Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.

1. UTERUS

2. INTRODUCTION
• The uterus is a hollow muscular organ located
in the female pelvis between the bladder and
rectum
• In layman’s language, the uterus is called the
womb.
• It is also called hystera, on which word
hysterectomy is based.

3. DEFINITION
• Uterus is a child-bearing organ in females,
situated in the pelvis between bladder and
rectum. Though hollow it is thick walled and firm,
and can be palpated bimanually during a PV (per
vaginal) examination.

4. Conti..
• It is the organ which protects and provides nutrition to a fertilized
ovum, enabling it to grow into a fully formed fetus.
• At the time of childbirth or parturition, contractions of muscle in the
wall of the organ result in expulsion of the fetus from the uterus.

5. SIZE AND SHAPE
• The uterus is pyriform in shape.
• It is about 7.5 cm long, 5 cm broad, and
2.5 cm thick. It weighs 30 to 40 grams

6. Parts of Uterus
A fundus
Body with two surfaces, anterior or
vesicles and posterior or intestinal
Two lateral borders
Cervix
The uterus comprises:

7. Conti..
• It is divisible into an upper expanded part
called the body and a lower cylindrical part
called the cervix.
• The junction of these two parts is marked by a
circular constriction called the isthmus.
• Part of uterus above the opening of fallopian
tube is called the fundus.
• The body forms the upper two-thirds of the
organ, and the cervix forms the lower one-
third

8. Fundus
• The fundus is formed by the free upper end of the uterus.
• Fundus lies above the openings of the uterine tubes.
• It is convex like a dome.
• It is covered with peritoneum and is directed forward when the bladder is empty.
• The fertilized oocyte is usually implanted in the posterior wall of the fundus or
upper part of body of uterus

9. Conti..
• The anterior or vesical surface of the body is flat and related to the urinary
bladder.
• It is covered with peritoneum and forms the posterior or superior wall of the
uterovesical pouch.
• The posterior or intestinal surface is convex and is related to coils of the terminal
ileum and to the sigmoid colon.
• It is covered with peritoneum and forms the anterior wall of the rectouterine
pouch

10. Conti..
• Each lateral border is rounded and convex.
• It provides attachment to the broad ligament of the uterus which connects it to
the lateral pelvic wall.
• The uterine tube opens into the uterus at the upper end of this border.
• This end of the border gives attachment to the round ligament of the uterus,
antero-inferior to the tube; and to the ligament of the ovary postero-inferior to
the tube.
• The uterine artery ascends along the lateral border of the uterus between the
two layers of the broad ligament

11. Conti..
• In sagittal section, the cavity of the body of the uterus is seen as a mere slit
because the uterus is compressed anteroposteriorly.
• In coronal section, the cavity is seen to be triangular in shape, the apex being
directed downwards. At the apex, the cavity becomes continuous with the canal
of the cervix. The junction is called the internal os.
• The superolateral angles of the cavity receive the openings of the right and left
uterine tubes

12. Layers of uterus
• uterus consists of three layers:
• Perimetrium: The outermost, protective layer.
• Myometrium: The highly muscular middle layer. This is what expands
during pregnancy and contracts to push your baby out.
• Endometrium: The inner layer or lining of your uterus (uterine lining).
This layer of your uterus is shed during your menstrual cycle.

13. LIGAMENTS OF UTERUS
Peritoneal Ligaments
1. The anterior ligament consists of the
uterovesical fold of peritoneum.
2. The posterior ligament consists of the
rectovaginal fold forming rectovaginal
pouch of peritoneum
3. The right and left broad ligaments are
folds of peritoneum
Fibromuscular Ligaments
1. Round ligaments of the uterus
2. Transverse cervical ligaments
3. Uterosacral ligaments

16. VENUS SUPPLY OF UTERUS

17. SUPPORTS OF THE UTERUS
• The uterus is a mobile organ which undergoes extensive changes in size and
shape during the reproductive period of life.
• It is supported and prevented from sagging down by a number of factors which
are chiefly muscular and fibromuscular.

18. Primary Supports
Muscular or active supports
1. Pelvic diaphragm
2. Perineal body
3. Distal urethral sphincter
mechanism
Fibromuscular or mechanical supports
1. Uterine axis
2. Pubocervical ligaments
3. Transverse cervical ligaments
of Mackenrodt
4. Uterosacral ligaments
5. Round ligaments of uterus

19. Secondary Supports
These are of doubtful value and are formed by peritoneal ligaments.
1. Broad ligaments
2. Vesicouterine pouch and fold of peritoneum
3. Rectovaginal or rectouterine pouch and fold of peritoneum

21. Pelvic Diaphragm
• The pelvic diaphragmsupports the pelvic viscera and resists any rise in the intra-
abdominal pressure.
• The pubococcygeus part of the levator ani is partly inserted into the perineal
body between the vagina and the rectum.
• Some of these fibres also form a supporting sling and a sphincter for the vagina,
and so indirectly for the uterus and the urinary bladder.

22. Conti..
• If the pubococcygeus is torn during parturition, the support to the vagina is lost,
and the latter tends to sink into the vestibule along with the uterus, thus causing
prolapse of the uterus.
• The efficacy of the levator ani as a support is also lost when the perineal muscles
are torn. They normally fix the perineal body, and make it an anchor for the
levator ani

23. Perineal Body
• It is a fibromuscular node to which ten muscles are attached.
• It acts as an anchor for the pelvic diaphragm, and thus maintains the integrity of
the pelvic floor.
• The muscles are two superficial transversus perinei, two deep transversus
perinei, two pubococcygeus part of levator ani, two bulbospongiosus and single
sphincter ani externus and unstriped fibres of longitudinal muscle coat of the anal
canal

24. Urethral Sphincter Mechanism
• The urogenital diaphragm does not exist as sphincter urethrae is within the wall
of the urethra.
• The urethral sphincter mechanism exists.
• In addition, there are compressor urethrae and sphincter urethrae vaginalis.
• Since these are inserted into vagina, they support the uterus indirectly

25. Uterine Axis
• The anteverted position of the uterus itself prevents the organ from sagging
down through the vagina.
• Any rise in intra-abdominal pressure tends to push the uterus against the bladder
and pubic symphysis, which further accentuates anteversion.
• The angle of anteversion is maintained by the uterosacral and round ligaments

26. Pubocervical Ligaments
• These ligaments connect the cervix to the posterior surface of pubis.
• They are derived from the endopelvic fascia, and correspond to the
medial and lateral puboprostatic ligaments in the male

27. Transverse Cervical Ligaments of Mackenrodt
• These are also known by various
other names like lateral cervical
ligaments; cardinal ligaments;
paracervical ligaments; retinacula
uterine sustentaculum of Bonny

28. Uterosacral Ligaments
• These are also condensations of the endopelvic fascia.
They connect the cervix to the periosteum of the
sacrum and are enclosed within rectouterine folds
ofperitoneum (which form the lateral boundaries of the
rectouterine pouch).
• The uterosacral ligaments keep the cervix braced
backwards against the forward pull of the round
ligaments. The two ligaments form a couple that
maintains the uterine axis

29. Round Ligaments of Uterus
• The round ligaments are two fibromuscular flat bands, 10 to 12 cm long, which lie
between the two layers of the broad ligament, anteroinferior to the uterine tube.
• Each ligament begins at the lateral angle of the uterus, runs forwards and
laterally, passes through the deep inguinal ring, traverses the inguinal canal and
merges with the areolar tissue of the labium majus after breaking up into thin
filaments.

30. Function
What does a uterus do?
• The three main jobs of your uterus are:
• Pregnancy: Your uterus stretches to grow your baby during
pregnancy. It can also contract to help push your baby out of your
vagina.
• Fertility: Your uterus is where a fertilized egg implants
during conception and where your baby grows.
• Menstrual cycle: Your uterine lining is where blood and tissue come
from during menstruation.

31. What are the common conditions of the
uterus?
• Uterine fibroids: Small, noncancerous tumors in uterus.
• Uterine polyps: Growths in the endometrial lining of uterus.
• Uterine cancer: Cancer of your uterus, such as endometrial cancer or uterine
sarcoma.
• Endometriosis: A condition when uterine lining grows in places other than
uterus.
• Pelvic inflammatory disease: An infection of reproductive organs.
• Uterine prolapse: A condition where uterus slips out of position.
• Infertility: The inability to get pregnant.