Outlines of the diseases of women / by John Phillips.

  • Phillips, John.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of the diseases of women / by John Phillips. Source: Wellcome Collection.

    43/332 (page 23)
    Fig anteflexion. The position of the uterus changes from time to time and under different circumstances; it lies roughly in the centre of the pelvic cavity, the fundus being just below the brim of the pelvis. Its long axis coincides very nearly with the axis of the pelvic inlet, but is slightly behind the centre of the true conjugate diameter: hence it is about at right angles to the plane of the, inlet and to the vaginal and urethral axes, while it is parallel to the anal axis. The uterus lies with its anterior surface touching the bladder, no intestines lying in the utero-vesical space. There is slight dextral torsion of the organ on its long axis, so that the left cornu with its Fallopian tube is rotated somewhat forward, toward the symphysis pubis, the right backwards and away from it. The cervix should point backwards and down- wards, the os uteri looking into the hollow of the sacrum. The uterus is retained in this position by (a) its several ligaments—viz.: 1. Broad ligaments later- ally—which suspend it and by which side to side move- ment is controlled. 2. Utero-sacral ligaments —which with the anterior wall of the vagina form a beam traversing the pelvic cavity antero-posteriorly, and in which the uterus finds support, being attached firmly to both (Fig. 19 : 6). 3. Utero-vesical ligaments (Fig. 19 : 7). 4. Round ligaments—these by their course prevent backward displacement of the uterine fundus. They pass in front of the deep epigastric artery, downwards, inwards and backwards be- tween the layers of the broad ligaments to their insertion just below the uterine cornua (Fig. 19 : 5). (b) two extrinsic forces—viz.: 1. The elasticity of the pelvic floor. 2. The perineal body, which is believed to act as a support, but the value attached to it is exaggerated. The pelvis is placed in such a position in the erect posture Peritoneal surface of the pelvic floor from above. (Diagrammatic.) Bladder in section. Uterus. Rectum. Fallopian tube. Round ligament showing through peritoneum. Utero-sacral ligament. Utero-vesical ligament. Para-rectal pouch. Para-vesical pouch. Douglas' pouch. Utero-vesical pouch. 1. 2. 3- 4- 5- 6. 7- 8. 9- 10. 11.