Pathology and treatment of diseases of women.

  • Martin, August Eduard, 1847-1933.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Pathology and treatment of diseases of women. Source: Wellcome Collection.

    24/500 (page 4)
    which is intimately connected with the underlying stroma. The latter is made up of connective tissue, having small spindle-shaped cells embed- ed m which are the essential ovarian elements, the ovarian or Graafian roilicles. The stroma is poorly developed in its cortical portion, but is more abundant in the vascular or medullary portion. In the cortical por- tion the stroma forms a network for the ovarian follicles, while in the medullary or vascular portion it forms a supporting structure for the ' D’my branching bloodvessels and nerves (see Figs. 10, 11 and 12). The medullary or vascular portion is continued directly with its ves- sels and nerves into the hilus ovarii, which latter is continuous with the posterior wall of the ligamentum latum. Within the hilus ovarii is contained the parovarium or epoophoron, the rudiments of the sexual portion of the corpus Wolfii. The epoophoron is formed almost like a comb, a number of canals or tubules terminating in one large collecting canal or tube, the latter running parallel to the Fallopian tube. These tubes are lined with a single layer of ciliated cylindrical epithelium. Not infrequently the transverse tubules extend into the medullary por- tion of the ovary. All the.pelvic Organs are covered with peritoneum, with the exception, of the ovaries. The peritoneum is continued from the inner side of the anterior abdominal wall over the bladder, descends from the fundus of this organ down into the excavatio vesico-uterina (covered in Fig. 2 by the uterus) and reaches the uterus at a point about midway of its anterior wall. Here it connects intimately with the uterus, ascends and covers the fun- dus uteri and descends posteriorly into the excavatio recto-uterina (cavum Douglasii) where it reaches its deepest point just above the posterior vaginal vault. Then the peritoneum is reflected upward over the ante- rior wall of the rectum. The space between the peritoneum and vaginal wall is very broad anteriorly, between the two being contained a portion of the bladder, while posteriorly the space is very narrow: at this point it is easy to enter the peritoneal cavity through the vagina. (Important for the surgeon.) In the lateral parts of the pelvis the peritoneum descends into the fossae paravesicales (see Figs. 2 and 4), ascends to the height of the ligamentum latum, descends into the fossae pararectales and ascends on either side of the rectum in front of the sacrum and the ilium. The cavity above the peritoneal covering is the cavum serosum pelvis, and beneath it is the cavum subserosum pelvis, which is filled with pelvic connective tissue and reaches down to the muscular floor of the pelvis (the diaphragma pelvis rectale et urogenitale), on both sides. The cavum subserosum pelvis is divided into three parts, anteriorly the subserosium paravesicale, in the middle the subserosium para- uterinum and posteriorly the subserosium pararectale. The uterus. vagina, and tubes are completely enclosed with pelvic con-