Ovarian Ligament

The body of the uterus is covered with peritoneum except where this is reflected off at two sites, anteriorly on to the bladder at the uterine isthmus and laterally at the broad ligaments. Anteriorly, the peritoneum is only loosely adherent to the supravaginal cervix; this allows for bladder distension. The muscle wall is thick and made up of a criss-cross of involuntary fibres mixed with fibroelastic connective tissue.

The mucosa is applied directly to muscle with no submucosa intervening. The mucosa of the body of the uterus is the endometrium, made up of a single layer of cuboidal ciliated cells forming simple tubular glands which dip down to the underlying muscular wall. Below this epithelium is a stroma of connective tissue containing blood vessels and round cells.

The cervical canal epithelium is made up of tall columnar cells which form a series of complicated branching glands; these secrete an alkaline mucus which forms a protective 'cervical plug' filling the canal.

The vaginal aspect of the cervix is covered with a stratified squamous epithelium continuous with that of the vagina.

The mucosa of the corpus undergoes extensive changes during the menstrual cycle which may be briefly summarized thus:

1 first 4 days—desquamation of its superficial two-thirds with bleeding;

2 subsequent 2-3 days — rapid reconstitution of the raw mucosal surface by growth from the remaining epithelial cells in the depths of the glands;

3 by the 14th day the endometrium has reformed; this is the end of the proliferative phase;

4 from the 14th day until the menstrual flow commences is the secretory phase; the endometrium thickens, the glands lengthen and distend with fluid and the stroma becomes oedematous and stuffed with white cells.

At the end of this phase three layers can be defined:

1 a compact superficial zone;

2 a spongy middle zone—with dilated glands and oedematous stroma;

3 a basal zone of inactive non-secreting tubules.

With degeneration of the corpus luteum there is shrinkage of the endometrium, the arteries retract and coil, producing ischaemia of the middle and superficial zones, which then desquamate. It is probable that spasm of the vessels in the basal layer (which remains non-desquamated) prevents the woman bleeding to death.

Only very slight desquamation and bleeding takes place in the mucosa of the cervical canal.

Ligament Infundibulo Ovarien

Infundibulo-pelvic ligament with ovarian vessels

Fimbriae

Hydatid

Ampulla

Infundlbulum

Ovary

Sroad ligament

Fig. 106 The Fallopian tube, ovary and broad ligament.

Infundibulo-pelvic ligament with ovarian vessels

Fimbriae

Hydatid

Ampulla

Infundlbulum

Ovary

Sroad ligament

Fig. 106 The Fallopian tube, ovary and broad ligament.

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