Anatomy of the uterus

Anatomy of the uterusAnatomical features of uterus. Functions of the uterus. Blood supply and innervation of the uterus
~ 5 min

In this note, we will consider the anatomy of the uterus (uterus)

Uterus (uterus)
Uterus (uterus)
Uterus (uterus)
Uterus (uterus)

It is an organ of the female reproductive system.

The uterus takes part in the implantation of a fertilized oocyte, provides fetal develpment and parturition, and is also a direct anatomical substrate of menstrual function.

Holotopy

It is projected onto the pubic region of the anterior abdominal wall.

It is located in the pelvic cavity in a certain position:

  • the term anteversio uteri means the inclination of the uterus anteriorly in relation to the axis pelvis plane;
  • the term anteflexio uteri means the inclination of the fundus and body of the uterus anteriorly in relation to the isthmus and cervix.

Skeletotopy

It is located between the 2nd and 4th sacral vertebrae (S 2-S4).

Syntopy

  • The urinary bladder is located anteriorly to it.
Urinary bladder (vesica urinaria)
Urinary bladder (vesica urinaria)
  • The rectum lies posteriorly.
Rectum (rectum)
Rectum (rectum)
  • The uterine appendages (ovary and its rudimentary formations, uterine tube) are located laterally.
Ovary (ovarium)
Ovary (ovarium)
Uterine tube
(tuba uterina)
Uterine tube<br />
 (tuba uterina)
  • The loops of the small intestine lie superiorly.
Loops of the small intestine
Loops of the small intestine
  • The vagina is located inferiorly.
Vagina (vagina)
Vagina (vagina)

Macroscopic structure

The uterus consists of the following parts:

1. The fundus of the uterus (fundus uteri), which is the superior convex part of the uterus located above the confluence of the fallopian tubes.

Fundus of the uterus (fundus uteri)
Fundus of the uterus (fundus uteri)
Fundus of the uterus (fundus uteri)
Fundus of the uterus (fundus uteri)

2. The body of the uterus (corpus uteri), which is the main part of the organ.

Body of the uterus (corpus uteri)
Body of the uterus (corpus uteri)
Body of the uterus (corpus uteri)
Body of the uterus (corpus uteri)

3. The isthmus of the uterus (isthmus uteri), which is a narrowed part

Isthmus of the uterus
(corpus uteri)
Isthmus of the uterus<br />
 (corpus uteri)

4. The cervix of the uterus (cervix uteri), which has two parts:

Cervix of the uterus (cervix uteri)
Cervix of the uterus (cervix uteri)
Cervix of the uterus (cervix uteri)
Cervix of the uterus (cervix uteri)

the vaginal part of the cervix (portio vaginalis cervicis), which extends into the vagina;

Vaginal part of the cervix (portio vaginalis cervicis)
Vaginal part of the cervix (portio vaginalis cervicis)
  • the supravaginal part of the cervix (portio supravaginalis cervicis), which is located superiorly to the vagina.
Supravaginal part of the cervix (portio supravaginalis cervicis)
Supravaginal part of the cervix (portio supravaginalis cervicis)
Supravaginal part of the cervix (portio supravaginalis cervicis)
Supravaginal part of the cervix (portio supravaginalis cervicis)

5. The vaginal part shows the external os of the uterus (ostium uteri), which leads into the cervical canal and its cavity.

External os of the uterus (ostium uteri)
External os of the uterus (ostium uteri)
External os of the uterus (ostium uteri)
External os of the uterus (ostium uteri)

The external os of the uterus has the shape of a transverse fissure, and it is delimited by the anterior labium (labium anterior) and the posterior labium (labium posterior)

Anterior labium (labium anterius)
Anterior labium (labium anterius)
Posterior labium (labium posterius)
Posterior labium (labium posterius)

The uterus has the following surfaces:

  • The vesical surface (facies vesicalis), which is facing the bladder.
Vesical surface (facies vesicalis)
Vesical surface (facies vesicalis)
  • The intestinal surface (facies intestinalis), which is facing the rectum.
Intestinal surface (facies intestinalis)
Intestinal surface (facies intestinalis)

And also, two borders:

  • The right border of the uterus (margo uteri dexter)
  • The left border of the uterus (margo uteri sinister)
Left border of the uterus (margo uteri sinister)
 Left border of the uterus (margo uteri sinister)

The wall of the uterus consists of several layers.

The mucous membrane (tunica mucosa), which is called the endometrium (endometrium) in the uterus and is lined with a simple columnar epithelium, which in the vaginal part is replaced by a striated squamous epithelium

Mucous membrane (tunica mucosa)
Mucous membrane (tunica mucosa)
Mucous membrane (tunica mucosa)
Mucous membrane (tunica mucosa)

Inside the uterus, there is the uterine cavity (cavitas uteri)

Uterine cavity (cavitas uteri)
Uterine cavity (cavitas uteri)
Uterine cavity (cavitas uteri)
Uterine cavity (cavitas uteri)

which passes into the cervical canal (canalis cervicalis uteri)

Cervical canal (canalis cervicalis uteri)
Cervical canal (canalis cervicalis uteri)
  • The mucous membrane of the uterus has no folds, except for the cervical canal, where the palmate folds (plicae palmatae) are located
Palmate folds (plicae palmatae)
Palmate folds (plicae palmatae)
  • In addition, the uterine mucosa contains uterine glands (glandulae uterinae), which open on the surface of the epithelium.

The muscular layer (tunica muscularis), which is called the myometrium (myometrium) in the uterus and is the thickest layer of its wall.

Muscular layer (tunica muscularis)
Muscular layer (tunica muscularis)
Muscular layer (tunica muscularis)
Muscular layer (tunica muscularis)

It has three layers:

  1. Longitudinal layer (stratum longitudinale), which is an external thin layer.
  2. Circular layer (stratum circulare), which is the most pronounced.
  3. Longitudinal layer (stratum longitudinale), which is an internal thin layer.

The serosa (tunica serosa), which is called the perimetrium in the uterus and is a visceral sheath of the peritoneum.

Serosa (tunica serosa)
Serosa (tunica serosa)
Serosa (tunica serosa)
Serosa (tunica serosa)

In relation to the peritoneum, the uterus is located mesoperitoneally. The lateral surfaces of the isthmus and the supravaginal part of the cervix, as well as the vaginal part of the cervix are not covered with the peritoneum.

Between the rectum and the uterus, there is the recto-uterine pouch (excavatio rectouterina), which is also known as the pouch of Douglas;

Recto-uterine pouch (excavatio rectouterina)
Recto-uterine pouch (excavatio rectouterina)
Recto-uterine pouch (excavatio rectouterina)
Recto-uterine pouch (excavatio rectouterina)

Between the bladder and the uterus, there is a vesico-uterine pouch (excavatio vesicouterina)

Vesico-uterine pouch (excavatio vesicouterina)
Vesico-uterine pouch (excavatio vesicouterina)
Vesico-uterine pouch (excavatio vesicouterina)
Vesico-uterine pouch (excavatio vesicouterina)

In addition, in the anatomy of the uterus, there is such a structure as the parametrium (parametrium)

Parametrium (parametrium)
Parametrium (parametrium)

It is the loose tissue around the uterus that is more pronounced anteriorly and laterally to the isthmus of the uterus. The parametrium gradually passes down into the paracervical tissue fiber and the tissue surrounding the vagina. Anteriorly, it passes into the paravesical tissue, and posteriorly it passes into the pararectal tissue.

Ligaments of the uterus

The uterus has 3 ligaments:

The broad ligament of the uterus (lig. latum uteri), which acts as the mesentery. Vessels and nerves pass between its sheaths, surrounded by connective tissue.

Broad ligament of the uterus (lig. latum uteri)
Broad ligament of the uterus (lig. latum uteri)

The ligament has the shape of an irregular quadrilateral located in the frontal plane.

There is a number of structures within its thickness:

  • the uterine tube (tuba uterina)
Uterine tube (tuba uterina)
Uterine tube (tuba uterina)
  • the proper ligament of the ovary (lig. ovarii proprium)
Ligament of the ovary (lig. ovarii proprium)
Ligament of the ovary  (lig. ovarii proprium)
  • the round ligament of the uterus (lig. teres uteri)
Round ligament of the uterus (lig. teres uteri)
Round ligament of the uterus (lig. teres uteri)
  • the mesentery of the uterine tube (mesosalpinx)
Mesentery of the uterine tube (mesosalpinx)
Mesentery of the uterine tube (mesosalpinx)
  • the ovary (ovarium) is attached to the posterior sheath
Ovary (ovarium)
Ovary (ovarium)

The round ligament of the uterus (lig. teres uteri), which arises from the lateral border of the uterus.

Round ligament of the uterus (lig. teres uteri)
Round ligament of the uterus (lig. teres uteri)

It is located within the broad ligament of the uterus, passes through the inguinal canal, and breaks up into fibrous bundles that end in the thickness of the labia majora.

Cardinal ligaments of the uterus (ligg. cardinalia uteri), which are strands of fibrous and smooth muscle fibers stretched between the isthmus of the uterus and the lateral wall of the pelvis.

Supporting structures of the uterus

The uterus remains in its position due to a number of anatomical structures and physical factors.

  1. Features of the structure of the serosa of the uterus, which contains a large number of elastic fibers and is tightly fused with the myometrium
  2. Ligaments of the uterus
  3. Ligaments of the ovary
  4. The connection of the uterus with the vagina and tissues of the perineum
  5. Recto-uterine ligaments and muscles that attach the uterus to the rectum
  6. Fibrous tissue that fuses the cervix of the uterus with the urinary bladder
  7. Intra-abdominal pressure

Blood supply

  • The uterine artery (a. uterina)

Venous drainage

  • Uterine veins (vv. uterinae) drain blood into the uterine venous plexus.

Lymph drainage

  • Lumbar lymph nodes (nodi lymphatici lumbales)
  • The internal iliac lymph nodes (nodi lymphatici iliaci interni)
  • The sacral lymph nodes (nodi lymphatici sacrales)
  • The deep inguinal lymph nodes (nodi lymphatici inguinales profundi)
  • The superficial inguinal lymph nodes (nodi lymphatici inguinales superficiales)

Innervation

  • Afferent innervation is provided by the sensitive fibers of the sacral spinal nerves.
  • Parasympathetic innervation is provided by fibers of the pelvic splanchnic nerve from the sacral parasympathetic nucleus.
  • Sympathetic innervation is provided by the sympathetic plexus.
Dictionary

Anatomy of the uterus

Fundus of the uterus
fundus uteri
Body of the uterus
corpus uteri
Isthmus of the uterus
isthmus uteri
Cervix of the uterus
cervix uteri
Vaginal part of the cervix of the uterus
portio vaginalis cervicis
Supravaginal part of the cervix of the uterus
portio supravaginalis cervicis
External os of the uterus
ostium uteri
Anterior labium
labium anterius
Posterior labium
labium posterius
Vesical surface
facies vesicalis
Intestinal surface
facies intestinalis
Right border of the uterus
margo uteri dexter
Left border of the uterus
margo uteri sinister
Mucous membrane
tunica mucosa
Endometrium
endometrium
Menstruation
mensis
Uterine cavity
cavitas uteri
Cervical canal
canalis cervicalis uteri
Palmate folds
plicae palmatae
Lamina propria
lamina propria
Uterine glands
glandulae uterinae
Muscular layer
tunica muscularis
Myometrium
myometrium
Longitudinal layer
stratum longitudinale
Circular layer
stratum circulare
Serous coat
tunica serosa
Perimetrium
perimetrium
Recto-uterine pouch
excavatio rectouterina
Vesico-uterine pouch
excavatio vesicouterina
Parametrium
parametrium
Broad ligament of the uterus
lig. latum uteri
Round ligament of the uterus
lig. teres uteri
Cardinal ligaments of the uterus
ligg. cardinalia uteri
Uterine artery
a. uterina
Uterine veins
vv. uterinae
Lumbar lymph nodes
nodi lymphatici lumbales
Internal iliac lymph nodes
nodi lymphatici iliaci interni
Sacral lymph nodes
nodi lymphatici sacrales
Deep inguinal lymph nodes
nodi lymphatici inguinales profundi
Superficial inguinal lymph nodes
nodi lymphatici inguinales superficiales
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