Uterus

Womb (uterus) - Gypsy hollow body, which has the form of a pear. It distinguished the bottom (fundus uteri), body (corpus), the isthmus (isthmus) and neck (the cervix) (Fig. 330). The fundus of the uterus is the highest part, jutting out over the mouths of the fallopian tubes. The body is flattened and tapering gradually to the isthmus. The isthmus is the most the tapered part of the uterus length 1 see the cervix has a cylindrical shape, starts from the isthmus and ends in the vagina front and rear lips (labia anterius et posterius). Rear lip thinner and more is in the lumen of the vagina. The uterus has an irregular triangular slit. In the bottom of the uterus is the basis of the cavity, which opened the mouth of the fallopian tubes (ostium uteri), the top of the cavity goes into the cervical canal (canalis cervicis uteri). In the cervix produce internal and external openings. The antenatal women outer hole in the cervix has a ring-shaped form, parous - form cracks that caused her tears during childbirth (Fig. 331).

uterus fallopian tube, ovary and part of the vagina
330. Uterus fallopian tube, ovary and part of the vagina (back view).
1 - the fundus uteri; 2 - isthmus tubae uterinae; 3 - mesosalpinx; 4 - tuba uterina; 5 - epoophoron; 6 - ampulla tubae uterinae; 7 - fimbria tubae; 8 - lig. suspensorium ovarii with blood vessels; 9 - ovarium; 10 - lig. ovarii proprii; 11 - lig. teres uteri; 12 - lig. latum uteri; 13 - a. uterina; 14 - vagina; 15 - cervix uteri; 16 - corpus uteri.

vaginal part of cervix of the uterus
331. Vaginal part of cervix of the uterus (R. D. Sinelnikov).
A - nulliparous women; B - parous.

The length of the uterus 5-7 cm, width at the bottom of 4 cm, wall thickness reaches up to 2-2,5 cm, weight 50, At nagaragawa weight of the uterus increases up to 80-90 g, and sizes increase by 1 see the uterus accommodates 3-4 ml of liquid, parous - 5-7 ml of a Cross-section of the body cavity of the uterus equal 2-2,5 cm, parous - 3-3,5 cm, the neck has a length of 2.5 cm, parous - 3 cm, diameter of 2 mm, parous - 4 mm In the uterus there are three layers: Muco, muscle and serous.
The mucous membrane (tunica mucosa seu, endometrium) is lined with ciliated epithelium, permeated with a large number of simple tubular glands (gll. uterinae). In the cervix are mucous glands (gll. cervicales). The thickness of the mucous membrane ranges from 1.5 to 8 mm, depending on the period of the menstrual cycle. The mucous membrane of the uterus continues into the lining of the fallopian tubes and cervix, where it forms palemonidae folds (plicae palmatae). These folds are clearly expressed in children and nulliparous women.
Muscular layer (tunica muscularis seu, the myometrium) is the most thick layer formed by smooth muscles, interspersed with elastic and collagen fibers. To allocate separate muscular layers of the uterus impossible. Studies show that in the process of development, when there was a merger of two of ureter, circular muscle fibers are mutually intertwined with each other (Fig. 332). In addition to these fibers, there are circular fibers, surrounding corkscrew artery oriented radially from the surface of the uterus to its cavity. In the neck loop muscle spirals have a sharp bend and shape of the circular muscle layer.

the circuit configuration in the uterus muscle fibers
332. The circuit configuration in the womb of muscle fibers. Thick lines marked fiber front part of the uterus that overlap and show spiral progress in the plane sections (Benninghoff).

The serous membrane (tunica serosa seu, perimetrium) presents visceral peritoneum, which firmly adherent to the muscle membrane. The peritoneum the front and rear walls along the edges of the cervix connects in a wide uterine ligaments, at the bottom of the isthmus and the belly of the front wall of the uterus moves to the back wall of the bladder. At the crossing site is formed deepening (excavatio vesicouterina). The peritoneum back wall of the uterus is fully covered by the neck and even spliced for 1.5-2 cm from the back wall of the vagina, then goes to the front surface of the rectum. Naturally, this deepening (excavatio rectouterina) deeper than the gallbladder-uterine. Thanks anatomical connection abdomen and the back wall of the vagina possible diagnostic puncture premonicion-uterine deepening. The peritoneum of the uterus covered mesothelium has the basal membrane and four connective tissue layer, oriented in different directions.
Ligaments. Broad ligament of the uterus (lig. latum uteri) is located on the edges of the uterus and, being in the frontal plane reaches the side wall of the pelvis. This link does not stabilize the position of the uterus, and performs the function of bryzek. In conjunction distinguish the following parts. 1. The mesentery of the fallopian tube (mesosalpinx) is located between the fallopian tube, ovary and the ligament of the ovary; between the sheets mesosalpinx are epoophoron and paroophoron representing two rudimentary education. 2. Fold the rear sheet peritoneal broad ligament forms the mesentery of the ovary (mesovarium). 3. Part of the chords below their own bundles of ovary is mesentery of the uterus, where between her sheets and on each side of the uterus lies loose connective tissue (forceps). Across the mesentery of the broad ligament of the uterus are the organs, vessels and nerves.
Round ligament of the uterus (lig. teres uteri) steam, has a length of 12-14 cm, thickness of 3-5 mm, begins at the level of the mouths of the fallopian tubes from the anterior wall of the uterus and passing between the pieces of the broad uterine ligaments down and lateral. Then penetrates into the inguinal canal and ends on the pubis in the thickness of the labia majora.
The main ligament of the uterus (lig. cardinale uteri) steam. is located in the frontal plane at the base lig. latum uteri. Starts from the cervix and attached to the side of the pelvis, fixes the cervix.
Premonicion-uterine and gallbladder-uterine ligament (ligg. rectouterina et vesicouterina) respectively connect the uterus to the rectum and bladder. In bundles meet smooth muscle fibers.
Topography and position of the uterus. The uterus is located in the pelvic cavity between the bladder in front and rectum back. Polerowania uterine possible through the vagina and rectum. The bottom and the body of the uterus mobile in the pelvis, so full bladder or rectum influence the position of your uterus. When emptied the pelvic bottom of the uterus forward (anteversio uteri). In norm the uterus is not only tilted forward, and bent in the region of the isthmus (anteflexio). The opposite position of the uterus (retroflexio), usually considered pathological.
The function. In the uterine cavity cherished fruit. During delivery of the fetus and placenta by the reduction of muscles of the uterus are expelled from the body. If no pregnancy occurs rejection hypertrophied mucous membrane in the period of the menstrual cycle.
Age peculiarities. Uterus of a newborn girl is cylindrical, with the length of 25-35 mm and a weight of 2, the cervix in 2 times longer than its body. In the cervical channel offers a mucous plug. Due to the small size of the small pelvis, the uterus is located high in the abdomen, reaching fifth lumbar vertebra. The front surface of the uterus in contact with the back wall of the bladder, back - from the rectum. The right and left edges are in contact with the urinary tract. After the birth for the first 3-4 weeks uterus grows faster and formed a distinct front bending, which is then stored in adult women. To 7 years appears the bottom of the uterus. Dimensions and weight of the uterus more permanent to 9-10 years. Only after 10 years the rapid growth of the uterus. Its weight depends on the age and pregnancy. In 20 years the uterus weighs 23 grams in 30 years-46, 50 years - 50,