A Text-book of Diseases of Women

by Charles B. Penrose

A detailed description of such anatomical relations is out of place here. It is especially important to study the distribution of the arterial supply and the relations of the ureters. [Fig. 208] will refresh the memory upon these points.

Fig. 208.—Posterior view of the uterus, the tubes and ovaries, and the broad ligaments: I.P.L., infundibulo-pelvic ligament; O.A., ovarian artery; U.A., uterine artery; U., ureter. The utero-sacral ligaments are seen on each side of the posterior aspect of the cervix.

The ovarian artery, which corresponds to the spermatic in the male, is a branch of the abdominal aorta. It runs tortuously between the layers of the upper part of the broad ligament, from the pelvic wall to the upper angle of the uterus. Before reaching the uterus it divides into two branches. The upper branch supplies the fundus uteri; the lower branch anastomoses at the side of the uterus with the uterine artery.

During its course in the broad ligament the ovarian artery gives off branches to the ampulla and the isthmus of the Fallopian tube, to the ovary, and to the round ligament.

Fig. 209.—Anterior view of the uterus, the tubes and ovaries, and the broad ligaments. The upper part of the bladder, the anterior wall of the vagina, and the peritoneum on the anterior aspect of the broad ligaments have been removed. U., ureter; U.A., uterine artery; O.A. ovarian artery; R.L., round ligament.

The uterine artery arises from the anterior division of the internal iliac, and runs downward and inward toward the cervix uteri. The vessel is tortuous, and is loosely supported by the cellular tissue at the base of the broad ligament. The lowest point which it reaches is on a level with the external os uteri, and at this point it crosses the ureter.

At about this point it gives off the circular artery of the cervix, which anastomoses with its fellow of the opposite side. The uterine artery then passes upward, and reaches the uterus near the level of the internal os. It passes along the side of the uterus in a very tortuous manner, and anastomoses with the ovarian artery.

The vaginal arteries usually arise from the anterior division of the internal iliac artery. They sometimes arise from the uterine or middle hemorrhoidal artery.