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ANATOMY Uterus The uterus is supplied mainly by 2 arteries. 1) Uterine artery, 2) Ovarian artery.

From the internal iliac artery or the hypogastric artery, the uterine artery branches, enters the base of the broad ligament to the side of the uterus. At the supravaginal portion of the cervix, it divides into the 1) cervicovaginal artery, which supplies the lower cervix and upper vagina, and 2) a main branch which extends upward dividing into 3 terminal branches. 1) Ovarian branch anastomosing with the ovarian artery 2) Tubal branch supplying the fallopian tube 3) Fundal branch supplying the upper part of the uterus The ovarian artery branches directly from the aorta and enters the broad ligament through the infundibulopelvic ligament. It divides into several branches entering the ovary and a main branch which anastomoses with the ovarian branch of the uterine artery. On both sides of the uterus, arcuate veins unite to form the uterine vein which empties into the internal iliac vein and then to the common iliac vein. Within the broad ligament, veins form the pampiniform plexus which terminates in the ovarian vein. The R ovarian vein empties into the inferior vena cava while the left ovarian vein empties into the left renal vein. There are 3 ligaments extending from the surface of the uterus. 1) Round ligament, 2) broad ligament, and 3) cardinal ligament. The round ligament originates below and anterior to the fallopian tube, extending laterally and downward to the inguinal canal and terminates in the upper portion of the labia majora. The Sampson artery, a branch of the uterine artery, runs within this ligament. (gubernaculum testes in male) The broad ligament extends from the lateral uterine margin to the pelvic sidewalls. [mesosalpinx fallopian tube, mesoteres round ligament, mesovarium uterovarian ligament]

Beneath the fimbriated end of the fallopian tube towards the pelvic wall runs the infundibulopelvic ligament a.k.a. suspensory ligament of the ovary wherein ovarian vessels traverse. The thick base of the broad ligament is continuous with the connective tissue of the pelvic floor. The cardinal ligament is the densest portion. (a.k.a transverse cervical ligament, Mackenrodt ligament) It unites with the supravaginal portion of the cervix. Cervix: internal iliac nodes. Uterine corpus: internal iliac nodes, para-aortic nodes. Sympathetic. Fallopian Tube The fallopian tube is divided into the interstitial, isthmus, ampulla and infundibulum. The interstitial portion is within the uterus. The isthmus is a narrow portion that joins the uterus with a wider portion, the ampulla. The infundibulum is fimbriated and funnel-shaped opening distally to the abdominal cavity. Sympathetic. Vagina The proximal portion is supplied by the cervical branch of the uterine artery and by the vaginal artery. The vaginal artery originates from either the uterine / inferior vesical / or internal iliac artery. The posterior vaginal wall is supplied by the middle rectal artery. The distal vaginal walls are supplied by the internal pudendal artery. The venous plexus follows the course of the arteries. Lower third: inguinal lymph nodes. Middle third: internal iliac nodes Upper third: external, internal, common iliac nodes.