Overview 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 Blood Supply Arterial supply ovarian artery passes just over the ureter "bridge over troubled waters" 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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