Uterus

Womb (uterus) is a smooth hollow body pear shaped, situated in the pelvic cavity of women. During pregnancy (see) uterus is plodovitost.

womb
Fig. 1. Sagittal section of the uterus parous women: 1 - the bottom; 2 - cavity; 3 - body; 4 - supracervical part; 5 - the isthmus; b - the middle part; 7 - vaginal part.

Fig. 2. Ligaments, fixing the uterus in the pelvis: 1 - Sacro-uterine ligament; 2 - cardinal ligament; 3 - pubic-cystic ligament and gallbladder-uterine ligament; 4-bladder; 5 - the cervix; 6 - rectum.

Uterus (Fig. 1) consists of the body (corpus), cervix (the cervix) and isthmus (isthmus). The body cavity of the uterus on the front section has the form of a triangle in the upper corners of which opened the mouth of the fallopian tubesat the bottom - the inner opening of the cervical canal. The uterine wall consists of three layers: the mucosal (endometrium), muscle membrane (myometrium) and the serosal (abdominal) cover (perimetry).
The mucous membrane of the uterine cavity is lined with cylindrical epithelium. The endometrium is composed of two layers: surface (functional) layer, changing in different phases of the menstrual cycle, and deep (basal, have not experienced significant changes. In the thickness of the mucous membrane there are numerous glands, form and function which change depending on the phase of the menstrual cycle: in phase proliferation they have a tubular shape, in the phase of secretion glands become convoluted and allocate the secret (see the Menstrual cycle).
Muscular layer is the most powerful layer of the uterus. It consists of interwoven smooth muscle fibers, forming a spiral turns, located inclined to the axis of the uterus.
Serous (abdominal) cover with uterine passes to urinary bladder and the upper part of the rectum. Between the bladder and the uterus peritoneum forms gallbladder-uterine cavity, and between the uterus and rectum - premonicion-uterine cavity.
In the cervix distinguish vaginal part, protruding into the lumen of the vagina and available so inspection with the help of mirrors, and supracervical part above inaccessible for the direct examination. Vaginal portion of the cervix is covered with multi-layer flat epithelium whitish-pink color. Outside the uterine cervix in antenatal women has a rounded shape. Parous due side tears of cervix outer jaws has the form of cross located slit. This characteristic has a great consistency and is used in forensic practice. The cervical canal is spindle shape its internal surface is lined with a mucous membrane with many folds. The mucous membrane is coated with cylindrical cells of the epithelium. The border between the cylindrical epithelium of the cervix and multilayer epithelium of vaginal part of cervix is in the area of external uterine throat at the beginning of the cervical canal and therefore not visible in the study of women using mirrors. In inflammatory diseases (gonorrhea, septic infection), traumatic lesions of the cervix, and hormonal disorders can form the so-called cervical erosion, under which the place of damage is being replaced by multi-layer flat epithelium cylindrical.
The mucous membrane of the cervix produces mucous secret alkaline reaction, which has pronounced antibacterial properties, which prevents the penetration of pathogens of infection from the vagina into the uterus. Alkaline reaction secret is of some importance in the fertilization process, because it contributes to the activation of the movement of sperm.
Between the body and neck of the uterus is the isthmus. During pregnancy the isthmus together with part of the lower part of the uterus forms the lower uterine segment, which is part of prodovolstvia. The length of the entire uterus outside of pregnancy is about 8 see 2/3 length falls on the body of the uterus and 1/3 on the neck. The length of the neck is 0.5 - 1 see When the underdevelopment of the uterus (infantilism) length of the cervix may approach the length of the body of the uterus and even to surpass it.
The uterus is located in the pelvis and is not acting for the plane entrance pelvic and vaginal portion of the cervix is at the level of the sciatic spines. The uterus is tilted forward, the bottom of it directed to the fold. Between the body and neck of the uterus formed an angle of 70 - 100 degrees, outdoor anterior (position anteversio-flexio). Such physiological position of the uterus caused by the presence of ligaments and muscles of the pelvic floor (Fig. 2). From the uterus few forward and below the site of discharge pipes leave the round ligament, which are included in the internal holes of the inguinal canal. Round ligament of the uterus is held at an angle to the front. The dropped uterus prevent cardinal ligament, laid in the basis of the broad ligaments, hips uterine ligament (between the isthmus of the uterus and the sacrum), uterine examining the link (between the isthmus of the uterus and the bladder) and the pelvic floor muscles (mainly muscle lifting the anus).
The uterus has some flexibility, it is displaced during filling of the bladder and rectum. Various changes of the position of the uterus are observed in diseases of the genital organs (parametritis, parametritis, myoma of the uterus), the perineal ruptures , etc.
The blood supply to the fibroids through paired ovarian and uterine arteries. Ovarian artery originates from the abdominal aorta or renal artery. Uterine artery branches hypogastric artery is included in the uterus at the level of the isthmus. Arteries are accompanied paired veins. Lymph from the uterus flowing mainly in the lymph nodes of the pelvis. In innervation of the uterus participates sympathetic, parasympathetic nervous systemand spinal nerves. Of the diseases of the uterus more often inflammatory disease (postpartum, post-abortion, gonorrheal metroendometritis), precancerous changes of the cervix uteri (see Cervicitis) and the endometrium, benign and malignant tumors (fibroids, polyps, cancer).

  • Benign tumors of the uterus
  • Malignant tumors of the uterus