Where is the uterus in the body
Anatomy of the Uterus | Ovaries | 3D Anatomy Tutorial
[Music]
hey I'm James and today I'm going to
discuss the uterus
I'll start by going over the structures
that make up the uterus
The Associated ligaments and related
viscera I will have move on to arterial
supply and venous drainage finally I
will discuss the relationship between
the blood supply and the ureter and its
implications for hysterectomy make sure
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the term uterus gets thrown around a lot
yet most are confused as to what
structures actually make up the uterus
the uterus consists of the uterine
corpus which is located here and most
distally do uterine cervix the uterine
corpus is described as having a fundus
located in a proximal region here and a
body located here some textbooks will
also describe an estimate portion
located here when the uterine cavity
narrows as it approaches the cervical
canal the cervix has two openings a
proximal opening here refer to as the
internals of course and a distal Oakland
which is the external South course which
allows for communication between the
uterine cavity the cervical canal and
the vagina which isn't included on this
model the uterus is described as having
three layers an inner endometrium which
lines two uterine cavity this is a
highly vascular glandular layer that is
subject to great changed for add the
menstrual cycle the myometrium is this
middle layer here it is primarily
muscular tissue with a small proportion
of fibrous tissue the outer layer is
named the peri me trium which is formed
by the overlying peritoneum however this
is not included in this model at the
moment the structure of the cervix
located here is slightly more
complicated and is not typically
described in anatomical texts it is
primarily a fibrous structure that acts
as a sphincter during pregnancy the
uterine tubes extend from the lateral
walls of the uterine corpus as we can
see here and here
they provide a connection between
Neutron corpus and the ovaries located
here and here although is important to
stress that there is no direct
connection between the ovary and uterine
tube instead fimbria located at the most
lateral ends of the uterine tube sweep
the ovum into the uterine tube the
female reproductive tract is therefore
open because there is a direct
connection between the outside world and
the female abdominal cavity this
provides two routes for the spread of
infection and a route for endometrial
tissue to reach the abdominal cavity as
there is no direct connection between
the ovary and uterine tube there is a
chance that our oven will not reach the
tube if fertilization occurs outside of
the tube it can result in an ectopic
abdominal pregnancy there are a number
of ligaments that's how associates with
the uterus your ovarian
ligaments which is located here and
around ligaments can be considered as
one continuous cord that runs from the
ovary so the corpus Tula labia majora
Loran Lichtman leaves the pelvic cavity
while a deep inguinal ring traverses
inguinal canal leaves through the
superficial inguinal ring and an
insertion to earth labia majora the
ovarian and man ligament are remnants of
the gubin a column which is the
embryonic cord like structure that
guides the cone attitude inguinal canal
normally the sense of the ganas will
only occur in males the other Lichtman
that can be considered at this point is
two broad ligaments the uterus is a sub
peritoneal structure similar to lots of
the bladder and a rectum and soul apart
Neum which we can see has been added
here and here draped over the uterus the
peritoneal matrix over the uterus forms
the parameter ium which is considered
the external layer of the uterus which
we can see here the peritoneum not
attached the uterus is too broad
ligaments the broad ligament can be
further subdivided in accordance with
the structures it is associated with so
at the moment we can see the past neom
here
and here can we refer to as the Mesa
ovarium and measure saplings
respectively because they're associated
with the ovary and need to run tube if
we rotate the model we can see the final
part of the broad ligaments which we can
refer to as the Mesa metrium which is
here so from this point on we are going
to consider the visceral and flush
relations of the uterus on the screen we
can see the uterus has been Hemi sect
heads and the Hemi sector bladder and
rectum have been added so if we rotate
the model around we can see that the
bladder is located anterior to the
uterus Ana rectum is located to the
posterior of the uterus the peritoneum
has once again been added to the model
and as you can see it drapes over the
pelvic viscera and so the pelvic viscera
can be described as submerged steel
structures here we can see the perineum
overlined the round ligaments of the
uterus and here the Platinum is over
line the ovarian neurovascular bundle
and consequently forming the suspensory
ligaments of the ovary pouches are also
forms between the pelvic viscera and
tearily between the bladder and uterus
we have the utero vesicle pouch the
space between uterus and the rectum
posterity here is known as the buter a
rectal pouch or sometimes referred to
her as the pouch of douglas these
pouches are within the personal cavity a
former space in which free fluid can
accumulate director utrom pouch located
here is the most inferior portion of the
peritoneal cavity and is often the first
place for free peritoneal fluid to
accumulate the collection of free fluids
can be a consequence of physiological or
pathological processes colder synthesis
is the process of draining this fluid
through the introduction of a spinal
needle through the vaginal wall through
the vaginal forces which you can see
here the furnaces are formed due to the
projection of the cervix which is here
into the vaginal cavity which forms a
continuous lateral recess around the
outside of the cervix and
war the relationship between the vagina
cervix and Neutron corpus are described
as a series of angles these angles are
relative to the long axis through the
center of these structures so as we
rotate the model we concede that the
cervix here projects into the vagina
here so we compared the long axes
through the vagina and through the
cervix it will create an angle of
anteversion similarly as we compare the
long axis through the cervix and the
uterine corpus it creates an angle of
anti flexion and this angle of anti
flexion allowing uterine corpus to
assume its natural position on the
superior surface of the bladder here
however the uterus can assume other
positions within the pelvis due to
alterations in the angles such as retro
version and retro flexion though these
variations rarely have clinical
implications various supporting
structures within the pelvis are thought
to assist in maintaining the angles of
anti version and anti flexion these
structures been the Cardinal ligaments
and each her sacral ligaments there is
little agreement with in the literature
about the attachment of these ligaments
though in general they are thought to be
connective tissue structures that
contain associated nerves and vessels
they extend from the cervix to the
sacrum in the case of the uterus sacral
ligaments and from the cervix to the
internal iliac vessels as in the case of
the Cardinal ligaments blood supply and
drainage at the pelvic viscera are from
branches of the internal iliac artery
and internal iliac vein which we can see
here however the ovary is slightly
different because the ovarian arteries
arise directly from the aorta these mini
ovarian arteries here and venous blood
is drains valley ovarian veins which on
the right hand side will drain into the
IVC and a left hand side will drain into
the left renal vein the uterine artery
arises directly from the internal iliac
artery the vagina artery which we can
see here was sometimes arise from
uterine artery
although in some cases it will arise
from the internal iliac artery at the
level of the cervix the uterine artery
will split to form the ascending branch
which will supply the corpus the uterine
tube and sometimes the ovary and a
descending branch which will supply it
to vagina however it is important to
remember that great variation is often
observed in this region of the body and
so it is important to trace the vessels
in order to ascertain which structures
they are supplying an important
relationship to remember is the position
of the uterine artery relative to that
of the ureter at the approximate level
of the issue spine the ureter will pass
inferior to that of detron vessels which
can be easily remembers using a phrase
water passes under the bridge the ureter
is in danger of being clamped ligated or
transected during hysterectomy
DHA is also vulnerable to injury during
an OVA or xme as your ovarian vessels by
very close to less of the ureter as they
cross over the pelvic brim so just a
quick summary the uterus is a collective
term referring to the uterine corpus and
cervix it is a sub peritoneal structure
as it lies inferior to the peritoneal
cavity pouches are located both anterior
and posterior to lead hrus within the
peritoneal cavity which allow for the
accumulation of free fluids the uterus
is supplied by the uterine artery which
is a branch of the internal iliac artery
Neutron artery is closely related to the
ureter and a level of the issue of
spines so it is important to remember
that the ureter passes inferior to the
artery during hysterectomy we'd love to
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