- Approximate the size/shape of a pear with a central cavity and thick muscular walls (~7x5x3cm and 40g)
- Fundus (superiorly)
- Body
- Isthmus (internal os)
- Cervix (inferiorly; external os)
- Can lie ante- or retroverted in relation to the vagina
- Muscle (myometrium) in 3 layers (separated by vascular layers): outer/external (thin, longitudinal, merging with ligaments); middle/intermediate (very thick, spiral muscle fibres with vessels running between them); inner/internal (thin, oblique)
- Because they run in different directions, they encourage vascular occlusion during menstruation/post-partum haemostasis
- Lined by endometrium which pierces the myometrium. Endometrium changes in response to the menstrual cycle
- Supported by muscles of the pelvic floor and several ligaments:
- Pubocervical ligaments (from cervix anteriorly to the pubis)
- Cardinal ligaments/transverse cervical ligaments (from cervix laterally to the lateral pelvic side walls)
- Uterosacral ligaments (from cervix to the sacrum)
- Often seen posterior to the uterus in the Pouch of Douglas and are a common site for endometriosis
- Round ligament
- Remnant of the gubernaculum
- Extends from the uterus laterally (although anterior to the fallopian tubes) to the pelvic side wall and the inguinal canal before down to the labia majora
- Holds uterus in anteversion although can be very lax (particularly in/after pregnancy)
- Often divided at hysterectomy
- Blood supply mainly from the uterine artery (anterior div of internal iliac artery)
- It runs in the lower edge of the broad ligament to the uterus where it runs up the side
- The ureter lies immediately beneathe it
- Some supply is from anastomoses with the ovarian artery via the ovarian ligament
Notes on Medicine/Surgery 