Surface of thigh)

Femoral N.(enters thigh behind inguinal lig.It supplies iliacus M.+ skin&muscles
L2,3,4 of the front of thigh)

Obturator N.(crosses pelvic brim,it leaves pelvis through obturator

L2,3 foramen & enters thigh&supplies medial side of thigh)

Branches from
medial border
of psoas M

4th lumbar root (it joins 5th lumbar N. to form lumbosacral trunk
of lumbosacral which enters pelvis to join sacral plexus)
trunk

genital Br.(supplies cremastric M. )

Branch from Genitofemoral N. it divides into

ant.surface L1,2
of psoas M femoral Br.(skin of small area of thigh)
15
16