Special Surgical Procedures II
LESSON 2: Procedures in Gynecological and Obstetrical Surgery
2-7. THE LIGAMENTS OF THE UTERUS
a. Broad Ligaments. From each side of the uterus, the pelvic peritoneum extends laterally, downward, and backward. A double fold of pelvic peritoneum forms the layers of the broad ligament, enclosing the uterus. These layers separate to cover the floor and sides of the pelvis. The uterine tube is situated within the free upper border of broad ligament. The part of the broad ligament lying immediately below the uterine tube is termed the mesosalpinx. The ovary lies behind the broad ligament.
b. Round Ligaments. These fibromuscular bands are attached to the uterus. Each round ligament passes forward and laterally between the layers of the broad ligament to enter the deep inguinal ring.
c. Transverse Cervical Ligaments. These cardinal ligaments are composed of connective tissue masses with smooth muscle fibers that are strong support for the uterus in the pelvis.
d. Uterosacral Ligaments. These are a posterior continuation of the peritoneal tissue, which forms the cardinal ligaments. The ligaments pass posteriorly to the sacrum on either side of the rectum.
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