Ligaments of the Uterus
Definition
Ligaments are structures that support the internal female reproductive organs in the pelvis.
Categories
The ligaments can be divided into three categories:
- Broad ligament - a sheet of peritoneum, associated with both the uterus and ovaries.
- Uterine ligaments - ligaments primarily associated with the uterus.
- Ovarian ligaments - ligaments primary associated with the ovaries.
Collectively, these ligaments are tough and non-extensible.
They support the female viscera
Provide a conduit for neurovascular structures
Broad Ligament
The broad ligament is a flat sheet of peritoneum, associated with the uterus, fallopian tubes and ovaries.
Extends from the lateral pelvic walls on both sides, and folds over the internal female genitalia, covering their surface anteriorly and posteriorly.
Subdivisions
- Mesometrium - Surrounds the uterus and is the largest subsection of the broad ligament. It runs laterally to cover the external iliac vessels, forming a distinct fold over them. The mesometrium also encloses the proximal part of the round ligament of the uterus.
- Mesovarium - Part of the broad ligament associated with the ovaries. It projects from the posterior surface of the broad ligament and attaches to the hilum of the ovary, enclosing its neurovascular supply. It does not, however, cover the surface of the ovary itself.
- Mesosalpinx - Originates superiorly to the mesovarium, enclosing the fallopian tubes.
Round Ligament
The round ligament of the uterus originates at the uterine horns, in the parametrium.
It enters the pelvis via the deep inguinal ring
Passes through the inguinal canal
Continues on to the labia majora where its fibers spread and mix with the tissue of the mons pubis.
Mackenrodt's Ligament
The cardinal ligament (or Mackenrodt's ligament, lateral cervical ligament, or transverse cervical ligament) is a major ligament of the uterus.
It is located at the base of the broad ligament of the uterus.
It attaches the cervix to the lateral pelvic wall by its attachment to the Obturator fascia of the Obturator internus muscle, and is continuous externally with the fibrous tissue that surrounds the pelvic blood vessels. It thus provides support to the uterus.
Applied Anatomy
Mackenrodt's ligament is of clinical significance in hysterectomy, due to its close proximity to the ureters, which can get damaged during ligation of the ligament.
* * * * * * * * * * *
