Volume 1

A treatise on the science and practice of midwifery / by W.S. Playfair.

Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the science and practice of midwifery / by W.S. Playfair. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    74/440 (page 48)
    The round ligaments. The vesico- uterine and utero- sacral liga- ments. Altera- tions during pregnancy. The Fallo- pian tubes. The round ligaments are essentially muscular in struc- ture. They extend from the upper border of the uterus, with the fibres of which their muscular fibres are continuous, transversely and then obliquely downwards, until they reach the inguinal rings, where they blend with the cellular tissue. In the first part of their course the muscular fibres are solely of the unstriped variety, but soon they receive striped fibres from the transversalis muscles, and the columns of the inguinal ring, which surround and cover the unstriped muscular tissue. In addition to these structures they con- tain elastic and connective tissue, and arterial, venous, and nervous branches; the former from the iliac or cremasteric arteries, the latter from the genito-crural nerve. According to Mr. Rainey, the principal function of these ligaments is to draw the uterus towards the symphysis pubis during sexual intercourse, and thus to favour the ascent of the semen. The vesico-uterine ligaments are two folds of peritoneum passing in front from the lower part of the body of the uterus to the fundus of the bladder. The utero-sacral ligaments consist of folds of peritoneum of a crescentic form, with their concavities looking inwards: they start from the lower part of the posterior surface of the uterus, and curve backwards to be attached to the third and fourth sacral vertebrae. Within their folds exist bundles of muscular fibres, continuous with those of the uterus, as well as connective tissue, vessels, and nerves. The experi- ments of Savage, as well as of other anatomists, show that these ligaments have an important influence in preventing downward displacement of the womb. During pregnancy all these ligaments become greatly stretched and unfolded, rising out of the pelvic cavity and accommodating themselves to the increased size of the gravid uterus; and they again contract to their natural size, possibly through the agency of the muscular fibres contained within them, after delivery has taken place. The Fallopian tubes, the homologues of the vasa de- ferentia in the male, are structures of great physiological interest. They serve the double purpose of conveying the semen to the ovary, and of carrying the ovule to the uterus. From the latter function they may be looked on as the excretory ducts of the ovaries; but, unlike other excretory