The diseases of women : a handbook for students and practitioners / by J. Bland-Sutton and Arthur E. Giles.

  • Bland-Sutton, John, Sir, 1855-1936.
Date:
1909
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of women : a handbook for students and practitioners / by J. Bland-Sutton and Arthur E. Giles. Source: Wellcome Collection.

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    nerve by its superficial perineal branches also supplies the labium. The Pelvic Peritoneum,,—The pelvic peritoneum in women has a complex disposition, which it is necessary to thoroughly appreciate in order to comprehend the various morbid conditions to which the pelvic organs are liable. The peritoneum, as it descends from the posterior wall of the abdomen, enters the cavity of the true pelvis and covers the anterior face of the sacrum, the ureters, sacral plexus of nerves, and iliac vessels ; it also invests the first part of the rectum, and forms the meso-rectum. It gradually leaves the sides of the second part of the rectum, and, passing on to the upper 2 centimetres of the posterior vaginal wall, extends over the whole of the posterior aspect of the body of the uterus. Continuing, it invests the fundus and anterior surface of the body of the uterus, and leaves it at the level of the internal os to cover the posterior surface of the bladder, and then ascends on the anterior abdominal wall. As the peritoneum invests the uterus, a fold, known as the mesometrium (broad ligament), extends from each side of it, which becomes con¬ tinuous with the peritoneum investing- the iliac fossa. Thus the transverse fold formed by the uterus and its mesometria divides the pelvic cavity into two recesses, of which the pos¬ terior is the recto-vaginal fossa (pouch of Douglas) and the anterior the utero-vesical fossa. It will be necessary to study these fossse and the mesometrium in detail. The Mesometrium.—This important fold is formed by the peritoneum as it is reflected over the uterus and Fallopian tubes ; it consists of two layers of serous membrane. The part in relation with the uterus and tubes has the fat of the subserous tissue replaced by unstriped muscle tissue, but as it approaches the floor of the pelvis fat again appears in relation with it. The mesometrium lodges between its layers, in addition to the Fallopian tube, the ovary with the paro-