Uterus

 Uterus

Uterus is hollow pyriform (pear shaped muscular organ).

Location;

Situated in pelvis between bladder infront and rectum behind.

Postion of uterus; normal position of uterus is Anteverted uterus.

Measurement of Uterus 

8cm long, 5cm wide at fundus, wall thickness 1.25cm

Weight; 50-80gm

Parts of Uterus

1. Body or Corpus 

2. Isthmus

3. Cervix

1. Body or Corpus

Fundus; Uppermost part, widest part of uterus.

Lie above opening of uterine tube.

It connects to fallopian tube.

Body lie between the opening of uterine tube and isthmus 

Corpus where fertilized egg implant during pregnancy.

2. Isthmus

Constricted part, between body and cervix (0.5cm).

Below internal OS lie between corpus and cervix (narrow part of uterus).

3. Cervix

Mainly composed of fibrous connective tissue.

Cervix open to vagina.

Extends from isthmus and ends at external OS.

Cervix

Supravaginal; cervix  part lying above vagina called supravaginal.

Vagina cervix; cervix part lies within vagina called vaginal cervix.

Body Cavity

Triangular shape, there is no Ccavity in fundus.

Length of uterine cavity; 6.5-7cm

Cervical canal is fusiform (spindle) and measure 2.5cm

Associated Structure of Uterus

Anteriorly; Above internal OS, body form uterovesical pouch, below the internal OS, it separated from base of bladder by loose areolar connective tissue.

Posteriorly; Form pouch of Douglas containng wall of intestine.

Laterally 

Broad ligament attached to lateral side of uterus on each side.

Uterovesical Pouch; fold of peritoneum over inferior wall of Uterus and bladder.

Rectouterine pouch (Pouch of Douglas); peritoneal fold between posterior wall of uterus and rectum.

Structure of Uterus

Layers of Uterus

Body consist three layers;

1. Parametrium (perimetrium)

2. Myometrium

3. Endometrium

1. Parametrium

Parametrium is also known as perimetrium

It is outer layer.

It is protective layer.

2. Myometrium; 

Myometrium is middle layer. Thick bundle of smooth fibres held by connective tissue.

Arranged in;

Outer longitudinal

Middle interlacing

Inner circular

Myometrium layer expand during pregnancy and contract to push baby out.

3. Endometrium; inner layer, uterine layer 

Mucus lining cavity called endometrium, shed during menstrual cycle.

It contains endometrial glands, vessels, nerves.

Layers of Endometrium

Layers of endometrium are;

1. Stratum compactum

2. Stratum spongiosum

3. Stratum basalis

Endometrium layer divided into Two layer;

1. Functional layer 

2. Basal layer

1. Functional layer 

It is site of proliferation, secretion and degeneration.

2. Basal layer

Regenerative endometrium after menstrual loss of functionalis.

Endometrium – Changes to (Decidua) during pregnancy.

Blood supply of Uterus

1. Uterine artery

2. Internal iliac artery

3. Ovarian artery

4. Vaginal artery

Vein 

Drain into internal iliac veins.

Lymphatics

From fundus; lymphatic drain into periaortic lymph node.

Cornu drain; to superficial inguinal lymph node.

Lower part of uterus drain to external iliac lymph node.

Cervix; sensitive to touch, heat and grapsed by instrument.

Drainage from;

External iliac

Obturator lymph node

Paracervical lymph node

Internal iliac lymph node

Sacral lymph node

Nerves

Ovarian plexus nerve

Uterovaginal plexus

Pelvic plexus