| Uterosacral ligament | |
|---|---|
 Uterosacral ligament (in white color) connect between the sacrum and uterus. | |
| Details | |
| Identifiers | |
| Latin | ligamentum rectouterinum [1] |
| TA98 | A09.1.03.032 |
| TA2 | 3840 |
| FMA | 19111 |
| Anatomical terminology | |
The uterosacral ligaments (or rectouterine ligaments [1] ) are major ligaments of uterus that extend posterior-ward from the cervix to attach onto the (anterior aspect of the [2] ) sacrum. [3]
The uterosacral ligaments consist of fibrous connective tissue, and smooth muscle tissue. [3]
The uterosacral ligaments pass inferior to the peritoneum. They embrace the rectouterine pouch, and rectum. [3] The pelvic splanchnic nerves run on top[ further explanation needed ] of the ligament. [4]
The uterosacral ligaments pull the cervix posterior-ward, counteracting the anterior-ward pull exerted by the round ligament of uterus upon the fundus of the uterus, thus maintaining anteversion of the body of the uterus. [3]
The uterosacral ligaments may be palpated during a rectal examination, but not during pelvic examination. [3]
The cervix or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the time of Hippocrates, over 2,000 years ago. The cervix is approximately 4 cm long with a diameter of approximately 3 cm and tends to be described as a cylindrical shape, although the front and back walls of the cervix are contiguous. The size of the cervix changes throughout a woman's life cycle. For example, during the fertile years of a woman's reproductive cycle, females tend to have a larger cervix vis á vis postmenopausal females; likewise, females who have produced offspring have a larger sized cervix than females who have not produced offspring.
The uterus or womb is the organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic and fetal development of one or more fertilized eggs until birth. The uterus is a hormone-responsive sex organ that contains glands in its lining that secrete uterine milk for embryonic nourishment.
The inguinal canal is a passage in the anterior abdominal wall on each side of the body, which in males, convey the spermatic cords and in females, the round ligament of the uterus. The inguinal canals are larger and more prominent in males.
The human female reproductive system is made up of the internal and external sex organs that function in the reproduction of new offspring. The reproductive system is immature at birth and develops at puberty to be able to release matured ova from the ovaries, facilitate their fertilization, and create a protective environment for the developing fetus during pregnancy. The female reproductive tract is made of several connected internal sex organs—the vagina, uterus, and fallopian tubes—and is prone to infections. The vagina allows for sexual intercourse, and is connected to the uterus at the cervix. The uterus accommodates the embryo by developing the uterine lining.
The pelvic floor or pelvic diaphragm is an anatomical location in the human body, which has an important role in urinary and anal continence, sexual function and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and smooth, ligaments and fascia. and separates between the pelvic cavity from above, and the perineum from below. It is formed by the levator ani muscle and coccygeus muscle, and associated connective tissue.
The rectouterine pouch is the extension of the peritoneum into the space between the posterior wall of the uterus and the rectum in the human female.
The cystocele, also known as a prolapsed bladder, is a medical condition in which a woman's bladder bulges into her vagina. Some may have no symptoms. Others may have trouble starting urination, urinary incontinence, or frequent urination. Complications may include recurrent urinary tract infections and urinary retention. Cystocele and a prolapsed urethra often occur together and is called a cystourethrocele. Cystocele can negatively affect quality of life.
The ovarian artery is an artery that supplies oxygenated blood to the ovary in females. It arises from the abdominal aorta below the renal artery. It can be found within the suspensory ligament of the ovary, anterior to the ovarian vein and ureter.
The transversalis fascia is the fascial lining of the anterolateral abdominal wall situated between the inner surface of the transverse abdominal muscle, and the preperitoneal fascia. It is directly continuous with the iliac fascia, the internal spermatic fascia, and pelvic fascia.
The parametrium is the fibrous and fatty connective tissue that surrounds the uterus. This tissue separates the supravaginal portion of the cervix from the bladder. The parametrium lies in front of the cervix and extends laterally between the layers of the broad ligaments. It connects the uterus to other tissues in the pelvis. It is different from the perimetrium, which is the outermost layer of the uterus.
The pelvic cavity is a body cavity that is bounded by the bones of the pelvis. Its oblique roof is the pelvic inlet. Its lower boundary is the pelvic floor.
Uterine prolapse is a form of pelvic organ prolapse in which the uterus and a portion of the upper vagina protrude into the vaginal canal and, in severe cases, through the opening of the vagina. It is most often caused by injury or damage to structures that hold the uterus in place within the pelvic cavity. Symptoms may include vaginal fullness, pain with sexual intercourse, difficulty urinating, and urinary incontinence. Risk factors include older age, pregnancy, vaginal childbirth, obesity, chronic constipation, and chronic cough. Prevalence, based on physical exam alone, is estimated to be approximately 14%.
The iliolumbar ligament is a strong ligament which attaches medially to the transverse process of the 5th lumbar vertebra, and laterally to back of the inner lip of the iliac crest.
The tectorial membrane of atlanto-axial joint is a tough membrane/broad, strong band representing the superior-ward prolongation of the posterior longitudinal ligament.
The perimetrium is the outer serosal layer of the uterus, derived from the peritoneum overlying the uterine fundus, and can be considered a visceral peritoneum. It consists of a superficial layer of mesothelium, and a thin layer of loose connective tissue beneath it.
In human female anatomy, the vesicouterine pouch, also uterovesicle pouch, is a fold of peritoneum over the uterus and the bladder. Like the rectouterine pouch, it is a female pelvic recess, but shallower and closer to the anterior fornix of the vagina.
The cardinal ligament is a major ligament of the uterus formed as a thickening of connective tissue of the base of the broad ligament of the uterus. It extends laterally from the cervix and vaginal fornix to attach onto the lateral wall of the pelvis. The female ureter, uterine artery, and inferior hypogastric (nervous) plexus course within the cardinal ligament. The cardinal ligament supports the uterus.
A pelvic examination is the physical examination of the external and internal female pelvic organs. It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, discharge, urinary incontinence, or trauma. It can also be used to assess a woman's anatomy in preparation for procedures. The exam can be done awake in the clinic and emergency department, or under anesthesia in the operating room. The most commonly performed components of the exam are 1) the external exam, to evaluate the vulva 2) the internal exam with palpation to examine the uterus, ovaries, and structures adjacent to the uterus (adnexae) and 3) the internal exam using a speculum to visualize the vaginal walls and cervix. During the pelvic exam, sample of cells and fluids may be collected to screen for sexually transmitted infections or cancer.
The development of the reproductive system is the part of embryonic growth that results in the sex organs and contributes to sexual differentiation. Due to its large overlap with development of the urinary system, the two systems are typically described together as the genitourinary system.
The vaginal support structures are those muscles, bones, ligaments, tendons, membranes and fascia, of the pelvic floor that maintain the position of the vagina within the pelvic cavity and allow the normal functioning of the vagina and other reproductive structures in the female. Defects or injuries to these support structures in the pelvic floor leads to pelvic organ prolapse. Anatomical and congenital variations of vaginal support structures can predispose a woman to further dysfunction and prolapse later in life. The urethra is part of the anterior wall of the vagina and damage to the support structures there can lead to incontinence and urinary retention.
This article incorporates text in the public domain from page 1260 of the 20th edition of Gray's Anatomy (1918)
