Uterine Ligaments

Uterine Ligaments

Ligaments of uterine body

1) Round ligament:
Origin:remnant of gubernaculum of ovary.
Description : 
• 2 fibromuscular structures 12 cm in length.
• Arises as a continuation of the cornu of the uterus.
• Pass to reach the lateral pelvic wall through anterior layer of broad ligament.
• Enters inguinal canal through deep ring.
• Ends by firm attachment to labia majora.
Blood supply:Sampson’s artery (branch from ovarian artery).

Uterine Ligaments
Uterine Ligaments

Clinical importance: 
♦ Obstetrics:
• Important factor keeping AVF position of uterus.
• Steady the growing uterus in pregnant females & with uterine contraction.
• Cause inguinal pain during pregnancy, if hypertrophied.
♦ Gynecology :
• Used in correcting RVF by many surgical procedures.
• Inguinal hernia or hydrocele may be caused by passage through inguinal canal.
• In fetus, it’s surrounded by processus vaginalis (if remains patent called canal of
Nuck) which is rare site of hernia.

2) Ovarian ligament:
Remnant of gubernaculum of ovary.
2 fibromuscular structures.
Lies between the 2 layers of broad ligament.
Connecting the lower pole of the ovary to the cornu of uterus.

3) Broad ligament:
Composed of 2 layers of peritoneum: anterior & posterior.
Continuous with each other around the fallopian tube free border.
Divide from each other at the pelvic floor attached border.

Parts : 
1) Infundibulopelvic ligament (Containing suspensory ligament of ovary):
Connect the lateral pelvic wall to the upper pole of ovary & infundibulum.
2) Mesoverium: fold of peritoneum attaches the ovarian Hilum at anterior border to
the posterior layer of broad ligament.
3) Mesosalpinx: the part between fallopian tube above & ovarian ligament below.
4) Mesometrium: the peritoneal part below mesosalpinx and lateral to corpus.
5) Inferior portion: thickened & contains lateral ligament of cervix.

Contents : 
1. Fallopian tube: in the upper (free) border.
2. Two ligaments: ovarian & round in different planes.
3. Two vessels: uterine & ovarian blood vessels.
4. Two embryonic remnants of Wolffian system:
• Gartner duct: runs parallel to tube then descend downwards lateral to the
uterus & vagina.
• Remnants of tubules: a) Kobelt’s tubules: in the outer part.
b) Epoophoroon: between ovary & tubes.
c) Paraphoroon: between ovary & uterus.
5. Nerves & lymphatics.
6. Condensed extra-peritoneal tissue.
7. Smooth muscle fibers.

Applied anatomy: 
1) Cystic dilatation of Gartner duct leads to:
Para-ovarian cyst: between the 2 layers of broad ligament.
Gartner cyst: projects into anterior wall of the vagina.
2) Smooth muscle fibers may develop (broad ligamentary fibroid).
3) Inflammation of parametrium: leading to parametrial abscess.
4) Broad ligament may be a site for hematoma or even pregnancy.

Cervical ligaments


1) Mackenrodt’s ligament (Cardinal ligament)

(Lateral cervical ligament) (Transverse cervical ligament)
Extends in fan-shaped manner from the lateral side of supravaginal cervix &
vaginal vault to the lateral pelvic wall.
Ureter passes through it in the ureteric canal.
Uterine vessels runs in it till the lateral aspect of the cervix.

2) Uterosacral ligament
Extends from the supravaginal cervix & vaginal vault.
Runs backwards surrounding the rectum.
Inserted into the rectal wall & 3rd sacral piece.

3) Pubocervical ligament
Extends from the supravaginal cervix & vaginal vault. forwards surrounding
Surrounding the upper part of urethra.
Inserted into periosteum of back of symphysis pubis.

The female pelvic organs: The Uterine Ligaments

Introduction to Female Reproductive Anatomy Part 2 – Uterine Ligaments – 3D Anatomy Tutorial

Uterine Ligaments of the Reproductive System

Uterus and uterine ligaments

Uterine Ligaments

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Dr.Galal Baligh

OB-GYN Specialist

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