• Female reproductive anatomy: ligaments
    • broad ligament of uterus
      • connects uterus, Fallopian (uterine) tubes, and ovaries to lateral walls and floor of pelvis
      • mesosalpinx
        • a subdivision of broad ligament that suspends Fallopian (uterine) tubes
      • mesovarium
        • a subdivision of broad ligament that suspends ovaries
      • mesometrium
    • round ligament of uterus 
      • connects fundus of uterus to labia majora
      • within broad ligament
      • enters deep ring, passes through inguinal canal, and exits superficial ring
      • a derivative of lower part of gubernaculum
    • cardinal ligament of uterus
      • aka transverse cervical (Mackenrodt's) ligament of uterus
      • connects cervix and lateral parts of fornix of vagina to lateral pelvic walls
      • contains uterine artery/vein
        • uterine artery via anterior division of internal iliac artery
    • sacrospinous ligament
      • connects ischial spine to sacrum, lies superior to the pudendal nerve (S2-4)
        • pudendal nerve block through sacrospinous ligament 
    • ovarian ligament
      • connects ovary to uterus 
    • suspensory ligament of ovary
      • connects ovary to lateral walls of pelvis
      • contains ovarian artery/vein, nerves, and lymphatics
        • ovarian artery via abdominal aorta
  • Female reproductive anatomy: pouches of pelvis
    • vesicouterine pouch
      • a peritoneal sac between bladder and uterus
    • rectouterine pouch (of Douglas)
      • a peritoneal sac between uterus and rectum
      • lies behind posterior fornix of vagina
      • lowest portion of peritoneal cavity
        • culdocentesis is aspiration of fluid from rectouterine pouch by a needle puncture of posterior fornix of vagina
Venous Drainage
  • Venous drainage
    • left ovarian vein → left renal vein → inferior vena cava (IVC)
    • right ovarian vein → inferior vena cava (IVC)
Lymphatic Drainage
  • Lymphatic drainage
    • lumbar (para-aortic) lymph nodes
      • ovary
      • fundus of uterus
    • superficial inguinal lymph nodes
      • vulva
      • superolateral uterus (via round ligament of uterus)
    • internal iliac (hypogastric) lymph nodes
      • upper vagina
      • middle vagina
      • body of uterus
      • cervix
    • external iliac (obturator) lymph nodes
      • upper vagina
      • body of uterus
      • cervix
    • sacral lymph nodes
      • lower vagina

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