2. Introduction
Uterus is inverted pear shaped, highly
mobile ,thick walled ,muscular organ in
the female body.
It is situated obliquely in the lesser
pelvis between urinary bladder
anteriorly and the rectum & sigmoid
colon posteriorly.
3. Importance of Support
The Supporter of the Uterus is
needed to kept it in it’s actual
position & prevented from sagging
down .
The uterus is supported and
prevented from prolapse(downward
Displacement) by a number of
structures providing support to it.
6. A. Pelvic Diaphragm
It is a gutter shaped musculo-fascial
partition between the pelvic cavity &
perinium .
Pubococcygeus part of levetor ani plays
the most significant supportive role of
uterus.
Pubococcygeus has 4 components:
Pubococccygeus proper, Puborectalis,
puboanalis and pubovaginalis/
pubovesicalis
Pubovaginalis narrows the hiatus
urogenitalis & constricts the vagina from
side to side & prevents the discent of
Uterus.
8. B. Perineal Body
It is a pyramidal fibromuscular node intervening
between the anal canal & urogenital apparaters.
It is known as gynaecological perineum which receives
the attachment of following muscle : longitudinal muscle
coat of anal canal ,sphincter ani exturnus, superficial
transverse perini (2) , deep transverse perini (2)
Bulbospongious, pubococcygeus part of levetor ani
The perineal body acts as an anchor for the pelvic
diaphragm & maintains the integrity of the pelvic floor.
If it is torn during delivery & not properly repaired the
,urogenital hiatus becomes enlarged, the vagina dilates
& uterus descent.
9.
10. C. Urogenital Diaphragm
It is a
musculofascial
partition
between the
pelvic cavity &
the anterior
part of pelvic
outlet.
It helps in
closure of
urogenital
hiatus from
bellow &
constricts the
vagina.
12. Uterine Axis
Angle of Anteversion
It is forward angle
formed by long axis of
vagina & that of cervix at
the level of external os
measuring approx. 90°
provided Urinary Bladder
and rectum are empty.
Angle of Anteflexion
It is forward angle
formed by long axis of
uterus & that of cervix at
the level of internal os
measuring approx. 125°
-170° provided Urinary
Bladder and rectum are
empty
13. 3. Fibromuscular support
Mackenrodt’s Ligaments : These are fan shaped fibro-
muscular band derived from condensation of parametric
tissue .They form a hammock that keep the cervix in
position & prevent downward displacement of uterus. It
is also known as lateral /transverse cervical ligament/
cardinal ligament.
Pubocervical ligaments : these are a pair of thin fibrous
band which extend from cervix to the posterior surface
of pubis.
Uterosacral ligaments : Each ligaments extends from
cervix to the 3rd sacral vertebra .They pull the cervix
backwards & help in maintenance of anteversion &
anteflexion position of uterus.
14.
15. Round Ligaments of Uterus
It is a remnant of
distal part of
gubernaculum of
ovary .
Attached
proximally to the
cornu of uterus
and distally to the
labia majora.
It pull the fundus
forwards &
maintains the
Anteversion &
anteflexion.
17. Broad Ligaments
Each Ligament is Broad , quadrilateral fold of
peritoneum that extends from lateral borders
of Uterus to the lateral pelvic wall.
19. Utero vesical fold : It is formed by
reflection of peritoneum that extends
from anterior border of the body of
uterus to the upper surface of urinary
bladder.
Rectovaginal / Rectouterine fold : It
is formed by peritoneal reflection from
posterior fornix of vagina to the
rectum. It forms the floor of pouch of
Doglus .
20. 2. Pelvic cellular Tissue/
Loose packing meterial
The parametric tissue made up of fibro-
areolar & fibro-muscular tissue fills up
the dead space between pelvic
peritoneum & pelvic floor & act as a
packing structure .
Ovarian hormones control the growth of
parametric tissue
