So let's have a look in a bit more
detail at the uterus and the uterine
tubes. We can see in this diagram
the uterus is being opened up
and the uterine tubes and the ovaries
have been opened to see their internal
structure. If we look at the uterus, then we
can see there is three layers to the uterus.
We have the perimetrium. We have the
myometrium and the endometrium.
The perimetrium is this peritoneal
layer, the serous layer
on the outside of the uterus. That's
a layer you touch if you were to
press on the uterus.
You then have the myometrium,
which is this muscular wall
that's really in the middle of the uterus, this
muscular wall made up of the smooth muscles.
And then we have the inner mucosal
layer and that's the endometrium.
And this is the layer that typically
sheds during the menstrual
cycle. So we have those three layers.
Three layers of the uterus.
If we look at the uterine tubes, then the
uterine tubes connect the ovaries when we have
paired ovaries: left one, right one
And the uterine tubes connect these ovaries
to the uterine cavity. And we have four parts
to the uterine tubes.
We have infundibulum.
The infundibulum is the most lateral extension
of the uterine tubes. And these contain
finger like projections called
ovarian fimbriae. Here we see the
infundibulum. And these ovarian fimbria
come close and not physically
attach to the ovary
but they come very close to
the ovary. One finger may
in-fact attach to the ovary. But the rest of the
fimbria are kind of surrounding the ovary
and these collect the ovum
once its been dispelled from the ovary.
Once the ovum has been
dispelled and passes into the fimbria,
it then passes down the ampulla. The ampulla
is the widest part of the uterine tube
and this is usually where the fertilization
occurs. And then the fertilized
gametes then will pass
down through the uterine tube
through a region called the isthmus. And then
we have a uterine part that is actually
a part of the uterine tube that
is embedded within the uterus itself.
So we have various parts of a
uterine tube. We have this nice dilated
infundibulum and the various fimbriae.
We then have an ampulla. We have an isthmus
and then we have a uterine part.
This is enters into the uterus, one
runs within the wall of the uterus.
The uterus can assume
And the normal position is what’s
known as the anteverted and anteflexed.
That is assumed this
kind of orientation.
But you can have a whole
series of different orientation
based on the angle
that the cervix takes
at the vagina. So this angle here
and this can be defined as
being anteverted or retroverted.
So here we have what you
consider to be an anteverted
cervix; because, the cervix
is pointing slightly anteriorly.
If this was to turn more in this
direction, you will have a retroverted
cervix in relation to the vagina. You
can remember in relation to the vagina
being "v" and inverted if it’s an
anteverted or retroverted cervix.
Whether uterus is anteflexed or
retroflexed determines on the
position of the fundus. And here we can see
that the direction of fundus is pointing
whether its pointing quite anteriorly like
here, where you say you have an anteflexed
uterus or whether it is more retroflexed
which we can see in this direction
where the uterus is
Now this has important consideration,
the position of the uterus.
It usually positions like this
and it compress on the...
rest on the top of the bladder.
If it's slightly more anteflexed, it can press on the
bladder and mean the lady has to go to the toilet more often
to carry out micturition on a more regular basis, as
the bladder can't fill to what it is expected to.
And if it's more retroflexed, then you can see there
is a potential for the uterine prolapse.
With increases in intra abdominal pressure, then
that's going to push down on these pelvic organs.
And usually, the uterus will be
pushed against the bladder here.
But if it assumed this more retroflexed
and may be retroverted position
then you can see there is the potential
to increases of pressure to just push
the uterus down through the vagina and
you can have the uterine prolapse;
being a insignificant, being a
small prolapse as the
cervix pushes more into the vagina or being a
full prolapse when the cervix may well
protrude out of the vaginal opening.
So the position of the
uterus can be quite variable
and it can have significant consequences.