UTERUS

GROSS & MICRO ANATOMY

V.Janarthanan (29/10/2008)
II-MBBS

By-

SURFACE LOCATION

DEFINITION
The uterus is a hollow, thick-walled and pearshaped 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 cm  Cervix - 2.5 cm}  BREADTH : 5.0 CM  THICK : 2.5 CM  WEIGHT : 30-40 GMS

POSTERIOR VIEW

DIVISIONS
 Fundus  Corpus  Cervix (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 fundus  Laevo rotation of cervix

PARAMEDIAN SAGITTAL SECTION IN SITU

LAYERS
 Outer perimetrium serosa  Middle myometrium muscular layer  Inner endometrium mucosa

SEROSA
 VESICO-UTERINE POUCH  POUCH OF DOUGHLAS  BROAD LIGAMENT

cleared injected specimen

UTERINE CAVITY
 Antero-posteriorly flattened  6 cm in length  Triangular in coronal section

SAGITTAL SECTION

CERVIX
 VAGINAL PART  SUPRA VAGINAL PART  ARBOR-VITAE ARRANGEMENT

UTERINE ADNEXA

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

UTERUS-INSITU ANTERO SUPERIOR VIEW

APPLIED
 RETROVERSION  RETROFLEXION  RETROCESSION  PROLAPSE

COURTESY
GRAYS TEXT BOOK OF ANATOMY B.D.CHAURASIAS TEXTBOOK OF ANATOMY www.medindia.net/surgicalprocedures/hyster ectomy_uterus_anatomy.htm - 65k www.amaassn.org/ama/pub/category/7140.html - 10k