The Uterine And Cervical Ligaments: Difference between revisions
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== Uterine Ligaments == | == Uterine Ligaments == | ||
=== Broad Ligament | === Broad Ligament === | ||
[[File:Parts-of-the-Broad-Ligament-Mesometrium-Mesovarium-and-Mesosalpinx..jpg|thumb|412x412px|Broad Ligament]] | [[File:Parts-of-the-Broad-Ligament-Mesometrium-Mesovarium-and-Mesosalpinx..jpg|thumb|412x412px|Broad Ligament]] | ||
The broad ligament contains the round ligament, the fallopian tube, arteries, veins, lymphatics, nerve fibers, | ==== Description ==== | ||
The broad ligament is a double flat peritoneum sheet. Its upper outer border form a ligament where ovarian vessels pass. It contains the round ligament, the fallopian tube, arteries, veins, lymphatics, nerve fibers, loose connective tissue, and remnants of Wolffian duct. | |||
It has three subdivisions, | ==== Attachments ==== | ||
It extends from the [[Female Genital Tract|uterus]] and fans out to the lateral pelvic wall. | |||
==== Function ==== | |||
The broad has three subdivisions, all three subdivisions help to maintain the uterus in its place in the pelvis, but it is not the main support. | |||
Mesometrium: the largest part of the ligaments surround the uterus. | Mesometrium: the largest part of the ligaments surround the uterus. | ||
| Line 22: | Line 26: | ||
Mesovarium: projects from the posterior surface of the broad ligament and enclose the [[Polycystic Ovarian Syndrome|ovary]] vascular supply not covering the [[Female Genital Tract|ovary]] itself. | Mesovarium: projects from the posterior surface of the broad ligament and enclose the [[Polycystic Ovarian Syndrome|ovary]] vascular supply not covering the [[Female Genital Tract|ovary]] itself. | ||
Mesosalpinx: | Mesosalpinx: traps the [[Female Genital Tract|fallopian]] tube and originates from the mesovarium<ref>https://teachmeanatomy.info/pelvis/female-reproductive-tract/ligaments/</ref>. | ||
==== Clinical Relevance ==== | |||
Gartner's cyst, it develops in response to the dilatation of Wolffian duct, persists in the anterolateral wall of the vagina. Need surgical intervention only in patients with severe symptoms or if it causes obstetrical complications<ref>Bala R, Nagpal M, Kaur M, Kaur H. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743283/ Posterior vaginal wall Gartner's duct cyst.] Journal of mid-life health. 2015 Oct;6(4):187.</ref><ref>Rios SS, Pereira LC, Santos CB, Chen AC, Chen JR, Maria de Fátima BV. [https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-016-0936-1 Conservative treatment and follow-up of vaginal Gartner’s duct cysts]: a case series. Journal of medical case reports. 2016 Dec;10(1):147.</ref>. | |||
==== Assessment ==== | |||
For investigation, urinary tract [[Ultrasound Scans|ultrasound]] or [[MRI Scans|magnetic resonance image]] MRI. For confirmation, vaginal diagnostic ultrasound will be one. | |||
=== Round Ligament === | === Round Ligament === | ||
[[File:Round ligaments of uterus.jpg|thumb|287x287px|Round Ligament]] | [[File:Round ligaments of uterus.jpg|thumb|287x287px|Round Ligament]] | ||
A fibromuscular connective tissue | |||
==== Description ==== | |||
A fibromuscular band of connective tissue, runs forward and downward between the two sheets of the broad ligament. It runs down deep in the inguinal canal to enter the labia majora <ref>Gossman W, Fagan SE, Sosa-Stanley JN, Peterson DC. [https://www.ncbi.nlm.nih.gov/books/NBK499970/ Anatomy, abdomen and pelvis, uterus]. InStatPearls [Internet] 2019 Jul 11. StatPearls Publishing.</ref>. It is about 10-12 cm in length. | |||
==== Attachment ==== | |||
It attaches proximally at the superior and lateral side of the uterus at the cornu, its fiber blend with that of the labia majora and mons pubis and inserts at mons pubis below the skin. | |||
==== Function ==== | |||
It pulls the uterus forward, helping to maintain the uterus anteverted. | |||
==== Clinical Relevanc ==== | |||
=== Ovarian Ligament === | === Ovarian Ligament === | ||
== Cervical Ligaments | ==== Description ==== | ||
It is a short fibromuscular structure that lies with the broad ligament, | |||
==== Attachment ==== | |||
It attaches to the posterolateral aspect of the uterus | |||
==== Function ==== | |||
It connects the ovary with the uterus at the cornu. | |||
== Cervical Ligaments == | |||
=== Cardinal Ligaments/ Mackenrodt’s Ligaments === | === Cardinal Ligaments/ Mackenrodt’s Ligaments === | ||
Revision as of 20:49, 16 June 2020
Original Editor - Khloud Shreif
Top Contributors - Khloud Shreif, Lucinda hampton, Safiya Naz and Temitope Olowoyeye
Description[edit | edit source]
The structures of the internal genitalia/ female reproductive system is supported by the pelvic floor musculature, pelvic fascia, and ligaments on both sides of the uterus. These ligaments divided into, uterine ligaments that are soft and lax, having a limited role in supporting the uterus and internal genitalia, unlike the cervical ligaments which are tough, non-extensible, and condensed thinking of pelvic tissue.
Uterine Ligaments[edit | edit source]
Broad Ligament[edit | edit source]
Description[edit | edit source]
The broad ligament is a double flat peritoneum sheet. Its upper outer border form a ligament where ovarian vessels pass. It contains the round ligament, the fallopian tube, arteries, veins, lymphatics, nerve fibers, loose connective tissue, and remnants of Wolffian duct.
Attachments[edit | edit source]
It extends from the uterus and fans out to the lateral pelvic wall.
Function[edit | edit source]
The broad has three subdivisions, all three subdivisions help to maintain the uterus in its place in the pelvis, but it is not the main support.
Mesometrium: the largest part of the ligaments surround the uterus.
Mesovarium: projects from the posterior surface of the broad ligament and enclose the ovary vascular supply not covering the ovary itself.
Mesosalpinx: traps the fallopian tube and originates from the mesovarium[1].
Clinical Relevance[edit | edit source]
Gartner's cyst, it develops in response to the dilatation of Wolffian duct, persists in the anterolateral wall of the vagina. Need surgical intervention only in patients with severe symptoms or if it causes obstetrical complications[2][3].
Assessment[edit | edit source]
For investigation, urinary tract ultrasound or magnetic resonance image MRI. For confirmation, vaginal diagnostic ultrasound will be one.
Round Ligament[edit | edit source]
Description[edit | edit source]
A fibromuscular band of connective tissue, runs forward and downward between the two sheets of the broad ligament. It runs down deep in the inguinal canal to enter the labia majora [4]. It is about 10-12 cm in length.
Attachment[edit | edit source]
It attaches proximally at the superior and lateral side of the uterus at the cornu, its fiber blend with that of the labia majora and mons pubis and inserts at mons pubis below the skin.
Function[edit | edit source]
It pulls the uterus forward, helping to maintain the uterus anteverted.
Clinical Relevanc[edit | edit source]
Ovarian Ligament[edit | edit source]
Description[edit | edit source]
It is a short fibromuscular structure that lies with the broad ligament,
Attachment[edit | edit source]
It attaches to the posterolateral aspect of the uterus
Function[edit | edit source]
It connects the ovary with the uterus at the cornu.
Cervical Ligaments[edit | edit source]
Cardinal Ligaments/ Mackenrodt’s Ligaments[edit | edit source]
Ligaments of the cervix, connect the lateral side of the cervix and vagina to the lat pelvic wall and provide support to the uterus and vagina.
This ligament with uterosacral ligament and other pelvic musculature collaborate to support the pelvic organs and prevent prolapse.
During hysterectomy due to cervical cancer, the cardinal ligaments are involved and they may be removed as they are a common site for cancerous cells to ensure the disease is free.
Ureter and uterine vessels are related and near to the cardinal/ mackenrodt’s ligaments and may be injured during surgeries if the ligaments are manipulated[5].
Utero-sacral Ligaments[edit | edit source]
Known as sacrocervical ligaments or recto-uterine ligaments, extend from the posterior aspect of the cervix and vagina and directed backward to surround the rectum and insert in the base of the third sacral vertebrae.
Pubo-cervical Ligaments[edit | edit source]
Extend from the anterior of the cervix and vagina and directed forward to surround the urethra below the bladder and insert in the posterior aspect of the symphysis pubis.
References[edit | edit source]
- ↑ https://teachmeanatomy.info/pelvis/female-reproductive-tract/ligaments/
- ↑ Bala R, Nagpal M, Kaur M, Kaur H. Posterior vaginal wall Gartner's duct cyst. Journal of mid-life health. 2015 Oct;6(4):187.
- ↑ Rios SS, Pereira LC, Santos CB, Chen AC, Chen JR, Maria de Fátima BV. Conservative treatment and follow-up of vaginal Gartner’s duct cysts: a case series. Journal of medical case reports. 2016 Dec;10(1):147.
- ↑ Gossman W, Fagan SE, Sosa-Stanley JN, Peterson DC. Anatomy, abdomen and pelvis, uterus. InStatPearls [Internet] 2019 Jul 11. StatPearls Publishing.
- ↑ Eid S, Iwanaga J, Oskouian RJ, Loukas M, Tubbs RS. Comprehensive Review of the Cardinal Ligament. Cureus. 2018 Jun;10(6).
- ↑ AnatomyZone. Introduction to Female Reproductive Anatomy Part 2 - Ligaments - 3D Anatomy Tutorial. Available from: http://www.youtube.com/watch?v=Bf_sr2qRRWs[last accessed 14/6/2020]
